A few notes on the recent Nordic Air Quality conference – Is Air Quality a challenge in the Nordics?

Last month IVL Swedish Environmental Research Institute held an online conference on Nordic Air Quality. It covered many interesting topics from the impact of air quality in the Nordics to health, welfare, and socio-economic inequalities to climate change. If you think that the adverse effects of air pollution are negligible in the Nordics compared to the rest of the world, I am sorry to disappoint you.

Consciously or subconsciously, we make decisions that affect us in a way or another every day. And there is a risk to every choice we make in life. These short or long term risks can be at a low cost or even at the price of one’s precious life!

To make reasonable conscious choices, we need to thoroughly understand the risk associated with our decisions, to us, our loved ones, our societies, and the environment.

I believe who we really are is hindered by prioritizing the impact of our actions on each of those circles.

For example, the food we eat has a direct impact on our health and the environment. Based on how it has grown, processed, and traveled to end up in our shopping basket. You can choose it in a store according to how you assess the risks associated with your nutrition to the effect it will have on your environment. The same can be valid for how you commute in a city. As soon as you choose to drive a car, you know the risks associated with it on the road and hope you make a conscious decision based on those.

But how about the air we breathe? Can we really make a conscious choice of the quality of what we inhale? Are we well aware of the risks associated with its quality? Is it the same to die in a car accident or instead due to long term exposure to contaminant air?

All these interesting ethical questions came up along with other topics last week at a webinar (conference) held by IVL Swedish Environmental Research Institute. The webinar was about the Nordic Air Quality, and it mostly focused on the quality of outdoor (ambient) air. It was great to see from most of the nordic countries a presentation about the status of their air quality and also to know about studies of the socio-economic impact of air pollution on the Nordic economy!

You may ask, compared to the rest of the world, is Air pollution really in the Nordics? Well, the answer is sad, yes! It might not be as pronounced as many parts of the world, but it still has an impact on the health and economics of Nordics.

According to Bertil Forsberg, a professor in environmental medicine at Umea University, it is estimated that about 7600 people die due to air pollution in Sweden every year. This has been calculated in the latest environmental health report (Miljöhälsorapport 2017) published by the Swedish Public Health Agency.

In Denmark, the burden cost of air pollution on the government is estimated by 10 Billion EUR per year (DCE,2020), Camila Geels reported, including death, hospital visits, and leaves of absence.

According to Torben Sigsgaard, Institute of public health, Aarhus University, within the environmental risk factors of air pollution (morbidity rate) ranks after smoking and physical inactivity, in Denmark. He commented that there have been millions of euros on safer roads and regulations in the traffic and car industry. Still, insufficient attention in comparison has been spent on air pollution in Denmark, comparing the risks.

Otto Hänninen from Finish institute for health and welfare talked about 12 sources of environmental pollutants (including radiation and urban noise). He presented that the total burden of these factors is 3100 deaths in Finland; (53000 years of life lost and 13000 equivalent years lived with disability): vs 270 in car accidents, vs 1700 due to alcohol, vs 5000 due to smoking!

To conclude, although Nordic countries have a higher quality of outdoor air, indeed, there is still a negative impact on the health and welfare of pollutants on the living of people on Nordics.

On the other hand, I would like to highlight that Nordic countries have unique high-resolution data on individual levels. This makes them an excellent test-bed for studying the health effects of air pollution. Camila Geels nicely described the so-called “Impact pathway chain” and how mortality/ morbidity and cost analysis is done in 6 steps:

1. Knowing a specific source of the emissions of air pollutants.
2. Calculating the distribution of concentrations in the atmosphere.
3. Generating maps of air quality and combining them with the map of populated areas.
4. Calculate the personal exposure to air pollutants, including exposure-response functions (functions describing how much a given dose of a component, what kind of health impact it provides).
5. Calculate how many asthma cases there are; the same with premature death, hospital visit, etc.
6. Valuation of money on each of these cases can calculate the cost for society.

She gave an example of a study in Norway, in which they showed by the above method air pollution leads to more welfare inequality!

I learned a lot about improvements within the society, policies, behavioral changes concerning the pollution problem. However, in the end, the webinar opened a question in my mind. I realized there is a gap of knowledge within the field. How about the indoor air, where we spend 90% of our time? We get most of the exposure from there, yet there are few studies to bring this invisible player into the game! Torben Sigsgaard excellently touched upon it and said: "the significant risk is there (indoors)". For an additional fact that indoor air quality is also affected by the quality of outdoor air!

Therefore, it can be predicted that indoor air quality is more prominent than we anticipate. Now it is the time to think about what kind of air we breathe in our "safe" places! 

/Ida Iranmanesh, researcher Sally R