Person: Kienzler, Sarah
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Veröffentlichung Quantifying the environmental burden of disease for children and adolescents in Germany(2023) Kienzler, Sarah; Plaß, Dietrich; Tobollik, Myriam; Wintermeyer, DirkVeröffentlichung Estimating the morbidity related environmental burden of disease due to exposure to PM2.5, NO2 and O3 in outdoor ambient air(European Topic Centre on Human health and the environment, 2022) Kienzler, Sarah; Soares, Joana; Ortiz, Alberto González; Plaß, DietrichVeröffentlichung Health Risk Assessment of Air Pollution: assessing the environmental burden of disease in Europe in 2021(ETC-HE, 2023) Soares, Joana; Kienzler, Sarah; Plaß, DietrichThis report presents the results of the environmental burden of disease (EBD) assessment related to air pollution in 2021 for the 27 Member States of the European Union and an additional 14 European countries (Albania, Andorra, Bosnia and Herzegovina, Iceland, Kosovo under UNSCR 1244/99, Liechtenstein, Monaco, Montenegro, North Macedonia, Norway, San Marino, Serbia, Switzerland, and Türkiye). The estimations differentiate the EBD by three individual pollutants, fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3), considering all-cause mortality as well as cause-specific mortality and morbidity. For the analyses, various burden of disease indicators were used, such as attributable deaths (AD), years of life lost (YLL), years lived with disability (YLD), disability-adjusted life years (DALY) and attributable hospitalisation cases. In 2021, long-term exposure to concentration levels above the WHO Air Quality Guideline levels of PM2.5 and NO2, resulted in 293 000 and 69 000 AD from all natural causes, respectively. There were 27 000 AD related to short-term exposure to O3. For EU27, the number of AD is 253 000, 52 000 and 22 000, respectively. When considering both the number of deaths and the age at which it occurs, the YLL (YLL per 100 000 inhabitants) is 2 936 000 (618) for long-term exposure to PM2.5 and 740 000 (132) to NO2, and 299 000 (54) due to short-term exposure to O3. For EU27, YLL (YLL per 100 000 inhabitants) are 2 584 000 (584), 532 000 (120), 234 000 (53), respectively. When comparing long-term exposure, both all-cause and cause-specific analyses point to PM2.5 as the pollutant with the highest burden. The cause-specific analyses resulted in 2 528 363 DALY in all countries or 2 310 387 DALY in the EU27. The burden attributable to NO2 was considerably lower, with 634 721 DALY and 403 788 DALY in all countries and in the EU27, respectively. Looking at the single disease entities, ischemic heart disease contributed the most to the overall burden of PM2.5, with 759 303 DALY in all countries and 704 525 DALY in the EU27. The lowest burden was related to Asthma (children), with 25 932 and 23 969 DALY in all countries and the EU27, respectively. For NO2, the highest disease burden was associated with diabetes mellitus (314 574 DALY; EU27: 197 031 DALY) and the lowest with asthma (adults) (all countries: 115 425 DALY; EU27: 62 460 DALY). No corresponding indicators were calculated for O3, yet short-term exposure to O3 was associated with 15 986 attributable hospital admissions in the selected European countries. When comparing the results, it is important to note that different age groups (i.e. children, adults, and elderly) were considered in the estimates, according to the relevant concentration-response functions. © European Topic Centre on Human Health and the Environment, 2023Veröffentlichung Toward an adequate level of detail in flood risk assessments(2023) Sieg, Tobias; Kienzler, Sarah; Vogel, Kristin; Rust, HenningFlood risk assessments require different disciplines to understand and modelthe underlying components hazard, exposure, and vulnerability. Manymethods and data sets have been refined considerably to cover more details ofspatial, temporal, or process information. We compile case studies indicatingthat refined methods and data have a considerable effect on the overall assess-ment of flood risk. But are these improvements worth the effort? The adequatelevel of detail is typically unknown and prioritization of improvements in aspecific component is hampered by the lack of an overarching view on floodrisk. Consequently, creating the dilemma of potentially being too greedy or toowasteful with the resources available for a risk assessment. A "sweet spot" between those two would use methods and data sets that cover all relevantknown processes without using resources inefficiently. We provide three keyquestions as a qualitative guidance toward this "sweet spot".For quantitativedecision support, more overarching case studies in various contexts are neededto reveal the sensitivity of the overall flood risk to individual components. Thiscould also support the anticipation of unforeseen events like the flood event inGermany and Belgium in 2021 and increase the reliability of flood riskassessments. © 2023 The AuthorsVeröffentlichung Burden of disease due to ambient particulate matter in Germany - explaining the differences in the available estimates(2022) Kienzler, Sarah; Plaß, Dietrich; Schuster, Christian; Tobollik, Myriam; Wintermeyer, DirkAmbient particulate matter (PM2.5) pollution is an important threat to human health. The aim of this study is to estimate the environmental burden of disease (EBD) for the German population associated with PM2.5 exposure in Germany for the years 2010 until 2018. The EBD method was used to quantify relevant indicators, e.g., disability-adjusted life years (DALYs), and the life table approach was used to estimate the reduction in life expectancy caused by long-term PM2.5 exposure. The impact of varying assumptions and input data was assessed. From 2010 to 2018 in Germany, the annual population-weighted PM2.5 concentration declined from 13.7 to 10.8 (micro)g/m3. The estimates of annual PM2.5-attributable DALYs for all disease outcomes showed a downward trend. In 2018, the highest EBD was estimated for ischemic heart disease (101.776; 95% uncertainty interval (UI) 62,713-145,644), followed by lung cancer (60,843; 95% UI 43,380-79,379). The estimates for Germany differ from those provided by other institutions. This is mainly related to considerable differences in the input data, the use of a specific German national life expectancy and the selected relative risks. A transparent description of input data, computational steps, and assumptions is essential to explain differing results of EBD studies to improve methodological credibility and trust in the results. Furthermore, the different calculated indicators should be explained and interpreted with caution. 2022 by the authorsVeröffentlichung Disease costs due to outdoor ambient particulate matter pollution in Germany, 2018(2023) Kienzler, Sarah; Plaß, Dietrich; Tobollik, Myriam; Wintermeyer, DirkVeröffentlichung Environmental health risks to children and adolescents: an umbrella review on indoor and outdoor air pollution(European Topic Centre on Human Health and the Environment, 2023) Castro, Alberto; Kappeler, Ron; Kienzler, Sarah; Plaß, Dietrich; Scutaru, Ana Maria; Valtanen, KerttuChildren are particularly vulnerable to environmental factors including indoor and outdoor air pollution. In order to present the state-of-the-art knowledge for the health effects for children related to outdoor and indoor air pollution, scoping reviews followed by umbrella reviews is conducted. Thereby, intervention studies are included as a special case of evidence generation as they may directly point to solutions to improve the situation. Prioritization of topics among numerous potential health risks and pollutants is based on available evidence, potential health impact on population level, potential individual health risks for exposed children, possibility to conduct interventions and specificity of the topic for children in Europe. For ambient air pollution there is strong evidence for effects on mortality, respiratory endpoints such as development of asthma, decreased lung function and lung function development, and respiratory infections. Similarly strong evidence exists for the development of asthma and severe asthma attacks in relation to secondhand smoke exposure. Further, studies provide reliable evidence for children exposed to mould to be at risk for a number of health outcomes of the respiratory tract including development of asthma, exacerbation of asthma, allergic rhinitis and wheeze. For numerous other outcomes there are indications of health effects, although uncertainty remains about causality. These health effects amount to substantial burden of disease in Europe. Unfortunately data on the effectiveness of interventions to reduce exposure levels and/or health risks in children are scarce. There is thus an urgent need for a better understanding of which interventions are most useful to prevent environmental health problems in European children. In future reports health effects in children from other research areas such as noise, climate change and chemicals will be dealt with. © European Topic Centre on Human Health and the EnvironmentVeröffentlichung Health Risk Assessment of Air Pollution and the impact of the new WHO Guidelines(European Topic Centre on Human Health and the Environment, 2022) Soares, Joana; Ortiz, Alberto González; Gsella, Artur; Kienzler, Sarah; Horálek, Jan; Plaß, Dietrich