Case studies

Case studies have been carried out within the ENHIS project for the following environmental risk factors: Environmental Tobacco Smoke (ETS), outdoor air pollution (PM10), proximity to traffic noise, and homes with mould and dampness.

Environmental Tobacco Smoke (ETS): Health hazard to children

ETS causes a number of non-fatal (asthma episodes) and fatal health effects. In view of the considerable health impact of ETS on children, measures to restrict smoking in indoor environments should be a major public health objective. Particularly, reducing children’s ETS exposure should focus on promoting smoke-free homes and cars (ENHIS).

It was estimated that exposure to ETS increases the number of asthma episodes by 6% to 10%, depending on the current smoking prevalence in each country.

Outdoor air pollution: Health hazard to children

Epidemiological studies carried out on five continents have demonstrated that there are consistent associations between a range of adverse health outcomes and changes in the concentrations of PM10. Children are more vulnerable and susceptible than adults to the impact of air pollution because they are developing their lungs, their immune system is still immature, they spend more time outdoors and exercising, and they have an increased ventilation rate compared to adults. For asthmatic children, moreover, particulate matter can aggravate asthma.

An increase of 1.7% in premature mortality in children 0-4 years has been connected to an increase of 10 ug/m3 in short-term exposure to particulate matter 10 ug/m3 (PM10) . However, the amount of ill-health attributable to air pollution among European children is high due to the widespread nature of the exposure and the relatively high incidence of related health problems (i.e. respiratory problems) in the population (WHO, 2007n).

Children in proximity to traffic noise

Children living in the proximity of roads with heavy traffic are exposed to high ambient air pollutant concentrations and high noise levels.

The exposure distribution of road traffic noise in children (0 – 14 yrs) in the case study for two cities in North Rhine-Westphalia varies per city. 17 – 34 % of the children are exposed to noise levels of more than 60 dB(A) during the day and 21 – 34 % are exposed to noise levels of more than 50 dB(A) at night.

First health impact assesment (HIA) analyses show that although the noise exposure distribution varies, the proportion of children that is highly sleep-disturbed is approximately 5 % in both cities. The proportion of highly annoyed children due to traffic noise varies between the cities from 5 – 10 % of all children exposed to road traffic noise (WHO, 2007o).

Children living in homes with mould and dampness

A case study on exposure to dampness/mould in homes was done for Czech urban children using the assessment of doctor-diagnosed asthma cases/asthma symptoms attributable to reported dampness signs/mould. The data was available from the survey conducted on 7850 children aged 5-17 years in 2001. There was the total number of 400 360 children in the target group of the urban child population from the participant cities; this figure represents 25% of the overall number of children in the relevant age group in CZ. The doctor-diagnosed asthma was recorded in 5.1 % of children, wheeze and night cough was reported in 4.5% and 15.8%, respectively. The reported recent exposure to damp spots or moulds at homes was 7.6% (WHO, 2007p).