Health and Air Pollution Exposure Research

1. Health and Air Pollution Exposure Research Sotiris Vardoulakis APRIL Meeting 23 June 2009

2. Passive diffusion sampling • Active (pumped) sampling • Gravimetric particle sampling • Remote open path analysers • Light scattering instruments • Passive diffusion sampling • Active (pumped) sampling • Gravimetric particle sampling • Bio-monitoring • Exposure diaries • Toxicological evidence • Epidemiological evidence (time-series & cohort studies) • Mortality data, hospital admissions, clinic visits, etc. Air Quality Monitoring Exposure Monitoring Environmental Epidemiology Air Quality Modelling Exposure Modelling Health Impact Assessment • Exposure-response relationships • Baseline mortality / morbidity • Duration of exposure • Duration of health effects • Age / gender distribution • Disability weights • Meteorology • Terrain effects • Urban canopy effects • Moving vehicles effects • Building ventilation/infiltration • Indoor sources & sinks • Regional background • Location of residence, workplace, school, etc. • Transient microenvironments • Time-activity pattern • Population distribution • Statistical person profile • Susceptible groups Atmospheric Emissions Population Exposure Health Impacts Air Pollutant Concentration

3. Air Pollution Exposure & Health Impact Assessment Case Studies • “Green Grid” tree planting intervention in East London (PUrE, EPSRC-funded) • “Red Route” traffic management intervention in Birmingham (Birmingham City Council & PUrE , EPSRC) • Improving Sustainability of the Indoor Environment (PUrE-INTRAWISE, EPSRC-funded) • Chemicals in the household (INTARESE, EU FP7 funded) • Improved stoves to reduce indoor air pollution in Kenya (Chadwick Trust & GTZ)

4. East London Green Grid • Create a better environmental context for development • Improve air quality • Improve flood risk management • Enhance biodiversity and ecological values • Secondary health benefits (e.g. mental health, exercising) http://www.thames-gateway.org.uk/projects-content.asp?id=160

5. Grid cell depth = 10 m Canopy height = 5 m Human receptor = 1.5 m Dispersion Modelling Approach • UFORE used to estimate PM10 interception PM10 wind

6. (μg m-3) Post-intervention PM10 (μg m-3) Air Pollution Modelling ADMS-URBAN & UFORE Pre-intervention University of Manchester & Forrest Research (PUrE)

7. Health Impact Assessment – 1 Respiratory Hospital Admissions Averted Res. Hospital Admissions

8. Health Impact Assessment – 2 Premature Deaths Averted Premature Deaths

9. Health Benefits London Green Grid

10. Red Route Network • Reduces traffic congestion by removal of stopping/parking • Areas where parking is restricted are defined by red lines • Road and traffic signal improvements • Use parking facilities off the main road • Red Routes blamed to be fast-flowing mini motorways disrupting community life and commercial activities.

11. Birmingham Traffic Management Intervention SCOTLAND ENGLAND BIRMINGHAM LONDON

12. Stratford Road

13. Red Route Stratford Road

14. Stratford Road (Birmingham) East NO2 and BTEX passive tubes West NOX analyser PM10 (TEOM) 14 m 12 m 3.5 m 6 m 6 m 22.5 m

15. N Centenary Square: 17.05 Bristol Road: 25.35 27.09 31.97 Warwick Road 24.76 Weatheroak Road 33.05 21.84 27.77 25.27 23.82 Annual mean NO2 (ppb) 28.31 Shakespeare Road 28.18 22.77 Fulham Road 23.62 29.78 Stratford Road Wilton Road Johns Road 30.21 Newton Road Baker Street 40.41 16.03 31.18 Durham Road

16. Dispersion Modeling (OSPM) NO2 O3 Benzene Vardoulakis S., Valiantis M., Milner J., ApSimon H., 2007. Operational air pollution modelling in the UK – street canyon applications and challenges. Atmospheric Environment 41, 4622–4637

17. Population Exposure Model Junction 100 m Street canyon Surrounding 300 m Background

18. Health Benefits: Air Quality

19. Multi-Criteria Decision Analysis

20. OUTDOOR & GLOBAL ENVIRONMENT INDOR & LOCAL ENVIRON MENT THE LIFE CYCLE OF OPTIONS Use of space (CASE STUDIES) ENERGY PROVISION Cold/heat related Social interaction s morbidity/mortality Sense of control Winter /summer Extraction of Energy Thermal indoor fuels efficiency comfort temperatures Fuel p rocessing Psycho - social Modal well - being Mould growth switching Power & house dust V entilation Cardio - respiratory generation mites morbidity Power Indoor air Micro - E missions to indoor distribution quality generation environment E mission s to outdoor Outdoor air Emissions environment quality & wastes Environmental impacts Climate change ( Resource depletion, Global warming, A cidification, Nu trification, Eco - toxicity etc. ) An Integrated Framework for Improving Sustainability of the Indoor Environment(PUrE Intrawise)

21. Integrated Assessment of Health Risks of Environmental Stressors in Europe Toluene • Household Chemicals • Toluene • Formaldehyde • Phthalates (DBP) • Policy Measures (e.g. Directive 2005/59/EC limiting the use of toluene in adhesives and spray paints) • Integrated Exposure Assessment (ConsExpo) • Multi-pathways • Chronic & acute health effects • Population subgroups

22. Improved stoves to reduce indoor air pollution in Kenya (Caroline Ochieng) http://www.who.int/indoorair/en/

23. Conlusions • Relatively small margin for ambient air quality improvement in UK cities, but synergies between air pollution and climate change • Improved indoor air quality by optimising building design, ventilation and energy use in houses • Large health benefits from air quality improvement (indoor and outdoor) in developing countries

24. Current Research at LSHTM • Environmental Epidemiology research • Operational monitoring and modelling techniques to characterise exposure to air pollution • Health impact assessment of environmental interventions • Quantitative Multi-Criteria Decision Analysis (direct and indirect health impacts)

25. Other air pollution related projects at PEHRU (mainly epidemiology) • NERC-funded project on high temperatures, ozone and health (with Univ. Edinburgh) – led by Paul Wilkinson • DH-funded project on ozone-mortality relationships (with St George's and Univ. Edinburgh) – led by Ben Armstrong • DH-funded project on air pollution and cardiovascular disease – led by Shakoor Hajat • DH-funded project on the oxidative potential of outdoor air pollution (with King's College) – led by Cathryn Tonne • ESRC fellowship on air pollution and health in London – Cathryn Tonne • EPSRC-funded LUCID project on adaptation to climate change and air pollution in London (led by UCL) • Wellcome Trust air pollution-related burdens as part of a project on climate change mitigation – led by Andy Haines

26. Acknowledgments • Public & Environmental Health Research Unit: • Zaid Chalabi, Tony Fletcher, Paul Wilkinson, Ben Armstrong, Sari Kovats, Carolyn Stephens, Chris Grundy, Shakoor Hajat, Emma Hutchinson, Sam Pattenden, Ai Milojevic, Cathryn Tonne, James Milner, Antonio Gasparrini, Rebecca Steinbach, Caroline Ochieng, Xiyu Phoon, Simon Lloyd • Health Protection Agency (Giovanni Leonardi) • Environment Agency (Bernard Fisher) • PUrE and PUrE-INTRAWISE consortia • INTARESE consortium • INERIS institute (France)