The physical and social impact of traffic-related air ...

The physical and social impact of traffic-related air ...

The physical and social impact of traffic-related air pollution on the health of Scottish residents Dr Jackie Hyland MBChB, MD, MFPHM, MBA Exposure Dynamics Scottish air pollution trends for all regulated emissions, 1990 (baseline) to 2014 Bailey et al., 2016, p13 Forest plot showing the HR results for all cause mortality from exposure to elevated levels of traffic-related NOx/NO2 emissions Forest Plot showing meta analysis for HR for respiratory/lung disease from NOx/NO2 exposure Number of papers reporting each health-related outcome A conceptual model of the main determinants of health (Whitehead et al., 2001, p314) Confounding factors considered in the cohort

studies Scottish (Air Quality) Needs Assessment Study (McAllister and Hyland, 2014) Less than 1% of Scottish residents live in AQMAs Most are aged between 29-40 years (75%) Men (54%) 19% of AQMA residents are in the most deprived quintile. Mortality and hospitalization rates were lower in AQMA residents Reducing air pollution by 13gm3 = reduction AQMA attributable deaths 73 pa by 1gm3 =reduction non-AQMAs 153 attributable deaths. AQMA attributable hospitalisations = 1,961; non-AQMA attributable hospitalisations = 27,517. Record of air pollution levels recorded at air quality monitoring sites in Edinburgh and Glasgow, 20-28th March 2012

NHS 24 calls for air pollution related symptoms one week, during (20/03-28/03/12) and one week after high levels of air pollution recorded in Glasgow and Edinburgh Dundee Ward Areas Coronary Heart Disease Admissions, by Dundee Ward, both sexes, all ages, 2002-2005 Air Pollution - Perceived barriers to change 20 18 16 14 12 10 Number of comments 8 6 4 2 0

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r oo fc o k ac l t or p ns ra t ic bl Pu s on ti op Air Pollution - Perceived incentives for change Number of comments 14

12 10 8 6 4 2 0 s il g e gy ns ns ns sis an od on in lif ra o on y

o o o e o ti l l l n f ti y ti ti ti g a a o p p b rc no

an gr op op an do ,o pl ity r fo fo ht ch te c l y , d t c l i g

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Fr tiv as ra no pu eli ub t/q nt E na n T o p n e D e o c e e rm

rs nc /e pm fo siv nm /i pe gs le o n s n o , I n h ir v vi cle po alt

nv sa de hi es e e l e r e H v r ia e/ nt nc ng sa ctu viz a a ti

u ti n e lu n Fi str Pl ol ce ra p f i/ n in or ise sf nd e is d a g b

Fin in Su n an Pl t or p s an Key themes to encourage behaviour change 6 5 4 Number of comments 3 2

1 0 ier la th He le sty e lif nv re e tt Be t en m n iro

ey on gm iv n Sa l cia So y ilit is b on sp e r e at im l C e

ng a ch ty fe a S e ag m I n tio ti pe m o C n tti e

G nd ou r ga w no d an in re tu u ef th Main mode of travel - large urban, remote rural and Scotland, 2009/2010. (Transport Scotland, 2017)

Type approval (left) and real-world emissions (right) from diesel light duty vehicles across Euro standards. (European Commission, 2013, p22). Estimated premature deaths from urban air pollution exposure, Europe and Scotland Estimated loss of productivity due to air pollution related illness, Europe and Scotland Risk of physical inactivity compared to road accidents, deaths UK, 2008 (Cavill, 2013) The cost comparison for active travel interventions in Scotland, based on YLL and cost per QALY Cost benefit analysis of LEZ in Scotland annual estimated value Conclusions The evidence suggests there is little impact on population health from traffic-related air pollution at current emission levels. There may be health effects for vulnerable individuals but this is difficult to prove. The wider socioeconomic benefits of improving air quality in Scotland must be considered in policy development and

implementation. It is unlikely that the Clean Air For Scotland Strategy will deliver improved air quality and health without substantial investment, better alignment of planning and a greater public engagement to support public and active transport options. This is the first time a health and socioeconomic approach to trafficrelated air pollution from problem to policy has been documented for Scotland. Research Recommendations Source reduction Improve emissions from vehicles Review urban planning. Pathway Investigate how behaviour of individuals leads to increased exposure Health Improve understanding of vulnerability Policy development Assess the costs, opportunity costs and benefits by sector (business, health, society) taking into account changing background levels, new technology and policy implementation over time. Acknowledgements

Professor Peter Donnelly Dr Jo Inchley Professor David Harrison Dr Damien Williams Dr Paul Reynolds Dr Emma Fletcher Dr David McAllister Mr John Dr Malcolm Members of Scottish Transport Emissions Partnership (STEP Dr Colin Ramsay Dr Drew Walker Mrs Lesley Marley

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