01/12/2011 Transport & Health: some major issues · 01/12/2011 Transport & Health: some major...

01/12/2011

Transport & Health: some major issues 2011 Annual Polis conference Brussels Luc Int Panis

Research coordinator Environmental Risk & Health at the

Flemish Institute for Technological Research

Transport Transportation Research Institute (Univ. Hasselt)

01/12/2011 2 © 2009, VITO NV – Alle rechten voorbehouden

Issues

» What fraction of PM causes health effects?

» Traffic

» Black Carbon

» What are the major health impacts of cycling?

» Not air quality

» Minor accidents: need to quantify risk and costs

» How can we effectively solve both problems? …and achieve a major health benefit


Traffic is not healthy (may be PM, noise, stress, …. , ?)

Acute effect


Walking in Oxford street vs Hyde park

McCreanor et al. New Engl J Med. 2007

Diesel: Hyde park vs Oxford street

Acute effect


Gauderman et al. 2007 The Lancet

Chronic effect


Asthma incidence and prevalence related to air pollution

(causes new cases not just exacerbation, confirms HEI, 2009 consensus

Acute &

Chronic effect



Source VMM, ChemKar, 2009

EC

Bron VMM, ChemKar PM10 HotSpots, 2010

City of Antwerp (Borgerhout)

Measured PM composition in Flanders

Could it be the tiny black fraction?

Black Carbon


Personal exposure to Black Carbon

Bicycle

ride Car

commute


In transport;

6,3%

Home-based

activities;

29,9%

Sleep; 35,5%

Work; 17,0%

Social & Leisure;

6,3%

Shopping; 1,1% Other; 3,9%

Time-activity

In transport;

21,0%

Home-based

activities;

26,7%Sleep; 25,0%

Work; 12,2%

Social & Leisure;

8,9%

Shopping; 2,0%

Other; 4,3%

Contribution to exposure

In transport;

29,8%

Home-based

activities;

21,8%

Sleep; 13,9%

Work; 12,8%

Social & Leisure;

12,8%

Shopping; 3,2% Other; 5,6%

Contribution to dose

Personal exposure to Black Carbon

Black Carbon



Does a very brief exposure

to high peaks of Black Carbon

really cause health effects

in healthy people?


Looking for health effects


Jacobs et al (2010) Bos et al. (2011)

Differences in clinical endpoints per location

Endpoint Near ring road Clean room

Difference P-value Difference P-value

Log Exhaled NO, ppb -2.9% (-3.0% to -2.7%) 0.04 -3.3% (-3.1% to 3.5%) 0.63

Log PFA closure time, s 0.028 (-0.0035 to 0.060) 0.09 0.022 (-0.0045 to 0.048) 0.11

Log Il-6, pg/mL 0.070 (-0.031 to 0.17) 0.18 -0.015 (-0.095 to 0.064) 0.71

Clara cell protein, µg/L 2.8% (-8.0% to 13.7%) 0.61 2.7% (-6.6% to 11.7%) 0.58

Leukocyte counts, per µL 1.3% (-2.0% to 4.6%) 0.44 2.5% (-1.1% to 6.1%) 0.19

Neutrophil counts, per µL 4.6% (0.51% to 13.1%) 0.03 2.4% (-2.3% to 7.2%) 0.33

Percentage neutrophils, % 3.9% (1.5% to 6.2%) 0.003 0.22% (-1.8% to 2.2%) 0.83

Subclinical responses in healthy cyclists briefly exposed to traffic-related air pollution: an intervention study Lotte Jacobs, Tim S Nawrot, Bas de Geus, Romain Meeusen, Bart Degraeuwe, Alfred Bernard, Muhammad Sughis, Benoit Nemery, Luc Int Panis Environmental Health 2010 9:64

http://www.ehjournal.net/content/9/1/64







Very preliminary indications for Neurological effects?


Cycling is

very healthy


But perhaps

not always?


Reduce the cost of minor accidents

TAPAS based on SHAPES

Source: Rabl & De Nazelle 2012


Costs of minor accidents (SHAPES project) (Aertsens et al, 2010)

Type of injury

& consequences

Acute Body Injuries Light injuries No injuries

Cost category Long term Short term

Direct Costs Medical costs 369 43 13 0

non medical

costs

327 89 65 64

Indirect costs Productivity loss 4616 537 104 37

Leisure time loss 144 18 18 9

Intangible costs permanent

invalidity

1018 0 0 0

WTP to avoid

pain

1885 19 60 0

WTP to avoid

psych. conseq.

858 103 24 135

Other costs costs for 3rd

parties

131 11 39 49

TOTAL 9348 820 322 295

Minor accidents, major health costs


Avg. cost (€) CI_low (€) CI_high (€) NO_Injury 295 157 476

LIGHT_Injury 322 244 411

Acute Injury _Short Term 820 588 1089

Acute Injury _Long Term 9348 3764 17425

minor accident 841 579 1205

•Minor accident risk is 155 per million kilometers cycled (1 accident each 6500 km)

•Injury risk is 121 per million kilometers cycled

(1 injury each 8264 km)

• Average cost of minor accident is 841 euro

(0.125 euro/ km)

•Total cost of minor cycling accidents in Belgium is 57 - 183 million €

Much higher than expected BUT

Major benefits can result from avoiding accidents

Costs of minor accidents (SHAPES project)


0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

22%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Units associated with the correspondent

explanatory variables

Share of commuter

cyclists

Commuting distance

Accident risk

Slopes

Traffic volume 2(municipal network)

Figure 1: Variation of the dependant variable (i.e. share of commuter cyclists) as several

explanatory variables change while holding all others constant at their means

How can we increase the modal share of cycling? (Vandenbulcke, 2011)

01/12/2011

How can we effectively solve

the BC and accident problems and

maximise the health benefits?

[email protected]

[email protected]

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

22%

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Units associated with the correspondent

explanatory variables

Share of commuter

cyclists

Commuting distance

Accident risk

Slopes

Traffic volume 2(municipal network)

Figure 1: Variation of the dependant variable (i.e. share of commuter cyclists) as several

explanatory variables change while holding all others constant at their means

mailto:[email protected]

mailto:[email protected]


Persoonlijke blootstelling aan roet

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

Bla

ck c

arb

on

(n

g/m

³)

N=7039

N=4742

N=2259

N=72406 N=17298


Persoonlijke blootstelling aan roet in het verkeer

0

5000

10000

15000

20000

25000

Bla

ck c

arb

on

(n

g/m

³)

N=3190

N=645

N=1167N=1161

N=614

N=72

N=190


BDNF

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