 So I'm Vlatka and I'm out of voice at the moment. So I will be speaking about health without my personal health. If you have problems hearing me, you have to shout out because obviously I cannot know. I will keep very close to microphone and afterwards I would like countries to disinfect this microphone. Okay, so let's start. As you know, WHO World Health Organization is saying alarming things that air pollution is driving global health crisis, that it has certain numbers of millions that's worldwide, but most of the population living in the planet are exposed to unsafe limits for the air pollution. And what's of course interesting is that air pollution is a mixture of gases like SO2 and NOXs and particles, which then later on is very important for health, because for example particles on those we can have some heavy metals that are then influencing health or gases can make secondary particles and so on. The complexity of air pollution is important and it's kind of difficult as well for health to then make links. So what are particles? So the particles are small compounds, let's say, we separate them by mass or by size. And in this graph we see the concentration in total of particles, how much of those are PM10, so you see that in the right side that it's quite low and the most of the particles are actually smaller than PM2.5 or finer or ultra fine particles, which then means something else for health and this is that they can go very deep into lungs. So here we are. So this graph shows the position fraction per particle diameter. So as you see in upper respiratory tract you can have mostly bigger particles like PM10. Then as you go lower and lower smaller particles of PM2.5 or lower ultra fine particles are deposited. And then of course this means something for how long it will stay in your body basically. So for deposition in Avleoli, so these are the small tissue in the lungs that are making them transfer oxygen. The smallest particles are deposited and then of course the clearance can last for years afterwards mechanism. So two main things are that why particles are important. These are for ultra fine particles but the same goes for larger particles. It affects cellular level which means cells and it affects as well circulation. So in terms of a cellular level or if it affects on a cell it can do oxidative stress which basically means damages to a cell or it can do inflammation. And then of course this means later on that there will be certain dysfunction in vasoconstriction or so your blood vessels will constrict and dilate less flexible which then means of course that you will have problems with adapting to either low temperatures or high temperatures and there will be more chances that you will develop then for example stroke through this and so on. And another influence of this oxidative stress and inflammation is on blood coagulability which then makes a link with this vasoconstriction or dilatation. Basically your blood is coagulated more and your vessels are not as flexible so which is like a double problem. So this is on a cellular level and then on a circulation level is basically that particles are deposited into lungs and then as same as oxygen is going via red blood cells same particles can do so they can be transferred to blood and then via blood they can go into heart, into brain, into liver, bone marrow and so on. So there will be two ways or two mechanisms how this will affect your health. This lovely graph or table shows basically I wanted to express like what are the WHO limits or World Health Organization and what are EU limit values. So for example for SO2 you see how much higher EU limits are or for example particulate matter. It's 2.5 fold for PM2.5 or 2 fold for PM10 which brings another question. For NO2 basically WHO limits are the same as EU levels, limit levels and those are basically somehow saying that this limit of 40 micrograms per meter cube is the value that will avoid most severe exposure problems while for the PM2.5 and PM2.10 concentration there is discrepancy in between the limit values. So for example WHO is saying okay after we have certain amount of evidence that will show that after 10 micrograms per cubic meter there will be severe or more severe exposure and more severe health effects. That's why we cut off at this point while US has a different cut off point and EU is quite behind so 25 micrograms per meter square. Okay this is a number of studies showing non-linear correlation with how much you are exposed to PM2.5, concentrations of 2.5. Basically what I wanted to say with these two graphs is that for example in Lufthad and you have a cut off point or saying the good air quality of PM2.5 is something around 20 or 40 which is totally meaningless. It's basically, this is totally my opinion, saying the values are based on what, on policy that currently exists, that is currently under process of review and that is politically agreed. So it's not even scientifically proven. It doesn't, or like there is basically something we have to check also okay we are seeing the air quality is good or not but what this means like under which, what is then good and we have to define this, whether is it for health or is it just some scale that we developed and we agreed okay this will be a good or not. So this is maybe a point to take home and then think about later on when we want to think okay these measurements that we are doing for what, for environment, for health, for climate and then we can develop a scale or at least have a rationale why we are using this scale. In terms of exact numbers like affecting health, so I prepared this graphic on increased risk for health impacts and there is difference between long-term exposure and short-term exposure and we are different kind of meta-analysis, scientific agreement at the current level is that like every increase of 10 micrograms of PM 2.5 or 20 micrograms of PM 10 will increase for example mortality by 6.2 on a population level. So this might not seem much, 6.2, but if you take whole of Belgium and calculate that this or how many Belgians are exposed to higher concentrations than 10 micrograms per meter square, a meter cube, then you will get a pretty high number. And the same goes as well for the arrest, like infant mortality, for prevalence of bronchitis, for asthma attacks, for hospital admissions and so on. And now one super nice slide, because I heard that most of you are programmers and you're like numbers and you're like as well. A lot of texts may be in a code, but I thought, okay, you might like this slide. So this is something that WHO developed, basically it's showing a summary of all the evidence and then meta-analysed together forming parameters were taken in. So like mortality, different kind of mortality, infant mortality or adult mortality, then different kind of hospitalization for respiratory disease, then you have cardiovascular disease, hospitalization and so on, prevalence and incidence of bronchitis and asthma among adults and among children and then lost working days. And those are all numbers for if you see pollutant, PM or ozone. Very little is for NOx and there is a reason why. And relative risk means basically by each 10% micrograms increase, you will get additional, so 1.062 in the first line basically means 6.2% of increase. In all cause mortality age, 30 plus I think. So just for you so you can interpret this kind of data and then maybe even use it in your calculations. This is something from WHO saying that around third of all lung cancer or stroke on heart disease are basically attributed to air pollution. For lung cancer probably the rest of 2.3 are for smoking, for stroke or some other risk factors and so on. And this graph goes together with why are we speaking about PM mostly in NO3 or ozone because there are a lot of publications around PM. So it's more easy to segregate PM and do analysis on that. While for NOx much less is done. Mainly because it's kind of scientist found out that it needs to be adjusted at 4 PM and because it's quite difficult to measure, blah, they are less prone to do the scientific measurements around this. But this does not mean that we should not take it seriously. So we should not measure NOx or we should not think how this affects health. Basically absence of evidence is not evidence of absence. So as time progresses we develop the methods for including measurements of NOx on our health. The data will probably grow bigger of course and the knowledge. So this is one thing that Committee on Medical Effects of Air Pollution from UK did and this is I think the biggest report on NO2 and health and how much it affects our health. So basically like 23% of one policy reduction of all traffic pollutants would have influence on all cause mortality I think and so on. And one last thing is why are different numbers for premature deaths according to different sources? So basically the answer is in the methods that they are using for example global burden of disease uses different kind of concentrations and CREIT on which they are looking the concentrations. They are using different kind of pollution so not just outdoor air pollution but also indoor air pollution and they are coding their health outcomes differently. So for EEA or European Environmental Agency they are not coding it so they are just taking all of the causes together while global burden of disease takes only four. Strokes, ischemic heart disease, COPD, some lung cancer and so on. So these basically mean that you should not compare the number of deaths from different sources rather look at as a relative number in this pile of numbers and not comparing the numbers. And to finally conclude that people in Europe are breathing a little bit cleaner air than five years ago so there is things that we can do and that we should do to improve our health. Nature-wise is there a simple explanation in this case? Is it that not being part of the meta-vehicle industry? Maybe. No, I think it's back then when Europe developed directive which was in 2002 if I'm not mistaken. There was just not so much evidence that they would and there were not so much evidence in Europe so this is one of the problems where for example database that exists in US it's so huge through Medicare and they are much better in just analyzing strokes together than they pair it with the data from the measurement stations and then see how it correlates to the hospital admissions and so on. And I think nowadays in Europe we have a big pool of data so I think now when air quality directive revision starts this year that there will be a big scientific community that will then want to influence this limit values but I think there is also work to do from the citizens. They need to be also aware of their role to demand lower limit values. On that note as well most of the countries in Europe are even struggling with reaching the EU level limit values now so I think 12 countries are being, steps are taken by commission to put them on court for breaching the limit so I don't know there will be a big opposition I think from the member states as well. Thank you.