The assessment, compiled by national agencies, and appearing in the 1 September edition of medical journal, The Lancet, also cited traffic pollution as the cause of more than 25,000 new cases of adult chronic bronchitis; more than 290,000 episodes of child bronchitis; more than half a million asthma attacks; and more than 16 million person-days of restricted activities.

“First, there is abundant evidence that current levels of air pollution have adverse health effects, ” said the author of the research, Dr Nino Kunzli, of the University of Basel. “From a public-health perspective it is therefore an ethical consequence to estimate and communicate the impact to the public. To abstain from impact assessment, given the many uncertainties, would promote decisions without consideration of aspects of public health,” he added.

The project initiated by the World Health Organisation (WHO) Europe, which

has called for a co-ordinated European transport policy to reduce pollution, used data on mortality and respiratory problems from the three nations, ranging from 1993 to 1998. The research measured population exposure to particulate matter of up 10 micrometers in diameter (PM10), the standard European measure. The traffic-related fraction was estimated based on PM10 emission inventories, because it is a useful indicator of several sources of outdoor air pollution such as fossil-fuel combustion.

Kunzli pointed out that by contrast with directly countable events, such as deaths due to traffic accidents, which can be listed in national health statistics, it is not possible to directly identify the victims of complex substances and mixtures with cumulative toxicity, such as smoking or air pollutants. Neither are the health-relevant characteristics of the exposure unanimously defined, nor are the health outcomes specifically linked to air pollution only, he says. Therefore, uncertainty remains characteristic of any attempt to decide which cases can be attributed. This was dealt with by deriving the number of cases ‘at least’ attributable to air pollution.

Other worrying findings were that about twice as many deaths can be attributed to air pollution than to road accidents – frequently the target of governmental public education campaigns – and that the health costs of pollution from traffic across the three countries amounted to about 1.7% of the gross domestic product.

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