COMMITTEE ON THE MEDICAL EFFECTS OF AIR POLLUTANTS

SHORT NOTE OF MEETING 29th FEBRUARY 2008

Matters Arising

1. Professor Ken Donaldson; Professor Dafydd Walters and Mr Ben Armstrong have been reappointed to the Committee for a further 3 years.

2. Notes by Mr Ben Armstrong and Professor Duncan Laxen on points relating to the Gauderman et al (2007) paper on traffic and lung development would be circulated to the Committee and then incorporated in a letter to the Department of Health regarding this study. A record of the Committee's discussions on this paper would appear in the minutes of the February and June 2007 and February 2008 meetings. The paper would be further discussed in the context of other studies for the forthcoming statement on children's health and the forthcoming quantification of morbidity report. Further COMEAP discussions of the issue of roadside exposures were also likely.

3. The COMEAP draft report on 'Long-term exposure to air pollution - Effect on Mortality' had been published on the website in July 2007. 8 comments and 4 peer reviews had been received. Proposed changes in response to these comments had been incorporated into the report and the new draft would be circulated to the sub-group soon. It was hoped to publish the updated report by summer 2008.

4. The morbidity working group had met on 12th October 2007. The group would focus initially on quantifying the effects of COPD and chronic bronchitis/cardiovascular disease/asthma and birth outcomes. The Secretariat would be circulating some material on COPD/chronic bronchitis to the morbidity sub-group shortly.

5. A focussed document had been prepared for the draft asthma report providing a suggested logical framework for the potential routes and mechanisms by which air pollution might cause asthma. This had been discussed with the Chairman and had now been sent to Professor Stephen Holgate for comment before circulation to the asthma report drafting group. Specific literature searches would be performed on the key areas of evidence that were relevant to causation of asthma. The document currently addressed only atopic asthma. It was hoped to publish at least a subset of the material by Christmas 2008 or earlier if possible.

6. The subgroup on children's health held a teleconference on 20th February 2008 to discuss further work required to develop the statement. The statement was focussed on whether there was any need to dissent from the advice given in the WHO's report 'Effects of Air Pollution on Children's Health and Development - a Review of the Evidence (2005)'. The statement will be prepared for final clearance at the June 2008 meeting of COMEAP.

Report of the Review of COMEAP

7. In accordance with Cabinet Office guidelines, COMEAP had been reviewed. The report of this review would appear on the website shortly. Various recommendations in the review were discussed, particularly those relating to Secretariat resources and those relating to the website. Some improvements to the website had already occurred. A new member of staff had been recruited to address communication across the whole toxicology group and development of the COMEAP website would be one aspect of his work. It was noted that, despite the impression in the report of the review, the merger of COMEAP with the Expert Panel on Air Quality Standards (EPAQS) had not yet occurred.

Development of Membership of COMEAP

8. COMEAP needed experts on both air pollution and health and on diseases potentially affected by air pollution. Whether the latter type of expert should be co-opted was discussed but it was felt to be better if they were full members of the Committee. Several options were discussed to increase the pool of potential applicants, including younger applicants, to the Committee. These included having a COMEAP 'stand' at professional society meetings and actively drawing the attention of specific potential applicants to advertisements for vacancies.

Use of Substitute Fuels in Cement Kilns

9. COMEAP was asked for advice on the use of meat and bone meal (MBM); processed sewage pellets (PSP) or refuse-derived fuel (RDF) as substitute fuels in cement kilns. Members were generally reassured by the emissions data provided from trials but a formal conclusion awaits the agreement of a statement by correspondence after the meeting.

Buncefield Fire - Modelling of Predicted Concentrations and Health Impacts Under Less Favourable Weather Conditions

10. COMEAP considered a draft report, from HPA London and the Met Office, modelling the impact of the least favourable weather conditions in 2005 in terms of predicted particle concentrations from a Buncefield-type incident. There was a slightly increased predicted impact above the negligible impact of the incident itself but the predicted impact was a minute fraction of the impact experienced in the smog of December 1952. Comments from COMEAP will be taken into consideration before publication of the final report.

Presentation from Dr Richard Atkinson on a Time-Series Study on Particle-Metrics and Health

11. Dr Richard Atkinson gave a presentation on the preliminary results of a DEFRA-funded project on different particle-metrics (including particle numbers) and health. Following the discussion with COMEAP, a final report will be produced and the work submitted for publication.

Miller et al (2007) Long-term Exposure to Air Pollution and Incidence of Cardiovascular Events in Women - Possible Reasons for Large Coefficient.

12. The Secretariat had collated a list of possible reasons for the large coefficient reported in this study based on the discussion at the February 2007 meeting, further correspondence on the article and a letter from Professor Philip Poole-Wilson. The speculative reasons discussed included particular susceptibility of women over 50 or untreated subjects with undiagnosed heart disease; reduced measurement error; greater effects of traffic-related PM2.5; an overestimate of the effect due to confounding or chance. Overall, it was felt that there were some reasons to be cautious and confirmation from other studies was needed.

Any Other Business

13. The recent Department of Health calls for research on carbon monoxide; air pollution and nanotoxicology were welcomed.

Date of next meeting

14. The next meeting is the Annual Air Pollution Meeting due to be held at the Institute of Environment and Health at Cranfield on 15th-16th April 2008.

Secretariat
April 2008

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