Documente Academic
Documente Profesional
Documente Cultură
To cite this article: Raquel Beatriz Jimenez & Nicolas Caceres Bronfman (2012): Comprehensive
indicators of traffic-related premature mortality, Journal of Risk Research, 15:9, 1117-1139
To link to this article: http://dx.doi.org/10.1080/13669877.2012.705314
1. Introduction
Chile has been experiencing accelerated economic growth during the past decades.
A great portion of its commercial activity takes place in the Metropolitan Region
(MR) where Santiago, the capital of Chile, is located. By the year 2005, the population of the MR was 6,538,896, equivalent to 41% of the national population (Instituto Nacional de Estadsticas 2012).
Historically, this region has registered unusually high levels of atmospheric pollution, and although they have decreased considerably in the last few years, there
are frequent incidents where levels of air pollution exceed the air quality standards
established by local authorities. Industrial activity and over one million vehicles circulating in the region about 42% of the national total are the main contributors
*Corresponding author. Email: rjimenez@unab.cl
ISSN 1366-9877 print/ISSN 1466-4461 online
2012 Taylor & Francis
http://dx.doi.org/10.1080/13669877.2012.705314
http://www.tandfonline.com
1118
to this problem. While the increase in the proportion of private vehicles in relation
to the total MR vehicle eet reects a common tendency in developing countries,
poorly functioning public transportation has also been a determinant in the growing
number of private vehicles in recent years. All of the aforementioned factors contribute to the worsening of the already serious issues in this region, including trafc
congestion, air pollution, ambient noise levels, and road accidents, among others.
Nearly 40% of the countrys road accidents and nearly 25% of all resulting national
fatalities take place in the MR.1 Despite these gures, Chilean society does not perceive vehicular risks as unacceptable (Bronfman and Cifuentes 2003).
1.1. Impacts on public health from motorized vehicle transit
Motor vehicle circulation causes external impacts that have negative effects on public health, the most recognizable of which are road accidents and atmospheric pollution, followed by lesser-studied impacts such as those related to reduced physical
activity, high ambient noise levels, and the disposal of out-of-use vehicles, among
others.
Negative health impacts from motorized trafc differ signicantly. For a clear
illustration of this difference, consider trafc accidents, which result in injuries of
varying severity, and exposure to air pollution, which results in cardiovascular and
respiratory diseases. Exposure to both trafc accidents and air pollution has been
associated with mortality, so mortality has been widely used to quantify these
effects. In fact, several studies measuring such impacts in terms of trafc-related
mortality have been published in recent years (Fisher et al. 2002; Knzli et al.
2000; World Heatlh Organization [WHO] 2009).
The development of impact indicators is fundamental for measuring and monitoring the effects of motorized transit on public health, especially in high-risk areas
(WHO 2000). For example, in the Netherlands, De Hartog et al. (2010) quantied
the impact on all-cause mortality derived from the modal shift of 500,000 people
from car to bicycle, by calculating the number of life years gained and lost associated with increased physical activity, trafc accidents, and air pollution, respectively.
In Chile, the National Environmental Committee (CONAMA) has developed
health impact estimates of exposure to trafc-related air pollution in order to evaluate how the implementation of new regulations benets public health. Similarly, the
National Commission of Trafc Safety (CONASET) annually develops road accident indicators based on historical records as a quantitative measure of the impact
of trafc accidents. Nevertheless, so far no indicators have been developed in Chile
to account for the global effect that vehicle circulation has on public health, particularly in terms of premature mortality, whose major causes are exposure to air pollution and road accidents.
1.2. Trafc-related air pollution
As a result of different processes, motor vehicle circulation generates a number of
different pollutants resulting from varying processes, mainly through exhaust gases,
brake and tire wear, and Resuspended Dust (RSD). This results in a complex mixture of pollution being emitted into the atmosphere, including particulate material
and gaseous pollutants such as NOx, SOx, VOCs, and greenhouse gases, among others. These primary pollutants are precursors of the secondary formation of ne
1119
particulate material (PM2.5) and ground level ozone (O3) in the atmosphere. Therefore, the presence of these pollutants has also been associated with vehicle activity
(WHO 2000).
Road trafc contributes signicantly to the high levels of air pollution observed
in urban areas around the world. In Chile, the latest emission inventory carried out
by CONAMA for the MR estimated that mobile sources contributed 37% of the
PM10, 35% of the PM2.5, and 73% of the NOx emitted into the atmosphere during
the year 2005 (Escobar 2007).
1.2.1. Emission estimates
Motor vehicle emissions are usually estimated as a function of the distance traveled
in a given time and area, and as a function of an emission factor (EF), as shown in
the following equation:
Ei NAj EFij
where Ei is the emitted amount of pollutant i in grams, NAj is the activity level or
the distance in kilometers traveled by a vehicle of the category j in the area and
period under observation, and EFij is the EF of pollutant i for this category, in
grams per kilometer. Both parameters in Equation (1) are inuenced by several factors. Caserini, Giugliano, and Pastorello (2008) estimated the relation of the NA of
passenger cars and their age according to the type of fuel, using information from
the circulating vehicle stock in Italy during 2004. These authors proposed the following function:
NAaf h eba
where NA(a)f are the kilometers traveled by a vehicle of age a that uses type f fuel.
EFs for exhaust emission depend directly on circulation speed and fuel
consumption. These factors are generally differentiated according to the emission
abatement technology, quality standards performance, and fuel type. Ntziachristos
and Samaras (2000) developed EFs for different sizes of particulate matter and a
number of gas pollutants, in the frame of the COPERT III2 project, a European
model for vehicular emission estimates.
Exhaust EFs are also affected by usage, age, and poor vehicle maintenance.
The effect of these factors on the emission quantity and its chemical composition
can be integrated by correcting the EF with damage factors (DF). Ntziachristos and
Samaras (2000) developed damage curves for passenger cars according to
kilometers traveled and circulation speed. In Chile, CONAMA has estimated local
DF based on measurements made in technical revision plants (TRP).
The EFs for RSD traditionally used in literature are found in the US EPAs AP42,3 a compilation of EFs for different activities. According to this publication, the
RSD-related EF for evaluations that consider prolonged periods of time is dened
as follows:
"
#
0;65
1;5
sL
W
P
3
FELP k
C 1
2
3
4N
1120
1121
diseases and chronic and acute exposure to this pollutant (Bell et al. 2004). For
instance, Jerrett et al. (2009) studied the relationship between death by various
causes and chronic exposure to O3. The authors found an increase of 1.029 (95%
CI; 1.0101.048) in the relative risk of death due to respiratory diseases, associated
with an increase of 10 ppb in environmental O3 concentration.
The increase in the risk of premature death due to exposure to trafc-related air
pollution has been estimated as a function of various parameters. Hoek et al. (2002)
developed risk indicators in accordance with the residential proximity to highly
transited roads, as did Finkelstein, Jerrett, and Sears (2004), Kim et al. (2004) and
Brauer et al. (2003), among others. Biwer and Butler (1999) developed death risk
indicators per traveled kilometer, associated with the emissions of heavy duty
vehicles during transportation of hazardous substances. In London, Kaur and
Nieuwenhuijsen (2009) estimated death risk indicators from personal exposure to
PM2.5 and carbon monoxide in a transport microenvironment for different modes of
transport.
The selection of parameters to be used in the model must be made with special prudence and care. If possible, locally obtained C-R coefcients should be used, given
that they account for the unique characteristics of both local population and local
pollutant mixture. The use of coefcients obtained from studies developed in other
1122
1.6. Overview
Motorized transportation plays a fundamental role in the economic development
process and in satisfying personal transportation needs. However, it also generates
negative externalities that signicantly impact the populations quality of life,
mainly through atmospheric pollution and road accidents. The current organization
of modern societies and their unsustainable mobility patterns have made these
impacts more and more evident.
1123
A number of studies have quantied direct and indirect impacts of motor transportation on public health. On one hand, epidemiologic studies have established
indicators that relate the exposure to atmospheric pollutants to an increase in the
incidence of adverse health effects, including premature death. On the other hand,
annual indexes of road accident mortality show that this is a manifested public
health problem and one of the major reasons for death due to external causes
worldwide. Although the elaboration of health impact indicators is fundamental in
order to identify, evaluate, and monitor impacts that can be attributed to vehicle circulation, no global indicators have been developed so far to reect the accumulation
of impacts that this activity causes on public health.
Furthermore, no existing indicators express the individual impact of each class
of vehicle on public health and safety simultaneously. For instance, factors such as
type of fuel, age of vehicle, and motor technology, among others, are responsible
for differences in emission quantity and composition. At the same time, differences
in vehicle attributes such as weight, height, and circulation speed inuence accident
risk and the magnitude of its consequences.
The main goal of this study was to design and quantify indicators of premature
mortality caused by exposure to atmospheric pollutants and road accidents that
different motor vehicle classes inict on society.
Given that motor vehicle circulation generates a number of pollutants, each of a
different nature, whose effects are highly correlated, we considered the pollutants
PM2.5 and O3 as indicators of trafc-related air pollution. This is supported by the
fact that the effects of these pollutants independently contribute to increase the
observed levels of morbidity and mortality in the population (Jerrett et al. 2009).
2. Methodology
In this study, we designed indicators to account for the total premature mortality
associated with the circulation of different types of vehicles. Total premature
mortality is understood as the total number of premature deaths that occurred as a
consequence of road accidents and exposure to O3 and PM2.5 derived from the
pollutant emissions from the MRs vehicle eet, in a given year.
Indicators for different vehicle categories will be obtained as a function of
different parameters: per traveled kilometer, vehicle, lifetime of the vehicle, and
category. All estimations will be made with the MR in 2005 as a basic scenario, as
this is the most recent year for which the information required for this study is
available.
1124
1125
ECF
[g/m3] PM2.5/ton
1.01E04
2.01E04
1.59E04
3.04E03
4.42E05
ECF
ppbO3/ton
NOx
VOC
5.80E04
2.64E04
as described in Equation (4). The ECF used in this study was obtained from Rizzi
(2008) and CONAMA (2009), as detailed in the Tables 1 and 2.
Their authors estimated these ECF specically for the MR, based on information
pertinent to the year 2005.
2.3. Mortality resulting from trafc accidents
The health impact associated with road accidents was estimated as the number of
deaths that occurred in the MR during 2005 as a consequence of this type of accident, attributable to different vehicle categories.
The total number of deaths from road accidents in the MR during 2005 was
obtained from information from death certicates. Only fatalities with secondary
diagnoses classied under the letter V of the ICD-10 were considered. However,
death certicates do not contain details about characteristics of the accident, nor
about the vehicles implicated, information that is essential to determine the responsibility of the fatalities resulting from trafc accidents between the participating
vehicles. In order to explore the contribution of each type of vehicle on total mortality from trafc accidents, data from historical records of road accidents from
CONASET were used. Both the level of involvement in accidents with fatal results
and the magnitude of the impact were estimated.
The characteristics of all accidents that occurred in the area and period of study,
and that resulted in at least one fatality, were analyzed, classifying the accidents
according to the number of vehicle categories involved. In cases where two or more
categories were involved, it was assumed that each participating vehicle carries the
responsibility for all the resulting deaths. In order to attribute the responsibility of
the resulting fatalities to the different vehicle categories, in cases where two or more
categories were involved, it was assumed that each participating vehicle was
responsible for all the resulting deaths. The implications of this assumption, among
1126
others, are analyzed further on. The percentage of the total number of deaths from
historical records for trafc accidents associated with each category was used to
determine each categorys responsibility in the real mortality levels from road accidents, according to the registry of death certicates.
Finally, the total number of deaths per category was distributed across the number of vehicles in circulation belonging to each category and their annual activity
level, in order to obtain differentiated indicators of mortality from road accidents
per driven km for each category.
3. Results
3.1. Vehicle stock characteristics
Signicant variations were found among data from different sources, especially with
regard to the total number of vehicles. This may be due to the rule that exempts
new vehicles from the otherwise mandatory vehicle inspections and maintenance
during the rst years of use.6 Furthermore, some drivers have their required vehicle
inspections done outside the region, while others simply evade the process.
The circulating vehicle eet was classied into 15 categories. In order to obtain
vehicle subcategories compatible with the EF used in the emission estimation process, all categories were disaggregated according to fuel type, emission abatement
technology, and compliance with emission standards. The technological composition
of each category was obtained from TRP-derived information and then projected
over the total number of vehicles per category reported by INE. The results of these
analyses are shown in the rst four columns of Table 3. The total sum of vehicles
in circulation in the area and period of study was 1,068,294, of which 63% were
private passenger cars.
30.775
65.632
7.338
36.244
16.453
8.184
Jeep
Minibus, van
School bus
Light truck
Medium-sized
truck
Heavy truck
150.470
14.264
Collective taxi
Pickup
26.539
677.773
Number of
vehicles
Private passenger
car
Taxi
Category
Subcategory
c
80
20
96
2
3
87
1
12
70
17
13
83
11
7
39
18
41
2
12
4
84
23
37
40
37
33
30
45
32
Composition
(%)
19,052
9859
60,000
60,000
60,000
60,000
60,000
60,000
30,000
30,000
30,000
30,000
30,000
30,000
30,000
30,000
30,000
30,000
30,000
30,000
30,000
55,000
55,000
55,000
46,000
46,000
46,000
86,000
86,000
Annual
kma
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
0.23
NA
NA
0.23
NA
NA
0.23
NA
NA
NA
0.23
0.25
0.16
0.10
0.53
0.35
0.21
0.66
0.43
PM2.5b
0.56
3.66
0.48
2.22
0.40
0.48
2.22
0.40
0.39
2.50
1.05
0.39
2.50
1.05
0.39
2.50
1.05
0.40
0.39
2.50
1.05
2.47
1.73
1.23
5.13
3.59
2.57
11.74
6.46
NOx
0.003
0.004
0.01
0.01
NA
0.01
0.01
NA
0.00
0.005
0.01
0.005
0.005
0.01
0.005
0.005
0.01
NA
0.005
0.005
0.01
0.01
0.01
0.01
0.02
0.02
0.02
0.03
0.03
SOx
0.07
0.002
0.07
0.002
NA
0.07
0.002
NA
0.07
0.002
0.001
0.07
0.002
0.001
0.07
0.002
0.001
NA
0.07
0.002
0.001
0.003
0.003
0.003
0.003
0.003
0.003
0.003
0.003
NH3
0.28
0.54
0.31
0.31
0.31
0.31
0.31
0.31
1.02
1.02
1.02
1.02
1.02
1.02
1.55
1.55
1.55
1.55
1.55
1.55
1.55
5.44
5.44
5.44
13.69
13.69
13.69
59.03
59.03
RSD
(Continued)
0.14
1.91
0.17
2.01
0.41
0.17
2.01
0.41
0.21
1.81
0.08
0.21
1.81
0.08
0.21
1.81
0.08
0.41
0.21
1.81
0.08
1.30
0.97
0.64
1.30
0.97
0.91
1.30
0.65
VOC
Table 3. Vehicle stock MR 2005 disaggregated by category, emission abatement technology and fuel type, and pollutant emission in g/km.
15.728
7.936
Motorcycle
Urban public
transportation
bus
Interurban bus
2.261
Private bus
Subcategory
23
35
65
44
25
31
32
15
51
2
25
17
27
31
100
Composition
(%)
Source: Elaboration based on TRP, INE, Lepeley and Cifuentes (1999), Caserini et al. (2008).
a
Values obtained from Caserini et al. (2008), Lepeley and Cifuentes (1999), and others.
b
PM2.5 from exhaust emissions.
c
Type 1: EURO I; Type 2: EURO II; Type 3: EURO III, or higher.
d
Not applicable.
4.394
Rural public
transportation
bus
4.303
Number of
vehicles
Category
Table 3. (Continued).
86,000
4500
4500
80,000
80,000
80,000
40,000
40,000
40,000
40,000
35,000
35,000
35,000
35,000
25,000
Annual
kma
0.16
NA
NA
0.21
0.48
0.30
0.61
0.25
0.16
0.11
0.77
0.32
0.20
0.14
0.32
PM2.5b
NOx
4.70
0.03
0.15
6.14
12.28
8.77
8.49
4.67
3.40
2.38
11.19
6.15
4.47
3.13
6.15
0.03
0.002
0.002
0.04
0.03
0.04
0.02
0.02
0.02
0.02
0.02
0.02
0.02
0.02
0.02
SOx
0.003
0.002
0.002
0.003
0.003
0.003
0.003
0.003
0.003
0.003
0.003
0.003
0.003
0.003
0.003
NH3
0.58
8.78
1.17
0.85
1.30
1.21
1.26
0.63
0.57
0.40
1.68
0.84
0.75
0.53
0.84
VOC
59.03
0.01
0.01
33.76
33.76
33.76
29.41
29.41
29.41
29.41
21.43
21.43
21.43
21.43
21.88
RSD
1128
R.B. Jimenez and N.C. Bronfman
1129
subcategories are the greatest contributors to the emissions of this pollutant, followed by the remaining buses and trucks. Estimations obtained for diesel pickups,
jeeps, and vans are comparable with medium-sized trucks and buses EURO I or
higher. Additionally, these categories emission levels of NH3 and VOC are comparable to those of natural gas vehicles.
In general, motorcycles show the lowest emission rates for all the pollutants per
kilometer traveled, except for VOC, as mentioned earlier.
3.2.2. Changes in PM2.5 and O3 environmental concentration
Table 4 shows the marginal increase in the environmental concentration of secondary pollutants PM2.5 and O3, estimated per vehicle, lifetime, category, and kilometer
traveled for each vehicle category.
Motorized vehicles circulating in the MR contributed a total of 25.5 ppb of O3
and 13.8 g/m3 of secondary PM2.5 to the ambient levels of these two pollutants in
2005. The heavy truck category is the greatest contributor of these two pollutants to
the environmental concentration per traveled kilometer, followed by Urban Public
Transportation Buses, and by buses and trucks in general. Inversely, the motorcycle
category presents the lowest PM2.5 rates per traveled kilometer, while the O3 rates
per kilometer traveled obtained for motorcycles are comparable with the light truck
category rates. The greatest contribution per category is made by private passenger
cars and heavy trucks.
3.2.3. Mortality attributable to exposure to PM2.5 and O3
Indicators of mortality attributable to exposure to O3 and PM2.5 were obtained for
each category as a function of different parameters: traveled kilometers, vehicle,
Table 4. Contributions to O3 and PM2.5 ambient concentration, in ppb and g/m3,
respectively, per traveled kilometer, annual contribution per vehicle and per category.
Category
Heavy truck
Urban public
transportation bus
Rural public
transportation bus
Interurban bus
Private bus
Medium-sized truck
Light trucks
School bus
Minibus, van
Pickup
Jeep
Private passenger car
Taxi
Collective taxi
Motorcycle
a
ppb
O3/km
ppb
O3/veh
ppb
O3
g/m3
PM2.5/km
g/m3
PM2.5/veh
g/m3
PM2.5
5.10E09
5.20E09
4.40E04
4.20E04
3.62
3.3
4.90E09
3.30E09
2.30E04
2.60E04
3.45
2.09
3.20E09
1.30E04
0.57
2.80E09
1.10E04
0.49
3.70E09
3.80E09
2.50E09
1.20E09
6.40E10
7.30E10
6.10E10
4.80E10
8.10E10
3.50E10
3.40E10
1.10E09
1.30E04
9.50E05
1.20E04
6.80E05
1.90E05
2.20E05
1.80E05
1.40E05
1.10E05
2.10E05
2.00E05
4.90E06
0.56
0.21
1.9
2.45
0.14
1.43
2.77
0.45
7.26
0.55
0.29
0.02
2.60E09
2.60E09
2.10E09
8.90E10
7.60E10
4.60E10
2.30E10
1.70E10
1.40E10
7.70E11
7.40E11
1.20E11
9.10E05
6.40E05
1.20E04
2.70E05
2.30E05
2.10E06
6.90E06
5.00E06
2.50E06
4.60E06
4.40E06
1.00E06
0.39
0.15
1.62
1.78
0.17
0.91
1.03
0.16
1.37
0.12
0.06
0.0002
1130
Table 5. Indicators of premature mortality from exposure to O3 (acute) and PM2.5 (chronic)
per traveled kilometer, annual deaths per vehicle, and per lifetime.
Category
Heavy truck
Urban public transportation bus
Interurban bus
Rural public transportation bus
Private bus
Medium-sized truck
Light truck
School bus
Minibus, van
Pickup
Jeep
Private passenger car
Taxi
Collective taxi
Motorcycle
Deaths/
km
Annual deaths/
vehicle
Expected deaths
during lifetimea
8.92E07
6.09E07
5.11E07
4.81E07
4.74E07
3.90E07
1.64E07
1.37E07
8.59E08
4.40E08
3.24E08
3.02E08
1.56E08
1.51E08
8.78E09
4.23E02
4.87E02
2.05E02
1.68E02
1.19E02
2.13E02
5.12E03
4.10E03
5.01E04
1.32E03
9.73E04
5.07E04
9.36E04
9.04E04
2.13E04
7.35E01
1.41E+00
5.91E01
4.86E01
3.43E01
3.71E01
7.84E02
6.28E02
7.68E03
2.02E02
1.49E02
9.35E03
1.72E02
1.67E02
5.23E03
Lifetime values for car (18.4 years), motorcycle (24.5 years), bus (28.9 years), commercial vehicle
(15.3 years), and heavy truck (17.4 years) were taken from Samaras and Ntziachristos (2008).
Table 6. Number of cases attributable to exposure to O3 (Acute) and PM2.5 (Chronic) per
category.
Categorya
Heavy truck
Urban public transportation bus
Light truck
Medium-sized truck
Private passenger car
Pickup
Minibus, van
Interurban bus
Rural public transportation bus
Jeep
School bus
Private bus
Taxi
Collective taxi
Motorcycle
Total
a
Acute O3
Chronic PM2.5
Total
22
20
15
12
45
17
9
4
3
3
1
1
3
2
0.09
157
612
369
314
285
241
182
161
86
69
27
29
26
21
11
0.03
2433
634
389
329
297
286
199
170
90
72
30
30
27
24
13
0.12
2590
1131
Category
Private
passenger car
Taxi
Collective taxi
Pickup
Jeep
Minibus, van
School bus
Light truck
Medium-sized
truck
Heavy truck
Motorcycle
Urban public
transportation
bus
Rural public
transportation
bus
Interurban bus
Private bus
Total
a
Total
Category
(Ministry
Total
of
Simple
category
Double Multiple
Involvement
Health)e
accidentsa accidentsb accidentsc (CONASET)d
(%)
102
48
12
162
29.9
218
4
3
49
5
8
2
24
2
3
1
39
5
0
13
35
5
0
0
6
0
3
0
8
3
7
4
94
10
11
15
67
10
1.2
0.7
17.3
1.9
2.1
2.7
12.3
1.9
9
5
126
14
15
20
90
14
1
10
66
0
14
43
1
1
3
2
25
112
0.3
4.7
20.6
2
34
150
0.4
9
1
288
4
1
211
2
5
44
15
7
543f
2.7
1.2
100
20
9
729
Simple accidents deaths include run overs, overturns, and crashes that do not involve other categories.
Double accident deaths include crashes between two categories or between one category and a bicycle.
c
Multiple accident deaths include crashes of more than two categories, considering bicycles.
d
Total deaths registered by CONASET. This database contains disaggregated information about each
vehicle categorys involvement in fatal accidents, but does not consider deaths caused by the accident
that occurred posterior to it.
e
Total deaths according to Ministry of Health. This database contains information of the total number
of deaths caused by road accidents, but does not contain information regarding vehicles involvement
in accidents causing those deaths.
f
This number does not match the total number of annual deaths registered by CONASET (465 deaths).
The reason for the difference is that the responsibility for deaths in double accidents (126 deaths) and
multiple accidents (23 deaths) was attributed to each participating vehicle category, resulting in a double count of the number of fatalities.
b
1132
Deaths/km
Annual deaths/vehicle
Deaths/lifetime
Motorcycle
Urban public transportation bus
Private bus
Interurban bus
School bus
Light truck
Pickup
Private passenger car
Medium-sized truck
Rural public transportation bus
Jeep
Minibus, van
Collective taxi
Taxi
Heavy truck
4.80E07
2.36E07
1.59E07
1.33E07
9.09E08
4.51E08
2.79E08
1.87E08
1.85E08
1.71E08
1.52E08
7.62E09
5.84E09
5.65E09
2.84E09
2.16E03
1.89E02
3.98E03
4.55E03
2.73E03
2.48E03
8.37E04
3.22E04
8.51E04
6.97E04
4.55E04
2.29E04
3.51E04
3.39E04
2.44E04
5.31E02
5.46E01
1.15E01
1.32E01
4.18E02
3.81E02
1.28E02
5.93E03
1.30E02
2.01E02
6.97E03
3.50E03
6.46E03
6.25E03
4.25E03
1133
Heavy trucks
Urban public transportation bus
Private bus
Interurban bus
Rural public transportation bus
Motorcycle
Medium-sized truck
School bus
Light truck
Minibus, van
Pickup
Private passenger car
Jeep
Taxi
Collective taxi
8.94E07
8.45E07
6.34E07
6.14E07
5.28E07
4.89E07
4.09E07
2.27E07
2.09E07
9.36E08
7.19E08
4.89E08
4.76E08
2.12E08
2.09E08
4.25E02
6.76E02
1.58E02
2.14E02
2.12E02
2.37E03
2.22E02
6.82E03
7.60E03
7.29E04
2.16E03
8.29E04
1.43E03
1.27E03
1.25E03
0.74
1.95
0.46
0.62
0.61
0.06
0.39
0.10
0.12
0.01
0.03
0.02
0.02
0.02
0.02
636
539
36
92
93
34
311
50
419
185
325
503
44
34
18
22% is due to road accidents and 78% to the exposure to pollutants generated by
motor vehicle circulation. This corresponds to 10.4% of all mortality registered in
the MR in this period, and a rate of 520 premature deaths per million habitants.
Table 9 shows global indicators of premature mortality and the total fatalities
estimated for all categories. The heavy truck, urban public transportation bus, and
private passenger car categories are responsible for 19, 16, and 15% of the estimated total mortality that can be attributed to motor vehicle trafc, respectively.
Heavy trucks and urban public transportation buses present the highest indicators per kilometer traveled. The impact magnitudes of these two categories are congured quite differently: urban transportation buses indicator of total mortality is
formed almost evenly between road accidents and pollutant exposure, while mortality attributed to heavy trucks is dominated by pollutant exposure. The opposite
occurs with motorcycles: 98% of the global indicator of premature deaths per kilometer traveled is determined by road accidents, and only 2% to pollutant exposure.
The motorcycle category presents high indicators of premature deaths per kilometer traveled in comparison to other categories, even compared to indicators
obtained for rural public transportation buses and medium-sized trucks. For this category, the estimated premature deaths indicator per traveled kilometer is 7, 10, and
23 times higher than the estimation for pickups, private passenger cars and taxis,
respectively.
The results obtained for taxi and collective taxi categories were the lowest. For
these categories, the indicators per traveled kilometer are 11, 10, and 4 times lower
than the estimated indicators for school buses, pickups and private passenger cars,
respectively.
4. Discussion
This study presents two main results. First, a set of comprehensive indicators of
trafc-related impacts on public health was developed, in order to yield complete
1134
information about the total impact on premature mortality resulting from motorized
trafc. Second, estimates of total impact on premature mortality were obtained for
each vehicle category, as a function of different parameters (premature deaths per
driven kilometer, year, and lifetime).
Traditionally, trafc-related mortality is associated only to direct mortality, i.e.
death as a consequence of trafc accidents, where the relationship between cause
and effect is clearly evident and straightforward. However, the extent to which
motor vehicles inuence premature mortality is much greater than their involvement in trafc accidents, and when additional impacts from this activity are
considered, the real impact of road trafc on mortality is signicantly larger.
One of the major implications of this common misinterpretation is that both
community and regulators base their decisions on incomplete information, and
therefore, it would be expected that results from such decision-making processes
be biased.
For example, in Chiles MR, trafc accidents were responsible for a mortality
rate of 114 annual deaths per million inhabitants during 2005, equivalent to 2.3%
of all-cause mortality registered in this period. According to our results, when the
two main factors that inuence trafc-related mortality are considered simultaneously, the rate of annual deaths per million inhabitants increases to 520, and the
equivalent percentage of the total deaths registered in the same area and time period
increases to 10.4%.
The results of this study indicate that the public transportation buses generate
the greatest health impact on MRs population in terms of annual premature deaths
per vehicle and premature deaths during a vehicles lifetime. However, the number
of transported passengers was not considered within this study. If this variable were
integrated in the analysis, the numbers would show that public transportation buses
are signicantly safer and less pollutant, which makes them the most efcient
means for transporting passengers. While it is essential that authorities with competence in the transport sector strengthen the participation of public transport in the
MRs transportation matrix and encourage the public to use this means of transportation, equally important is the need to adopt measures to reduce this activitys negative impacts on society.
The MR health and environment authorities have assessed the implementation
of different measures in the transport sector, with the aim of decreasing its contribution to the alarming pollution levels observed in the region and reducing their
impact on public health. Also, various governmental organisms make constant
efforts to reinforce road safety plans and control vehicles in circulation, in order
to reduce the risks of accidents. However, the adoption of these measures alone
and separately is not enough to deal with the expected impacts of the regions
accelerated growth of vehicles in circulation: coordinated and integrated multisector action is essential, including public participation throughout the decisionmaking process.
The comprehensive indicators developed in this study are a useful tool which
can support the complex process of deciding between transportation modes by
delivering complete disaggregated information of premature mortality attributable to
different types of vehicle.
Multiple impacts and benets of each means of transportation must be considered when making such decisions, because of the multiple trade-offs existing
between road safety, a clean environment, comfort, and the satisfaction of personal
1135
needs. For example, the change from gas vehicles into hybrid electric vehicles is a
cost-effective measure for the society, in terms of emission reduction. On the other
hand, these vehicles are generally smaller and lighter, and therefore in disadvantage
when facing bigger and heavier vehicles in an accident, given that death and serious
injury risks are higher for passengers in the lighter vehicle involved in the accident.
Another example is the case of motorcycles: using this type of vehicle has several
benets for the user, mainly linked to low operational cost and avoidance of trafc
congestion. Yet, motorcycles present the highest death risk due to accidents. Our
indicators allow the inclusion of public health requirements when such decisions
are being made.
1136
1137
transportation (i.e. trafc accidents) are perceived by the Chilean population as relatively not dreadful, known, and with a small personal effect. Motor vehicles and
public transportation are signicantly associated with high personal and social benets, according to Bronfman and Cifuentes (2003).
Another important difference lies in the levels of uncertainty inherent to the
assessment process of deaths by these two causes. An important part of the uncertainty concerning the assessment of air pollution-related deaths is determined by the
uncertainty in the estimation of C-R functions, the differences in exposure at individual levels, variability in the population, and the various assumptions used in the
calculations, among others (Knzli 2002). On the contrary, the number of accident
related-deaths is obtained based on historical records and death certicates, so
uncertainty associated to this process comes from databases, errors, and biased
information.
Notes
1. The information source is the National Committee of Transit Security (CONASET) of
the Transport and Telecommunications Ministry.
2. Computer program to calculate emissions from road transport, 3rd version.
3. Available at http://www.epa.gov/ttn/chief/ap42/ch13/nal/c13s0201.pdf.
4. Information from the Ministry of Health.
5. Average speeds are obtained from the starting pointdestination survey of traveling in
Great Santiago 2006, performed by the Ministry of Transportation and Telecommunication (2008).
6. This is due to the assumption that emission abatement systems would maintain their efciency during the rst years of use.
1138
References
Attewell, R., M. McFadden, and K. Seyer. 1999. Vehicle compatibility: Analysis of fatal
crashes (No. CR181). Canberra: Federal Ofce of Road Safety.
Bell, M.L., A. McDermott, S.L. Zeger, J.M. Samet, and F. Dominici. 2004. Ozone and shortterm mortality in 95 US urban communities, 19872000. JAMA 292, no. 19: 23728.
Biwer, B.M., and J.P. Butler. 1999. Vehicle emission unit risk factors for transportation risk
assessments. Risk Analysis 19, no. 6: 115771.
Brauer, M., G. Hoek, P. van Vliet, K. Meliefste, P. Fischer, U. Gehring, et al. 2003. Estimating long-term average particulate air pollution concentrations: Application of trafc indicators and geographic information systems. Epidemiology 14, no. 2: 22839.
Bronfman, N.C., and L.A. Cifuentes. 2003. Risk perception in a developing country: The
case of Chile. Risk Analysis 23, no. 6: 127185.
Caserini, S., M. Giugliano, and C. Pastorello. 2008. Trafc emission scenarios in Lombardy
region in 19982015. Science of the Total Environment 389, no. 23: 45365.
Cifuentes, L.A., J. Vega, K. Kopfer, and L.B. Lave. 2000. Effect of the ne fraction of particulate matter versus the coarse mass and other pollutants on daily mortality in Santiago,
Chile. Journal of the Air & Waste Management Association 50, no. 8: 128798.
CONAMA. 2007. Evaluacin de nuevas medidas de control de emisiones para el sector
transporte en la Regin Metropolitana [Evaluation of new emission control actions for
the transport sector in the Metropolitan Region]. Santiago, Chile. Comisin Nacional del
Medioambiente. http://www.eclac.cl/ilpes/noticias/paginas/3/36023/DICTUC2007-MedidasFuentesMoviles.pdf.
CONAMA. 2009. Antecedentes para el anlisis general de impacto econmico y social del
anteproyecto de la norma de calidad primaria para PM2.5 Santiago [Background for the
overall analysis of economic and social impacts from the quality standard for primary
PM2.5 in Santiago]. Comisin Nacional del Medioambiente. http://www.asiquim.cl/web/
documentos/AGPM25_InformeFinal_completo.pdf.
de Hartog, J.J., H. Boogaard, H. Nijland, and G. Hoek. 2010. Do the health benets of
cycling outweigh the risks? Environmental Health Perspectives 118, no. 8: 110916.
Dhondt, S., Q. Le Xuan, H. Vu Van, and L. Hens. 2010. Environmental health impacts of
mobility and transport in Hai Phong Vietnam. Stochastic Environmental Research and
Risk Assessment, 25, no. 3: 36376.
Escobar, J. 2007. Actualizacin del Inventario de Emisiones de Contaminantes Atmosfricos
en la Regin Metropolitana 2005 [Update of inventory of air pollutant emission in the
metropolitan region 2005]. DICTUC, Ponticia Universidad Catlica de Chile. Santiago:
Commisin Nacional Del Medio Ambiente Regin Metropolitana.
Evans, L. 2004. Trafc safety. Bloomeld Hills, MI: Science Serving Society.
Evans, L., and M.C. Frick. 1992. Car size or car mass: Which has greater inuence on fatality risk? American Journal of Public Health 82, no. 8: 110512.
Finkelstein, M.M., M. Jerrett, and M.R. Sears. 2004. Trafc air pollution and mortality rate
advancement periods. American Journal of Epidemiology 160, no. 2: 1737.
Fisher, G., K. Rolfe, T. Kjellstrom, A. Woodward, S. Hales, A. Sturman, Kingham, S., et al.
2002. Health effects due to motor vehicle air pollution in New Zealand. Report to the
Ministry of Transport.
Hoek, G., B. Brunekreef, S. Goldbohm, P. Fischer, and P. van den Brandt. 2002. Association
between mortality and indicators of trafc-related air pollution in the Netherlands: A
cohort study. The Lancet 360, no. 9341: 12039.
Instituto Nacional de Estadsticas [National bureau of statistics]. 2012. Proyecciones y Estimaciones de Poblacin. http://palma.ine.cl/demograa/menu/EstadisticasDemogracas/proyecciones.aspx.
Jacobs, G., A. Aeron-Thomas, A. Astrop, and G. Britain. 2000. Estimating global road
fatalities (No. TRL Report 445). Crowthorne: Transport Research Laboratory.
Jerrett, M., R.T. Burnett, C.A. Pope, III, K. Ito, G. Thurston, D. Krewski, Y. Shi., et al.
2009. Long-term ozone exposure and mortality. New England Journal of Medicine 360,
no. 11: 108595.
Kaur, S., and M.J. Nieuwenhuijsen. 2009. Determinants of personal exposure to PM2.5, ultrane particle counts, and CO in a transport microenvironment. Environmental Science &
Technology 43, no. 13: 473743.
1139
Kim, J., S. Smorodinsky, M. Lipsett, B.C. Singer, A. Hodgson, and B. Ostro. 2004. Trafcrelated air pollution near busy roads: The East Bay Childrens Respiratory Health Study.
American Journal of Respiratory and Critical Care Medicine 170, no. 5: 5206.
Knzli, N. 2002. The public health relevance of air pollution abatement. European Respiratory Journal 20, no. 1: 198209.
Knzli, N., R. Kaiser, S. Medina, M. Studnicka, O. Chanel, P. Filliger, M. Herry., et al.
2000. Public-health impact of outdoor and trafc-related air pollution: A European
assessment. The Lancet 356, no. 9232: 795801.
Laden, F., L.M. Neas, D.W. Dockery, and J. Schwartz. 2000. Association of ne particulate
matter from different sources with daily mortality in six US cities. Environmental Health
Perspectives 108, no. 10: 9417.
Laden, F., J. Schwartz, F.E. Speizer, and D.W. Dockery. 2006. Reduction in ne particulate
air pollution and mortality: Extended follow-up of the Harvard Six Cities study. American Journal of Respiratory and Critical Care Medicine 173, no. 6: 66772.
Lepeley, F., and L.A. Cifuentes. 1999. Un modelo de emisiones vehiculares para Santiago y
su aplicacin en la evaluacin del retiro anticipado de vehculos antiguos [A model of
vehicle emissions and its application in the assessment of early removal of old vehicles
in Santiago]. Santiago: Ponticia Universidad Catlica de Chile.
Loomis, D., M. Castillejos, D.R. Gold, W. McDonnell, and V.H. Borja-Aburto. 1999. Air
pollution and infant mortality in Mexico City. Epidemiology 10, no. 2: 11823.
Medina, E., and A.M. Kaempffer. 2007. Consideraciones epidemiolgicas sobre los traumatismos en Chile [Epidemiological considerations on injuries in Chile]. Rev Chil Cir vol
59, no. 3: 17584.
National Research Council. 1993. Protecting visibility in national parks and wilderness
areas. Washington, DC: Committee on Haze in National Parks and Wilderness Areas.
Ntziachristos, L., and Z. Samaras. 2000. COPERT III computer programme to calculate
emissions from road transport: Methodology and emission factors (version 2.1) (No.
49). Copenhagen: European Environment Agency.
Ostro, B. 1996. A methodology for estimating air pollution health effects (No. WHO/EHG/
96.5). Geneva: World Health Organization.
Pope, C.A., III, R.T. Burnett, M.J. Thun, E.E. Calle, D. Krewski, K. Ito, and G.D. Thurston.
2002. Lung cancer, cardiopulmonary mortality, and long-term exposure to ne particulate
air pollution. JAMA 287, no. 9: 113241.
Pope, C.A., III, R.T. Burnett, G.D. Thurston, M.J. Thun, E.E. Calle, D. Krewski, and
J. Godleski. 2004. Cardiovascular mortality and long-term exposure to particulate air
pollution. Circulation 109, no. 1: 717.
Pope, C.A., III, M. Ezzati, and D.W. Dockery. 2009. Fine-particulate air pollution and life
expectancy in the United States. New England Journal of Medicine 360, no. 4: 37686.
Rizzi, L. 2008. Costos externos del transporte automotor vial en la Regin Metropolitana
de Santiago [External costs of road transportation in the Metropolitan Region of Santiago, Chile, Mimeo]. Santiago, Chile: Universidad Catlica de Chile.
Samaras, Z., and L. Ntziachristos. (2008). European database of vehicle stock for the calculation and forecast of pollutant and greenhouse gases emission with TREMOVE and
COPERT. Final Report (No. 08.RE.0009.V2). Thessaloniki, Greece.
Sommer, H., R. Seethaler, O. Chanel, M. Herry, S. Masson, and J.-C. Vergnaud. 1999.
Health costs due to road trafc-related air pollution. Paper presented at the WHO Ministerial Conference on Environment and Health, London, UK.
US EPA. 1999. The benets and costs of the clean air act 1990 to 2010 (No. EPA-410-R99-001). Washington, DC: US Environmental Protection Agency.
Vassanadumrongdee, S., and S. Matsuoka. 2005. Risk perceptions and value of a statistical
life for air pollution and trafc accidents: Evidence from Bangkok, Thailand. Journal of
Risk and Uncertainty 30, no. 3: 26187.
World Health Organization [WHO]. 2000. Transport, environment and health. Ed. C. Dora
and M. Phillips. Austria: World Health Organization.
World Health Organization [WHO]. 2009. Global status report on road safety: Time for
action (No. NLM classication: WA 275). Geneva: World Health Organization.