Strategies for Clean Air and Health Conference

November 5-7, 2003
Rome, Italy

Final Conference Statement

Conference Statement Appendix

Conference Concept Document

Background Papers
- Health Effects, (J. Samet, D. Krewski)
- Air Quality Modelling, (N. Reid, P. Misra, M. Amann, J. Hales)
- Policy Tools, (A. Rabl, J. Nathwani, M. Pandey, F. Hurley)
- Policy Options, (L. van Bree, J. Vandenberg, L. Craig
- General Comments on Background Documents
- Green & Armstrong Comments




An Approach to Recording Expert Opinion




November 5 – 7, 2003,Santo Spirito Hospital, Rome, Italy


Examine health effective policy options for air quality management in North America and Europe based on currently available scientific information.


The meeting will be of interest to air quality policy makers, air quality managers at the federal/provincial/state and municipal levels, industry and business representatives, and researchers and representatives from academia, government agencies and the private sector.


Health Canada
Canadian Petroleum Products Institute
Rome E Health Authority
Ontario Ministry of the Environment

For more information:


The Conference will promote exchange of knowledge between North America and Europe on technical, scientific and management issues to identify policy opportunities for air quality improvement, through the presentation of synthesis papers, facilitated poster presentations, and break-out group discussions. The meeting will provide a platform for identifying innovative management approaches and future research needs to further support policy decisions.

The task of identifying strategies for effective air quality management to improve human health and the environment involves a number of scientific, technical and economic considerations. While lack of full scientific certainty is a limitation to identifying optimal policy interventions, lessons have been learned from experience and research to guide health effective air quality policy development and implementation. The conference will address the following specific questions:

• What does health effects research tell us about the risks from air pollution, including who should be protected, and from what sources or components of the air pollution mixture?
• In addition to scientific evidence, what are the key considerations for public policy development, for example the role of scientific uncertainty, public risk perception, requirements for risk communication etc.
• What sources contribute to risks to public health, and what methods are available to link sources to exposures? How can air quality modeling inform local, regional and continent wide air management strategies?
• What are the expected future benefits of existing policies for pollution reduction for cars, power plants, etc.?
• What are the advantages and disadvantages of alternative policy approaches (e.g. NAAQS, limit values, best available technologies?).
• What are currently the most prominent research priorities to improve air quality management and is the science community targeting these priorities?

This joint meeting of the NERAM International Colloquium Series and the AIRNET European Thematic Network on Air Pollution and Health is the first of its kind to provide an integrated review of the best available information to inform clean air strategies based on:

1. Exposure and health effects,
2. Air quality modeling over time and space, and
3. Strategies for risk management and risk reduction including technology approaches, emissions trading, and policy analysis tools such as cost-benefit analysis, and communication of risks and uncertainties.

The joint character of the meeting provides a unique opportunity to contrast and synergize research findings and management approaches in Europe and North America.


Bert Brunekreef, Utrecht University
Rick Burnett, Health Canada
Lorraine Craig, NERAM
Bart Croes, California Air Resources Board
Francesco Forastiere, Epidemiology, Rome E Health Authority
Peter van den Hazel, International Society of Doctors for the Environment
Daniel Krewski, McLaughlin Centre for Population Health Risk Assessment
Michal Krzyzanowski, WHO European Centre for Environment and Health
Robert Maynard, UK Department of Health
Ken Ogilvie, Pollution Probe
Jonathan Samet, Johns Hopkins University
Callum Searle, European Commission – Research Directorate-General
John Shortreed, NERAM
Tony Clarke-Sturman, Shell International Petroleum Company Limited
James J. Sloan, University of Waterloo
John Vandenberg, USEPA
Leendert van Bree, Netherlands Environmental Assessment Agency (RIVM)
Robert Willes, Cantox Environmental Inc.
Martin Williams, UK Department of Environment
Andre Zuber, European Commission – Environment Directorate-General


Click HERE to download entire document or click on the following individual papers:

Title Page and ISBN page

Table of Contents

L. Craig, D. Krewski, J. Shortreed, and J. Samet

Strategies For Clean Air And Health Conference Statement
L. Craig, D. Krewski, J. Shortreed, J. Samet, and L. van Bree

PART I - Ambient Air Quality

Assessing sources of PM2.5 in cities influenced by regional transport
J.R. Brook, R.L. Poirot, T.F. Dann, P.K.H. Lee, C.D. Lillyman, and T. Ip

Modelling the intra-urban variability of ambient traffic pollution in Toronto, Canada
M. Jerrett, M.A. Arain, P. Kanaroglou, B. Beckerman, D. Crouse, N.L. Gilbert, J.R. Brook, N. Finkelstein,
and M.M. Finkelstein

Two years fine and ultrafine particles measurements in Rome, Italy
A. Marconi, G. Cattani, M. Cusano, M. Ferdinandi, M. Inglessis, G. Viviano, G. Settimo, and F. Forastiere

Impact of iron and steel industry and waste incinerators on human exposure to dioxins, PCBs and heavy metals: results of a cross-sectional study in Belgium
S. Fierens, H. Mairesse, J-F. Heilier, J-F. Focant, G. Eppe, E. De Pauw, and A. Bernard

PART II - Health Effects

Health effects associated with exposure to ambient air pollution
J. Samet, and D. Krewski

Ambient air pollution and population health: Overview of health effects posters presented at the 2003 AIRNET/NERAM Conference
D. Krewski, and D. Rainham

Sources of uncertainty in calculating mortality and morbidity attributable to air pollution
T. Sahsuvaroglu, and M. Jerrett

Urban air pollution and respiratory emergency visits at Paediatric Unit, Reggio Emilia, Italy
E. Bedeschi, C. Campari, S. Candela, N. Caranci, G. Frasca, G. Collini, C. Galassi, and M.A. Vigotti

Urban air pollution and emergency visits for respiratory complaints in Pisa, Italy
M.A. Vigotti, F. Chiaverini, P. Biagiola, and G. Rossi

Increase of exhaled nitric oxide in children exposed to low levels of ambient ozone
M. Nickmilder, C. de Burbure, S. Carbonnelle, X. Dumont, A. Derouane, and A. Bernard

PART III - Mechanism of Effect

Lung permeability, antioxidant status and NO2 inhalation: a selenium supplementation study in rats
C.Y. de Burbure, J-F. Heilier, J. Nève, A. Becker, C. Albrecht, P.J.A. Borm, J. Gromadzinska, W. Wasowicz, K. Rydzynski, and A.M. Bernard

Chromosomal aberrations by fluorescence in situ hybridization (fish) – biomarker of exposure to
carcinogenic PAHs

O. Beskid, B. Binkova, Z. Dusek, P. Rössner, I. Kalina, T.A. Popov, P.B. Farmer, R.J. Srám

PART IV - Policy Tools and Approaches

Air quality modelling for policy development
N. Reid, P.K. Misra, M. Amman, and J. Hales

Tools and strategies for improving policy responses to the risk of air pollution
A. Rabl, J. Nathwani, M. Pandey, and F. Hurley

Analysis of PM2.5 using the environmental Benefits Mapping and Analysis Program (BenMAP)
K. Davidson, A. Hallberg, D. McCubbin, and B. Hubbell

Developing risk-based priorities for reducing air pollution in urban settings in Ukraine
M. Brody, J. Caldwell, and A. Golub

Air quality improvements with European environment policies: SO2 case study in a coastal region in Portugal
M.C. Pereira, R.C. Santos, and M.C.M. Alvim-Ferraz

Health impact assessment of PM10 exposure in the city of Caen, France: Is eliminating air pollution peaks enough?
P. Glorennec, and F. Monroux

PART V - Science-Policy Issues

Fine particles: From scientific uncertainty to policy strategy
R. Maas

Clean Air Strategy: An ENGO perspective on the science-policy interface
M.K. Wallis

Closing the gap between science and policy on air pollution and health - The AIRNET enterprise
L. van Bree, N. Fudge, J.T. Tuomisto, and B. Brunekreef



Keynote Address

Perspectives on the Science - Policy Interface
Ken Ogilvie, Pollution Probe

Barriers and Gaps to Information Effectiveness at the Science-Policy Interface
David Briggs, Imperial College London

Parallel Sessions - (Complete file of available Abstracts)

Paper Session 1: Health

H.R. Anderson
, WHO Task Force – Estimation of risk coefficients for health impact assessment of ambient air pollution in Europe.
Ferran Ballester, Valencian School of Studies for Health – Air pollution & cardiovascular admission short-term relationshi
p in 15 Spanish cities: Results within the Emecas Project.
Annelie Behndig, University Hospital – Diverging airway inflammatory responses to diesel exhaust exposure in health and asthmatic subjects with and without inhaled corticosteroid treatment.
Aaron Cohen, Health Effects Institute – Measuring the health impacts of actions to improve air quality: The HEI research program.

Paper Session 2: Tools

Fintan Hurley, Institute of Occupational Medicine – Issues in estimating the public health impacts of ambient air pollution - what are the morbidity impacts that matter, and what are the main sources of uncertainty?
Pierpaolo Mudu, WHO ? Hearts project: Building a tool for the assessment and integration of health impacts from urban transport systems.
Brian Miller, Institute of Occupational Medicine – Developments in impact assessment for chronic effects on cause-specific mortality.
L. Gephart, ExxonMobil Petroleum and Chemical – Estimating the health impact of ground level ozone attributed to VOC emissions: An alternative science-based approach.

Paper Session 3: Modelling/Case Studies

Michael Jerrett, McMaster University – Modeling the intra-urban variability of ambient traffic pollution in Toronto, Canada.
Markus Amann, IIASA – An integrated assessment of air pollution control strategies for Europe.
Jeff Brook, Environment Canada – Windsor/Quebec City case study.



R. Cox et al., IPIECAThe IPIECA urban air quality management approach.
K. Davidson et al., Abt Associates Inc.– BenMAP, The environmental benefits mapping and analysis program: A policy analysis tool for estimating health benefits from air quality improvements.
L. Gephart, ExxonMobil Biomedical Sciences, Inc. - Estimating the health-based economic impacts of ground level ozone attributed VOC emissions: An alternate science-based approach.
S.S. Jensen et al., National Environmental Research InstituteImpact assessment system for urban air pollution and population exposure.
R.S. McColl et al., University of WaterlooHealth Effects Indicator Decision Index (HEIDI): A risk-based tool for ranking abatement of air pollutant release inventories according to expected local and regional health effects.
M. Nicolich, J. Gamble, ExxonMobil Biomedical Sciences, Inc.Proposed framework for an effectiveness analysis for PM reduction.
R. San José et al., Technical University of MadridA tool to evaluate in real-time and forecasting mode the air quality impact of industrial emissions.
R. Torfs et al., VITONo regret policy measures for particulate matter from traffic sources.


D. Briggs,
SAHSU, Imperial College London - Air pollution modeling for support to policy on health and environmental risks in Europe (APMoSHPERE).


P. Berry, Health Canada – Assessing and adapting to the health effects of climate change in Canada.


P. Aalto, et al., HEAPSS - Aerosol number concentration measurements in five European cities during HEAPSS.
U. Ackermann-Liebrich, L. Bayer-Oglesby
et al., University of BaselSwiss cohort study on air pollution and lung diseases in adults (SAPALDIA 2): methods, participation and air pollution development.
E. Bedeschi et al., ASL di Reggio EmiliaUrban air pollution and respiratory emergency visits at paediatric unit, Reggio Emilia, Italy.
P. Glorennec, Ecole Nationale de la Santé PubliqueHealth impact assessment of exposures to PM10 in the city of Caen, France.
U. Gehring et al. GSF - Institute of Epidemiolgy - Long-term Effects of Air Pollution & Mortality - The German Cohort on Mortality & Air Pollution in women (GECOMO - Air).
C. Guastadisegni
et al., Istituto Superiore di SanitaOxidative potential of environmental particulate matter from sites with varying traffic density: Correlation between antioxidants depletion and arachidonic acid release.
J. Heinrich,
et al., GSF National National Research Center for Environment and Health - Bitterfeld Study.
T. Lanki et al. Department of Environmental Health, KTL, Kuopio, Finland - Air pollution and hospitalisations for first myocardial infarction (MI) in the HEAPSS cohort
S. Loft,
Institute of Public Health, University of Copenhagen - Studies of Air Pollution and Health in Denmark 20
P. Michelozzi,
Epidemiology ASL RM/E - PHEWE - Assessment and Prevention of acute Health Effects of Weather conditions in Europe
L. Modig
et al., Umeå UniversityHealth impact of ozone levels in Sweden – A national assessment
H-G. Mücke
, WHO - APHEIS: Influence of vehicular traffic in health impact assessment of air pollution.
M. Neuberger et al., University of ViennaAcute effects of particulate matter on respiratory diseases in Austria.
M. Nickmilder
et al., Catholic University of LouvainLung inflammation in children with short term exposure to ambient ozone: Evidence of a threshold.
S. O’Connell
, I. Matthews, University of WalesAn epidemiological assessment of individual’s biological uptake of particulate air pollution and related health effects.
T. Sahsuvaroglu, M. Jerrett
, McMaster UniversitySources of uncertainty in calculating mortality and morbidity attributable to air pollution.
M.A.Vigotti et al., Epidemiologia Ambientale, Universita' di Pisa - Urban air pollution and emergency room visits for respiratory complaints
H. Walton, Department of Health, UKIs there a threshold for associations between ozone concentrations and outcomes?
C. Yap, I. Beverland et al., University of StrathelydeHealth effects of long-term exposure to air pollutants in Scotland.


T. Bellander, M. Krusa, National Institute of Environmental Medicine, and Environmental Health, Stockholm County Council, Stockholm - Factors influencing individual Nitrogen Dioxide Exposure in Stockholm
S. Fierens
et al., Catholic University of LouvainImpact of iron and steel industry and waste incinerators on human exposure to dioxins, PCBs and heavy metals: results of a cross-sectional study in Belgium.
T. Götschi et al., ECRHS II - Correlations between Surrogates of Exposure to Ambient Air Pollution (PM2.5 mass, Sulphur, NO2, black Smoke, Silicon) across 21 European Centres
D. Lolova
et al., National Center of Hygiene, Medical Ecology & NutritionAmbient air pollution and children’s exposure to lead & cadmium in a smelter region in Bulgaria.


A. Bernard et al., Catholic University of LouvainLung hyperpermeability and asthma prevalence in schoolchildren: unexpected associations with the attendance of indoor chlorinated swimming pools.
A. Blomberg et al., University HospitalClara cell protein (CC16) as a biomarker for ozone exposure in humans.
E. Brits et al., VITOEvaluation of the mutagenicity of PM10 and PM2.5 collected in an industrial and urban area of Antwerp.
A.Cebulska-Wasilewska, A. Panek et al., Department of Radiation and Environmental Biology - Influence of the PAH on the DNA Damage Detected in Unexposed and Occupationally Exposed Donors from Košice
A.Cebulska-Wasilewska, A. Panek
et al., Department of Radiation and Environmental Biology - Influence of Occupational Exposure to PAHs on Lymphocytes susceptibility to the induction of DNA damage (sampling in Sofia)

C.Y. de Burbure
et al., UCLLung permeability, antioxidant status and NO2 inhalation: a selenium supplementation study in rats.
A. Gábelová Laboratory of Mutagenesis and Carcinogenesis - EXPAH: Risk assessment of the air pollution mixtures - 'in vitro study'
B. Lagerkvist, B. Forsberg et al., Environmental & Occupational MedicinePulmonary epithelial integrity in children – relationship to swimming pool attendance and ambient ozone exposure.
A. Peters, et al., AIRGENE Study Group - Air Pollution and Inflammatory Response in Myocardial Infarction Survivors: Gene-environment interaction in a high risk group (AIRGENE)
R. Singh, et al., Cancer Biomarkers and Prevention Group, Leicester, UK - EXPAH: Effects of polycyclic aromatic hydrocarbons (PAHs) in environmental pollution on exogenous and endogenous DNA damage – oxidative damage
R.J. Sram, Inst. of Exprimental Medicine AS CR & Health Institute of Central Bohemia, Prague - EXPAH: Chromosomal Aberrations by Fluorescence In Situ Hybridization (FISH)- Biomarker of Exposure to Carcinogenic PAHs
R.J. Sram, Inst. of Exprimental Medicine AS CR & Health Institute of Central Bohemia, Prague -EXPAH: Effects of Polycyclic Aromatic Hydrocarbons (PAHs) on Environmental Pollution on exogenous and endogenous DNA damage - Czech cohort
M. Taronna, P.A. Bertazzi et al., Università degli Studi di MilanoShort-term exposure to PM2.5, PM1 and blood coagulation in humans


I. Beverland et al., University of StrathclydeThe metal content of airborne particles: Application to epidemiological research.
S.A. Bremner et al., St. George’s Hospital Medical School – Particle species and daily mortality and admissions in the West Midlands, UK.
F. Cassee et al., RIVMQualitative differences in particulate air pollution at different locations throughout Europe.
B. De Berardis et al., Laboratory of Environmental HygieneSeasonal trend of the physico-chemical characteristics of PM2.1: A study by SEM/EDX and XPS in an urban area of Rome.
R. Pozzi et al., Laboratory of Environmental HygieneEffects of Rome winter urban air particles on monocyticmacrophagic raw 264.7 cell line.


Alvim- Ferraz et al., Universidade do Porto – European directives for air quality: Analysis of the new limits in comparison with asthmatic symptoms in children.
M. Brody
et al., US EPADeveloping risk-based priorities for reducing air pollution in urban settings in Ukraine.
Q. Chiotti, Pollution ProbeMaking the linkage between air issues and human health: An ENGO perspective on sustainable transportation policy in central Ontario.
B. Forsberg et al., Umeå UniversityPredicted health impact of congestion pricing in Stockholm – a local assessment.
G. Granville, CASAAlberta's PM and ozone management framework.
M.C. Pereira et al., Universidade do PortoAir quality improvements with European environment policies: SO2 case study in a coastal region in Portugal.
O. Raaschou-Nielsen et al. Institute of Cancer Epidemiology, Denmark - Health Effects of PM in Denmark - Do particle filters on heavy-duty vehicles solve the problem?
K. Samadashvili, - Clean Air and Health Policy Considerations in South Caucasian Countries


P. Aarnio et al., National Public Health InstituteComposition of and exposure to PM2.5 while commuting in the metro and on the street.
M. Gerlofs-Nijland et al., National Institute for Public Health and the Environment - HEPMEAP: In vitro and in vivo toxicity potency of ambient fine and coarse PM across Europe: the influence of traffic exhaust emissions.
V. Ilacqua, M. Jantunen, National Public Health Institute Exposure to traffic generated VOCs: Total exposure in urban environments and the specific contribution of exposure in street traffic.
A. Marconi et al, Italian National Institute of HealthTwo years fine and ultrafine particles measurements in Rome, Italy.
N. Metz, BMW GroupPM10-Exposure assessment for a city in Europe from 1950 to 2050.
K. Samadashvili, – Review of the health effects from motor vehicle traffic in Tbilisi.


N. Fudge, AIRNET AIRNET Science-Policy Interface Work Group
G. Hoek
, AIRNET AIRNET Epidemiology Work Group
N. Janssen, AIRNET AIRNET Exposure Assessment Work Group
E. Sanderson et al., AIRNET AIRNET Health Impact Assessment Work Group
A. Totlandsdal, AIRNET AIRNET Toxicology Work Group
A. Totlandsdal et al., AIRNET AIRNET stakeholder survey
J. Urbanus, CONCAWE Trends in European Ambient Air Quality
J. Urbanus, CONCAWE Trends in European Automotive Fuels Quality and Emissions
N. Fudge, AIRNET AIRNET Communication Strategy

S. Chicherin
, Voeikov Main Geophysical Observatory, St. Petersburg Some special problems of improving air quality strategies for Russian cities. - View from the inside
A. Soares et al., Scientists for Health and Research for Development (SHARED) SHARED Resources project: the sharingpoint.
E.M.A.L. Rameckers, European Federation of Allergy and Airways Diseases Patients' Association Communication on Health Risks of Air Pollution

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Last Updated: February 19, 2008
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