Methodologies for Assessing the Real Costs to Health of Environmental Stressors.

The Horizon Europe project MARCHES will further develop and refine a methodology to assess health costs of environmental stressors, and bring the findings to use in six European regions.

The air we breathe and the water we drink provide essential life-support to humans and are critical to the opportunities for maintaining good health throughout a lifetime. Air pollution is currently considered the largest environmental burden in Europe causing about 350,000 premature deaths annually. Drinking water quality is compromised in many parts of Europe from the leaching of agricultural fertilizer nitrates that have been found to trigger cancers from long-term exposures at low concentrations.

To underpin regular use of integrated economic and health modeling in impact assessments and socioeconomic analysis by public authorities, the MARCHES project aims to advance methodological rigor and consistency in accounting for the welfare economic health costs of air pollution and drinking water nitrate, based on systematic reviews of health effects, and by extending the consensus on established approaches on premature mortality with disability-adjustment of the associated morbidity burdens, while developing European-wide exposure modeling for integrated assessment.

Guidelines and unit prices
The MARCHES project will provide guidelines and unit prices for socio-economic analysis that can be applied routinely by EU and national authorities. Upon expert and stakeholder consultations, this will be demonstrated in case studies with public authorities in five Member States (Denmark, the Czech Republic, Estonia, Spain and Sweden) and in one west-Balkan country (Kosovo).

Total project funding is €4M and the project runs from 1.1.2023 to 31.12.2026.

The MARCHES project will go beyond state-of-the-art by:

  • identifying exposure-response functions for novel health end-points
  • by adding a disability dimension to health cost accounting
  • setting a European standard for high-quality exposure modeling
  • addressing drinking water nitrates with impact-pathway analysis.

It will have ambition by developing guidelines for how future impact assessments specifically can integrate health costs of air and drinking water pollution, with methodological implications for how to account for environmental stressors in general.

Air pollution
For air pollution, the MARCHES project gives priority to the morbidity impacts asthma incidence, lung cancer and chronic obstructive pulmonary disease (COPD).

Additionally, the MARCHES project will address a series of ‘new’ outcomes from air pollution identified in the health literature such as diabetes, cognitive disorders/dementia, Parkinson’s disease, low birth weight and depression to investigate whether evidence from the recently published systematic reviews is sufficiently robust to allow for inclusion in impact assessments in a European setting, and what the relevant exposure-response functions are.

Drinking water nitrate
For drinking water nitrate, the project gives priority to cancers related to gastro-intestinal sites (e.g. stomach cancer and colon cancer) and impacts on infants in terms of adverse birth outcomes and methemoglobinemia.