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  • Journal article
    Goel R, Goodman A, Aldred R, Nakamura R, Tatah L, Garcia LMT, Diomedi-Zapata B, de Sa TH, Tiwari G, de Nazelle A, Tainio M, Buehler R, Gotschi T, Woodcock Jet al., 2022,

    Cycling behaviour in 17 countries across 6 continents: levels of cycling, who cycles, for what purpose, and how far?

    , Transport Reviews, Vol: 42, Pages: 58-81, ISSN: 0144-1647

    International comparisons of cycling behaviour have typically been limited to high-income countries and often limited to the prevalence of cycling, with lack of discussions on demographic and trip characteristics. We used a combination of city, regional, and national travel surveys from 17 countries across the six continents, ranging from years 2009 through 2019. We present a descriptive analysis of cycling behaviour including level of cycling, trip purpose and distance, and user demographics, at the city-level for 35 major cities (>1 million population) and in urbanised areas nationwide for 11 countries. The Netherlands, Japan and Germany are among the highest cycling countries and their cities among the highest cycling cities. In cities and countries with high cycling levels, cycling rates tend to be more equal between work and non-work trips, whereas in geographies with low cycling levels, cycling to work is higher than cycling for other trips. In terms of cycling distance, patterns in high- and low-cycling geographies are more similar. We found a strong positive association between the level of cycling and women’s representation among cyclists. In almost all geographies with cycling mode share greater than 7% women made as many cycle trips as men, and sometimes even greater. The share of cycling trips by women is much lower in geographies with cycling mode shares less than 7%. Among the geographies with higher levels of cycling, children (<16 years) are often overrepresented. Older adults (>60 years) remain underrepresented in all geographies but have relatively better representation where levels of cycling are high. In low-cycling settings, females are underrepresented across all the age groups, and more so when older than 16 years. With increasing level of cycling, representation of females improves across all the age groups, and most significantly among children and older adults. Clustering the cities and countries into homogeneous cycling typo
  • Journal article
    Brand C, Dons E, Anaya-Boig E, Avila-Palencia I, Clark A, de Nazelle A, Gascon M, Gaupp-Berghausen M, Gerike R, Gotschi T, Iacorossi F, Kahlmeier S, Laeremans M, Nieuwenhuijsen MJ, Orjuela JP, Racioppi F, Raser E, Rojas-Rueda D, Standaert A, Stigell E, Sulikova S, Wegener S, Panis LIet al., 2021,

    The climate change mitigation effects of daily active travel in cities

    , Transportation Research Part D: Transport and Environment, Vol: 93, Pages: 1-18, ISSN: 1361-9209

    Active travel (walking or cycling for transport) is considered the most sustainable form of personal transport. Yet its net effects on mobility-related CO2 emissions are complex and under-researched. Here we collected travel activity data in seven European cities and derived life cycle CO2 emissions across modes and purposes. Daily mobility-related life cycle CO2 emissions were 3.2 kgCO2 per person, with car travel contributing 70% and cycling 1%. Cyclists had 84% lower life cycle CO2 emissions than non-cyclists. Life cycle CO2 emissions decreased by −14% per additional cycling trip and decreased by −62% for each avoided car trip. An average person who ‘shifted travel modes’ from car to bike decreased life cycle CO2 emissions by 3.2 kgCO2/day. Promoting active travel should be a cornerstone of strategies to meet net zero carbon targets, particularly in urban areas, while also improving public health and quality of urban life.
  • Journal article
    Brand C, Gotschi T, Dons E, Gerike R, Anaya-Boig E, Avila-Palencia I, de Nazelle A, Gascon M, Gaupp-Berghausen M, Iacorossi F, Kahlmeier S, Panis LI, Racioppi F, Rojas-Rueda D, Standaert A, Stigell E, Sulikova S, Wegener S, Nieuwenhuijsen MJet al., 2021,

    The climate change mitigation impacts of active travel: Evidence from a longitudinal panel study in seven European cities

    , GLOBAL ENVIRONMENTAL CHANGE-HUMAN AND POLICY DIMENSIONS, Vol: 67, Pages: 1-15, ISSN: 0959-3780

    Active travel (walking or cycling for transport) is considered the most sustainable and low carbon form of getting from A to B. Yet the net effects of changes in active travel on changes in mobility-related CO2 emissions are complex and under-researched. Here we collected longitudinal data on daily travel behavior, journey purpose, as well as personal and geospatial characteristics in seven European cities and derived mobility-related lifecycle CO2 emissions over time and space. Statistical modelling of longitudinal panel (n = 1849) data was performed to assess how changes in active travel, the ‘main mode’ of daily travel, and cycling frequency influenced changes in mobility-related lifecycle CO2 emissions.We found that changes in active travel have significant lifecycle carbon emissions benefits, even in European urban contexts with already high walking and cycling shares. An increase in cycling or walking consistently and independently decreased mobility-related lifecycle CO2 emissions, suggesting that active travel substituted for motorized travel – i.e. the increase was not just additional (induced) travel over and above motorized travel. To illustrate this, an average person cycling 1 trip/day more and driving 1 trip/day less for 200 days a year would decrease mobility-related lifecycle CO2 emissions by about 0.5 tonnes over a year, representing a substantial share of average per capita CO2 emissions from transport. The largest benefits from shifts from car to active travel were for business purposes, followed by social and recreational trips, and commuting to work or place of education. Changes to commuting emissions were more pronounced for those who were younger, lived closer to work and further to a public transport station.Even if not all car trips could be substituted by active travel the potential for decreasing emissions is considerable and significant. The study gives policy and practice the empirical evidence needed to assess climate
  • Journal article
    Corada K, Woodward H, Alaraj H, Collins CM, de Nazelle Aet al., 2021,

    A systematic review of the leaf traits considered to contribute to removal of airborne particulate matter pollution in urban areas

    , Environmental Pollution, Vol: 269, Pages: 1-13, ISSN: 0269-7491

    Global urban planning has promoted green infrastructure (GI) such as street trees, shrubs or other greenspace in order to mitigate air pollution. Although considerable attention has been paid to understanding particulate matter (PM) deposition on GI, there has been little focus on identifying which leaf traits might maximise airborne PM removal. This paper examines existing literature to synthesize the state of knowledge on leaf traits most relevant to PM removal. We systematically reviewed measurement studies that evaluated particulate matter accumulated on leaves on street trees, shrubs green roofs, and green walls, for a variety of leaf traits. Our final selection included 62 papers, most from field studies and a handful from wind tunnel studies. The following were variously promoted as useful traits: coniferous needle leaves; small, rough and textured broadleaves; lanceolate and ovate shapes; waxy coatings, and high-density trichomes. Consideration of these leaf traits, many of which are also associated with drought tolerance, may help to maximise PM capture. Although effective leaf traits were identified, there is no strong or consistent evidence to identify which is the most influential leaf trait in capturing PM. The diversity in sampling methods, wide comparison groups and lack of background PM concentration measures in many studies limited our ability to synthesize results. We found that several ancillary factors contribute to variations in the accumulation of PM on leaves, thus cannot recommend that selection of urban planting species be based primarily on leaf traits. Further research into the vegetation structural features and standardization of the method to measure PM on leaves is needed.
  • Journal article
    Heydari S, Tainio M, Woodcock J, de Nazelle Aet al., 2020,

    Estimating traffic contribution to particulate matter concentration in urban areas using a multilevel Bayesian meta-regression approach

    , Environment International, Vol: 141, Pages: 1-8, ISSN: 0160-4120

    Quantifying traffic contribution to air pollution in urban settings is required to inform traffic management strategies and environmental policies that aim at improving air quality. Assessments and comparative analyses across multiple urban areas are challenged by the lack of datasets and methods available for global applications. In this study, we quantify the traffic contribution to particulate matter concentration in multiple cities worldwide by synthesising 155 previous studies reported in the World Health Organization (WHO)’s air pollution source apportionment data for PM10 and PM2.5. We employed a Bayesian multilevel meta-regression that accounts for uncertainties and captures both within- and between-study variations (in estimation methods, study protocols, etc.) through study-specific and location-specific explanatory variables. The final sample analysed in this paper covers 169 cities worldwide. Based on our analysis, traffic contribution to air pollution (particulate matter) varies from 5% to 61% in cities worldwide, with an average of 27%. We found that variability in the traffic contribution estimates reported worldwide can be explained by the region of study, publication year, PM size fraction, and population. Specifically, traffic contribution to air pollution in cities located in Europe, North America, or Oceania is on average 36% lower relative to the rest of the world. Traffic contribution is 28% lower among studies published after 2005 than those published on or before 2005. Traffic contribution is on average 24% lower among cities with less than 500,000 inhabitants and 19% higher when estimated based on PM10 relative to PM2.5. This quantitative summary overcomes challenges in the data and provides useful information for health impact modellers and decision-makers to assess impacts of traffic reduction policies.
  • Journal article
    Dons E, Laeremans M, Orjuela JP, Avila-Palencia I, de Nazelle A, Nieuwenhuijsene M, Van Poppel M, Carrasco-Turigas G, Standaert A, De Boever P, Nawrot T, Panis LIet al., 2019,

    Transport most likely to cause air pollution peak exposures in everyday life: Evidence from over 2000 days of personal monitoring

    , Atmospheric Environment, Vol: 213, Pages: 424-432, ISSN: 1352-2310

    BackgroundAir quality standards are typically based on long term averages – whereas a person may encounter exposure peaks throughout the day. Exposure peaks may contribute meaningfully to health impacts beyond their contribution to long term averages, and therefore should be considered alongside longer-term exposures. We aim to define and explain peak exposure to black carbon air pollution and look at the relationship between short peak exposures and longer term personal exposure.MethodsA peak detection algorithm was applied to pooled data from two independent studies. High-resolution personal black carbon monitoring was performed in 175 healthy adult volunteers for a minimum of two 24-h periods per person. At the same time, we retrieved information on the time-activity pattern. Data covered Belgium, Spain, and the United Kingdom. In total, 2053 monitoring days were included.ResultsExposure profiles revealed 2.8 ± 1.6 (avg ± SD) peaks per person per day. The average black carbon concentration during a peak was 4206 ng/m³. On 5.5% of the time participants were exposed to peak concentrations, but this contributed to 21.0% of their total exposure. The short time in transport (8%), was responsible for 32.7% of the peaks. 24.1% of the measurements in transport were categorized as peak exposure; while sleeping this was only 0.9%. When considering transport modes, participants were most likely to encounter peaks while cycling (34.0%). Most peaks were encountered at rush hour, from Monday through Friday, and in the cold season. Gender and age had no impact on the presence of peaks. Daily average black carbon exposure showed only a moderate correlation with peak frequency (r = 0.44). This correlation coefficient increased when considering longer term exposure to r > 0.60 from 10 days onward.ConclusionsThe occurrence of peaks varied substantially over time, across microenvironments and transport modes. Daily average exposure was moderately correlat
  • Journal article
    An R, Shen J, Ying B, Tainio M, Andersen ZJ, de Nazelle Aet al., 2019,

    Impact of ambient air pollution on physical activity and sedentary behavior in China: A systematic review

    , Environmental Research, Vol: 176, Pages: 1-9, ISSN: 0013-9351

    This study systematically reviewed scientific evidence linking ambient air pollution to physical activity and sedentary behavior in China. A keyword and reference search was conducted in PubMed, Web of Science, and the Cochrane Library. Predetermined selection criteria included—study designs: interventions or experiments, retrospective or prospective cohort studies, cross-sectional studies, and case-control studies; subjects: people of all ages; exposures: specific air pollutants and/or overall air quality; outcomes: physical activity and/or sedentary behavior; and country/area: mainland China. Ten studies met the selection criteria and were included in the review. Six adopted a cross-sectional design and the remaining four adopted a prospective cohort design. Four studies assessed a specific air pollutant namely particulate matter with diameter <2.5 μg/m3 (PM2.5), whereas the remaining six focused on overall air quality, defined using air quality indexes. Decline in overall air quality and increase in PM2.5 concentration were found to be associated with reduced daily/weekly duration of outdoor leisure-time and/or transportation-related physical activity such as walking but increased duration of daytime/nighttime sleeping among Chinese residents. In contrast, evidence linking overall air quality and PM2.5 concentration to sedentary behavior remains mixed and inconclusive. In conclusion, preliminary evidence indicates that ambient air pollution impacts Chinese residents’ daily physical activity-related behaviors. Future studies adopting objective measures of physical activity and a longitudinal or experimental study design are warranted to examine the impact of air pollution on sensitive sub-populations such as children, older adults and people with pre-existing conditions, and in locations outside China.
  • Journal article
    Keidel D, Maria Anto J, Basagana X, Bono R, Burte E, Carsin A-E, Forsberg B, Fuertes E, Galobardes B, Heinrich J, de Hoogh K, Jarvis D, Kunzli N, Leynaert B, Marcon A, Le Moual N, de Nazelle A, Schindler C, Siroux V, Stempfelet M, Sunyer J, Temam S, Tsai M-Y, Varraso R, Jacquemin B, Probst-Hensch Net al., 2019,

    The role of socioeconomic status in the association of lung function and air pollution - A pooled analysis of three adult ESCAPE cohorts

    , International Journal of Environmental Research and Public Health, Vol: 16, ISSN: 1660-4601

    Ambient air pollution is a leading environmental risk factor and its broad spectrum ofadverse health effects includes a decrease in lung function. Socioeconomic status (SES) is knownto be associated with both air pollution exposure and respiratory function. This study assesses therole of SES either as confounder or effect modifier of the association between ambient air pollutionand lung function. Cross-sectional data from three European multicenter adult cohorts were pooledto assess factors associated with lung function, including annual means of home outdoor NO2.Pre-bronchodilator lung function was measured according to the ATS-criteria. Multiple mixedlinear models with random intercepts for study areas were used. Three different factors (education,occupation and neighborhood unemployment rate) were considered to represent SES. NO2 exposurewas negatively associated with lung function. Occupation and neighborhood unemployment rateswere not associated with lung function. However, the inclusion of the SES-variable education improvedthe models and the air pollution-lung function associations got slightly stronger. NO2 associationswith lung function were not substantially modified by SES-variables. In this multicenter Europeanstudy we could show that SES plays a role as a confounder in the association of ambient NO2 exposurewith lung function.
  • Journal article
    Avila-Palencia I, Laeremans M, Hoffmann B, Anaya-Boig E, Carrasco-Turigas G, Cole-Hunter T, de Nazelle A, Dons E, Götschi T, Int Panis L, Orjuela JP, Standaert A, Nieuwenhuijsen MJet al., 2019,

    Effects of physical activity and air pollution on blood pressure

    , Environmental Research, Vol: 173, Pages: 387-396, ISSN: 0013-9351

    AIM: To assess the main and interaction effects of black carbon and physical activity on arterial blood pressure in a healthy adult population from three European cities using objective personal measurements over short-term (hours and days) and long-term exposure. METHODS: A panel study of 122 healthy adults was performed in three European cities (Antwerp, Barcelona, and London). In 3 seasons between March 2015 and March 2016, each participant wore sensors for one week to objectively measure their exposure to black carbon and monitor their physical activity continuously. Blood pressure was assessed three times during the week: at the beginning (day 0), in the middle (day 4), and at the end (day 7). Associations of black carbon and physical activity with blood pressure and their interactions were investigated with linear regression models and multiplicative interaction terms, adjusting for all the potential confounders. RESULTS: In multiple exposure models, we did not see any effects of black carbon on blood pressure but did see effects on systolic blood pressure of moderate-to-vigorous physical activity effect that were statistically significant from 1 h to 8 h after exposure and for long-term exposure. For a 1METhour increase of moderate-to-vigorous physical activity, the difference in the expected mean systolic blood pressure varied from -1.46 mmHg (95%CI -2.11, -0.80) for 1 h mean exposure, to -0.29 mmHg (95%CI -0.55, -0.03) for 8 h mean exposure, and -0.05 mmHg (95%CI -0.09, -0.00) for long-term exposure. There were little to no interaction effects. CONCLUSIONS: Results from this study provide evidence that short-term and long-term exposure to moderate-to-vigorous physical activity is associated with a decrease in systolic blood pressure levels. We did not find evidence for a consistent main effect of black carbon on blood pressure, nor any interaction between black carbon and physical activity levels.
  • Journal article
    Gerike R, de Nazelle A, Wittwer R, Parkin Jet al., 2019,

    Special issue "walking and cycling for better transport, health and the environment"

    , Transportation Research Part A: Policy and Practice, Vol: 123, Pages: 1-6, ISSN: 0191-2607
  • Journal article
    Haddad H, de Nazelle A, 2018,

    The role of personal air pollution sensors and smartphone technology in changing travel behaviour

    , Journal of Transport and Health, Vol: 11, Pages: 230-243, ISSN: 2214-1405

    Exposure to air pollution is affected by human behaviour, and has consequences for individual and collective health. One way to lessen the health effects of air pollution is to change personal travel behaviour with the help of new information, communication and sensing technologies. Our social research tracked the experiences of participants, air quality and technology enthusiasts, based in London who financially contributed to participate in an early-stage technical trial of a new air pollution sensor and app providing individuals with air pollution information (specifically levels of NO2 and VOCs). This paper reports the results of a before and after survey (returning respondents n = 22) and 12 in-depth interviews with individuals who took part in the beta test of the sensor and phone app. The survey results show that travel-related behaviours and attitudes relevant to air pollution did not change after using the technology. In contrast, expectations of technology performance and the extent it would influence behaviours were significantly lower after the trial than before. Further exploration during semi-structured interviews found that the participants, given their already high level of engagement with the topic, felt the capacity for immediate individual behaviour change was limited. As well as time and practical constraints, most people in this sample felt they were already doing what they could to avoid high levels of air pollution in their daily lives. Despite this, they had some recommendations to improve the app, such as the inclusion of real-time and historic maps, and the ability to make self and other comparisons. Overwhelmingly, people saw a broader role for the technology to engage the public with air pollution through raising awareness, and harnessing citizen science to collect diverse reliable data to inform policy and influence local policymakers to reduce air pollution levels.
  • Journal article
    Popoola OAM, Carruthers D, Lad C, Bright VB, Mead M, Stettler MEJ, Saffell JR, Jons RLet al., 2018,

    Use of networks of low cost air quality sensors to quantify air quality in urban settings

    , Atmospheric Environment, Vol: 194, Pages: 58-70, ISSN: 1352-2310

    Low cost sensors are becoming increasingly available for studying urban air quality. Here we show how such sensors, deployed as a network, provide unprecedented insights into the patterns of pollutant emissions, in this case at London Heathrow Airport (LHR). Measurements from the sensor network were used to unequivocally distinguish airport emissions from long range transport, and then to infer emission indices from the various airport activities. These were used to constrain an air quality model (ADMS-Airport), creating a powerful predictive tool for modelling pollutant concentrations. For nitrogen dioxide (NO2), the results show that the non-airport component is the dominant fraction (∼75%) of annual NO2 around the airport and that despite a predicted increase in airport related NO2 with an additional runway, improvements in road traffic fleet emissions are likely to more than offset this increase. This work focusses on London Heathrow Airport, but the sensor network approach we demonstrate has general applicability for a wide range of environmental monitoring studies and air pollution interventions.
  • Journal article
    Laeremans M, Dons E, Avila-Palencia I, Carrasco-Turigas G, Orjuela-Mendoza JP, Anaya-Boig E, Cole-Hunter T, De Nazelle A, Nieuwenhuijsen M, Standaert A, Van Poppel M, De Boever P, Int Panis Let al., 2018,

    Black Carbon Reduces the Beneficial Effect of Physical Activity on Lung Function

    , MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, Vol: 50, Pages: 1875-1881, ISSN: 0195-9131

    Introduction When physical activity is promoted in urban outdoor settings (e.g., walking and cycling), individuals are also exposed to FEV<sub xmlns:mrws="http://webservices.ovid.com/mrws/1.0">1</sub>|AIR POLLUTION|ACTIVE MOBILITY. It has been reported that short-term lung function increases as a response to physical activity, but this beneficial effect is hampered when elevated FEV<sub xmlns:mrws="http://webservices.ovid.com/mrws/1.0">1</sub>|AIR POLLUTION|ACTIVE MOBILITY concentrations are observed. Our study assessed the long-term impact of FEV<sub xmlns:mrws="http://webservices.ovid.com/mrws/1.0">1</sub>|AIR POLLUTION|ACTIVE MOBILITY on the pulmonary health benefit of physical activity.Methods Wearable sensors were used to monitor physical activity levels (SenseWear) and exposure to black carbon (microAeth) of 115 healthy adults during 1 wk in three European cities (Antwerp, Barcelona, London). The experiment was repeated in three different seasons to approximate long-term behavior. Spirometry tests were performed at the beginning and end of each measurement week. All results were averaged on a participant level as a proxy for long-term lung function. Mixed effect regression models were used to analyze the long-term impact of physical activity, black carbon and their interaction on lung function parameters, forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC, forced expiratory flow (FEF)25–75, and peak expiratory flow. Interaction plots were used to interpret the significant interaction effects.Results Negative interaction effects of physical activity and black carbon exposure on FEV1 (P = 0.07), FEV1/FVC (P = 0.03), and FEF25–75 (P = 0.03) were observed. For black carbon concentrations up to approximately 1 μg·m−3, an additional MET·h−1·wk−1 resulted in a trend toward lung function increases (FEV1, FEV1/F
  • Journal article
    Forns J, Sunyer J, Garcia-Esteban R, Porta D, Ghassabian A, Giorgis-Allemand L, Gong T, Gehring U, Sorensen M, Standl M, Sugiri D, Almqvist C, Andiarena A, Badaloni C, Beelen R, Berdel D, Cesaroni G, Charles M-A, Eriksen KT, Estarlich M, Fernandez MF, Forhan A, Jaddoe VWV, Korek M, Lichtenstein P, Lertxundi A, Lopez-Espinosa M-J, Markevych I, de Nazelle A, Raaschou-Nielsen O, Nieuwenhuijsen M, Perez-Lobato R, Philippat C, Slama R, Tiesler CMT, Verhulst FC, von Berg A, Vrijkotte T, Andersen A-MN, Heude B, Kramer U, Heinrich J, Tiemeier H, Forastiere F, Pershagen G, Brunekreef B, Guxens Met al., 2018,

    Air Pollution Exposure During Pregnancy and Symptoms of Attention Deficit and Hyperactivity Disorder in Children in Europe

    , EPIDEMIOLOGY, Vol: 29, Pages: 618-626, ISSN: 1044-3983
  • Journal article
    Laeremans M, Dons E, Avila-Palencia I, Carrasco-Turigas G, Orjuela JP, Anaya E, Cole-Hunter T, de Nazelle A, Nieuwenhuijsen M, Standaert A, Van Poppel M, De Boever P, Panis LIet al., 2018,

    Short-term effects of physical activity, air pollution and their interaction on the cardiovascular and respiratory system

    , ENVIRONMENT INTERNATIONAL, Vol: 117, Pages: 82-90, ISSN: 0160-4120

    Physical activity (PA) in urban environments may lead to increased inhalation of air pollutants. As PA and air pollution (AP) have respectively beneficial and detrimental effects on the cardiorespiratory system, the responses to these exposures can interact. Therefore, we assessed the short-term effects of PA, AP and their interaction on a set of subclinical cardiovascular and respiratory outcomes in a panel of healthy adults: heart rate variability (HRV), retinal vessel diameters, lung function and fractional exhaled nitric oxide (FeNO).One hundred twenty two participants measured their PA level and exposure to black carbon (BC), a marker of AP exposure, with wearable sensors during an unscripted week in three different seasons. The study was part of the PASTA project in three European cities (Antwerp: 41 participants, Barcelona: 41 participants, London: 40 participants). At the end of each measurement week, the health outcomes were evaluated. Responses to PA, BC and their interaction were assessed with mixed effect regression models. Separate models were used to account for a 2-h and 24-h time window.During the 2-h time window, HRV and lung function changed statistically significantly in response to PA (METhours) and logarithmic BC (%change). Changes in HRV marked an increased sympathetic tone with both PA (logarithmic LF/HF: +7%; p < 0.01) and BC (logarithmic HF: −19%; p < 0.05). In addition, PA provoked bronchodilation which was illustrated by a significant increase in lung function (FEV1: +15.63 mL; p < 0.05). While a BC %increase was associated with a significant lung function decrease (PEF: −0.10 mL; p < 0.05), the interaction indicated a potential protective effect of PA (p < 0.05). We did not observe a response of the retinal vessel diameters. Most subclinical outcomes did not change in the 24-h time window (except for a few minor changes in LF/HF, FeNO and PEF).Our results on the separate and combined effects of short-term PA and
  • Book chapter
    Riley R, de Nazelle A, 2018,

    Barriers and enablers of integrating health evidence into transport and urban planning and decision making

    , Integrating Human Health into Urban and Transport Planning A Framework, Editors: Nieuwenhuijsen, Khreis, Publisher: Springer, Pages: 641-655, ISBN: 9783319749839

    Global rates of urbanisation are on the rise. By 2050 around 70% of the ten billion global population is expected to be living in cities. Whilst cities are centres of education, wealth creation, innovation and progress they are simultaneously characterized by pollution, congestion, noise, heat and overcrowding, adversely impacting human health on a global scale. Strategic and comprehensive urban and transport planning and policy that integrates health can ameliorate some of these negative impacts. The evidence base for how we should be building our cities of the future is there. Nonetheless, current urban and transport planning fails to optimise health outcomes. This chapter discusses the barriers and enablers to effectively integrating health evidence into urban and transport planning decision making. These barriers are discussed under the themes of (1) differing understandings of health between sectors (2) differing understandings of evidence and difficulties around evidence translation (3) governance and politics and (4) institutional context. The second part of the chapter puts forward solutions to overcoming these barriers and suggests that enabling factors reside in improving communication and collaboration across sectors and disciplines. Such collaboration is likely to be facilitated by changes both to the institutional context in which decisions are made and to the way research is developed and communicated.
  • Journal article
    Tonne C, Milà C, Fecht D, Alvarez M, Gulliver J, Smith J, Beevers S, Ross Anderson H, Kelly Fet al., 2018,

    Socioeconomic and ethnic inequalities in exposure to air and noise pollution in London

    , Environment International, Vol: 115, Pages: 170-179, ISSN: 0160-4120

    BACKGROUND: Transport-related air and noise pollution, exposures linked to adverse health outcomes, varies within cities potentially resulting in exposure inequalities. Relatively little is known regarding inequalities in personal exposure to air pollution or transport-related noise. OBJECTIVES: Our objectives were to quantify socioeconomic and ethnic inequalities in London in 1) air pollution exposure at residence compared to personal exposure; and 2) transport-related noise at residence from different sources. METHODS: We used individual-level data from the London Travel Demand Survey (n = 45,079) between 2006 and 2010. We modeled residential (CMAQ-urban) and personal (London Hybrid Exposure Model) particulate matter <2.5 μm and nitrogen dioxide (NO2), road-traffic noise at residence (TRANEX) and identified those within 50 dB noise contours of railways and Heathrow airport. We analyzed relationships between household income, area-level income deprivation and ethnicity with air and noise pollution using quantile and logistic regression. RESULTS: We observed inverse patterns in inequalities in air pollution when estimated at residence versus personal exposure with respect to household income (categorical, 8 groups). Compared to the lowest income group (<£10,000), the highest group (>£75,000) had lower residential NO2 (-1.3 (95% CI -2.1, -0.6) μg/m3 in the 95th exposure quantile) but higher personal NO2 exposure (1.9 (95% CI 1.6, 2.3) μg/m3 in the 95th quantile), which was driven largely by transport mode and duration. Inequalities in residential exposure to NO2 with respect to area-level deprivation were larger at lower exposure quantiles (e.g. estimate for NO2 5.1 (95% CI 4.6, 5.5) at quantile 0.15 versus 1.9 (95% CI 1.1, 2.6) at quantile 0.95), reflecting low-deprivation, high residential NO2 areas in the city centre. Air pollution exposure at residence consistently overestimated personal exposure; this overestimation varied with age
  • Journal article
    Dons E, Laeremans M, Anaya-Boig E, Avila-Palencia I, Brand C, de Nazelle A, Gaupp-Berghausen M, Götschi T, Nieuwenhuijsen M, Orjuela JP, Raser E, Standaert A, Int Panis Let al., 2018,

    Concern over health effects of air pollution is associated to NO<inf>2</inf>in seven European cities

    , Air Quality, Atmosphere and Health, Vol: 11, Pages: 591-599, ISSN: 1873-9318

    Subjective perception of air pollution is important and can have impacts on health in its own rights, can lead to protective behaviour, or it can be leveraged to engage citizens and stakeholders in support of cleaner air policies. The aim of the current analysis was to examine associations between level of concern over health effects of air pollution and personal and environmental factors. In seven European cities, 7622 adult participants were recruited to complete an online questionnaire on travel and physical activity behaviour, perceptions and attitudes on active mobility and the environment, and sociodemographics. Air pollution at the home address was determined using Europe-wide PM2.5and NO2land use regression models. Mixed effects logistic regression was used to model concern over air pollution (worried versus not worried; city as random effect). Fifty-eight percent of participants were worried over health effects of air pollution with large differences across cities (Antwerp 78%, Barcelona 81%, London 64%, Orebro 11%, Rome 72%, Vienna 43%, Zurich 33%). Linking mean modelled air pollution to mean level of concern per city gave a good correlation for NO2(r2= 0.75), and a lower correlation for PM2.5(r2= 0.49). In the regression model, sex, having children in the household, levels of physical activity, and NO2at the home address were significantly linked to individual concern over health effects of air pollution. We found that NO2but not PM2.5at the home address was associated with concern over health effects of air pollution.
  • Report
    Pimpin L, Retat L, Fecht D, de Preux LB, Sassi F, Gulliver J, Belloni A, Ferguson B, Corbould E, Jaccard A, Webber Let al., 2018,

    Estimation of costs to the NHS and social care due to the health impacts of air pollution
  • Journal article
    Cai Y, Hansell A, Hodgson S, Elliott P, Fecht D, Gulliver J, Key T, de Hoogh K, Hveem K, Morley D, Vienneau D, Blangiardo Met al.,

    Road traffic noise, air pollution and incident cardiovascular disease: a joint analysis of the HUNT, EPIC-Oxford and UK Biobank cohorts

    , Environment International, ISSN: 0160-4120

    Background: This study aimed to investigate the effects of long-term exposure to road traffic noiseand air pollutionon incident cardiovascular disease (CVD)in three large cohorts: HUNT, EPIC-Oxford and UK Biobank. Methods: In pooled complete-casesample of the three cohorts from Norway and the United Kingdom(N=355,732), 21,081 incident all CVD cases including 5,259ischemic heart disease (IHD)and 2,871cerebrovascular cases were ascertained between baseline (1993-2010)and end of follow-up (2008-2013)through medical recordlinkage. Annual mean 24-hour weighted road traffic noise(Lden) and air pollution (particulate matter with aerodynamic diameter ≤10 μm [PM10],≤2.5 μm [PM2.5]andnitrogen 39dioxide[NO2])exposure at baseline address was modelled using a simplified version of the Common Noise Assessment Methods in Europe (CNOSSOS-EU)and European-wide Land Use Regression models.Individual-level covariate data were harmonised and physically pooled across the three cohorts. Analysis was via Cox proportional hazard model with mutual adjustmentsforboth noise and air pollution andpotential confounders. Results: No significant associations were found between annual mean Ldenand incidentCVD,IHD or cerebrovascular disease in the overall populationexcept that the association withincident IHD was significantamong current-smokers.In the fully adjusted models including adjustmentfor Lden, an interquartile range (IQR) higher PM10(4.1μg/m3) or PM2.5(1.4μg/m3) was associated witha5.8% (95%CI: 2.5%-9.3%) and 3.7% (95%CI: 0.2%-7.4%) higherrisk for all incident CVD respectively. No significant associations were found between NO2and any of the CVD outcomes. Conclusions: We found suggestive evidence of a possible association between road traffic noise and incident IHD, consistent with current literature. Long-term particulate air pollution exposure, even at concentrations below current European air quality standards, w
  • Journal article
    Gulliver J, Elliott P, Hansell A, Cai Y, McCrea A, Garwood K, Fecht D, Briggs Det al., 2018,

    Local- and regional-scale air pollution modelling (PM10) and exposure assessment for pregnancy trimesters, infancy, and childhood to age 15 years: Avon Longitudinal Study of Parents And Children (ALSPAC).

    , Environment International, Vol: 113, Pages: 10-19, ISSN: 0160-4120

    We established air pollution modelling to study particle (PM10) exposures during pregnancy and infancy (1990–1993) through childhood and adolescence up to age ~15 years (1991–2008) for the Avon Longitudinal Study of Parents And Children (ALSPAC) birth cohort. For pregnancy trimesters and infancy (birth to 6 months; 7 to 12 months) we used local (ADMS-Urban) and regional/long-range (NAME-III) air pollution models, with a model constant for local, non-anthropogenic sources. For longer exposure periods (annually and the average of birth to age ~8 and to age ~15 years to coincide with relevant follow-up clinics) we assessed spatial contrasts in local sources of PM10 with a yearly-varying concentration for all background sources. We modelled PM10 (μg/m3) for 36,986 address locations over 19 years and then accounted for changes in address in calculating exposures for different periods: trimesters/infancy (n = 11,929); each year of life to age ~15 (n = 10,383). Intra-subject exposure contrasts were largest between pregnancy trimesters (5th to 95th centile: 24.4–37.3 μg/m3) and mostly related to temporal variability in regional/long-range PM10. PM10 exposures fell on average by 11.6 μg/m3 from first year of life (mean concentration = 31.2 μg/m3) to age ~15 (mean = 19.6 μg/m3), and 5.4 μg/m3 between follow-up clinics (age ~8 to age ~15). Spatial contrasts in 8-year average PM10 exposures (5th to 95th centile) were relatively low: 25.4–30.0 μg/m3 to age ~8 years and 20.7–23.9 μg/m3 from age ~8 to age ~15 years. The contribution of local sources to total PM10 was 18.5%–19.5% during pregnancy and infancy, and 14.4%–17.0% for periods leading up to follow-up clinics. Main roads within the study area contributed on average ~3.0% to total PM10 exposures in all periods; 9.5% of address locations were within 50 m of a main road. Exposure estimates will be used in a number of planned epidemiological studies.
  • Journal article
    Williams ML, Lott MC, Kitwiroon N, Dajnak D, Walton H, Holland M, Pye S, Fecht D, Toledano MB, Beevers SDet al., 2018,

    The Lancet Countdown on health benefits from the UK Climate Change Act

    , a modelling study for Great Britain, Vol: 2, Pages: e202-e213, ISSN: 2542-5196

    Background Climate change poses a dangerous and immediate threat to the health of populations in the UK and worldwide. We aimed to model different scenarios to assess the health co-benefits that result from mitigation actions. Methods In this modelling study, we combined a detailed techno-economic energy systems model (UK TIMES), air pollutant emission inventories, a sophisticated air pollution model (Community Multi-scale Air Quality), and previously published associations between concentrations and health outcomes. We used four scenarios and focused on the air pollution implications from fine particulate matter (PM2·5), nitrogen dioxide (NO2) and ozone. The four scenarios were baseline, which assumed no further climate actions beyond those already achieved and did not meet the UK's Climate Change Act (at least an 80% reduction in carbon dioxide equivalent emissions by 2050 compared with 1990) target; nuclear power, which met the Climate Change Act target with a limited increase in nuclear power; low-greenhouse gas, which met the Climate Change Act target without any policy constraint on nuclear build; and a constant scenario that held 2011 air pollutant concentrations constant until 2050. We predicted the health and economic impacts from air pollution for the scenarios until 2050, and the inequalities in exposure across different socioeconomic groups. Findings NO2 concentrations declined leading to 4 892 000 life-years saved for the nuclear power scenario and 7 178 000 life-years saved for the low-greenhouse gas scenario from 2011 to 2154. However, the associations that we used might overestimate the effects of NO2 itself. PM2·5 concentrations in Great Britain are predicted to decrease between 42% and 44% by 2050 compared with 2011 in the scenarios that met the Climate Change Act targets, especially those from road traffic and off-road machinery. These reductions in PM2·5 are tempered by a 2035 peak (and subsequent decline) in biomass (wood bu
  • Journal article
    Cole-Hunter T, de Nazelle A, Donaire-Gonzalez D, Kubesch N, Carrasco-Turigas G, Matt F, Foraster M, Martínez T, Ambros A, Cirach M, Martinez D, Belmonte J, Nieuwenhuijsen Met al., 2017,

    Estimated effects of air pollution and space-time-activity on cardiopulmonary outcomes in healthy adults: A repeated measures study.

    , Environment International, Vol: 111, Pages: 247-259, ISSN: 0160-4120

    BACKGROUND: Exposure to air pollution is known to affect both short and long-term outcomes of the cardiopulmonary system; however, findings on short-term outcomes have been inconsistent and often from isolated and long-term rather than coexisting and short-term exposures, and among susceptible/unhealthy rather than healthy populations. AIMS: We aimed to investigate separately the annual, daily and daily space-time-activity-weighted effect of ambient air pollution, as well as confounding or modification by other environmental (including noise) or space-time-activity (including total daily physical activity) exposures, on cardiopulmonary outcomes in healthy adults. METHODS: Participants (N=57: 54% female) had indicators of cardiopulmonary outcomes [blood pressure (BP), pulse (HR) and heart rate variability (HRV {SDNN}), and lung function (spirometry {FEV1, FVC, SUM})] measured on four different mornings (at least five days apart) in a clinical setting between 2011 and 2014. Spatiotemporal ESCAPE-LUR models were used to estimate daily and annual air pollution exposures (including PM10, PMCoarse, but not Ozone {derived from closest station}) at participant residential and occupational addresses. Participants' time-activity diaries indicated time spent at either address to allow daily space-time-activity-weighted estimates, and capture total daily physical activity (total-PA {as metabolic-equivalents-of-task, METs}), in the three days preceding health measurements. Multivariate-adjusted linear mixed-effects models (using either annual or daily estimates) were adjusted for possible environmental confounders or mediators including levels of ambient noise and greenness. Causal mediation analysis was also performed separately considering these factors as well as total-PA. All presented models are controlled by age, height, sex and season. RESULTS: An increase in 5μg/m3 of daily space-time-activity-weighted PMCoarse exposure was statistically significantly associated with
  • Journal article
    Smith RB, Fecht D, Gulliver J, Beevers S, Dajnak D, Blangiardo M, Ghosh R, Hansell A, Kelly F, Anderson HR, Toledano MBet al., 2017,

    Impact of London's road traffic air and noise pollution on birth weight: retrospective population based cohort study

    , BMJ, Vol: 359, ISSN: 1756-1833

    Objective To investigate the relation between exposure to both air and noise pollution from road traffic and birth weight outcomes.Design Retrospective population based cohort study.Setting Greater London and surrounding counties up to the M25 motorway (2317 km2), UK, from 2006 to 2010.Participants 540 365 singleton term live births.Main outcome measures Term low birth weight (LBW), small for gestational age (SGA) at term, and term birth weight.Results Average air pollutant exposures across pregnancy were 41 μg/m3 nitrogen dioxide (NO2), 73 μg/m3 nitrogen oxides (NOx), 14 μg/m3 particulate matter with aerodynamic diameter <2.5 μm (PM2.5), 23 μg/m3 particulate matter with aerodynamic diameter <10 μm (PM10), and 32 μg/m3 ozone (O3). Average daytime (LAeq,16hr) and night-time (Lnight) road traffic A-weighted noise levels were 58 dB and 53 dB respectively. Interquartile range increases in NO2, NOx, PM2.5, PM10, and source specific PM2.5 from traffic exhaust (PM2.5 traffic exhaust) and traffic non-exhaust (brake or tyre wear and resuspension) (PM2.5 traffic non-exhaust) were associated with 2% to 6% increased odds of term LBW, and 1% to 3% increased odds of term SGA. Air pollutant associations were robust to adjustment for road traffic noise. Trends of decreasing birth weight across increasing road traffic noise categories were observed, but were strongly attenuated when adjusted for primary traffic related air pollutants. Only PM2.5 traffic exhaust and PM2.5 were consistently associated with increased risk of term LBW after adjustment for each of the other air pollutants. It was estimated that 3% of term LBW cases in London are directly attributable to residential exposure to PM2.5>13.8 μg/m3during pregnancy.Conclusions The findings suggest that air pollution from road traffic in London is adversely affecting fetal growth. The results suggest little evidence for an independent exposure-response effect of traffic related noise on b
  • Journal article
    O'Driscoll R, Stettler MEJ, Molden N, Oxley T, ApSimon HMet al., 2017,

    Real world CO2 and NOx emissions from 149 Euro 5 and 6 diesel, gasoline and hybrid passenger cars

    , Science of the Total Environment, Vol: 621, Pages: 282-290, ISSN: 0048-9697

    In this study CO2 and NOx emissions from 149 Euro 5 and 6 diesel, gasoline and hybrid passenger cars were compared using a Portable Emissions Measurement System (PEMS). The models sampled accounted for 56% of all passenger cars sold in Europe in 2016. We found gasoline vehicles had CO2 emissions 13-66% higher than diesel. During urban driving, the average CO2 emission factor was 210.5 (sd. 47) gkm-1 for gasoline and 170.2 (sd. 34) gkm-1 for diesel. Half the gasoline vehicles tested were Gasoline Direct Injection (GDI). Euro 6 GDI engines <1.4ℓ delivered ~17% CO2 reduction compared to Port Fuel Injection (PFI). Gasoline vehicles delivered an 86-96% reduction in NOx emissions compared to diesel cars. The average urban NOx emission from Euro 6 diesel vehicles 0.44 (sd. 0.44) gkm-1 was 11 times higher than for gasoline 0.04 (sd. 0.04) gkm-1. We also analysed two gasoline-electric hybrids which out-performed both gasoline and diesel for NOx and CO2. We conclude action is required to mitigate the public health risk created by excessive NOx emissions from modern diesel vehicles. Replacing diesel with gasoline would incur a substantial CO2 penalty, however greater uptake of hybrid vehicles would likely reduce both CO2 and NOx emissions. Discrimination of vehicles on the basis of Euro standard is arbitrary and incentives should promote vehicles with the lowest real-world emissions of both NOx and CO2.
  • Journal article
    Douglas P, Freni-Sterrantino A, Leal Sanchez M, Ashworth DC, Ghosh RE, Fecht D, Font A, Blangiardo M, Gulliver J, Toledano MB, Elliott P, De Hoogh K, Fuller GW, Hansell ALet al., 2017,

    Estimating Particulate Exposure from Modern Municipal Waste Incinerators in Great Britain

    , Environmental science & technology, Vol: 51, Pages: 7511-7519, ISSN: 0013-936X

    Municipal Waste Incineration (MWI) is regulated through the European Union Directive on Industrial Emissions (IED), but there is ongoing public concern regarding potential hazards to health. Using dispersion modeling, we estimated spatial variability in PM10 concentrations arising from MWIs at postcodes (average 12 households) within 10 km of MWIs in Great Britain (GB) in 2003-2010. We also investigated change points in PM10 emissions in relation to introduction of EU Waste Incineration Directive (EU-WID) (subsequently transposed into IED) and correlations of PM10 with SO2, NOx, heavy metals, polychlorinated dibenzo-p-dioxins/furan (PCDD/F), polycyclic aromatic hydrocarbon (PAH) and polychlorinated biphenyl (PCB) emissions. Yearly average modeled PM10 concentrations were 1.00 × 10-5 to 5.53 × 10-2 μg m-3, a small contribution to ambient background levels which were typically 6.59-2.68 × 101 μg m-3, 3-5 orders of magnitude higher. While low, concentration surfaces are likely to represent a spatial proxy of other relevant pollutants. There were statistically significant correlations between PM10 and heavy metal compounds (other heavy metals (r = 0.43, p = <0.001)), PAHs (r = 0.20, p = 0.050), and PCBs (r = 0.19, p = 0.022). No clear change points were detected following EU-WID implementation, possibly as incinerators were operating to EU-WID standards before the implementation date. Results will be used in an epidemiological analysis examining potential associations between MWIs and health outcomes.
  • Journal article
    Koudis GS, Hu SJ, North RJ, Majumdar A, Stettler MEJet al., 2017,

    The impact of aircraft takeoff thrust setting on NO<inf>X</inf> emissions

    , Journal of Air Transport Management, Vol: 65, Pages: 191-197, ISSN: 0969-6997

    Reduced thrust takeoff has the potential to reduce aircraft-related NO X emissions at airports, however this remains to be investigated using flight data. This paper analyses the effect of takeoff roll thrust setting variability on the magnitude and spatial distribution of NO X emissions using high-resolution data records for 497 Airbus A319 activities at London Heathrow. Thrust setting varies between 67 and 97% of maximum, and aircraft operating in the bottom 10th percentile emit on average 514 g less NO X per takeoff roll (32% reduction) than the top 10th percentile, however this is dependent on takeoff roll duration. Spatial analysis suggests that peak NO X emissions, corresponding to the start of the takeoff roll, can be reduced by up to 25% by adopting reduced thrust takeoff activities. Furthermore, the length of the emission source also decreases. Consequently, the use of reduced thrust takeoff may enable improved local air quality at airports.
  • Journal article
    Jerrett M, Donaire-Gonzalez D, Popoola O, Jones R, Cohen RC, Almanza E, de Nazelle A, Mead I, Carrasco-Turigas G, Cole-Hunter T, Triguero-Mas M, Seto E, Nieuwenhuijsen Met al., 2017,

    Validating novel air pollution sensors to improve exposure estimates for epidemiological analyses and citizen science

    , Environmental Research, Vol: 158, Pages: 286-294, ISSN: 0013-9351

    Low cost, personal air pollution sensors may reduce exposure measurement errors in epidemiological investigations and contribute to citizen science initiatives. Here we assess the validity of a low cost personal air pollution sensor. Study participants were drawn from two ongoing epidemiological projects in Barcelona, Spain. Participants repeatedly wore the pollution sensor − which measured carbon monoxide (CO), nitric oxide (NO), and nitrogen dioxide (NO2). We also compared personal sensor measurements to those from more expensive instruments. Our personal sensors had moderate to high correlations with government monitors with averaging times of 1-h and 30-min epochs (r ~ 0.38–0.8) for NO and CO, but had low to moderate correlations with NO2 (~0.04–0.67). Correlations between the personal sensors and more expensive research instruments were higher than with the government monitors. The sensors were able to detect high and low air pollution levels in agreement with expectations (e.g., high levels on or near busy roadways and lower levels in background residential areas and parks). Our findings suggest that the low cost, personal sensors have potential to reduce exposure measurement error in epidemiological studies and provide valid data for citizen science studies.
  • Journal article
    Cai Y, Hodgson S, Blangiardo M, Gulliver J, Morley D, Vienneau D, de Hoogh K, Key T, Hveem K, Elliott P, Hansell Aet al., 2017,

    Road traffic noise and incident cardiovascular disease: a joint analysis of HUNT, EPIC-Oxford and UK Biobank

    , ICBEN 2017 Proceedings

    Aims: This study aimed to investigate the effects of long-term exposure to road traffic noise on incident CVD in three large cohorts: HUNT, EPIC-Oxford and UK Biobank. Methods: In a complete-case sample (N=361,699), 4,014 IHD and 2,109 cerebrovascular incident cases were ascertained between baseline (1993-2010) and end of follow-up (2008-2015) through medical record linkage. Annual mean road traffic noise exposure was modelled at baseline address. Individual-level covariate data were harmonised and data were pooled. Analyses used Cox proportional hazards model with adjustments for confounders, including air pollution. Results: For an interquartile range (IQR) (3.9 dBA) higher daytime noise, a non-significant association with incident IHD was seen (Hazard ratio (HR): 1.015, 95% Confidence Interval (CI): 0.989-1.042), fully adjusted. Statistically significant associations and interaction terms were seen in obese individuals (HR: 1.099, 95%CI: 1.029-1.174), and current-smokers (HR: 1.054, 95%CI: 1.007-1.103). No associations were found for ischemic or hemorrhagic stroke. Conclusions: Our study strengthens the evidence base for an effect of road traffic noise on incident IHD, whilst the association with incident stroke remains unclear.
  • Journal article
    Smyth E, Solomon A, Birrell MA, Smallwood MJ, Winyard PG, Tetley TD, Emerson Met al., 2017,

    Influence of inflammation and nitric oxide upon platelet aggregation following deposition of diesel exhaust particles in the airways.

    , British Journal of Pharmacology, Vol: 174, Pages: 2130-2139, ISSN: 0007-1188

    Background and Purpose: Exposure to nanoparticulate pollution has been implicated in platelet-driven thrombotic events such as myocardial infarction. Inflammation and impairment of NO bioavailability have been proposed as potential causative mechanisms. It is unclear, however, whether airways exposure to combustion-derived nanoparticles such as diesel exhaust particles (DEP) or carbon black (CB) can augment platelet aggregation in vivo and the underlying mechanisms remain undefined. We aimed to investigate the effects of acute lung exposure to DEP and CB on platelet activation and the associated role of inflammation and endothelial-derived NO.Experimental Approach: DEP and CB were intratracheally instilled into wild-type (WT) and eNOS−/− mice and platelet aggregation was assessed in vivo using an established model of radio-labelled platelet thromboembolism. The underlying mechanisms were investigated by measuring inflammatory markers, NO metabolites and light transmission aggregometry.Key Results: Platelet aggregation in vivo was significantly enhanced in WT and eNOS−/− mice following acute airways exposure to DEP but not CB. CB exposure, but not DEP, was associated with significant increases in pulmonary neutrophils and IL-6 levels in the bronchoalveolar lavage fluid and plasma of WT mice. Neither DEP nor CB affected plasma nitrate/nitrite concentration and DEP-induced human platelet aggregation was inhibited by an NO donor.Conclusions and Implications: Pulmonary exposure to DEP and subsequent platelet activation may contribute to the reports of increased cardiovascular risk, associated with exposure to airborne pollution, independent of its effects on inflammation or NO bioavailability.

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