Background: Environmental health effects vary considerably with regard to their severity, type of disease, and duration. Integrated measures of population health, such as environmental burden of disease (EBD), are useful for setting priorities in environmental health policies and research. This review is a summary of the full Environmental Burden of Disease in European countries (EBoDE) project report. Objectives: The EBoDE project was set up to provide assessments for nine environmental risk factors relevant in selected European countries (Belgium, Finland, France, Germany, Italy, and the Netherlands). Methods: Disability-adjusted life years (DALYs) were estimated for benzene, dioxins, secondhand smoke, formaldehyde, lead, traffic noise, ozone, particulate matter (PM2.5), and radon, using primarily World Health Organization data on burden of disease, (inter)national exposure data, and epidemiological or toxicological risk estimates. Results are presented here without discounting or age-weighting. Results: About 3–7% of the annual burden of disease in the participating countries is associated with the included environmental risk factors. Airborne particulate matter (diameter ≤ 2.5 μm; PM2.5) is the leading risk factor associated with 6,000–10,000 DALYs/year and 1 million people. Secondhand smoke, traffic noise (including road, rail, and air traffic noise), and radon had overlapping estimate ranges (600–1,200 DALYs/million people). Some of the EBD estimates, especially for dioxins and formaldehyde, contain substantial uncertainties that could be only partly quantified. However, overall ranking of the estimates seems relatively robust. Conclusions: With current methods and data, environmental burden of disease estimates support meaningful policy evaluation and resource allocation, including identification of susceptible groups and targets for efficient exposure reduction. International exposure monitoring standards would enhance data quality and improve comparability. Citation: Hänninen O, Knol AB, Jantunen M, Lim TA, Conrad A, Rappolder M, Carrer P, Fanetti AC, Kim R, Buekers J, Torfs R, Iavarone I, Classen T, Hornberg C, Mekel OC, EBoDE Working Group. 2014. Environmental burden of disease in Europe: assessing nine risk factors in six countries. Environ Health Perspect 122:439–446; http://dx.doi.org/10.1289/ehp.1206154

Motivated by growing considerations of the scale, severity, and risks associated with human exposure to indoor particulate matter, this work reviewed existing literature to: (i) identify state‐of‐the‐art experimental techniques used for personal exposure assessment; (ii) compare exposure levels reported for domestic/school settings in different countries (excluding exposure to environmental tobacco smoke and particulate matter from biomass cooking in developing countries); (iii) assess the contribution of outdoor background vs indoor sources to personal exposure; and (iv) examine scientific understanding of the risks posed by personal exposure to indoor aerosols. Limited studies assessing integrated daily residential exposure to just one particle size fraction, ultrafine particles, show that the contribution of indoor sources ranged from 19% to 76%. This indicates a strong dependence on resident activities, source events and site specificity, and highlights the importance of indoor sources for total personal exposure. Further, it was assessed that 10–30% of the total burden of disease from particulate matter exposure was due to indoor‐generated particles, signifying that indoor environments are likely to be a dominant environmental factor affecting human health. However, due to challenges associated with conducting epidemiological assessments, the role of indoor‐generated particles has not been fully acknowledged, and improved exposure/risk assessment methods are still needed, together with a serious focus on exposure control.

Indoor environmental conditions (thermal, noise, light, and indoor air quality) may affect workers’ comfort, and consequently their health and well-being, as well as their productivity. This study aimed to assess the relations between perceived indoor environment and occupants’ comfort, and to examine the modifying effects of both personal and building characteristics. Within the framework of the European project OFFICAIR, a questionnaire survey was administered to 7441 workers in 167 “modern” office buildings in eight European countries (Finland, France, Greece, Hungary, Italy, The Netherlands, Portugal, and Spain). Occupants assessed indoor environmental quality (IEQ) using both crude IEQ items (satisfaction with thermal comfort, noise, light, and indoor air quality), and detailed items related to indoor environmental parameters (e.g., too hot/cold temperature, humid/dry air, noise inside/outside, natural/artificial light, odor) of their office environment. Ordinal logistic regression analyses were performed to assess the relations between perceived IEQ and occupants’ comfort. The highest association with occupants’ overall comfort was found for “noise”, followed by “air quality”, “light” and “thermal” satisfaction. Analysis of detailed parameters revealed that “noise inside the buildings” was highly associated with occupants’ overall comfort. “Layout of the offices” was the next parameter highly associated with overall comfort. The relations between IEQ and comfort differed by personal characteristics (gender, age, and the Effort Reward Imbalance index), and building characteristics (office type and building’s location). Workplace design should take into account both occupant and the building characteristics in order to provide healthier and more comfortable conditions to their occupants.