European Journal of Epidemiology

, Volume 21, Issue 6, pp 449–458 | Cite as

Apheis: Health Impact Assessment of Long-term Exposure to PM2.5 in 23 European Cities

  • Elena Boldo
  • Sylvia Medina
  • Alain Le Tertre
  • Fintan Hurley
  • Hans-Guido Mücke
  • Ferrán Ballester
  • Inmaculada Aguilera
  • Daniel Eilstein on behalf of the Apheis group
Environmental epidemiology



Apheis aims to provide European decision makers, environmental-health professionals and the general public with up-to-date and easy-to-use information on air pollution (AP) and public health (PH). In the Apheis-3 phase we quantified the PH impact of long-term exposure to PM2.5 (particulate matter < 2.5 μm) in terms of attributable number of deaths and the potential gain in life expectancy in 23 European cities.


We followed the World Health Organization (WHO) methodology for Health Impact Assessment (HIA) and the Apheis guidelines for data collection and analysis. We used the programme created by PSAS-9 for attributable-cases calculations and the WHO software AirQ to estimate the potential gain in life expectancy. For most cities, PM2.5 levels were calculated from PM10 measurements using a local or European conversion factor.


The HIA estimated that 16,926 premature deaths from all causes, including 11,612 cardiopulmonary deaths and 1901 lung-cancer deaths, could be prevented annually if long-term exposure to PM2.5 levels were reduced to 15 μg/m3 in each city. Equivalently, this reduction would increase life expectancy at age 30 by a range between one month and more than two years in the Apheis cities.


In addition to the number of attributable cases, our HIA has estimated the potential gain in life expectancy for long-term exposure to fine particles, contributing to a better quantification of the impact of AP on PH in Europe.


Air pollution Europe Health impact assessment Life expectancy Mortality PM2.5 



The huge amount of work behind the Apheis programme is the fruit of the generous and constructive input from all the members of the Apheis network. We wish to give our special thanks and appreciation to all of them. The Apheis programme was supported by the European Commission DG SANCO programme of Community action on pollution-related diseases (contract Nos. SI2.131174 [99CVF2-604];␣SI2.297300 [2000CVG2-607]; SI2.326507 [2001CVG2-602] and the participating institutions in 12 European countries. Elena Boldo was supported by a grant from the Regional Ministry of Education (Order 7580/2003) and Regional Ministry of Health (Order 566/2001), Madrid Regional Government, Spain.


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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Elena Boldo
    • 1
    • 7
  • Sylvia Medina
    • 2
  • Alain Le Tertre
    • 2
  • Fintan Hurley
    • 3
  • Hans-Guido Mücke
    • 4
  • Ferrán Ballester
    • 5
  • Inmaculada Aguilera
    • 6
  • Daniel Eilstein on behalf of the Apheis group
    • 2
  1. 1.Carlos III Institute of HealthMadridSpain
  2. 2.InVS-National Institute of Public Health SurveillanceSaint MauriceFrance
  3. 3.Institute of Occupational MedicineEdinburghUK
  4. 4.WHO Collaborating Centre at the Federal Environmental AgencyBerlinGermany
  5. 5.Valencian School of Studies for HealthValenciaSpain
  6. 6.Andalusian School of Public HealthGranadaSpain
  7. 7.ISCIII-National Centre for EpidemiologyMadridSpain

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