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Should we be worried about air quality? by Prof. Stephen Peckham

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Should we be worried about air quality?

Professor Stephen Peckham

www.kent.ac.uk/chssCentre for Health Services Studies

Centre for Health Services Studies www.kent.ac.uk/chss

#High Court victory for air pollution campaigners in legal battle with Government

Action needs to be taken more quickly

Current forecasting for emissions is not based on actual emission levels from vehicles

Centre for Health Services Studies www.kent.ac.uk/chss

#Traffic and health

Centre for Health Services Studies www.kent.ac.uk/chss

#Vehicles emissions and pollutionDiesel engine exhaust emissions are a mixture of gases, vapours, liquid aerosols and substances made up of particles including:carbon (soot)nitrogenwatercarbon monoxidealdehydesoxides of nitrogenoxides of sulphurpolycyclic aromatic hydrocarbonsThe carbon particle or soot content varies from 60% to 80% depending on the fuel used and the type of engine. Most of the contaminants are adsorbed onto the soot. Petrol engines produce more carbon monoxide but much less soot than diesel engines.

Centre for Health Services Studies www.kent.ac.uk/chss

#Particulate matter and nitrogen dioxideMain source of NO2 is from vehicle emissionsNitrogen dioxide inflames the lining of the lungsItcanalso reduce immunity to lung infectionsNO2 is a precursor of ozonePM reaches deep into the body

Centre for Health Services Studies www.kent.ac.uk/chss

#Comparing vehicle emission sources

Centre for Health Services Studies www.kent.ac.uk/chss

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Effect of NO2 on childrens lung functionIncreased air pollution leads to both increased prevalence and severity of asthma especially in children - placing substantial demands on local health services and poor quality of life for sufferers and their families.

Centre for Health Services Studies www.kent.ac.uk/chss

#And not just asthmaExposure to fine particulateair pollution has adverse effects on cardio-pulmonary health leading to increased morbidity and mortality.A 10 g/m3 increase in 24 h NO2 has been associated with increases in all-cause, cardiovascular and respiratory mortality, and with hospital admissions for respiratory and cardiovascular diseases.The International Agency for Research on Cancer (IARC) has classified outdoor air pollution as a class I carcinogen based on an association between PM2.5 in outdoor air and lung cancer incidence or mortality.There are significant associations between long-term exposure to PM air pollution and lung cancer incidence in over 300,000 European subjects.

Air pollution levels should therefore be taken into account when considering the wider determinants of public health and the impact that changes in air pollution might have on the health of a population.

Bennett O, Kandala N-B, Ji C, et al. Spatial variation of heart failure and air pollution in Warwickshire, UK: an investigation of small scale variation at the ward-level. BMJ Open 2014;4:e006028.doi:10.1136/bmjopen-2014-006028

Centre for Health Services Studies www.kent.ac.uk/chss

#Early death .In 2014 Public Health England estimated that PM10 led to 28,000 early deaths every yearIt was estimated that in 2010 estimate that there were 1050 early deaths as a result of just PM2.5 air pollution across Kent & Medway (Kent and Medway Air Quality partnership Health Sub Group).In 2015 it was estimated that NO2 contributes to 29,000 excess deaths nationally in the UK. The College of Physicians identify that NO2 levels above 10g/m3 lead to permanent damage to childrens lungs. UK estimates indicate that short-term exposure to the levels of PM10 that we experienced in 2002 led to 6,500 deaths and 6,400 hospital admissions being brought forward that yearThe financial burdens of the health impacts in the UK are considerable. In 2005, estimates for man-made particulate pollution alone in the UK were 8.5-20.2 billion a year (Defra Air Quality Strategy, 2007

Centre for Health Services Studies www.kent.ac.uk/chss

#Air quality limitsNational limits are:PM2.5 25 g/m3 average over a yearPM10 40 g/m3 average over a year, more than 35 breaches of 40 g/m3 over 24 hour period.NO2 40g/m3 average per annum and 200g/m3 an hour on 18 occasions. Ozone (O3)120 g/m3 in 8 hour period (max 25 occasions in three years)For PM WHO guidelines are:PM2.5 10 g/m3 average over a year and 25 g/m3 over 24 hours.PM10 20 g/m3 average over a year, 50 g/m3 over 24 hour period.NO2 - as UK limitsOzone O3 100 g/m3 in 8 hour period

Centre for Health Services Studies www.kent.ac.uk/chss

#The inter-connectedness of public health Incidence of respiratory and cardiovascular diseaseCases of obesity and diabetes

Links to transport planning and air quality

Centre for Health Services Studies www.kent.ac.uk/chss

#On average, in England (2015):Each person made 17 trips by cycle during the year (all age groups); and cycled 53 milesEach person made 914 trips by 'all modes' (i.e. car, public transport, walking etc.), which means that cycling accounted for just under 2% of all trips Car/van drivers made 381 car trips; and drove 3,267 milesThe average length of a cycle trip was threemiles, while the average length of a car trip was about ninemiles

In Canterbury 2.7% of all travel to work trips are by cycle compared to 4% nationally

Centre for Health Services Studies www.kent.ac.uk/chss

#Measuring Air qualityDEFRA a national network of 40 zones with over 150 monitorsEach zone has a plan(we are South East)Responsibility locally is with district councils to measure air quality (over 200 councils over limits in 2015)In Kent and Medway there is a partnership approachData is gathered county wide from automatic air quality monitoring stationsRoadsideBackground/ruralThese are supplemented by diffusion tubesAreas where levels are in breach of national limits are designated Air Quality Management Areas and each of these should have a plan on how to bring the area into compliance

Centre for Health Services Studies www.kent.ac.uk/chss

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Centre for Health Services Studies www.kent.ac.uk/chss

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Centre for Health Services Studies www.kent.ac.uk/chss

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Air Quality Management Area 2 Canterbury City Centre

Centre for Health Services Studies www.kent.ac.uk/chss

#Canterbury :Average PM10 levels (ug/m3) by day and time in 2015AverageStatutory limitsMax daysPM1050 g/m324 hours3540 g/m31 yearn/a

Maximum

Centre for Health Services Studies www.kent.ac.uk/chss

#Canterbury: Average and Max ozone levels (ug/m3) by day and time in 2015AverageMaximumStatutory limitsMax daysOzone120 g/m3Maximum daily 8hour mean25 days averaged over 3 years

In 2015 Canterbury exceeded maximum levels (120ug/m3) on 11 days

Centre for Health Services Studies www.kent.ac.uk/chss

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Canterbury : Average and maximum NO2 levels by day and time in 2015Statutory limitsMax daysNitrogen dioxide (NO2)200 g/m31 hour1840 g/m31 yearn/a

AverageMaximum

Centre for Health Services Studies www.kent.ac.uk/chss

#Canterbury St Peters Place site: Average NO2 levels (ug/m3) by day and time in 2015Statutory limitsMax daysNitrogen dioxide (NO2)200 g/m31 hour1840 g/m31 yearn/a

AverageMaximum

Centre for Health Services Studies www.kent.ac.uk/chss

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Average NO2 Levels for selected Diffusion TubesSiteLocationCA2RoadsideSt Dunstans StreetCA9RoadsideSturry RoadCA17RoadsideMilitary RoadCA27RoadsideWincheapCA28RoadsideWincheapCA29KerbsideWincheapCA33RoadsideOld TanneryCA030RoadsideBroad Street

Annual average upper limit for NO2

Centre for Health Services Studies www.kent.ac.uk/chss

#And today .By and of August 2016 the ozone levels have breached national limits 13 times 24 since 1st January 2015.The current Air Quality Management Area is not compliant with national limits as some measurements breach NO2 limits Wincheap is particularly badTraffic is estimated to grow by between 20% and 30% with proposed developments over next 15 yearsCurrent emissions estimates potentially under estimate levels by 100% - new modelling formulas being developedWhile supporting district travel plan mode change is probably overestimated

Centre for Health Services Studies www.kent.ac.uk/chss

#The traffic problemTransport plan:Do nothing scenario leads to an 18% increase in traffic flowsPlan is to manage this to an increase of 10%However, increases will be concentrated in a few specific transport corridors:A291/A28New Dover RoadShifting people from cars involves substantial investment in alternativesProblems with traffic modelling:It was based on fewer than 16,000 housesDoes not take account of other developmentsMost schools are in Canterbury cityCurrently approx. 160,000 vehicle trips a day in Canterbury

Centre for Health Services Studies www.kent.ac.uk/chss

#Could cycling help? Balancing personal health and population health

Centre for Health Services Studies www.kent.ac.uk/chss

#Does cycling make you healthier?People who cycle regularly in mid-adulthood typically enjoy a level of fitness equivalent to someone 10 years younger and their life expectancy is two years above the average.On average, regular cycle commuters take more than one day per year less off sick than colleagues who do not cycle to work, saving UK businesses around 83m annually. Also, people who do not cycle-commute regularly have a 39% higher mortality rate than those who do.The health benefits of cycling outweigh the injury risks by between 13:1 and 415:1, according to studies. The figure that is most often quoted - and endorsed by the Government - is 20:1 (life years gained due to the benefits of cycling v the life-years lost through injuries).

Centre for Health Services Studies www.kent.ac.uk/chss

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Centre for Health Services Studies www.kent.ac.uk/chss

#Comparison with other university citiesCity% trips by cycleCambridge 31.0%Oxford18.8%Norwich14.9%York14.8%Portsmouth10.9%Bristol9.2%Exeter9.0%Canterbury


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