The Air and Health Monitoring Program (PSAS) is celebrating its 20th anniversary

Air pollution remains a public health issue in France and around the world. On December 11, 2017, Santé publique France’s Air and Health Program (PSAS) celebrated its 20th anniversary. To mark the occasion, Santé publique France created a storymap that traces the program’s history, highlights the key milestones of the past 20 years, and outlines the challenges ahead.

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PSAS by the Numbers

  • Since the PSAS was established, 120 quantitative health impact assessments (EQIS) have been conducted across 55 French urban areas, representing just over 21 million residents;

  • As part of monitoring the long-term health effects of pollution, a 10 µg/m³ increase in PM2.5 results in a 15% increase in the risk of non-accidental mortality;

  • Fine particulate matter pollution in mainland France accounts for more than 48,000 deaths each year, corresponding to an average loss of life expectancy at age 30 of 9 months.

Storymap - 20 Years of the PSAS

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The Air and Health Monitoring Program of Santé publique France

The Air and Health Monitoring Program (PSAS) was established in 1997 pursuant to the LAURE, the Law on Air and the Rational Use of Energy, of December 30, 1996, whose Article 3 stipulates that "the State shall ensure […] the monitoring of air quality and […] its effects on health."

The PSAS is coordinated by Santé publique France in close collaboration with regional intervention units and relies on a multidisciplinary network of partners (ADEME, AASQA, INERIS, INSERM, LCSQA, WHO, ORS Ile-de-France, etc.) to provide decision-makers with the expertise needed to guide public health policy decisions.

Using the results of epidemiological studies conducted since 1997, the PSAS monitors and characterizes the short- and long-term health effects of air pollution and conducts EQIS. EQIS are methods used to estimate the expected health benefits of actions aimed at reducing pollution levels. The objective is to support local, national, and European public policies for air quality management.

At its inception, the PSAS included 9 cities. Today, 20 French cities—including two in overseas territories—participate in the program, representing more than 15 million residents, which allows for the diversity of air pollution exposure in France to be taken into account.

Cities participating in the PSAS

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Due to climatic conditions, emission reduction policies, and potential changes in emission sources, health risks associated with air pollution are likely to change, and the PSAS will continue to monitor these developments and their impacts on health to best meet societal expectations and protect the health of the population.

Reminders on the impact of air pollution on health

Air pollution remains a major public health issue, as demonstrated by recent publications from Santé publique France, the World Health Organization, and the international literature. In October 2017, The Lancet Commission on Pollution and Health estimated that diseases caused by pollution were responsible for 9 million premature deaths in 2015—accounting for 16% of all deaths worldwide. Of these, 4.2 million annual deaths are attributable to fine particulate matter in ambient air.

Epidemiological, toxicological, and experimental studies highlight the links between exposure to air pollution and various diseases. There are no thresholds below which no health effects would be observed, whether for chronic or acute exposure.

Chronic diseases develop after several years of daily exposure, even at low concentration levels. These conditions are studied through cohort studies (long-term follow-up of a population sample), which show that pollution can cause cancers, cardiovascular diseases (heart attack, angina, stroke, heart rhythm disorders, etc.), and respiratory diseases (asthma, COPD, etc.). Recent studies also point to possible effects on reproduction, the risk of preterm birth, diabetes, children’s neurological development, and dementia in the elderly. By contributing to the development of these diseases, air pollution significantly reduces the quality of life and life expectancy of the population.

The worsening of symptoms of chronic conditions, or acute effects, can occur within a few hours to a few days after exposure, even at low concentrations. The least severe and most common effects include coughing, increased nasal secretions, phlegm, shortness of breath, and irritation of the nose, eyes, and throat… More serious effects, such as respiratory or cardiovascular issues, may also occur and lead to hospitalization or even death.

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