Air pollution is an important preventable cause of illness and disease around the world. Pollution levels in many South East Asian countries are higher than are typically found in the UK and other European countries. In Thailand, there are often unhealthy concentrations of ozone and airborne fine particulate matter in cities and towns. These pollutants are mostly caused by road traffic and industrial emissions. The pollution is regularly exacerbated by smoke (haze) from regional biomass burning, which mostly affects the northern provinces of Thailand. Indoor air pollution levels are also higher in Thailand and other countries in the region compared to the UK, which is partly because of ingress of outdoor pollutants, but is also due to second hand cigarette smoke and emissions from burning of charcoal, incense and other materials. It is important for government, industry and other stakeholders in Thailand to have a good understanding of the health impact from indoor and outdoor pollutants. In particular, the number of people living with disease caused by air pollution and the annual number of premature deaths from air pollutants, linked to the main emission sources. Knowledge of the health impacts is a prerequisite for developing appropriate intervention strategies to prevent future disease.
The TAPHIA project will collect a wide range of already available data on air pollution concentrations, population demographics, along with mortality and morbidity statistics. In addition, we will collect new data on indoor and outdoor pollution in urban and rural residences, and data on the time-activity patterns of a sample of the Thai population using a questionnaire. We will carefully review the published scientific evidence for the associations between air pollutants and health to derive appropriate mathematical relationships that can be used to predict the impact of long-term exposure on the health of the Thai population. In addition, we will produce a model of pollution exposure to the Thai population based on the available data. The health impacts will be expressed as annual numbers of premature deaths and the total number of population years that are lost or lived with disease (as disability-adjusted life years or DALYS). We will include a range of chronic diseases known to be caused by air pollution and diseases for which the evidence for an association is still emerging, although these data will be reported separately. Importantly, we will explicitly attempt to account for all uncertainties involved in the calculations so that we can express our evaluation in terms of the likely range of impacts rather than as single figures. This approach is novel, and will allow us to identify the main sources of uncertainty in our estimates and make recommendations to improve the data available for future evaluations. An important aspect of the project is early engagement with a wide range of stakeholders in Thailand to ensure we take account of a wide range of views and that we gain access to all relevant data. We are also setting up a project Advisory Board to help support our work. At the end of the project we plan to reengage with these stakeholders to start a dialogue about possible practical intervention strategies to reduce future risks.
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