Air pollution indoors and outdoors are the environmental factors with the greatest impact on health in Europe and are responsible for the largest burden of environment-related disease. Recent estimates indicate that 20 million Europeans suffer from respiratory problems every day. Particulate matter and especially small particles with a diameter less than 2.5 micrometres (PM2.5) are associated with increased mortality, especially from cardiovascular and cardiopulmonary diseases.
Asthma is increasing all over Europe, although there is a significant variation between EU-25 countries. The societal cost of asthma has been estimated at EUR 3 billion/year. Clearly, asthmatic persons, and particularly asthmatic children, are sensitive to air quality and several studies show a strong association between exposure to air pollution and the aggravation of asthma. To what extent air pollution initiates asthma is unclear.
Cancer in European children younger than 15 years of age is in general terms rare but remains one of the most common causes of death in children in industrialised countries. Radon exposure is the bestdocumented environment-related cause of cancer but is localised in geographical areas where radon precursors (uranium) occur naturally in the ground.
A number of chemicals are potentially carcinogenic. Approximately 500 are classified as carcinogens and are legally not allowed to reach the consumer. They may, however, reach the environment via diffuse sources, for instance in accidental cases. Arsenic in drinking water and cadmium from diffuse sources are environmental contaminants of special concern, because of increasing environmental exposure and their suspected carcinogenicity.
Every European citizen is today exposed to electromagnetic fields (EMF) which can be characterised in terms of their frequency and amplitude. Neither experimental studies on animals nor epidemiological studies have come to any conclusive results. On the basis of current scientific knowledge it is not possible to answer 'yes' or 'no' to the question of whether the use of mobile phones poses an increased risk of cancer.
Mercury and lead at concentrations that are sometimes observed in the environment are well known to have neurodevelopmental effects.
Environmental noise is probably the environmental factor that affects the largest number of Europeans. The main health risks of noise are annoyance, interference with social behaviour and speech communication, sleep disturbance and all its consequences, cardiovascular effects, hormonal responses and poor performance at work or school.
Endocrine disruptors are substances that interfere with hormone-dependent functions in the body such as embryonic development, production of sperm, control of the menstrual cycle, the onset of puberty and cancers in hormone-dependent tissues. Worldwide, a decline in semen quality has been observed over the past 50 years but no clear connection to endocrine disrupters has been established.
Every European citizen has man-made chemical contaminants in his or her body. Bio-monitoring of different populations clearly shows an increased body burden of some persistent and bioaccumulative substances, but concentrations of other substances are decreasing.