Environmental health is a top priority for ANSES's risk assessment work, with the challenge posed by the development of chronic diseases whose environmental aspects merit improved documentation.
Atmospheric pollution is a major issue since it:
- concerns the entire population;
- has no borders, involves multiple pollutants and comes from numerous sources;
- causes both acute and chronic health effects;
- is caused by direct emissions as well as complex chemical and photochemical atmospheric phenomena that can generate harmful secondary substances.
ANSES has been assessing the risks of exposure to air environments, including both outdoor and indoor air pollution, for many years.
Outdoor air quality
The effects on health and the environment of ambient air pollution caused by a large number of chemical pollutants have been well established for a number of years. In the 1990s, the state of knowledge was already sufficient to feed the ongoing debate in preparation for France’s 1996 law on air quality and the rational use of energy (LAURE).
The results of the ERPURS programme established by the ORS Ile-de-France, published in 1994, show that a link exists between pollution levels and population health.
In 1996, the French Law on air quality of 30 December transposed into French law Community Directive 96/62/EC which introduced a framework for the development of EU legislation for air quality monitoring. Under this law, the Commission must submit proposals for setting regulatory limit values (yearly averages and peak periods) for SO2, NO2, particulate matter, O3, benzene, CO, PAHs, arsenic, cadmium, mercury and nickel. This directive was the basis for four daughter directives setting regulatory limit values for these pollutants.
In 2008, the European legislation underwent simplification and clarification with regard to air quality thanks to the single Directive 2008/50/EC of 21 May 2008 which merges into a single Act, the Framework Directive of 1996, three of the daughter directives (99/30/EC, 2000/69/EC and 2002/3/EC) and provides for measures regarding PM2.5 (fine particles), while the last daughter directive, no. 2004/107/EC on the setting of limit values for PAHs, As, Cd, Hg and Ni, remains in force.
These regulations are still to a large extent relevant today. The reference values (standards) associated with these European regulations, to which the Member States must adhere, are the result of work carried out by WHO and therefore are based on sound health principles.
It has now been clearly established that exceeding the limit values set by the regulations presents proven health risks, and epidemiological studies conducted in the last few years have made it possible to objectively show the health risks, even at pollutant concentrations below the limit values currently in force in the European Union:
- in the short term, they are manifested as hospitalisations for cardiovascular and respiratory problems and premature deaths;
- in the long term, the studies tend to show a rise in the risk of developing lung cancer, or cardiovascular or respiratory ailments (heart attack, asthma and bronchial diseases, etc.).
Three recent studies have emphasised the impact of atmospheric chemical pollution on health:
- the European Aphekom study coordinated by the InVS found that values exceeding the WHO guideline value for PM2.5 particles as responsible for 19,000 premature deaths per year (1,500 in 9 French cities), 15,000 of which were cardiovascular in nature, for a total of 31.5 billion euros in healthcare and other associated costs;
- WHO/Europe's 2013 Review of Evidence on Health Aspects of Air Pollution, (REVIHAAP), whose goal was to support the revision of legislation on ambient air quality in Europe;
- the 2013 IARC evaluation that classifies outdoor air pollution, as well as the suspended particles composing it, as carcinogenic for humans (group 1, proven risk).
The Agency published two reports, one in 2004 followed by another in 2009. The first was on the health impact of urban atmospheric pollution and the second provided a synthesis of health aspects in support of the drafting of public service and warning announcements with regard to particulate matter in ambient air. The 2009 report concluded that the short-term effects of particles should be examined, but in light of the studies already existing on the subject, priority should be given to long-term effects, and that policies aiming to "lower average particulate concentration levels in the long term would provide a greater health benefit that a management strategy focusing on daily particulate pollution peaks."
Beyond the issue of warning and pollution peak management, the fight against chronic pollution on an everyday basis, all year round, should therefore be the priority, with the implementation of permanent measures for controlling emissions.
Indoor air quality
In the last few years, the Agency has been highly involved in work on indoor air quality, an area in which knowledge is much less developed, but whose health issues are of equal importance. In contrast to outdoor air pollution, which has received more media attention, interior air pollution remained relatively unknown until the early 2000s.
Yet, in temperate climates we spend on average 85% of our time in indoor environments - houses, workplaces, public buildings and transportation vehicles - with the majority of this time spent in the home. In all these places, exposure to numerous pollutants is possible.
The main indoor air pollutants are:
- chemical pollutants: volatile organic compounds (VOCs), nitrogen oxides (NOx), carbon monoxide (CO), polycyclic aromatic hydrocarbons (PAHs), phthalates, etc.;
- organic contaminants: moulds, household allergens from dust mites, pets and cockroaches, pollens, etc.;
- physical pollutants: radon, particles and fibres (asbestos, artificial mineral fibres), etc.
These pollutants have various emission sources: building components, furniture, combustion appliances (boilers, stoves, water heaters, etc.) and the infiltration of outdoor air pollution (ambient air, contaminated soil), but also depend on lifestyle (smoking or having pets, for example).
The quality of the air is a major health issue since it may affect our well-being and health, from simple discomfort (nasal problems, drowsiness, irritation of the eyes and skin) to the onset or aggravation of acute or chronic pathologies (respiratory allergies, asthma, cancer, disabling or fatal poisoning, etc.).
The Agency has been studying the health risks of indoor air since it was founded. This work is an integral part of both national and international efforts in a pioneering context.