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.

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.

The London Smog of December 1952

Clean Air Act of 1956

•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 m2

AIR POLLUTION PARTICLES AND THE LUNG

0

2000

4000

6000

8000

10000

12000

0 20 40 60 80

Time (mins following inhalation)

CPM/gram blood

Tc99-Technigas <100nm mmd

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Percentage Change in Health End-point for a 10Percentage Change in Health End-point for a 10g/mg/m33

Increase in PMIncrease in PM1010

(summarised from over 100 studies)(summarised from over 100 studies)

Adverse health effects of particles persist after controlling for smoking

Meta-analysis of TSP & cardiovascular mortalityAnderson R et al

*

Cardiovascular Mortality: PM2.5 and Black Smoke:Long-term Exposure

**

PM2.5 Black Smoke

Relative risk of all cause mortality per 10 g/m3 change in annual average PM2.5: 1.06 (95% CI:1.02-1.11)

Cardiac Admissions & PM10

*

Asthma & Bronchitis Associated with PM10

Influence of Closing and Reopening a Steel Mill in Utah Valley

Pope, Am J Public Health 19890 100 200 300

FeCuZnPbNi

0 100 200 300 0 100 200 300

Concentration (ppb)

1985-86 1986-87 1987-88

0

50

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Sep

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PM

10 (g

/m3)

Mean High PM10

Mean PM10

1985-86 1986-87 1987-88

0

20

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100

Sep

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Dec

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Emission of nitrogen oxides, sulphur dioxide, ammonia and non methyl VOCfrom anthrop0genic sources by sector in the UK

Traffic growth by mode for the period 1980-2003

Proportion of diesel vehicles in car fleet

(D’Amato et al, Clin Exp Allergy 2000; 30: 628-636)

COUNTRY DIESEL CARS (%)

Austria 54%

Belgium 52.2%

Spain 47.3%

France 40.2%

Italy 22.5%

Holland 20.3%

Portugal 18.8%

Germany 17.6%

UK 15.3%

Sweden 11.0%

EUROPEAN MEAN 25.3%*

* Forecast to increase to 50% by 2010

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

Particulate Matter

Photochemical smogPhotochemical smogincluding OZONEincluding OZONE

PollutantsPollutants

SunshineSunshineNONO22 + radiation + radiation NO + O NO + O

O + OO + O22 OO33

RORO22 + O + O22 RO + RO + OO33

Ozone

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

Complex Interactions Influencing Individual Health

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 PollutionMarch 2007

Reccommendations that Directly Influence Health

• Reduce hot spots of air pollution in urban settings.

Schematic representation of population exposure to air pollution and potential Impacts of air quality

management strategies

Schematic representation of population exposure to air pollution and potential Impacts of air quality

management strategies

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).

Schematic representation of population exposure to air pollution and potential Impacts of air quality

management strategies

Unravelling Environmental Factors Shaping Health

Air pollutionObesity Mental illness

What we must aspire to

Exercise Space and a sense of place

Diet

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.