Air Quality and the Public’s

Health

Professor Paul Cosford

Director for Health Protection & Medical Director, Public Health England

Routes to Clean Air 2017

Air pollution - still a problem

Public Health England

© Royal College of Physicians 2016

Latest WHO urban air quality database shows more than 80% of people living in urban areas are exposed

to air quality levels that exceed the WHO limits (WHO 2016)

3

PHE’s Role in Air Quality

Programme of work in support of national and local

government to reduce health effects of air pollution

Evidence development of the mortality and morbidity effects

associated with both indoor and outdoor air pollution

Advising those who are in a position to take action to

improve air quality at local, national and international level

o to reduce emissions of pollutants

o to help reduce exposure of the population to these

emissions

PHE’s Role in air quality

Raising public and professional awareness through

sustained public health engagement with local authorities

and other stakeholders

Assessing interventions to reduce exposure to air pollution,

and improve health and wellbeing

To focus on measures that have co-benefits for air pollution

with other PH priorities

Developing the evidence base

Current work

Advice to Defra on quantifying the mortality effects of

NO2

Long-term exposure to air pollution and cardiovascular

morbidity

Dementia

Public health risks associated with exposure to dust

particles in the London Underground

Guidance on estimating mortality attributable PM2.5 at Local

Authority level

Gowers et al, 2014 https://www.gov.uk/government/publications/estimating-local-mortality-burdens-associated-with-particulate-air-pollution

Public Health Outcomes Framework http://www.phoutcomes.info/

Local mortality burdens

The Health Impact of Environmental Hazards

Environmental Change and Health

Cover a wide range of issues around air pollution, including

• Exposure to low levels of carbon monoxide

• Optimising the assessment of health impacts of air pollution

• Nanoparticle exposure assessment

• Diesel exhaust particles and cerium nanoparticles

• Assessing interventions

www.hpru-ech.nihr.ac.uk

www.hieh.hpru.ac.uk

Health Protection Research Units

Developing the evidence base

Costs to the NHS and social care

PHE has commissioned a consortium led by the UK Health Forum to carry out

a project on the estimation of costs due to the health impacts of air pollution

Other examples

Raising Awareness and

Supporting Action by Local

Government

A briefing for Directors of Public Health

Overview

• Updated resource pack (first

launched in 2015)

• A suite of information,

guidance and

communication tools in six

easily accessed guides

• Recognises the vital role of

local authorities

• Designed to make it easier

for local authorities to be as

effective as possible in

improving local air quality

http://www.local.gov.uk/web/guest/publications/-/journal_content/56/10180/8324922/PUBLICATION

Volume 1.

Getting to grips with air pollution

A digest of latest evidence

and techniques

• Describes the key air

pollutants of concern

• Sets out current

understanding of health

impacts

• What are sources of air

pollution and exposure?

• Describes how local measures

can improve public health

• Provides case studies of local

action

• Introduces a ‘First Steps‘ -

Action Plan

Volume 2.

Understanding air pollution in your area

How to conduct a basic local

air quality assessment:

• A step by step guide to

understanding local air

quality issues

• How to identify higher risk

locations and key sources of

pollution

• How to do a comparative

assessment to aid

prioritisation

Volume 3.

Engaging local decision makers

How to make the case

for action

• Explaining contemporary air

pollution

• Checklist of local

stakeholders and their roles

• Potential synergies

between air quality and

other local policies

Every director of public health will want to

ensure that local air pollution is

appropriately assessed and prioritised

What action you they take next, however,

will depend on an assessment of the scale

of the problem.

Volume 4. Communicating during air

pollution episodes

Guidance on how to

communicate balanced and

accurate messages during

short term periods of high air

pollution. Includes:

• Background information on

air pollution episodes

• Appropriate health messages

to enable residents to make

informed decisions, e.g. on

how to reduce their exposure.

• Ideas for new communication

approaches

Helps to build awareness of

everyone’s role in tackling air

pollution

Volume 5. Communicating the long

term impacts of air pollution

Provides guidance and

key messages around:

• Explaining long–term air

pollution

• Risks

• Explaining the mortality

effect of long term

exposure

• Sources of air pollution

• Engaging the media

Includes 6 key principles for

communication about air

pollution

The public can play a critical role through

reducing their personal contribution to air

pollution and supporting local actions but..

Communication needs to be handled

carefully

Organised by Global Action Plan

PHE advised on the communication messages regarding health effects

of air pollutants and actions that people can take to reduce their

exposure and to reduce emissions

Over 200 events, 550 media and broadcast items and 28,000 tweets,

messages about air pollution and how to tackle it had a reach of 86

million

https://www.cleanairday.org.uk/celebration-report

National Clean Air Day

Support to Local government

To continue to support and, where necessary, co-ordinate local air quality networks bringing together public health professional, planners and other interested parties

The air quality plan for NO2 extended the number of local authorities required to undertake local feasibility studies and draw up local plans to reduce NO2 concentrations

Our local leads on air quality will consult with local authorities on the appropriate indicators of success in developing and implementing CAZs to enable local authorities to monitor their progress

Interventions

Air pollution: outdoor air quality and health

Focus on the cost-effectiveness of local interventions which aim to reduce

exposure to transport related air pollution The recommendations are

related to:

1. Planning

2. Clean air zones

3. Reducing emissions from public sector transport services and

vehicle fleets

4. Smooth driving and speed reduction

5. Cycle routes

6. Awareness raising

NICE Guidelines

Review of health impact assessment

methods for active travel/local travel plans

• Investigate methods that evaluate the

health outcomes from transport

interventions and active travel plans.

• Review modelling tools available for health

impact assessments of interventions at

different spatial scales.

Assessing interventions

PHE Evidence Review

Commissioned by the Department of Health

Practical recommendations for any actions not currently included in

the stratify, where possible, by health and economic impacts

The work will build on the UK’s 2017 plan for reducing roadside NO2

concentrations and the NICE guidelines

Wider remit to cover the pollutants that will be in the Clean Air

Strategy (NO2, SO2, VOCs, ammonia and PM) and other sources of

pollutants

PHE Evidence Review

PHE is commissioning 5 rapid evidence assessments

Planning/structural design interventions

Vehicle/fuel interventions

Social science/behavioural interventions

Industrial regulations/factory design/location

Agricultural regulations/ design/location

Report to be submitted to Ministers in August 2018

Head of Environmental Hazards and Emergencies Department: Naima Bradley

Air Quality and Public Health Group: Karen Exley (Group Leader), Alison

Gowers, Sani Dimitroulopoulou, Sarah Robertson, Christina Mitsakou

Local air quality leads: Alec Dobney, Lydia Izon-Cooper, Charlotte Landeg-Cox,

Adrienne Dunne, Amanda Craswell, Stuart Aldridge, Jamie Bond

Air Quality Review project manager James Stewart-Evans

Many others at PHE

Funding for NIHR Health Protection Research Units, Eurohealthy

Acknowledgements