2. The Urban Environment Impacts on Health and Wellbeing A successful urban area stimulates those who live and work there and reinforces self-esteem. The urban environment affect health and wellbeing of everyone who lives and works there. Many problems are concentrated in the most deprived areas where environmental, social and economic factors interact especially children and older people. Relationship between health, wellbeing and place are complex interacting and poorly understood.

3. Effects of Urban Environment on Health Air pollution: 24,000 deaths/yr brought forward by~8 months and 24,000 hospital admissions. Traffic accidents: 3,300 deaths and 29,000 serious injuries/yr. Climate: Winter - 25,700 extra deaths Dec 2005- March 2006. Summer - 2,000 excess deaths in heat- wave of 2003. Mental health: Strong association between urban residence and psychiatric disorders. Infectious disease: Spread of pandemic flue and new diseases with climate change. Obesity: 34,000 extra deaths each year.

4. The London Smog of December 1952 Clean Air Act of 1956

5. 1,000,000,000,000 particles enter into lungs daily 10,000 lts of air pass through the lungs every 24 hours. Surface area exposed to the external environment - 150 m 2 AIR POLLUTION PARTICLES AND THE LUNG

6. Tc 99 -Technigas <100nm mmd

7. % Increase Total Resp CardiovascularMortality Asthma Pneumonia COPD All resp. CardiovascularHospitalisation Upper resp Asthma Cough Lower respSymptoms PEF FEV1 Decreased lung function 4 3 2 1 Percentage Change in Health End-point for a 10 g/m 3 Increase in PM 10 (summarised from over 100 studies) Adverse health effects of particles persist after controlling for smoking

8. Meta-analysis of TSP & cardiovascular mortality Anderson R et al *

9. Cardiovascular Mortality: PM 2.5 and Black Smoke: Long-term Exposure * * PM 2.5 Black Smoke Relative risk of all cause mortality per 10 g/m 3 change in annual average PM 2.5: 1.06 (95% CI:1.02-1.11)

10. Cardiac Admissions & PM 10 *

11. Asthma & Bronchitis Associated with PM 10 Influence of Closing and Reopening a Steel Mill in Utah Valley Pope, Am J Public Health 1989 0100200300 Fe Cu Zn Pb Ni 01002003000100200300 Concentration (ppb) 1985-861986-871987-88 0 50 100 150 200 250 Sep - Nov Dec - Feb Sep - Nov Dec - Feb Sep - Nov Dec - Feb PM 10 ( g/m 3 ) Mean High PM 10 Mean PM 10 1985-861986-871987-88 0 20 40 60 80 100 Sep - Nov Dec - Feb Sep - Nov Dec - Feb Sep - Nov Dec - Feb Hospital Admissions Asthma + Bronchitis Ages 0-17

13. Emission of nitrogen oxides, sulphur dioxide, ammonia and non methyl VOC from anthrop0genic sources by sector in the UK

14. Traffic growth by mode for the period 1980-2003

15. Proportion of diesel vehicles in car fleet (DAmato et al, Clin Exp Allergy 2000; 30: 628-636) COUNTRYDIESEL CARS (%) Austria54% Belgium52.2% Spain47.3% France40.2% Italy22.5% Holland20.3% Portugal18.8% Germany17.6% UK15.3% Sweden11.0% EUROPEAN MEAN25.3%* * Forecast to increase to 50% by 2010

17. Temporal trend in sulphur dioxide emissions by source category in Hong Kong

18. Particulate Matter

20. Photochemical smog including OZONE Pollutants Sunshine NO 2 + radiation NO + O O + O 2 O 3 O + O 2 O 3 RO 2 + O 2 RO + O 3 RO 2 + O 2 RO + O 3

21. Ozone

22. Percentage change in PM10 emissions in selected European countries between 1990 and 2001

23. Complex Interactions Influencing Individual Health

24. The web of connections between increased car ownership and use and environmental and social outcomes in urban areas The Urban Environment – Royal Commission on Environmental Pollution March 2007

25. Reccommendations that Directly Influence Health Reduce hot spots of air pollution in urban settings.

26. Schematic representation of population exposure to air pollution and potential Impacts of air quality management strategies

27. Schematic representation of population exposure to air pollution and potential Impacts of air quality management strategies

28. Reccommendations that Directly Influence Health Reduce hot spots of air pollution in urban settings. Promotion of overall air pollution reduction for the whole population (Gap Closure).

29. Schematic representation of population exposure to air pollution and potential Impacts of air quality management strategies

30. Unravelling Environmental Factors Shaping Health Air pollution Obesity Mental illness

31. What we must aspire to Exercise Space and a sense of place Diet

32. Reccommendations that Directly Influence Health Reduce hot spots of air pollution in urban settings. Promotion of overall air pollution reduction for the whole population (Gap Closure). Develop a statutory framework for Health Impact Assessments as a component of Environment Impact Assessment in urban planning.