Health risk analysis related to exposure to ambuent air contamination as a component in the strategy aimed at reducing global non-infectious epidemics

View or download the full article: 

V.N. Rakitskii, S.L. Avaliani, S.M. Novikov, T.A. Shashina, N.S. Dodina, V.A. Kislitsin


F.F. Erisman Federal Scientific Centre of Hygiene, 2 Semashko Str., Mytishchi, 141014, Russian Federation


The article dwells on the analysis of the latest world data indicating that ambient air contamination is one of the most significant risk factors causing non-infectious diseases. Adverse effects produced on health are the most evident among sensitive population groups (women, children, and elderly people).

It was noted that risk management with well-grounded choice on the most efficient activities aimed at its minimization was rather rare in Russia; it is a key problem related to practical implementation of health risk analysis methodology in the country.
We highlighted that health risk analysis methodology was successfully applied when “Pure air” federal project was im-plemented within “Ecology” national project.

We recommended basic stages in assessing efficiency of activities aimed at health risk management, reducing population morbidity and mortality, creating comfortable and favorable urban environment in 12 cities that participated in “Pure air” federal project.

The article also contains suggestions on a unified algorithm based on economic estimation of alternative health risk man-agement techniques and ways to provide sanitary-epidemiologic welfare. The algorithm includes substantiating a necessity to perform examinations and health risk assessment under “basic” exposure, and determining priority problems; assessing residu-al health risks after each considered activity, assessing efficiency of technological, economic, and health-influencing activities; comparative health risk assessment; health risks ranking taking into account additional effects, as well as technological and economic efficiency; substantiating choice on the most optimal activities and presenting conclusions to decision-makers in the field; giving grounds for a decision being taken.

risk analysis, risk assessment, risk management, economic estimation, economic efficiency, population health, sanitary-epidemiologic welfare of the population, “Pure air” federal project, ambient air contamination
Rakitskii V.N., Avaliani S.L., Novikov S.M., Shashina T.A., Dodina N.S., Kislitsin V.A. Health risk analysis related to exposure to ambuent air contamination as a component in the strategy aimed at reducing global non-infectious epidemics. Health Risk Analysis, 2019, no. 4, pp. 30–36. DOI: 10.21668/health.risk/2019.4.03.eng
  1. Neinfektsionnye zabolevaniya i zagryaznenie atmosfernogo vozdukha [Non-infectious diseases and ambient air contamination]. World Health Organization, 2019, 12 p. Available at: (01.12.2019) (in Russian).
  2. Air pollution. World Health Organization, 2018. Available at: (01.12.2019).
  3. Global Health Observatory – Data repository. World Health Organization, 2018. Available at: (01.12.2019).
  4. Health risks of air pollution in Europe – HRAPIE project Recommendations for concentration–response functions for cost–benefit analysis of particulate matter, ozone and nitrogen dioxide. World Health Organization, 2013, 60 p.
  5. Landrigan P.J., Fuller R., Acosta N.J.R., Adeyi O., Arnold R., Basu N.N., Baldé A.B., Bertollini R. [et al.]. The Lancet Commission on pollution and health. Lancet, 2018, vol. 3, no. 391, pp. 462–512. DOI: 10.1016/S0140-6736(17)32345-0 pmid:29056410
  6. Gayer A., Adamkiewicz Ł., Mucha D., Badyda A. Air quality health indices – Review. MATEC Web of Conferences, 2018, vol. 247, pp. 00002. DOI: 10.1051/matecconf/201824700002
  7. Revich B.A., Avaliani S.L., Simons G.J. Air pollution and public health in a megalopolis: a case study of Moscow. Ekonomika regiona, 2016, vol. 12, no. 4, pp. 1069–1078.
  8. Draft WHO global strategy on health, environment and climate change. World Health Organization, 2018. Available at: (10.12.2019).
  9. Shartova N., Konstantinov P., Shaposhnikov D., Revich B. Сardiovascular mortality during heat waves in temperate climate: an association with bioclimatic indices. International Journal of Environmental Health Research, 2018, vol. 28, no. 5, pp. 522–534. DOI: 10.1080/09603123.2018.1495322
  10. Revich B.A., Shaposhnikov D.A., Anisimov O.A., Belolutskaya M.A. Impact of temperature waves on the health of residents in cities of the northwestern region of Russia. Problemy prognozirovaniya, 2019, vol. 3, no. 174, pp. 127–134 (in Russian).
  11. Popova A.Yu. Strategic priorities of the Russian Federation in the field of ecology from the position of preservation of health of the nation. Zdorov'e naseleniya i sreda obitaniya, 2014, vol. 251, no. 2, pp. 4–7 (in Russian).
  12. WHO Expert Meeting: Methods and tools for assessing the health risks of air pollution at local, national and international level. World Health Organization, 2014, 112 p. (in Russian).
  13. Zaitseva N.V. Effektivnost' i rezervy dostizheniya strategicheskikh prioritetov v snizhenii neinfektsionnykh zabolevanii, svyazannykh s faktorami okruzhayushchei sredy [Efficiency and reserves for achieving strategic priority goals in reducing non-infectious diseases related to environmental factors]. Aktual'nye voprosy analiza riska pri obespechenii sanitarno-epidemiologicheskogo blagopoluchiya naseleniya i zashchity prav potrebitelei: sbornik po materialam IX Vserossiiskoi nauchno-prakticheskoi konferentsii s mezhdunarodnym uchastiem. In: A.Yu. Popova, N.V. Zaitseva eds. Perm, 2019, pp. 7–12 (in Russian).
  14. Sostoyanie zagryazneniya atmosfery v gorodakh na territorii Rossii za 2018 god. Ezhegodnik [Ambient air contamination in cities in Russia in 2018. Annual edition]. Sankt-Peterburg, Federal'naya sluzhba po gidrometeorologii i monitoringu okruzhayushchei sredy (Rosgidromet), Glavnaya geofizicheskaya observatoriya im. A.I. Voeikova Publ., 2019, 251 p. (in Russian).
  15. Rakhmanin Y.A., Novikov S.М., Аvаliani S.L., Sinitsyna O.O., Shashina T.A. Actual problems of environmental factors risk assessment on human health and ways to improve it. Health Risk Analysis, 2015, no. 2, pp. 4–14 (in Russian). DOI: 10.21668/health.risk/2015.2.01.eng
  16. Novikov S.M., Fokin M.V., Unguryanu T.N. Actual problem of methodology and development of evidence-based health risk assessment associated with chemical exposure. Gigiena i sanitariya, 2016, vol. 95, no. 8, pp. 711–716 (in Russian).
  17. Onishchenko G.G., Novikov S.M., Rakhmanin Yu.A., Avaliani S.L., Bushtueva K.A. Osnovy otsenki riska dlya zdorov'ya naseleniya pri vozdeistvii khimicheskikh veshchestv, zagryaznyayushchikh okruzhayushchuyu sredu [Basics of health risk assessment under exposure to chemicals that pollute the environment]. In: Yu.A. Rakhmanin, G.G. Onishchenko eds. Moscow, Nauchno-issledovatel'skii institut ekologii cheloveka i gigieny okruzhayushchei sredy imeni A.N. Sysina Publ., 2002, 408 p. (in Russian).
  18. Onischenko G.G. Health risk assessment and management as an effective tool to solve issues to ensure the health and epidemiological well-being of the Russian Federation population. Health Risk Analysis, 2013, no. 1, pp. 4–14 (in Russian). DOI: 10.21668/health.risk/2013.1.01.eng
  19. Onishchenko G.G., Zaitseva N.V., May I.V., Shur P.Z., Popova A.Yu., Alekseev V.B., Dolgikh O.V., Zemlyanova M.A. [et al.]. Analiz riska zdorov'yu v strategii gosudarstvennogo sotsial'no-ekonomicheskogo razvitiya [Health risk analysis in the strategy for the state social and economic development]. In: G.G. Onishchenko, N.V. Zaitseva eds. Moscow, Perm, Izdatel'stvo permskogo natsional'nogo issledovatel'skogo politekhnicheskogo universiteta Publ., 2014, 738 p. (in Russian).
  20. WHO Regional Office for Europe, OECD (2015). Economic cost of the health impact of air pollution in Europe: Clean air, health and wealth. World Health Organization. Copenhagen, WHO Regional Office for Europe Publ., 2015, 54 p.
  21. Popova A.Yu., Gurvich V.B., Kuz'min S.V., Mishina A.L., Yarushin S.V. Modern issues of the health risk assessment and management. Gigiena i sanitariya, 2017, vol. 96, no. 12, pp. 1125–1129 (in Russian).
  22. Avaliani S.L., Bushtueva K.A., Gudkevich A.Z. [et al.]. Obosnovanie prioritetnosti prirodookhrannykh meropriyatii v Samarskoi oblasti na osnove effektivnosti zatrat po snizheniyu riska dlya zdorov'ya naseleniya [Substantiating priorities in environmental measures in Samara region based on cost effectiveness of activities aimed at reducing population health risks]. Moscow, Konsul'tatsionnyi tsentr po otsenke riska Publ., 1999, 209 p. (in Russian).
    1. Avaliani S.L., Novikov S.M., Bushtueva K.A. [et al.]. Upravlenie riskom dlya zdorov'ya v regione i finansirovanie prirodookhrannykh proektov (na primere Velikogo Novgoroda) [Health risk management in a region and funding for environmental projects (on the example of Velikiy Novgorod)]. Moscow, Tsentr ekologo-gigienicheskikh issledovanii Publ., 1999, 65 p. (in Russian).
  23. Gurvich V.B., Kuzmin S.V., Dikonskaya O.V., Malykh O.L., Yarushin S.V. Health risk management to provide health and epidemiological well-being to the population in municipalities (the experience of the Sverdlovsk region). Health Risk
    Analysis, 2013, no. 3, pp. 64–74. DOI: 10.21668/health.risk/2013.3.08.eng
  24. Onishchenko G.G., Popova A.Yu., Zaitseva N.V., May I.V., Shur P.Z. Health risk analysis in the tasks of improving sanitary and epidemiological surveillance in the Russian Federation. Health Risk Analysis, 2014, no. 2, pp. 4–13. DOI: 10.21668/health.risk/2014.2.01.eng
  25. Avaliani S.L., Novikov S.M., Shashina T.A., Dodina N.S., Kislitsin V.A., Mishina A.L. The urgent problems of the improvement of the environment management system based on the analysis of health risk assessment. Gigiena i sanitariya, 2014, vol. 93, no. 6, pp. 5–9 (in Russian).

You are here