BruxAir Short-term health effects of air pollution in the Brussels Capital Region 2001-2011

: an epidemiological time series approach

Scriptie/masterproef: Doctoral Thesis


Air pollution levels have decreased significantly over the previous
decades, yet increasing evidence reveals that air pollution remains
harmful even at current levels. These levels tend to be higher in densely
urbanised zones; in cities. As such, almost everybody is exposed to
outdoor air pollution. The health outcomes include the full spectrum from
mortality via hospital admissions to sub-clinical effects. Adverse health
effects occur both as a result from short term exposure (on the order of
days) and from sustained exposure (multiple years).
In the BruxAir project, short term effects of air pollution on health were
investigated by means of administrative data: the InterMutualistic
Agency keeps a record of all prescription-based purchases for residents
of Brussels (and the rest of Belgium). The date and quantity of sales
were linked to personal characteristics (age, sex, place of residence) and
to exposure measurements (daily, 4x4km² resolution). The aggregated
data were analysed with time series methodologies.
The objectives of the study were to (1) evaluate the use of the purchase
of respiratory medication sales as a proxy for the adverse health effects,
(2) optimize the statistical methodology, (3) estimate the relative risks
and (4) estimate the cost saving potential.
Results include (1) purchase is indeed a sensitive indicator, (2)
ensembles and compartment methods are promising methods to deal
with these classes of problems, (3) significant relative risks are found, in
particular for NO2 (a known proxy for traffic-related pollution) and for
grasses (the plant pollen that people are most commonly sensitized to)
and (4) an annual cost saving potential of €73k per 10% decrease in
NO2 concentrations in the Brussels Capital Region, counting only the
sales of reimbursable respiratory medications for asthma and/or chronic
obstructive pulmonary disease.
Datum Prijs14 jun 2016
Toekennende instantie
  • Vrije Universiteit Brussel
BegeleiderDanny Coomans (Promotor), Ronald Buyl (Promotor), An Van Nieuwenhuyse (Co-promotor), Christiaan Van Schravendijk (Jury), Marc Noppen (Jury), Kurt Barbé (Jury), Johan Boman (Jury) & BOULAND Catherine (Jury)

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