Two Decades of Air Pollution Health Risk Assessment: Insights From the Use of WHO's AirQ and AirQ+ Tools.

Objectives: We evaluated studies that used the World Health Organization's (WHO) AirQ and AirQ+ tools for air pollution (AP) health risk assessment (HRA) and provided best practice suggestions for future assessments. Methods: We performed a comprehensive review of studies using WHO's AirQ and AirQ+ tools, searching several databases for relevant articles, reports, and theses from inception to Dec 31, 2022. Results: We identified 286 studies that met our criteria. The studies were conducted in 69 countries, with most (57%) in Iran, followed by Italy and India (∼8% each). We found that many studies inadequately report air pollution exposure data, its quality, and validity. The decisions concerning the analysed population size, health outcomes of interest, baseline incidence, concentration-response functions, relative risk values, and counterfactual values are often not justified, sufficiently. Many studies lack an uncertainty assessment. Conclusion: Our review found a number of common shortcomings in the published assessments. We suggest better practices and urge future studies to focus on the quality of input data, its reporting, and associated uncertainties.

Policy-makers' views on translating burden of disease estimates in health policies: bridging the gap through data visualization.

BACKGROUND: Knowledge Translation (KT) and data visualization play a vital role in the dissemination of data and information to improve healthcare systems. A better understanding of KT and its utility requires examining its processes, and how these interact with available data tools and platforms and various users. In this context, the aim of this paper is to understand how relevant users interact with data visualization tools, in particular Global Burden of Disease (GBD) visualizations, while also examining KT processes related to data visualization. METHODS: A qualitative case-study consisting of semi-structured interviews with eight policy officers. Interviewees were selected by the Institute for Health Metrics and Evaluation (IHME) from three countries: Canada, Kenya and New Zealand. Data were analyzed through framework coding, using qualitative analysis software. RESULTS: Policy officers' responses indicated that data can prompt action by engaging users, and effective delivery and translation of data was enhanced by data visualization tools. GBD was considered valuable for use in policy (e.g., planning and prioritizing health policy; facilitating accountability; and tracking and monitoring progress and trends over time and between countries). Using GBD and data visualization tools, participants quickly and easily accessed key information and turned it into actionable messages; engaging visuals captured decision-makers' attention while providing information in a digestible, time-saving manner. However, participants emphasized an overall disconnect between research and public health. Functionality and technical issues, e.g., absence of tool guides and tool complexity, as well as lacking buy-in and awareness of certain tools from those less familiar with GBD, were named as major barriers. In order to address this "know-do" gap, user-friendly knowledge translation tools were stated as crucial, as was the importance of collaboration and leveraging different insights from data generators and users to inform health policy. CONCLUSIONS: Policy officers aware of KT are willing to utilize data visualization tools as they value them as an engaging and important mechanism to foster the use of GBD data in policy-making. To further facilitate policy officers' efforts to effectively use GBD data in policy and practice, further research is required into how users perceive and interact with data visualization and other KT tools.

Burden of disease studies in the WHO European Region-a mapping exercise.

Background: The World Health Organization (WHO) and the Institute for Health Metrics and Evaluation (IHME) have produced numerous global burden of disease (GBD) estimates since the 1990s, using disability-adjusted life-years (DALYs). Here we attempt to identify studies that have either independent DALY estimates or build on the work of WHO and IHME, for the WHO European Region, categorize them by scope of disease analysis and geographic coverage, and briefly compare their methodology (age weighting, discounting and disability weights). Methods: Google and Google Scholar were used with the search terms 'DALY', 'national burden of disease', Member State names and researcher's names, covering all years. Studies were categorized as: 'specific' (fewer than five disease categories or just risk factors for a single country), 'specific, multicountry' (fewer than five disease categories or just risk factors for more than one country), 'extensive' (covering five or more but not all disease categories for one country), 'full, sub country' (covering all relevant disease categories for part of one country) and 'full, country' (covering all relevant disease categories for one country). Results: A total of 198 studies were identified: 143 'specific', 26 'specific, multicountry', 7 'extensive', 10 'full, sub country' and 12 'full, country' [England (1), Estonia (2), France (1), Romania (1), Serbia (1), Spain (3), Sweden (2) and Turkey (1)]. About 5 (20%) of the 25 examinable 'extensive', 'full, sub country' and 'full, country' studies calculated DALYs using GBD 2010 methodology. Conclusions: Independent burden of diseases studies in Europe have been located, and categorized by scope of disease analysis and geographic coverage. Methodological choices varied between independent 'full, country' studies.

Программа AirQ+: пример расчета оценки воздействия загрязнения воздуха

AirQ+ – это компьютерная программа для количественной оценки воздействия загрязнениявоздуха на здоровье человека разработанный Европейским региональным бюро ВОЗ. Онаявляется преемником программы AirQ. Программа AirQ+ работает таким же образом, как и еепредшественница; пользователь вводит в нее соответствующую информацию, а онарассчитывает и графически отображает воздействие загрязнения воздуха на здоровьечеловека. Программа AirQ+ может обрабатывать данные о следующих загрязняющихвеществах (ЗВ): PM2,5, PM10, NO2, O3 и черный углерод (ЧУ). Программа AirQ+ включаетметодологии, в удобной для пользователя форме, оценки загрязнения окружающей среды(долгосрочного и краткосрочного) и загрязнения воздуха внутри помещений (долгосрочного)для указанных загрязняющих веществ. При расчетах можно учитывать различные последствиядля здоровья, связанные с острыми и хроническими заболеваниями, влияющие на показателизаболеваемости и смертности.

AirQ+ : Exemples de calculs

AirQ+ est un logiciel permettant de quantifier le fardeau et l'impact de la pollution atmosphérique sur la santé mis au point par le Bureau régional de l'OMS pour l'Europe. AirQ+ inclut de manière conviviale des méthodologies pour évaluer les effets de l'exposition à long terme (et à court terme) sur la pollution de l'air ambiant. Il permet de travailler sur les polluants suivants: PM2,5, PM10, NO2, O3 et le black carbon (BC). En outre, AirQ+ peut estimer les effets de la pollution de l'air intérieur liée à l'utilisation de combustibles solides (SFU). Divers indicateurs de santé liés à la mortalité et à la morbidité, à la fois en termes d’affections aiguës et chroniques peuvent être considérés pour les calculs. Les preuves scientifiques sous-jacentes sur les effets sur la santé de la pollution de l'air ambiant utilisées dans le logiciel proviennent principalement d'études menées en Europe de l'Ouest et en Amérique du Nord. Par conséquent, la pertinence (applicabilité) des résultats générés par le logiciel, pour les évaluations effectuées en dehors de ces régions, peut être associée à des incertitudes supplémentaires, doit être considérée avec prudence et nécessite un jugement d'expert.

AirQ+: example of calculations

AirQ+ is a software tool for quantifying the health burden and impact of air pollution developed by the WHO Regional Office for Europe. AirQ+ includes in a user-friendly way methodologies to assess the effects of long-term (and short-term exposure) to ambient air pollution. It can handle the following pollutants: PM2.5, PM10, NO2, O3 and black carbon (BC). Additionally, AirQ+ can estimate the effects of household air pollution related to Solid Fuel Use (SFU). Various health outcomes related to mortality and morbidity, both in terms of acute and chronic conditions can be considered for the calculations. The underlying scientific evidence on health effects from ambient air pollution used in the software comes mainly from studies conducted in Western Europe and North America. As a result, the applicability of the results generated by the software for assessments carried outside of these regions can be associated with additional uncertainties and should be considered with caution and involves expert judgment.

AirQ+: 1.0 example of calculations

AirQ+ is a software tool for quantifying the health impacts of air pollution developed by the WHO Regional Office for Europe1. It can handle the following pollutants: PM2.5, PM10, NO2, O3 and black carbon (BC). AirQ+ includes in a user-friendly way methodologies to assess the effects of long-term and short-term exposure to ambient air pollution. Additionally, AirQ+ can estimate the effects of household air pollution related to Solid Fuel Use (SFU). Various health outcomes related to mortality and morbidity, both in terms of acute and chronic conditions can be considered for the calculations. The underlying scientific evidence on health effects from ambient air pollution used in the software comes mainly from studies conducted in Western Europe and North America. As a result, the applicability of the results generated by the software for assessments carried outside of these regions can be associated with additional uncertainties and should be considered with caution and involves expert judgment.