Knowledge of the long-term effects of air pollution on human health has been improving over the last ten years, mainly as a result of efforts to design and carry out large-scale epidemiological studies. However, long-term data remains unavailable for Mediterranean countries, which are different to continental and northern European areas. These countries experience higher air temperatures, have different particle composition and are subject to Saharan dust. In previous short-term effect studies in Europe, a clear north-south gradient was observed in mortality associated with particulate matter (PM-10), with Mediterranean cities more at risk than north European cities. Better knowledge of the long-term effects of air pollutants, including fine and coarse particles, is needed to contribute to environmental and health policy, to update and support EU legislation in this field, to plan mitigation actions and to implement effective, practical measures.
The LIFE MED-HISS project was a demonstration project involving partners in Spain, France, Italy and Slovenia. Its main objectives were to:
The LIFE MED-HISS project has consolidated the knowledge base for the development, assessment, monitoring and evaluation of environmental policy and legislation, by setting up a surveillance system of long-term air pollution effects, based on retrospective cohorts recruited using data of National Health Interview Surveys (NHIS) already available in the four countries (France, Italy, Slovenia and Spain). In particular, the project showed that when data allowing effective linkage between air pollution and mortality/hospitalisation is available, existing resources can be more easily used to obtain results that are comparable to those obtained in larger and more expensive cohort studies.
A key result was the adoption of a low-cost approach which could be very useful for policy-makers in charge of public health surveillance. The project moreover developed tools and methods for the evaluation of the long-term effects of environmental exposure, and demonstrated the feasibility and reproducibility of the approach in other settings, locations and study periods.
Specific results of the project include:
he project is relevant for local policy action, and direct contacts with a variety of local, national, and European stakeholders and NGOs were established in order to discuss the main results of the project and organise future common initiatives. As regards concrete policy implications, the project beneficiary was directly involved in drafting the Air Quality Regional Plan of Piedmont Region.
Long-term impacts of the project included:
Additionally, specific activities were carried out to facilitate the transfer of the project’s methodology to other contexts (with protocols for data collection, statistical analysis, reports to stakeholders). Statistical analysis procedures were selected with the view to ensuring the maximum degree of transferability. The reliability and homogeneity of data collection and analysis procedures were reached by applying methods easily transferable to the scientific or technical departments of environmental/health agencies.
Further information on the project can be found in the project's layman report and After-LIFE Communication Plan (see "Read more" section).