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

Atmospheric Emissions Population Exposure Health Impacts Air Quality Modelling 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 Exposure Modelling Exposure-response relationships Baseline mortality / morbidity Duration of exposure Duration of health effects Age / gender distribution Disability weights Health Impact Assessment 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 Air Quality Monitoring Exposure Monitoring Toxicological evidence Epidemiological evidence (time-series & cohort studies) Mortality data, hospital admissions, clinic visits, etc. Environmental Epidemiology Air Pollutant Concentration

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)

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)

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

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

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

Health Impact Assessment – 2 Premature Deaths Averted Premature Deaths

Health Benefits London Green Grid

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.

Birmingham Traffic Management Intervention SCOTLAND LONDON BIRMINGHAM ENGLAND

Stratford Road

Red Route

22.5 m 12 m West East NO 2 and BTEX passive tubes 6 m 14 m 3.5 m NO X analyser PM 10 (TEOM) Stratford Road (Birmingham)

Warwick Road Weatheroak Road Newton Road Wilton Road Fulham Road Shakespeare Road Johns Road N Durham Road Centenary Square: Bristol Road: Baker Street Stratford Road Annual mean NO2 (ppb)

NO 2 O3O3 Benzene Vardoulakis S., Valiantis M., Milner J., ApSimon H., Operational air pollution modelling in the UK – street canyon applications and challenges. Atmospheric Environment 41, 4622–4637 Dispersion Modeling (OSPM)

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

Health Benefits: Air Quality

Multi-Criteria Decision Analysis

An Integrated Framework for Improving Sustainability of the Indoor Environment (PUrE Intrawise)

Integrated Assessment of Health Risks of Environmental Stressors in Europe 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 Toluene

Improved stoves to reduce indoor air pollution in Kenya (Caroline Ochieng)

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

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)

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 Other air pollution related projects at PEHRU (mainly epidemiology)

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)