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Air pollution as a risk factor in health impact assessments of a travel mode shift towards cycling
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
2018 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 11, no 1, article id 1429081Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: Promotion of active commuting provides substantial health and environmental benefits by influencing air pollution, physical activity, accidents, and noise. However, studies evaluating intervention and policies on a mode shift from motorized transport to cycling have estimated health impacts with varying validity and precision.

OBJECTIVE: To review and discuss the estimation of air pollution exposure and its impacts in health impact assessment studies of a shift in transport from cars to bicycles in order to guide future assessments.

METHODS: A systematic database search of PubMed was done primarily for articles published from January 2000 to May 2016 according to PRISMA guidelines.

RESULTS: We identified 18 studies of health impact assessment of change in transport mode. Most studies investigated future hypothetical scenarios of increased cycling. The impact on the general population was estimated using a comparative risk assessment approach in the majority of these studies, whereas some used previously published cost estimates. Air pollution exposure during cycling was estimated based on the ventilation rate, the pollutant concentration, and the trip duration. Most studies employed exposure-response functions from studies comparing background levels of fine particles between cities to estimate the health impacts of local traffic emissions. The effect of air pollution associated with increased cycling contributed small health benefits for the general population, and also only slightly increased risks associated with fine particle exposure among those who shifted to cycling. However, studies calculating health impacts based on exposure-response functions for ozone, black carbon or nitrogen oxides found larger effects attributed to changes in air pollution exposure.

CONCLUSION: A large discrepancy between studies was observed due to different health impact assessment approaches, different assumptions for calculation of inhaled dose and different selection of dose-response functions. This kind of assessments would improve from more holistic approaches using more specific exposure-response functions.

Place, publisher, year, edition, pages
Taylor & Francis, 2018. Vol. 11, no 1, article id 1429081
Keywords [en]
Active commuting, mode shift, emission factors, population exposure, commuters’ exposure, exposure response function, comparative risk assessment
National Category
Occupational Health and Environmental Health
Identifiers
URN: urn:nbn:se:umu:diva-144660DOI: 10.1080/16549716.2018.1429081ISI: 000424246900001PubMedID: 29400262Scopus ID: 2-s2.0-85053812003OAI: oai:DiVA.org:umu-144660DiVA, id: diva2:1181592
Available from: 2018-02-09 Created: 2018-02-09 Last updated: 2023-03-23Bibliographically approved
In thesis
1. Impacts of Active Transport on Health: with a focus on physical activity, air pollution, and cardiovascular disease
Open this publication in new window or tab >>Impacts of Active Transport on Health: with a focus on physical activity, air pollution, and cardiovascular disease
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: There are increasing number of health impact assessment studies investigating the health effects by transferring trips made by motorised transport to active commuting; however, air pollution exposure during active commuting and its impact on health has been less thoroughly assessed. It is furthermore uncertain whether there is any interaction effect between air pollution and physical activity for the risk of cardiovascular diseases. The overall aim of the thesis was to improve the knowledge base for assessments of the total impact on health of a mode shift resulting in both increased physical activity and increased air pollution exposure, especially regarding combined effects on cardiovascular risks.

Methods: The thesis is based on four studies. In Study I, methodological issues related to the assessment of air pollution in previous studies on the health impact of changes in transport mode were critically reviewed. In Study II, the effect of leisure time and active commuting physical activity, on chronic diseases was quantified by conducting a random-effect meta-analysis. In two prospective cohort studies, participants of the Västerbotten Intervention Programme living in the Umeå region were studied to assess the impact as well as interaction effect of physical activity and air pollution on the incidence (Study III) and recurrence (Study IV) of cardiovascular diseases.

Results: In previous studies on the health impact of changes in transport mode, there was a large methodological discrepancy between studies due to different assumptions for air pollution exposure assessments in general populations and commuters as well as methods for estimation of impacts. Randomeffect meta-analyses showed a beneficial effect of leisure time physical activity and active commuting on morbidity among individuals performing these activities at the minimum level of physical activity recommended by WHO, equivalent to 11.25 MET-hours per week. Beneficial effects of exercise on firstincident ischemic heart disease (IHD) were observed among individuals with high residential PM10/PM2.5 concentrations, but not among individuals with low concentrations. Adverse effects associated with high residential PM10 and PM2.5 concentrations were only observed among the individuals whom less frequently exercised. A statistically significant interaction effect was found between air pollution and exercise in training clothes for first-incident IHD but not for recurrence of IHD/stroke.

Conclusions: The results in this thesis strengthen the public health message that physical activity is beneficial for cardiovascular health, even in areas with air pollution. Therefore, public health and transport policies should be designed to improve population health through promotion of active transport and mitigation of air pollution.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2021. p. 86
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2132
Keywords
Health impact assessment, Air pollution, Active commuting, Exercise, Interaction. Cardiovascular diseases, Ischemic heart diseases, Stroke
National Category
Public Health, Global Health, Social Medicine and Epidemiology Occupational Health and Environmental Health
Research subject
Public health; Occupational and Environmental Medicine
Identifiers
urn:nbn:se:umu:diva-183309 (URN)978-91-7855-533-8 (ISBN)978-91-7855-532-1 (ISBN)
Public defence
2021-06-15, Triple Helix, Universitetsledningshuset/Zoom, Umeå, 13:00 (English)
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Supervisors
Note

Zoom: https://umu.zoom.us/j/62645020569

Passcode: 223344

Available from: 2021-05-25 Created: 2021-05-21 Last updated: 2021-06-22Bibliographically approved

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Raza, WasifForsberg, BertilNilsson Sommar, Johan

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