health welfare

Threats in the air

Each year approximately 10 000 people in the Nordic region die prematurely as a result of air pollution exposure, but the question of which pollutants are the most detrimental to health has yet to be resolved. Professor Jørgen Brandt and other participants in the NordForsk project NordicWelfAir are hunting for the answer.

Air pollution costs the Nordic countries tens of billions of kroner every single year. “It has a negative impact on human health and leads to higher mortality and greater inequality in the distribution of welfare. In order to regulate air pollution effectively, we have to find out which chemical substances are the most harmful and which population groups are affected the most,” says Jørgen Brandt, professor at the Department of Environmental Science at Aarhus University and project leader of the NordicWelfAir project.

Together, the 16 partners from five Nordic countries participating in the project will map out air pollution and its various components all the way down to a 1 km x 1 km resolution for all the Nordic countries. Project activities also include development of a common air pollution modelling framework which will, for the first time, make it possible to calculate air pollution levels in the Nordic countries from 1990 to the present with the same geographical resolution for all countries.

High costs and more disease
Although the air quality in the Nordic countries is relatively good compared with many other regions, the negative health effects of air pollution are significant. It can lead to respiratory disease, cardiovascular disease and cancer, as well as further complications for those already suffering from other illnesses.

“We have a problem with air pollution in the Nordic region. Our air may not be as bad as in Beijing, but it nonetheless poses a very serious health and socio-economic problem on a Nordic scale. We already know quite a bit about the consequences of air pollution exposure, and in Denmark alone there are close to 4 000 premature deaths related to air pollution each year. This is 20 times higher than the annual figures for traffic fatalities,” Professor Brandt states.

“Air pollution is a significant cause of disease, and it costs society an enormous amount of money. Just for Denmark the cost is DKK 30 billion each year,” he continues. “This includes costs associated with premature death, sickness absence and hospital admissions, for example.”

Which substances are most harmful and who is most affected?
In the face of such a severe problem that leads to both serious illness and high societal costs, it is imperative to find the best, most effective means of mitigation. That is what the NordicWelfAir project is planning to help with.

“Air pollution consists of a combination of many different types of particles and gases that can adversely affect human health in a variety of ways. We don’t really know which substances are most harmful. Therefore, the project will see whether the answer is, for instance, soot particles from oil, wood and coal-burning stoves; NOx emissions from automobiles leading to nitrate particles; or ammonium particles from agriculture,” the professor says, adding:

“In short, we are going to determine which sources are the most damaging pollutants and who is most vulnerable.”

Air pollution travels rapidly over great distances
Fine particles in the air are rapidly transported by wind across national borders and are deposited by rain and snow on surfaces below. Using different air pollution models, the NordicWelfAir project will identify where pollutants are coming from, and it may not necessarily be from a country close by.

“Pollutants in the air you breathe on the streets of Oslo or Copenhagen come from numerous sources,” the professor explains. “Local traffic is an obvious source, but some are coming from other cities and countries, even distant sources like China and the US or a cloud of volcanic ash from Iceland. Our model allows us to perform detailed calculations, which in turn can identify which areas are most exposed to air pollution and where it comes from. This is unprecedented at this scale in air pollution research.”

Nordic registers a goldmine for research
An important element of the NordicWelfAir project is to look at air pollution in relation to various diseases to find any significant relationships. The unique Nordic health registers compiled over many decades are essential in this context. The data sets show, for example, where individuals have lived and relocated. Linking these data to the project data model makes it possible to calculate the amount of air pollution these people have been exposed to over the past 25 years, almost hour by hour.

“The Nordic registers represent unlimited potential for our project. The public’s high level of trust in their respective authorities has enabled the countries to compile a wealth of information at the level of the individual. We have selected 17 pollutants (particulates and gases) we believe to be the most harmful, and using the registers we can in principle link them to hundreds of negative health effects,” Professor Brandt explains.

In addition, the NordicWelfAir project will study whether the effects of air pollution on health vary, for example between men and women, different age groups, income levels and education.

“All information about the various diseases people have, what is wrong with them and causes of death has been stored. This enables us to find out which substances and emissions are most detrimental, and which diseases they cause. We could write thousands of scientific articles based on this material, so it is safe to say that the Nordic registers are a goldmine for researchers,” says Jørgen Brandt with a smile.

Interdisciplinarity generates Nordic added value
Five groups representing completely different subject fields are working together on the NordicWelfAir project. While this could easily have been problematic, it has instead become one of the project’s strengths.

“The project involves researchers from environmental economics, atmospheric modelling, welfare research, register research and epidemiology, as well as researchers studying emissions of pollutants. With such a wide variety of scientific groups we learn a great deal from one another and probably look at things somewhat differently from how we would have done otherwise. It is both exciting and refreshing, and I’m certain that this way of working makes each of us better,” Professor Brandt says.

“It’s also very motivating to find that the individual fields are gaining new strength from cooperating with other Nordic scientists in the same area. Everyone has different areas of expertise and experience, which they share and use to enhance each other. In this way the project generates Nordic added value by boosting each country’s national research communities in the areas of emissions, register research or environmental economics.”

Research findings as a basis for policy
Co-coordinator of the NordicWelfAir project, Senior Scientist Camilla Geels, who is also from the Department of Environmental Science at Aarhus University, is hoping the project’s findings can be used as a basis for advising authorities on which emissions should be regulated more strictly.

“If we can prove that emissions from heating stoves, for example, are particularly harmful and can cause disease x and y, which in turns costs society z amount of money, that will make it easier for politicians to take concrete decisions. There are many cars in Nordic countries and motorists are often singled out as the major culprit when it comes to air pollution. Vehicle emissions are undeniably a problem, but the automobile industry is highly regulated compared with other sources of pollution such as residential heating,” she points out.

“Heating stoves are also a sensitive political subject as they represent something special to many Nordic residents. They are associated with family togetherness and good times and even though the vast majority of people have alternative heating sources, they still use their stoves,” Ms Geels explains, adding:

“The profile of the Nordic countries is greener than many other regions. If they stand united before the EU to advocate stricter regulation of air pollution and, in addition, can present concrete research findings from a joint Nordic activity like the NordicWelfAir project, they will have a much stronger voice than if each country tries to do it on its own.”

Hard to rule out other causes of disease
According to Professor Brandt, one of the most difficult aspects of the project will be proving that disease and health problems are in fact the result of air pollution as opposed to other factors.

“The epidemiological component of the project is looking at this issue. If you live near a highway it may well be noise pollution and not just emissions that cause health problems. Smoking and/or a poor diet are also potential causes of disease,” he says.

“It’s a difficult task, but here we will draw on data from the various registers in addition to other studies. For example, the University of Copenhagen has conducted a survey over many years asking nurses what they eat and drink, if they smoke and where they live. The Danish Cancer Society Research Center maintains a similar register of cancer patients. That is, they know a great deal about their lives.”

Ms Geels continues: “We can use this approach to compare information found in the national registers against other surveys, and attempt to rule out patients whose disease is rooted in other causes. We are also working together with the Department of Public Health at Aarhus University, where they have a research project where they take people into a chamber and expose them to air pollution. They measure how the subject’s body reacts in a wide variety of ways. This yields a better understanding of the physiological effects of polluted air when it comes to pulmonary and cardiovascular diseases, for example.”

Impossible without NordForsk
Both Jørgen Brandt and Camilla Geels are clear that this project would not have been possible without Nordic Programme on Health and Welfare under NordForsk.

“We are certain that NordForsk is the only entity that would have funded such a large, interdisciplinary Nordic project,” says Ms Geels.

“This is also part of the reason why everyone is so enthusiastic. This is a unique project that can yield revolutionary results within several subject fields, and people all over the world are following these efforts with major interest,” Professor Brandt adds before he concludes:

“We hope the outcome of our research will help to promote constructive political decisions that lower air pollution levels in the Nordic countries and lead to less disease and premature death. That would be the true measure of success for the NordicWelfAir project,”.

About NordicWelfAir

The NordicWelfAir project is funded under NordForsk’s Programme on Health and Welfare and has 16 partners from five different Nordic countries. The NordicWelfAir project will identify which emissions are most harmful to human health and, with the aid of the Nordic registers, determine which diseases they can cause and who is most vulnerable to negative health impacts.

Budget: NOK 30 million.

Duration: 2015–2020.

Project leader: Professor Jørgen Brandt, Department of Environmental Science, Aarhus University