SHORT NOTE OF MEETING 24th FEBRUARY 2006

Membership changes

1. Dr Timothy King, the Committee's new lay member was welcomed. Professor Virginia Murray's and Professor Tony Frew's terms of appointment had come to an end and they were thanked for their contribution to the Committee. Mr Fintan Hurley's term of appointment had also come to an end but he would be continuing as Chairman of the QUARK sub-group. Professor Roy Harrison had been co-opted onto the Committee.

Minutes of the last meeting

2. The minutes of the last meeting were agreed without any changes.

Matters arising

3. The Annual Air Pollution Research Meeting would not occur in April, its usual time, but it was hoped that the meeting would be held later in the year.

4. The Committee's report on Cardiovascular Disease and Air Pollution would be published on the 2nd of March.

QUARK2 - Update

5. COMEAP's Sub-Group on the Quantification of the Health Effects of Air Pollution in the UK (QUARK2) had been doing detailed work on the effects of long-term exposure to air pollution on mortality. An interim statement was published on the website on 18th January. Work was progressing well with a 40 to 50 page report providing more detailed support to this statement. Publication of this was intended by the summer. There was discussion of whether or not to wait for the completion of the next phase of work on long term exposure to air pollution and morbidity. The key points of this discussion would be relayed to the Chairman of the Sub-Group for a final view.

QUARK2 - Future Work - Morbidity

6. QUARK2 would be moving on to discussing the effect of long-term exposure to air pollution on morbidity, now that its discussion of the effects of long-term exposure to air pollution on mortality was well advanced. A paper raising some underlying issues regarding interpretation of the literature on long-term exposure to air pollution and morbidity was discussed. For example, it was unclear whether the effects seen in studies of long-term exposure to air pollution were due to sustained exposure or to repeated exposure to peak concentrations. There was also discussion of whether it would be best to review the overall literature to see what could be quantified or whether to consider which outcomes were likely to dominate a cost-benefit analysis and then to see what evidence was available on these outcomes. Another issue for consideration was whether any use could be made of the evidence from outside the air pollution literature on the proportion of deaths relative to wider morbidity outcomes e.g. the number of deaths from myocardial infarction compared with the number of people with angina. These exploratory discussions would be picked up again at the next meeting of the sub-group.

Hazard Identification

7. It was confirmed in general terms that COMEAP as a whole would consider whether the association between an air pollutant and a health outcome was likely to be causal. The QUARK sub-group would then look at an appropriate coefficient for quantification.

COMEAP Forward Plan

8. The asthma report and the ozone report would be picked up again in the near future.

9. A small group had been formed to look at the recent WHO publication on the Effects of Air Pollution on Children's Health and Development. This would identify any gaps and comment on whether the conclusions were likely to apply in a UK context.

10. The Health Protection Agency have asked COMEAP to comment on the levels of air pollutants which occurred as a result of the Buncefield Fire. Very little change in air pollution levels across London had been reported but a detailed summary of all the air pollution data was being prepared for COMEAP to discuss at it's June meeting. It was also suggested that COMEAP might wish to give guidance on what epidemiology studies might contribute to work on the possible effects on health of such an incident.

COMEAP Secretariat transfer to the Health Protection Agency

11. The Committee was informed that the Secretariat had been transferred to the Health Protection Agency. The Secretariat's previous role would continue as before on the Department of Health's behalf. The Committee remained a Department of Health Committee appointed by the Chief Medical Officer. Dr Hilary Walker would now attend from the Department of Health.

Roadside exposure

12. At present, the impact of changes to roadside emissions was derived by calculating the impact of changes in emissions on background monitoring site concentrations and then using the change in background monitoring site concentrations to quantify the health impacts. This was because the time-series studies used to derive the coefficients for quantification were based on urban background monitoring site concentrations. The background monitoring site concentrations are acting as surrogates for the distribution of personal exposures across the population. The relationship between the population distribution of personal exposures and background monitoring site concentrations is not fully understood. Understanding this might help in judging the impact of changes in roadside concentrations on health.

13. A project modelling population distribution of personal exposures has been funded with Professor Mike Ashmore under the Department of Health's Air Pollution Research Programme. In discussion with the Chairman, the Secretariat has asked Professor Duncan Laxen to liaise with Professor Ashmore on the Committee's behalf with a view to organising a seminar on this topic. The issue of roadside exposure would then come to COMEAP at a later date.

Recent paper on roads, railways and childhood cancers by Professor Knox

14. The above paper had been circulated to the Committee for comments by correspondence. The view of the Committee on Carcinogenicity on previous papers from the author had also been circulated.

15. It was agreed that it would be interesting to hear the views of experts in spatial epidemiological studies of childhood cancers on this study.

Date of next meeting

16. The next meeting is due to be held on 23rd June 2006.

March 2006

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