Dr Ian Mudway

Health Effects of Air Pollution

ian.mudway@kcl.ac.uk

• 1000’s new health studies, reviews (2006-2015)

• NPACT study (2013); ESCAPE (2013)

• REVIHAAP (July 2013); HRAPIE (Dec 2013)

• HEI Ultrafines report (2013) • WHO Black Carbon report

(2012) • IARC Diesel exhaust reports

(2013/2014) • WHO Burden of disease

report (March 2014) • “Every breathe we take....”

Royal College of Physicians (Feb 2016)

Better Evidence?

Impacts of Air Pollution across the Life Course

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Low birth weight

Smaller lungs

Increased risk of chronic disease Acute respiratory exacerbations

Increased vulnerability

Premature death

Quality of Life

Limiting potential

Additives

Nitrogen dioxides (incl. NO2), ozone, particulate matter, volatile organic carbon compounds.

PM associated chemicals

Nitrogen dioxides (incl. NO2), ozone, particulate matter (PNC, PM2.5, PM10, coarse PM), organic carbon, elemental carbon, volatile organic carbon compounds, quinones. PAHs, metals (Fe, Cu, Cr, V, Ni, Sb, As, Cd, Al, etc), stable radicals, SOA, POA, sulphate, nitrate, NaCl.

Visualising the true impact

NO2 in Tower Hamlets & Hackney

Modelled pollutant exposures

NO2

Black Carbon – a better health indictor? Toxic component or source indicator?

Estimated county- and season-specific relative risks (RR) of cardiovascular and respiratory hospitalization associated with PM2.5 components in 106 U.S. counties for the years 1999 through 2005

Janssen et al, Environ Health Perspect, 2011

Systematic review and meta-analysis of health effects of BC compared with PM mass based on data from time-series studies and cohort studies that measured both exposures

Internal dose of black carbon

Metals as biomarkers of exposure

Air in

Biomarkers out

Traffic related metals

Metals as biomarkers of exposure

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Causes for Optimism

Evidence that improving air pollution delivers measurable health benefits

Gauderman WJ, et al. NEJM. 2015;372(10):905-913.

John Evelyn 1620 –1706

Cleaner Fuels

Separate the vulnerable population from pollution sources Economic benefits

Green infrastructure

Moral imperative