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Theme 4: Project 1 - Optimising assessment of health impacts of air pollution
Introduction: Calculation of the health burden of air pollution on health currently concentrates on the effects of long-term exposure to fine particulate matter (PM2.5) on mortality in reports and in the form of a public health outcome indicator on the percentage of mortality related to fine particles. This is of major importance but there are also effects on other outcomes and of other pollutants.
A new set of recommendations for health impact assessment (HIA) of the effects of air pollution has been published by WHO and previous recommendations are available from the UK Committee on the Medical Effects of Air Pollutants (COMEAP). In addition, the underlying evidence is continually developing.
The UK, in contrast to many other WHO countries has a variety of routine statistics available to use as baseline rates. In addition, London, in particular, is a good place to develop health impact assessment approaches due to its’ rich dataset of air pollution exposure estimates. This allows investigation of the importance of matching the geographical scale of the exposure estimates in the epidemiological studies underlying the coefficient and the exposure estimates used in health impact assessment.
Aims: Estimate the health burden of total air pollution, and health impacts of feasible reductions in air pollution, in London, and more widely, using the WHO and COMEAP recommendations where appropriate.
Develop these approaches further using:
- imminent publications of meta-analyses on effects of short-term exposure to ozone, nitrogen dioxide (NO2) and PM2.5 and on long-term exposure to NO2 and asthma prevalence from DH funded work
- outputs from key air pollution and health projects due to report in 2014/15
- other areas of literature that can be reviewed to give a consensus position.
Apply these techniques to a selection of plausible air pollution exposure reduction intervention scenarios, selected in consultation with stakeholders such as the King’s Urban Public Health Collaborative, Defra, the GLA, Directors of Public Health and Air Quality Officers in Local Authorities, taking into account potential links with other projects.
Set out a strategy for further development of health impact assessment methodology considering use of simulations, raw data available within studies within the unit and consideration of the literature to investigate issues such as coherence across respiratory and cardiovascular outcomes, relationships between average and personal exposure, use of coefficients from multipollutant models, comparative risks and cessation lags.