Transport-related measures to mitigate climate change in Basel, Switzerland: A health-effectiveness comparison study

Electric vehicles and health: A scoping review

BACKGROUND

The health impacts of the rapid transition to the use of electric vehicles are largely unexplored. We completed a scoping review to assess the state of the evidence on use of battery electric and hybrid electric vehicles and health.

METHODS

We conducted a literature search of MEDLINE, Embase, Global Health, CINAHL, Scopus, and Environmental Science Collection databases for articles published January 1990 to January 2024. We included articles if they presented observed or modeled data on the association between battery electric or hybrid electric cars, trucks, or buses and health-related outcomes. We abstracted data and summarized results.

RESULTS

Out of 897 reviewed articles, 52 met our inclusion criteria. The majority of included articles examined transitions to the use of electric vehicles (n = 49, 94%), with fewer studies examining hybrid electric vehicles (n = 11, 21%) or plug-in hybrid electric vehicles (n = 8, 15%). The most common outcomes examined were premature death (n = 41, 79%) and monetized health outcomes such as medical expenditures (n = 33, 63%). We identified only one observational study on the impact of electric vehicles on health; all other studies reported modeled data. Almost every study (n = 51, 98%) reported some evidence of a positive health impact of transitioning to electric or hybrid electric vehicles, although magnitudes of association varied. There was a paucity of information on the environmental justice implications of vehicle transitions.

CONCLUSIONS

The results of the current literature on electric vehicles and health suggest an overall positive health impact of transitioning to electric vehicles. Additional observational studies would help expand our understanding of the real-world health effects of electric vehicles. Future research focused on the environmental justice implications of vehicle fleet transitions could provide additional information about the extent to which the health benefits occur equitably across populations.

Towards a Swiss health study with human biomonitoring: Learnings from the pilot phase about participation and design

BACKGROUND

A large-scale national cohort aiming at investigating the health status and determinants in the general population is essential for high-quality public health research and regulatory decision-making. We present the protocol and first results of the pilot phase to a Swiss national cohort aiming at establishing the study procedures, evaluating feasibility, and assessing participation and willingness to participate.

METHODS

The pilot phase 2020/21 included 3 components recruited via different channels: a population-based cross-sectional study targeting the adult population (20-69 years) of the Vaud and Bern cantons via personal invitation, a sub-study on selenium in a convenience sample of vegans and vegetarians via non-personal invitation in vegan/vegetarian networks, and a self-selected sample via news promotion (restricted protocol). Along with a participatory approach and participation, we tested the study procedures including online questionnaires, onsite health examination, food intake, physical activity assessments and biosample collection following high-quality standards.

RESULTS

The population-based study and the selenium sub-study had 638 (participation rate: 14%) and 109 participants, respectively, both with an over-representation of women. Of altogether 1349 recruited participants over 90% expressed interest in participating to a national health study, over 75% to contribute to medicine progress and help improving others' health, whereas about one third expressed concerns over data protection and data misuse.

CONCLUSIONS

Publicly accessible high-quality public health data and human biomonitoring samples were collected. There is high interest of the general population in taking part in a national cohort on health. Challenges reside in achieving a higher participation rate and external validity. For project management clear governance is key.

Health benefits from cleaner vehicles and increased active transportation in Seattle, Washington

BACKGROUND

Climate mitigation policies that focus on the transportation sector yield near-term health co-benefits that could motivate policy action.

OBJECTIVE

We quantified CO₂ emission reductions as well as the air pollution and health benefits of urban transportation policies promoting electric vehicles (EV) and walking and bicycling in Seattle, Washington.

METHODS

We compared a business-as-usual scenario projected to 2035 with intervention scenarios in which 35% of gasoline vehicles were switched to EV, and 50% of car trips less than 8 kilometers were replaced by walking or bicycling. We modeled changes in primary traffic-generated oxides of nitrogen (NO_x) and fine particulate matter (PM_2.5) as well as walking and bicycling activity, CO₂ emissions from traffic, and fatal traffic injuries due to the transportation policy scenarios. We estimated the impacts of these changes on annual cases of asthma and premature mortality in the Seattle population.

RESULTS

Increasing the use of EV, walking, and bicycling is estimated to reduce CO₂ emissions by 744 tons/year (30%) and lower annual average concentrations of primary traffic-generated NO_x and PM_2.5 by 0.32 ppb (13%) and 0.08 μg/m³ (19%), respectively. In Seattle, the lower air pollutant concentrations, greater active transportation, and lower fatal traffic injuries would prevent 13 (95% CI: -1, 28), 49 (95% CI: 19, 71), and 5 (95% CI: 0, 14) premature deaths per year, respectively and 20 (95% CI: 8, 27) cases of asthma per year.

SIGNIFICANCE

Moving towards cleaner vehicles and active transportation can reduce CO₂ emissions, improve air quality, and population health. The resulting public health benefits provide important motivation for urban climate action plans.

IMPACT STATEMENT

Using key components of the health impact assessment framework, we quantify the environmental and health benefits of urban transportation policy scenarios that promote electric vehicle use and replace short car trips with walking and bicycling as compared with a business as usual scenario in 2035. Our findings demonstrate that transportation scenarios promoting cleaner vehicles and active transportation can reduce CO₂ emissions, improve air quality, and increase physical activity levels, resulting in significant public health benefits.

Vehicular Traffic in Urban Areas: Health Burden and Influence of Sustainable Urban Planning and Mobility

Vehicular traffic is one of the major sources of air pollution in European cities. This work aims to understand which characteristics of the urban environment could influence mobility-related air pollution, quantify the health impacts of exposure to traffic-derived PM2.5 and NO2 concentrations, and assess the potential health benefits expected from traffic interventions. The health benefits modeled are intended to provide a set of comparable data to support decision-makers and encourage informed decision-making to design healthier cities. Targeting a large geographical coverage, 12 European cities from 9 countries were comparatively assessed in terms of mean daily traffic volume/area, the number of public transport stops/area, and the percentage of green and outdoor leisure areas, among other urban indicators. This was implemented using an open-source data mining tool, which was seen as a useful engine to identify potential strategies to improve air quality. The comparison of urban indicators in the selected cities evidenced two trends: (a) cities with the most heterogeneous distribution of public transport stops, as an indicator of poor accessibility, are also those with the lowest proportion of km dedicated to cycleways and footways, highlighting the need in these cities for more sustainable mobility management; and (b) the percentage of green and outdoor leisure areas may influence the share of journeys by bicycle, pointing out that promoting the perception of green routes is relevant to enhance the potential of active transport modes. Socioeconomic factors can be key determinants of the urban indicators and would need further consideration. For the health impact assessment (HIA), two baseline scenarios were evaluated and compared. One is based on mean annual traffic contributions to PM2.5 concentrations in each target city (ranging between 1.9 and 13 µg/m3), obtained from the literature, and the second is grounded on mean annual NO2 concentrations at all available traffic and urban background stations within each city (17.2–83.5 µg/m3), obtained from the European Environment Agency database. The intervention scenarios modeled were designed based on traffic mitigation strategies in the literature, and set to ranges of 6–50% in traffic-derived PM2.5 concentrations and of 4–12.5% in NO2 concentrations. These scenarios could result in only a 1.7% (0.6–4%) reduction in premature mortality due to exposure to traffic-derived PM2.5, and 1.0% (0.4–2%) due to exposure to NO2, as the mean for all the cities. This suggests that more ambitious pollution abatement strategies should be targeted.

Study protocol of the European Urban Burden of Disease Project: a health impact assessment study

INTRODUCTION

Cities have long been known to be society's predominant engine of innovation and wealth creation, yet they are also hotspots of pollution and disease partly due to current urban and transport practices. The aim of the European Urban Burden of Disease project is to evaluate the health burden and its determinants related to current and future potential urban and transport planning practices and related exposures in European cities and make this evidence available for policy and decision making for healthy and sustainable futures.

METHODS AND ANALYSIS

Drawing on an established comparative risk assessment methodology (ie, Urban and Transport Planning Health Impact Assessment) tool), in nearly 1000 European cities we will (1) quantify the health impacts of current urban and transport planning related exposures (eg, air pollution, noise, excess heat, lack of green space) (2) and evaluate the relationship between current levels of exposure, health impacts and city characteristics (eg, size, density, design, mobility) (3) rank and compare the cities based on exposure levels and the health impacts, (4) in a number of selected cities assess in-depth the linkages between urban and transport planning, environment, physical activity and health, and model the health impacts of alternative and realistic urban and transport planning scenarios, and, finally, (5) construct a healthy city index and set up an effective knowledge translation hub to generate impact in society and policy.

ETHICS AND DISSEMINATION

All data to be used in the project are publicly available data and do not need ethics approval. We will request consent for personal data on opinions and views and create data agreements for those providing information on current and future urban and transport planning scenarios.For dissemination and to generate impact, we will create a knowledge translation hub with information tailored to various stakeholders.

L’évaluation d’impact sur la santé, un outil pour promouvoir des politiques climatiques favorables à la santé

INTRODUCTION

Potential impacts of climate change on health are increasingly studied due to the diversity of the associated risks (heatwaves, air pollution, water- and vector-borne diseases). Consequently, adaptation and mitigation strategies, including tools, have been developed by different cities, states, and organizations to assess the effects of climate change on health.

OBJECTIVE

Health impact assessment (HIA) is a tool that could be used to assess the potential health impacts of climate change policies before their implementation. The objective of this study is therefore to analyze the way HIA is used in the development of these policies.

METHOD

A scoping review of grey and scientific literature in French and English (period: 1990-2019) allowed us to identify 35 articles and reports, with 6 using HIA specifically. The areas of HIA application related to transport, urban planning or the building sector. The main health issues addressed in these HIAs concerned air, noise, physical activity, urban heat islands, green spaces, and functional diversity.

RESULTS

These studies have shown that HIA is an approach that can facilitate cross-sectoral collaboration, and its flexibility allows for its application to adaptation and mitigation policies, as well as at several spatial scales (cities, regions).

DISCUSSION

The principal limitation in this approach relates to uncertainties associated with quantifying projected impacts.

Tools and Methods to Include Health in Climate Change Adaptation and Mitigation Strategies and Policies: A Scoping Review

Climate change represents a serious threat to the health and well-being of populations. Today, many countries, regions, and cities around the world are implementing policies and strategies to adapt to climate change and mitigate its effects. A scoping review was performed to identify tools and methods that help integrate health into climate change adaptation and mitigation policies and strategies. The literature search includes scientific and grey literature. The scientific literature was conducted using PubMed, Elsevier Embase, and Web of Science databases. A grey literature web search was performed to complement the results. A total of 35 studies (28 from the scientific literature and 7 from the grey literature) were finally included. A large majority of research articles (24/28) and almost all reports (6/7) from the grey literature were published after 2010. Results show that the tools that were found most frequently are the nested models (12/35), health impact assessment (6/35), vulnerability and adaptation assessment (3/35), conceptual frameworks (3/35), and mixed methods (3/35). This review shows an increasing interest in the topic of developing tools to better manage health issues in adaptation and mitigation strategies, with a recent increase in the number of publications. Additional analyses of tools’ effectiveness should be conducted in further studies.

Impacts of a climate change initiative on air pollutant emissions: Insights from the Covenant of Mayors

The Covenant of Mayors (CoM) is a successful European initiative which encourages local authorities to be proactive in fighting climate change. Recently, it expanded to cover adaptation and energy access/poverty and became a global initiative. In this study we investigate an additional perspective: synergies and trade-offs between climate and air quality. Signatories pledge to reduce their Greenhouse gas (GHG) emissions and voluntarily report their emissions, energy consumption and the measures that they carry out to reach their goals. We develop a methodology to estimate air pollutant emissions corresponding to CO₂ emissions CoM signatories report, using information they already submit and national estimates of air pollutant emission factors. The methodology is applied to over 1600 signatories in Europe, representing over 80 million inhabitants. Results show that, in general, signatories are reducing both types of emissions. However, there are also cases where emissions increase. We explore the reasons behind these changes and highlight the role of technological improvement. This work calls for an increased coherence between climate and air quality plans at the local scale and provides a first step and a tool to support signatories, even the smallest ones, to move in this direction.

Mitigation strategies for reducing air pollution

Today, it is increasingly recognized that air pollution hurts human health. Consequently, efficient mitigation strategies need to be implemented for substantial environmental and health co-benefits. A valid approach to reducing the air pollution effects on the environment and human health is proposed. Specific guidelines have been elucidated by differentiating them on the base of the final stakeholders (citizens, enterprises, and public authorities), of the emission sources (transport, household energy, industry, and energy generation sector, agriculture, and shipping area), and of the field of implementation (urban and extra-urban context). This paper can provide useful information for governments for the implementation of a strategic plan focused on emphasizing multi-pollutant emission reductions and overall air pollution-related risk.

Environmental public health risks in European metropolitan areas within the EURO-HEALTHY project

Urban areas in Europe are facing a range of environmental public health challenges, such as air pollution, traffic noise and road injuries. The identification and quantification of the public health risks associated with exposure to environmental conditions is important for prioritising policies and interventions that aim to diminish the risks and improve the health of the population. With this purpose in mind, the EURO-HEALTHY project used a consistent approach to assess the impact of key environmental risk factors and urban environmental determinants on public health in European metropolitan areas. A number of environmental public health indicators, which are closely tied to the physical and built environment, were identified through stakeholder consultation; data were collected from six European metropolitan areas (Athens, Barcelona, Lisbon, London, Stockholm and Turin) covering the period 2000-2014, and a health impact assessment framework enabled the quantification of health effects (attributable deaths) associated with these indicators. The key environmental public health indicators were related to air pollution and certain urban environmental conditions (urban green spaces, road safety). The air pollution was generally the highest environmental public health risk; the associated number of deaths in Athens, Barcelona and London ranged between 800 and 2300 attributable deaths per year. The number of victims of road traffic accidents and the associated deaths were lowest in the most recent year compared with previous years. We also examined the positive impacts on health associated with urban green spaces by calculating reduced mortality impacts for populations residing in areas with greater green space coverage; results in Athens showed reductions of all-cause mortality of 26 per 100,000 inhabitants for populations with benefits of local greenspace. Based on our analysis, we discuss recommendations of potential interventions that could be implemented to reduce the environmental public health risks in the European metropolitan areas covered by this study.

Estimated health benefits of exhaust free transport in the city of Malmö, Southern Sweden

Air pollution is responsible for one in eight premature deaths worldwide, and thereby a major threat to human health. Health impact assessments of hypothetic changes in air pollution concentrations can be used as a mean of assessing the health impacts of policy, plans and projects, and support decision-makers in choices to prevent disease. The aim of this study was to estimate health impacts attributable to a hypothetical decrease in air pollution concentrations in the city of Malmö in Southern Sweden corresponding to a policy on-road transportations without tail-pipe emissions in the municipality. We used air pollution data modelled for each of the 326,092 inhabitants in Malmö by a Gaussian dispersion model combined with an emission database with >40,000 sources. The dispersion model calculates Nitrogen Oxides (NO_x) (later transformed into Nitrogen Dioxide (NO₂)) and particulate matter with an aerodynamic diameter < 2.5 μg/m³ (PM_2.5) with high spatial and temporal resolution (85 m and 1 h, respectively). The average individual reduction was 5.1 (ranging from 0.6 to 11.8) μg/m³ in NO_2, which would prevent 55 (2% of all deaths) to 93 (4%) deaths annually, depending on dose-response function used. Furthermore, we estimate that the NO₂ reduction would result in 21 (6%) fewer cases of incident asthma in children, 95 (10%) fewer children with bronchitis every year, 30 (1%) fewer hospital admissions for respiratory disease, 87(4%) fewer dementia cases, and 11(11%) fewer cases of preeclampsia every year. The average reduction in PM_2.5 of 0.6 (ranging from 0.1 till 1.7) μg/m³ would mean that 2729 (0.3%) work days would not be lost due to sick-days and that there would be 16,472 fewer restricted activity days (0.3%) that year had all on-road transportations been without tail-pipe emissions. Even though the estimates are sensitive to the dose-response functions used and to exposure misclassification errors, even the most conservative estimate of the number of prevented deaths is 7 times larger than the annual traffic fatalities in Malmö, indicating a substantial possibility to reduce the health burden attributed to tail-pipe emissions in the study area.

Greenhouse gas emissions reduction in different economic sectors: Mitigation measures, health co-benefits, knowledge gaps, and policy implications

To date, greenhouse gas (GHG) emissions, mitigation strategies and the accompanying health co-benefits in different economic sectors have not been fully investigated. The purpose of this paper is to review comprehensively the evidence on GHG mitigation measures and the related health co-benefits, identify knowledge gaps, and provide recommendations to promote further development and implementation of climate change response policies. Evidence on GHG emissions, abatement measures and related health co-benefits has been observed at regional, national and global levels, involving both low- and high-income societies. GHG mitigation actions have mainly been taken in five sectors: energy generation, transport, food and agriculture, household and industry, consistent with the main sources of GHG emissions. GHGs and air pollutants to a large extent stem from the same sources and are inseparable in terms of their atmospheric evolution and effects on ecosystem; thus, GHG reductions are usually, although not always, estimated to have cost effective co-benefits for public health. Some integrated mitigation strategies involving multiple sectors, which tend to create greater health benefits. The pros and cons of different mitigation measures, issues with existing knowledge, priorities for research, and potential policy implications were also discussed. Findings from this study can play a role not only in motivating large GHG emitters to make decisive changes in GHG emissions, but also in facilitating cooperation at international, national and regional levels, to promote GHG mitigation policies that protect public health from climate change and air pollution simultaneously.

Public health co-benefits of greenhouse gas emissions reduction: A systematic review

BACKGROUND AND OBJECTIVES

Public health co-benefits from curbing climate change can make greenhouse gas (GHG) mitigation strategies more attractive and increase their implementation. The purpose of this systematic review is to summarize the evidence of these health co-benefits to improve our understanding of the mitigation measures involved, potential mechanisms, and relevant uncertainties.

METHODS

A comprehensive search for peer-reviewed studies published in English was conducted using the primary electronic databases. Reference lists from these articles were reviewed and manual searches were performed to supplement relevant studies. The identified records were screened based on inclusion criteria. We extracted data from the final retrieved papers using a pre-designed data extraction form and a quality assessment was conducted. The studies were heterogeneities, so meta-analysis was not possible and instead evidence was synthesized using narrative summaries.

RESULTS

Thirty-six studies were identified. We identified GHG mitigation strategies in five domains - energy generation, transportation, food and agriculture, households, and industry and economy - which usually, although not always, bring co-benefits for public health. These health gains are likely to be multiplied by comprehensive measures that include more than one sectors.

CONCLUSIONS

GHG mitigation strategies can bring about substantial and possibly cost-effective public health co-benefits. These findings are highly relevant to policy makers and other stakeholders since they point to the compounding value of taking concerted action against climate change and air pollution.

Evaluating Health Co-Benefits of Climate Change Mitigation in Urban Mobility

There is growing recognition that implementation of low-carbon policies in urban passenger transport has near-term health co-benefits through increased physical activity and improved air quality. Nevertheless, co-benefits and related cost reductions are often not taken into account in decision processes, likely because they are not easy to capture. In an interdisciplinary multi-model approach we address this gap, investigating the co-benefits resulting from increased physical activity and improved air quality due to climate mitigation policies for three urban areas. Additionally we take a (macro-)economic perspective, since that is the ultimate interest of policy-makers. Methodologically, we link a transport modelling tool, a transport emission model, an emission dispersion model, a health model and a macroeconomic Computable General Equilibrium (CGE) model to analyze three climate change mitigation scenarios. We show that higher levels of physical exercise and reduced exposure to pollutants due to mitigation measures substantially decrease morbidity and mortality. Expenditures are mainly born by the public sector but are mostly offset by the emerging co-benefits. Our macroeconomic results indicate a strong positive welfare effect, yet with slightly negative GDP and employment effects. We conclude that considering economic co-benefits of climate change mitigation policies in urban mobility can be put forward as a forceful argument for policy makers to take action.

Urban Form, Air Pollution, and Health

PURPOSE OF REVIEW

Urban form can impact air pollution and public health. We reviewed health-related articles that assessed (1) the relationships among urban form, air pollution, and health as well as (2) aspects of the urban environment (i.e., green space, noise, physical activity) that may modify those relationships.

RECENT FINDINGS

Simulation and empirical studies demonstrate an association between compact growth, improved regional air quality, and health. Most studies are cross-sectional and focus on connections between transportation emissions and land use. The physical and mental health impacts of green space, public spaces that promote physical activity, and noise are well-studied aspects of the urban environment and there is evidence that these factors may modify the relationship between air pollution and health. Urban form can support efforts to design clean, health-promoting cities. More work is needed to operationalize specific strategies and to elucidate the causal pathways connecting various aspects of health.

Monitoring of air pollution levels related to Charilaos Trikoupis Bridge

Charilaos Trikoupis bridge is the longest cable bridge in Europe that connects Western Greece with the rest of the country. In this study, six air pollution monitoring campaigns (including major regulated air pollutants) were carried out from 2013 to 2015 at both sides of the bridge, located in the urban areas of Rio and Antirrio respectively. Pollution data were statistically analyzed and air quality was characterized using US and European air quality indices. From the overall campaign, it was found that air pollution levels were below the respective regulatory thresholds, but once at the site of Antirrio (26.4 and 52.2μg/m³ for PM_2.5 and ΡΜ₁₀, respectively) during the 2nd winter period. Daily average PM₁₀ and PM_2.5 levels from two monitoring sites were well correlated to gaseous pollutant (CO, NO, NO₂, NO_x and SO₂) levels, meteorological parameters and factor scores from Positive Matrix Factorization during the 3-year period. Moreover, the elemental composition of PM₁₀ and PM_2.5 was used for source apportionment. That analysis revealed that major emission sources were sulfates, mineral dust, biomass burning, sea salt, traffic and shipping emissions for PM₁₀ and PM_2.5, for both Rio and Antirrio. Seasonal variation indicates that sulfates, mineral dust and traffic emissions increased during the warm season of the year, while biomass burning become the dominant during the cold season. Overall, the contribution of the Charilaos Trikoupis bridge to the vicinity air pollution is very low. This is the result of the relatively low daily traffic volume (~10,000 vehicles per day), the respective traffic fleet composition (~81% of the traffic fleet are private vehicles) and the speed limit (80km/h) which does not favor traffic emissions. In addition, the strong and frequent winds further contribute to the rapid dispersion of the emitted pollutants.

Participatory quantitative health impact assessment of urban and transport planning in cities: A review and research needs

INTRODUCTION

Urban and transport planning have large impacts on public health, but these are generally not explicitly considered and/or quantified, partly because there are no comprehensive models, methods and tools readily available. Air pollution, noise, temperature, green space, motor vehicle crashes and physical activity are important pathways linking urban and transport planning and public health. For policy decision-making, it is important to understand and be able to quantify the full-chain from source through pathways to health effects and impacts to substantiate and effectively target actions. In this paper, we aim to provide an overview of recent studies on the health impacts related to urban and transport planning in cities, describe the need for novel participatory quantitative health impact assessments (HIA) and provide recommendations.

METHOD

To devise our searches and narrative, we were guided by a recent conceptual framework linking urban and transport planning, environmental exposures, behaviour and health. We searched PubMed, Web of Science, Science Direct, and references from relevant articles in English language from January 1, 1980, to November 1, 2016, using pre-defined search terms.

RESULTS

The number of HIA studies is increasing rapidly, but there is lack of participatory integrated and full-chain HIA models, methods and tools. These should be based on the use of a systemic multidisciplinary/multisectorial approach and state-of-the-art methods to address questions such as what are the best, most feasible and needed urban and transport planning policy measures to improve public health in cities? Active citizen support and new forms of communication between experts and citizens and the involvement of all major stakeholders are crucial to find and successfully implement health promoting policy measures.

CONCLUSION

We provided an overview of the current state-of-the art of HIA in cities and made recommendations for further work. The process on how to get there is as important and will provide answers to many crucial questions on e.g. how different disciplines can effectively work together, how to incorporate citizen and stakeholder opinion into quantitative HIA modelling for urban and transport planning, how different modelling and measurement methods can be effectively integrated, and whether a public health approach can bring about positive changes in urban and transport planning.

Benefits on public health from transport-related greenhouse gas mitigation policies in Southeastern European cities

Climate change is a major environmental threat of our time. Cities have a significant impact on greenhouse gas emissions as most of the traffic, industry, commerce and more than 50% of world population is situated in urban areas. Southern Europe is a region that faces financial turmoil, enhanced migratory fluxes and climate change pressure. The case study of Thessaloniki is presented, one of the only two cities in Greece with established climate change action plans. The effects of feasible traffic policies in year 2020 are assessed and their potential health impact is compared to a business as usual scenario. Two types of measures are investigated: operation of underground rail in the city centre and changes in fleet composition. Potential co-benefits from reduced greenhouse gas emissions on public health by the year 2020 are computed utilizing state-of-the-art concentration response functions for PM_x, NO₂ and C₆H₆. Results show significant environmental health and monetary co-benefits when the city metro is coupled with appropriate changes in the traffic composition. Monetary savings due to avoided mortality or leukaemia incidence corresponding to the reduction in PM₁₀, PM_2.5, NO₂ and C₆H₆ exposure will be 56.6, 45, 37.7 and 1.0 million Euros respectively. Promotion of 'green' transportation in the city (i.e. the wide use of electric vehicles), will provide monetary savings from the reduction in PM₁₀, PM_2.5, NO₂ and C₆H₆ exposure up to 60.4, 49.1, 41.2 and 1.08 million Euros. Overall, it was shown that the respective GHG emission reduction policies resulted in clear co-benefits in terms of air quality improvement, public health protection and monetary loss mitigation.

Urban and Transport Planning Related Exposures and Mortality: A Health Impact Assessment for Cities

BACKGROUND

By 2050, nearly 70% of the global population is projected to live in urban areas. Because the environments we inhabit affect our health, urban and transport designs that promote healthy living are needed.

OBJECTIVE

We estimated the number of premature deaths preventable under compliance with international exposure recommendations for physical activity (PA), air pollution, noise, heat, and access to green spaces.

METHODS

We developed and applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) tool to Barcelona, Spain. Exposure estimates and mortality data were available for 1,357,361 residents. We compared recommended with current exposure levels. We quantified the associations between exposures and mortality and calculated population attributable fractions to estimate the number of premature deaths preventable. We also modeled life-expectancy and economic impacts.

RESULTS

We estimated that annually, nearly 20% of mortality could be prevented if international recommendations for performance of PA; exposure to air pollution, noise, and heat; and access to green space were followed. Estimations showed that the greatest portion of preventable deaths was attributable to increases in PA, followed by reductions of exposure to air pollution, traffic noise, and heat. Access to green spaces had smaller effects on mortality. Compliance was estimated to increase the average life expectancy by 360 (95% CI: 219, 493) days and result in economic savings of 9.3 (95% CI: 4.9, 13.2) billion EUR/year.

CONCLUSIONS

PA factors and environmental exposures can be modified by changes in urban and transport planning. We emphasize the need for a) the reduction of motorized traffic through the promotion of active and public transport and b) the provision of green infrastructure, both of which are suggested to provide opportunities for PA and for mitigation of air pollution, noise, and heat. Citation: Mueller N, Rojas-Rueda D, Basagaña X, Cirach M, Cole-Hunter T, Dadvand P, Donaire-Gonzalez D, Foraster M, Gascon M, Martinez D, Tonne C, Triguero-Mas M, Valentín A, Nieuwenhuijsen M. 2017. Urban and transport planning related exposures and mortality: a health impact assessment for cities. Environ Health Perspect 125:89-96; http://dx.doi.org/10.1289/EHP220.

Car free cities: Pathway to healthy urban living

BACKGROUND

Many cities across the world are beginning to shift their mobility solution away from the private cars and towards more environmentally friendly and citizen-focused means. Hamburg, Oslo, Helsinki, and Madrid have recently announced their plans to become (partly) private car free cities. Other cities like Paris, Milan, Chengdu, Masdar, Dublin, Brussels, Copenhagen, Bogota, and Hyderabad have measures that aim at reducing motorized traffic including implementing car free days, investing in cycling infrastructure and pedestrianization, restricting parking spaces and considerable increases in public transport provision. Such plans and measures are particularly implemented with the declared aim of reducing greenhouse gas emissions. These reductions are also likely to benefit public health.

AIMS

We aimed to describe the plans for private car free cities and its likely effects on public health.

METHODS

We reviewed the grey and scientific literature on plans for private car free cities, restricted car use, related exposures and health.

RESULTS

An increasing number of cities are planning to become (partly) private car free. They mainly focus on the reduction of private car use in city centers. The likely effects of such policies are significant reductions in traffic-related air pollution, noise, and temperature in city centers. For example, up to a 40% reduction in NO2 levels has been reported on car free days. These reductions are likely to lead to a reduction in premature mortality and morbidity. Furthermore the reduction in the number of cars, and therefore a reduction in the need for parking places and road space, provides opportunities to increase green space and green networks in cities, which in turn can lead to many beneficial health effects. All these measures are likely to lead to higher levels of active mobility and physical activity which may improve public health the most and also provide more opportunities for people to interact with each other in public space. Furthermore, such initiatives, if undertaken at a sufficiently large scale can result in positive distal effects and climate change mitigation through CO2 reductions. The potential negative effects which may arise due to motorized traffic detouring around car free zone into their destinations also need further evaluation and the areas in which car free zones are introduced need to be given sufficient attention so as not to become an additional way to exacerbate socioeconomic divides. The extent and magnitude of all the above effects is still unclear and needs further research, including full chain health impact assessment modeling to quantify the potential health benefits of such schemes, and exposure and epidemiological studies to measure any changes when such interventions take place.

CONCLUSIONS

The introduction of private car free cities is likely to have direct and indirect health benefits, but the exact magnitude and potential conflicting effects are as yet unclear. This paper has overviewed the expected health impacts, which can be useful to underpin policies to reduce car use in cities.

Health impact assessment of transport policies in Rotterdam: Decrease of total traffic and increase of electric car use

BACKGROUND

Green house gas (GHG) mitigation policies can be evaluated by showing their co-benefits to health.

METHOD

Health Impact Assessment (HIA) was used to quantify co-benefits of GHG mitigation policies in Rotterdam. The effects of two separate interventions (10% reduction of private vehicle kilometers and a share of 50% electric-powered private vehicle kilometers) on particulate matter (PM2.5), elemental carbon (EC) and noise (engine noise and tyre noise) were assessed using Years of Life Lost (YLL) and Years Lived with Disability (YLD). The baseline was 2010 and the end of the assessment 2020.

RESULTS

The intervention aimed at reducing traffic is associated with a decreased exposure to noise resulting in a reduction of 21 (confidence interval (CI): 11-129) YLDs due to annoyance and 35 (CI: 20-51) YLDs due to sleep disturbance for the population per year. The effects of 50% electric-powered car use are slightly higher with a reduction of 26 (CI: 13-116) and 41 (CI: 24-60) YLDs, respectively. The two interventions have marginal effects on air pollution, because already implemented traffic policies will reduce PM2.5 and EC by around 40% and 60% respectively, from 2010 to 2020.

DISCUSSION

The evaluation of planned interventions, related to climate change policies, targeting only the transport sector can result in small co-benefits for health, if the analysis is limited to air pollution and noise. This urges to expand the analysis by including other impacts, e.g. physical activity and well-being, as a necessary step to better understanding consequences of interventions and carefully orienting resources useful to build knowledge to improve public health.

Climate change impact on the PAH photodegradation in soils: Characterization and metabolites identification

Polycyclic aromatic hydrocarbons (PAHs) are airborne pollutants that are deposited on soils. As climate change is already altering temperature and solar radiation, the global warming is suggested to impact the environmental fate of PAHs. This study was aimed at evaluating the effect of climate change on the PAH photodegradation in soils. Samples of Mediterranean soils were subjected to different temperature and light radiation conditions in a climate chamber. Two climate scenarios were considered according to IPCC projections: 1) a base (B) scenario, being temperature and light intensity 20°C and 9.6W/m(2), respectively, and 2) a climate change (CC) scenario, working at 24°C and 24W/m(2), respectively. As expected, low molecular weight PAHs were rapidly volatilized when increasing both temperature and light intensity. In contrast, medium and high molecular weight PAHs presented different photodegradation rates in soils with different texture, which was likely related to the amount of photocatalysts contained in both soils. In turn, the hydrogen isotopic composition of some of the PAHs under study was also investigated to verify any degradation process. Hydrogen isotopes confirmed that benzo(a)pyrene is degraded in both B and CC scenarios, not only under light but also in the darkness, revealing unknown degradation processes occurring when light is lacking. Potential generation pathways of PAH photodegradation by-products were also suggested, being a higher number of metabolites formed in the CC scenario. Consequently, in a more or less near future, although humans might be less exposed to PAHs, they could be exposed to new metabolites of these pollutants, which might be even more toxic.

Do Climate Change Policies Promote or Conflict with Subjective Wellbeing: A Case Study of Suzhou, China

As public expectations for health rise, health measurements broaden from a focus on death, disease, and disability to wellbeing. However, wellbeing hasn’t been incorporated into the framework of climate change policy decision-making in Chinese cities. Based on survey data (n = 763) from Suzhou, this study used Generalized Estimation Equation approach to model external conditions associated with wellbeing. Then, semi-quantitative analyses were conducted to provide a first indication to whether local climate change policies promote or conflict with wellbeing through altering these conditions. Our findings suggested: (i) Socio-demographic (age, job satisfaction, health), psychosocial (satisfaction with social life, ontological security/resilience) and environmental conditions (distance to busy road, noise annoyance and range hoods in the kitchen) were significantly associated with wellbeing; (ii) None of existing climate change strategies in Suzhou conflict with wellbeing. Three mitigation policies (promotion of tertiary and high–tech industry, increased renewable energy in buildings, and restrictions on car use) and one adaption policy (increasing resilience) brought positive co–benefits for wellbeing, through the availability of high-satisfied jobs, reduced dependence on range hoods, noise reduction, and valuing citizens, respectively. This study also provided implications for other similar Chinese cities that potential consequences of climate change interventions for wellbeing should be considered.

Public health impacts of city policies to reduce climate change: findings from the URGENCHE EU-China project

BACKGROUND

Climate change is a global threat to health and wellbeing. Here we provide findings of an international research project investigating the health and wellbeing impacts of policies to reduce greenhouse gas emissions in urban environments.

METHODS

Five European and two Chinese city authorities and partner academic organisations formed the project consortium. The methodology involved modelling the impact of adopted urban climate-change mitigation transport, buildings and energy policy scenarios, usually for the year 2020 and comparing them with business as usual (BAU) scenarios (where policies had not been adopted). Carbon dioxide emissions, health impacting exposures (air pollution, noise and physical activity), health (cardiovascular, respiratory, cancer and leukaemia) and wellbeing (including noise related wellbeing, overall wellbeing, economic wellbeing and inequalities) were modelled. The scenarios were developed from corresponding known levels in 2010 and pre-existing exposure response functions. Additionally there were literature reviews, three longitudinal observational studies and two cross sectional surveys.

RESULTS

There are four key findings. Firstly introduction of electric cars may confer some small health benefits but it would be unwise for a city to invest in electric vehicles unless their power generation fuel mix generates fewer emissions than petrol and diesel. Second, adopting policies to reduce private car use may have benefits for carbon dioxide reduction and positive health impacts through reduced noise and increased physical activity. Third, the benefits of carbon dioxide reduction from increasing housing efficiency are likely to be minor and co-benefits for health and wellbeing are dependent on good air exchange. Fourthly, although heating dwellings by in-home biomass burning may reduce carbon dioxide emissions, consequences for health and wellbeing were negative with the technology in use in the cities studied.

CONCLUSIONS

The climate-change reduction policies reduced CO2 emissions (the most common greenhouse gas) from cities but impact on global emissions of CO2 would be more limited due to some displacement of emissions. The health and wellbeing impacts varied and were often limited reflecting existing relatively high quality of life and environmental standards in most of the participating cities; the greatest potential for future health benefit occurs in less developed or developing countries.

Development of a quantitative methodology to assess the impacts of urban transport interventions and related noise on well-being

Well-being impact assessments of urban interventions are a difficult challenge, as there is no agreed methodology and scarce evidence on the relationship between environmental conditions and well-being. The European Union (EU) project “Urban Reduction of Greenhouse Gas Emissions in China and Europe” (URGENCHE) explored a methodological approach to assess traffic noise-related well-being impacts of transport interventions in three European cities (Basel, Rotterdam and Thessaloniki) linking modeled traffic noise reduction effects with survey data indicating noise-well-being associations. Local noise models showed a reduction of high traffic noise levels in all cities as a result of different urban interventions. Survey data indicated that perception of high noise levels was associated with lower probability of well-being. Connecting the local noise exposure profiles with the noise-well-being associations suggests that the urban transport interventions may have a marginal but positive effect on population well-being. This paper also provides insight into the methodological challenges of well-being assessments and highlights the range of limitations arising from the current lack of reliable evidence on environmental conditions and well-being. Due to these limitations, the results should be interpreted with caution.