DOCSLIB.ORG

Associations Between Metal Constituents of Ambient Particulate Matter and Mortality in England: an Ecological Study

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Associations Between Metal Constituents of Ambient Particulate Matter and Mortality in England: an Ecological Study Open access Original research BMJ Open: first published as 10.1136/bmjopen-2019-030140 on 3 December 2019. Downloaded from Associations between metal constituents of ambient particulate matter and mortality in England: an ecological study Aurore Lavigne,1 Anna Freni Sterrantino ,2 Silvia Liverani,3 Marta Blangiardo,2 Kees de Hoogh,4,5 John Molitor,6 Anna Hansell 7 To cite: Lavigne A, Freni ABSTRACT Strengths and limitations of this study Sterrantino A, Liverani S, Objectives To investigate long- term associations between et al. Associations between metal components of particulate matter (PM) and mortality ► One of the largest studies to explore exposure to metal constituents of and lung cancer incidence. ambient particulate matter metal components of ambient air in relation to mor- Design Small area (ecological) study. and mortality in England: an tality and lung cancer incidence, with 13.6 million Setting Population living in all wards (~9000 individuals ecological study. BMJ Open population. per ward) in the London and Oxford area of England, 2019;9:e030140. doi:10.1136/ ► A large number of cases: 108 478 cardiovascular comprising 13.6 million individuals. bmjopen-2019-030140 disease deaths, 48 483 respiratory deaths and 24 Exposure and outcome measures We used land 849 incident cases of lung cancer in the study pe- ► Prepublication history and use regression models originally used in the Transport additional material for this riod and area, providing good statistical power to related Air Pollution and Health Impacts—Integrated paper are available online. To examine small excess risks. Methodologies for Assessing Particulate Matter study to view these files, please visit ► Established exposure models, developed and evalu- estimate exposure to copper, iron and zinc in ambient the journal online (http:// dx. doi. ated with measurements from a standardised mon- copyright. air PM. We examined associations of metal exposure org/ 10. 1136/ bmjopen- 2019- itoring campaign. 030140). with Office for National Statistics mortality data from ► An ecological study using registry data, without ac- cardiovascular disease (CVD) and respiratory causes and cess to individual-level confounders other than age AL and AFS are joint first with lung cancer incidence during 2008–2011. and sex. authors. Results There were 108 478 CVD deaths, 48 483 ► Metals were very highly correlated so multipollutant respiratory deaths and 24 849 incident cases of lung http://bmjopen.bmj.com/ Received 28 February 2019 models could not be used. Revised 22 October 2019 cancer in the study period and area. Using Poisson Accepted 05 November 2019 regression models adjusted for area- level deprivation, tobacco sales and ethnicity, we found associations lung cancer or respiratory mortality.6 It has between cardiovascular mortality and PM copper with 2.5 been suggested that metal components of PM interdecile range (IDR 2.6–5.7 ng/m3) and IDR relative may in part be responsible for toxic effects of risk (RR) 1.005 (95%CI 1.001 to 1.009) and between air pollution on the cardiovascular and respi- respiratory mortality and PM10 zinc (IDR 1135–153 ng/ 7 m3) and IDR RR 1.136 (95%CI 1.010 to 1.277). We did not ratory system. find relevant associations for lung cancer incidence. Metal In the Transport related Air Pollution and on December 13, 2019 at Basel University. Protected by elements were highly correlated. Health Impacts—Integrated Methodologies Conclusion Our analysis showed small but not fully for Assessing Particulate Matter (TRANS- consistent adverse associations between mortality and PHORM) study, copper zinc and iron content particulate metal exposures likely derived from non- of PM (PM10 and PM2.5) were found to be tailpipe road traffic emissions (brake and tyre wear), associated—positively and significantly—with which have previously been associated with increases in increases in inflammatory markers in the inflammatory markers in the blood. blood,8 which might be expected to be associ- ated with increased risks of cardiovascular and other diseases. However, a separate TRANS- © Author(s) (or their 9 employer(s)) 2019. Re- use INTRODUCTION PHORM study analysis of 19 cohorts with permitted under CC BY. Chronic exposure to toxic substances in partic- 9545 CVD deaths did not find any statistically Published by BMJ. ulate matter (PM) with aerodynamic diameter significant associations with metal (or other) For numbered affiliations see 1–3 4 less than 10 µm (PM10) and 2.5 µm (PM2.5) particulate components (PM10 or PM2.5). Here end of article. is associated with increased mortality levels we use the same data sets to examine associa- 1 5 Correspondence to from cardiovascular disease (CVD). Some tions with mortality using a much larger data 9 Dr Anna Hansell; studies also show links between this long- term set than TRANSPHORM study, to estimate ah618@ leicester. ac. uk exposure to traffic- related air pollution and particulate metal exposures for a population Lavigne A, et al. BMJ Open 2019;9:e030140. doi:10.1136/bmjopen-2019-030140 1 Open access BMJ Open: first published as 10.1136/bmjopen-2019-030140 on 3 December 2019. Downloaded from In the analyses, we used copper (Cu), iron (Fe) and zinc (Zn) in the PM10 fraction and copper and iron in 12 the PM2.5 fraction, all linked to non- tailpipe emissions. LUR models for this selection of elements showed a good leave- one- out validation, explaining more than 77% (R2) of the observed variability. Confounder data—deprivation, ethnicity and smoking data To adjust for possible confounders in this study, we included area- level ethnicity from Census 2011 and accounted for percent of White and Asian people per ward as covariates in the models. We also used the 2007 index of multiple deprivation (IMD) as a relative measure of area- level deprivation (publicly available from the Department for Communities and Local Government Figure 1 Study area compromising London and Oxford data. gov. uk). This combines seven domains: ‘income’, areas, with major roads and motorways. In the inset the area ‘employment’, ‘education’, ‘barriers to housing and localisation with regard to England map contains National services’, ‘crime’, ‘health’ and ‘living environment’. The Statistics data, Crown copyright and database right 2018; latter is divided into two subdomains: ‘indoor’ measuring contains OS data, Crown copyright and database right 2018. the quality of housing and ‘outdoor’ linked to air quality All rights reserved. and road traffic accidents.13 We excluded from the study the ‘health’ and ‘outdoor living environment’ domains,14 since we examined associations between health outcomes of 13.6 million living in and near London, England, with and air pollution measures. The remaining domains were 108478 CVD deaths and additionally 48 483 respiratory linearly combined to generate a ‘modified IMD’ relative deaths and 24 849 incident cases of lung cancer. score used in the analysis. High values of the modified IMD indicate higher deprivation. As a proxy for smoking, METHODS we used ward level tobacco expenditure (pounds/week/ copyright. Our study region covered a 10 782 km2 area around inhabitant) data obtained from CACI (CACI tobacco London and Oxford (figure 1) in 1533 wards, an English expenditure data are copyright 1996–2014 CACI Ltd.). Census area classification (primary unit of the English electoral geography) with a mean surface area ~7.0 km2 Health data and average 8892 inhabitants per ward, in our study Mortality counts for cardiovascular (International Classi- http://bmjopen.bmj.com/ period. fication of Diseases, Tenth Revision (ICD10) I00- I99) and respiratory (CDC10 J00- J99) disease and lung cancer inci- Exposure data dence counts (C33 and C34 ICD10 codes) were extracted In the region of London and Oxford PM was monitored for 2008–2011 from Office National Statistics data held during the years 2010–2011 as part of the European by the Small Area Health Statistics Unit, which provide Study of Cohorts and Air Pollution Effects (ESCAPE) 100% coverage of deaths. The counts were then adjusted 10 11 project. Filters measuring PM10 and PM2.5 from the by sex and 5- year age band. ESCAPE project were analysed for elemental compo- on December 13, 2019 at Basel University. Protected by sition and de Hoogh et al (2013)12 developed land use Patient and public involvement regression (LUR) models for a number of the elemental Patients were not involved in the development of the components including metals as part of the TRANS- research question or the design and conducting of the PHORM project. These models were used to predict PM10 study. and PM2.5 elemental composition for our study popula- tion for 2010–2011. In brief, 20 sites were monitored for Statistical analysis 10 three 2- week periods and PM2.5 and PM10 were separately The effect of PM exposure to copper, iron and zinc on collected using Harvard impactors. Their elemental health outcomes was analysed with Poisson regression composition was analysed using energy dispersive X-ray (a generalised linear model) of count data at small area fluorescence. The association of PM elemental compo- (ward) level, implemented in a Bayesian framework nents with land use covariates relative to traffic, popula- with spatial residuals, see online supplementary figure tion, industry, or nature was evaluated with LUR models. 1 for a graphical representation of the possible causal Then, local estimates at the postcode level were predicted mechanism. and aggregated at the super output area (SOA) level, with Let Yi denote the number of cases recorded in the spatial a population- weighted mean, for all SOAs in the study. unit i and Ei the expected count taking into account the Exposure was assigned for each case or incidence at post- age and sex structure of the population at risk (internal code level. standardisation). Then, using Poisson regression, Yi is 2 Lavigne A, et al. BMJ Open 2019;9:e030140.
Load more

Recommended publications
  • Open Letter to the ICO, Cmos and UK Data Providers: Reducing Barriers to Data Access for Research in the Public Interest – Lessons from COVID-19
    Open letter to the ICO, CMOs and UK data providers: Reducing barriers to data access for research in the public interest – lessons from COVID-19 Dear Ms Elizabeth Denham CBE, Prof Sir Chris Whitty, Dr Frank Atherton, Dr Gregor Smith, Dr Michael McBride, Ms Sarah Wilkinson, Rt Hon. Gavin Williamson MP, Sir Ian Diamond, Prof David Ford, Prof Kerina Jones, Prof Ronan Lyons, Ms Siobhan Carey CBE, Mr Roger Halliday, Mr Frank Hester OBE, Dr Janet Valentine, and Mr Duncan Selbie, Letter sent by email on 6th July 2020 The COVID-19 outbreak has sparked increased awareness of the importance of timely, system-wide data for examining trends and modelling different scenarios to inform policy response.1-5 The scale and speed of data access and use has been unprecedented in public health history. Pre-print articles sharing results before peer review have proliferated (with implications for research quality6 7) and over 500 vaccine and treatment clinical trials have been initiated in record time.8 The entire economy of knowledge production related to COVID-19 has been accelerated, with the understanding that, if we wait for perfect information before acting, we will be too late. COVID-19 is providing valuable lessons on improving data access and the importance of using data for efficient and effective service response. This situation contrasts sharply with the cumbersome processes usually faced by researchers using administrative (or routinely-collected) health data to inform policy-making on other topics, resulting from systems that are not purpose-built for research and summarised by four key obstacles. First, the cost of using administrative data is prohibitive.
    [Show full text]
  • Profile of Neighbourhoods in England and the Netherlands
    Environmental Pollution 198 (2015) 201e210 Contents lists available at ScienceDirect Environmental Pollution journal homepage: www.elsevier.com/locate/envpol Associations between air pollution and socioeconomic characteristics, ethnicity and age profile of neighbourhoods in England and the Netherlands * Daniela Fecht a, , Paul Fischer b,Lea Fortunato a, Gerard Hoek c, Kees de Hoogh a, 1, Marten Marra b, Hanneke Kruize b, Danielle Vienneau a, 1, Rob Beelen c, Anna Hansell a, d a UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK b Centre for Sustainability, Environment and Health, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 Bilthoven, The Netherlands c Institute for Risk Assessment Sciences (IRAS), Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands d Honorary Consultant, Imperial College Healthcare NHS Trust, London, UK article info abstract Article history: Air pollution levels are generally believed to be higher in deprived areas but associations are complex Received 29 April 2014 especially between sensitive population subgroups. Received in revised form We explore air pollution inequalities at national, regional and city level in England and the 28 November 2014 Netherlands comparing particulate matter (PM ) and nitrogen dioxide (NO ) concentrations and pub- Accepted 11 December 2014 10 2 licly available population characteristics (deprivation, ethnicity, proportion of children and elderly). Available online We saw higher concentrations in the most deprived 20% of neighbourhoods in England (1.5 mg/m3 3 higher PM10 and 4.4 mg/m NO2).
    [Show full text]
  • HEALTH PROTECTION RESEARCH UNIT ANNUAL REPORT 2017/18 Financial Year
    HEALTH PROTECTION RESEARCH UNIT ANNUAL REPORT 2017/18 Financial Year Note: The accompanying ‘NIHR Health Protection Research Unit – Guidance on Completion of Annual Reports’ for 2017/18 Financial Year contains essential guidance on the information you need to provide when completing this form. Please note that the overview of activities (and other sections of the Progress Report) should reflect activities which fall within the remit of the NIHR HPRU funding scheme. Please complete the form using a font size no smaller than 10 point (Arial). 1. UNIT DETAILS Name of the NIHR Health Protection Research Unit: Contact details of the individual to whom any queries on this Annual Report will be referred. Feedback on this report will be provided to the Director, copied to the manager. Name: Angela Lewis Job Title: Programme Manager Address: King’s College London, Franklin Wilkins Building, 150 Stamford Street, London SE1 9NH Email: [email protected] Tel: 020 7848 3765 2. DECLARATIONS AND SIGNATURES Contact details of the University administering the NIHR Health Protection Research Unit award: Name: King’s College London Address: Franklin Wilkins Building, 150 Stamford Street, London SE1 9NH Name of the Director: Professor Frank J. Kelly I hereby confirm, as Director of the NIHR Health Protection Research Unit award, that this Annual Report has been completed in accordance with the guidance issued by the Department of Health and provides an accurate representation of the activities of the NIHR Health Protection Research Unit: Signature …… ………….. Date: 8th May 2018…… (Director) NIHR Health Protection Research Unit– Progress Report 201718 1 3. SUMMARY OF ACTIVITIES FOR THE COLLECTIVE NIHR HPRU PUBLIC REPORT The NIHR HPRU in the Health Impact of Environment Hazards (HIEH) provides high quality scientific evidence to support PHE’s roles in implementing effective public health interventions to prevent and reduce the burden of ill health associated with environmental hazards.
    [Show full text]
  • Birth Weight, Early Childhood Growth and Lung Function In
    Respiratory epidemiology ORIGINAL ARTICLE Thorax: first published as 10.1136/thoraxjnl-2014-206457 on 16 July 2015. Downloaded from Birth weight, early childhood growth and lung function in middle to early old age: 1946 British birth cohort Yutong Cai,1 Seif O Shaheen,2 Rebecca Hardy,3 Diana Kuh,3 Anna L Hansell1,4 ▸ Additional material is ABSTRACT published online only. To view Background Findings from previous studies Key messages please visit the journal online (http://dx.doi.org/10.1136/ investigating the relationship between birth weight and thoraxjnl-2014-206457). adult lung function have been inconsistent, and data on birth weight and adult lung function decline are lacking. 1Department of Epidemiology What is the key question? and Biostatistics, MRC-PHE Few studies have investigated the relation between early ▸ Do associations between birth weight, early Centre for Environment and childhood growth and adult lung function. childhood growth and lung function change Health, School of Public Methods FEV1 and FVC were measured at ages 43 during midlife to early old age? Health, Imperial College years, 53 years and 60–64 years in the 1946 British London, London, UK 2 birth cohort study. Multiple linear regression models What is the bottom line? Centre for Primary Care and ▸ Early childhood growth and birth weight were Public Health, Barts and The were fitted to study associations with birth weight and London School of Medicine weight gain at age 0–2 years. Multilevel models associated with lung function in middle age, and Dentistry, Queen Mary particularly in women, but the effect size assessed how associations changed with age, with FEV1 University of London, London, and FVC as repeated outcomes.
    [Show full text]
  • Long-Term Exposure to Air Pollution and Chronic Bronchitis
    Long-term Exposure to Air Pollution and Chronic Bronchitis A report by the Committee on the Medical Effects of Air Pollutants Chairman: Professor Frank Kelly Chairman of QUARK Subgroup on Chronic Bronchitis: Professor Peter Burney © Crown copyright 2016 (Reissued with minor corrections to the appendices, July 2016) Produced by Public Health England for the Committee on the Medical Effects of Air Pollutants ISBN 978-0-85951-782-9 Foreword In this report we evaluate the epidemiological evidence linking long-term exposure to ambient air pollution and chronic respiratory morbidity with the aim of calculating the likely number of people affected in the UK. To undertake this task we established a working group to review the substantial body of literature available. To avoid double counting of effects in quantification, the working group focused on chronic bronchitis and assessed the non-lethal effects of long-term exposure to air pollution on the lung in terms of symptoms, ie cough and phlegm. I am extremely grateful to the working group members and the secretariat who, led by Professor Peter Burney, performed this detailed work and produced several draft reports for COMEAP to consider. Having completed this task, the working group concluded that the evidence of an association between chronic bronchitis and long-term exposure to air pollution was inconsistent and therefore not sufficient to infer a causal relationship in the UK today. Although concluding that the evidence base is not sufficiently robust to link long-term exposure to ambient air pollution and chronic respiratory morbidity, the working group was able to estimate that for up to 18% of those individuals reporting chronic phlegm in 2010, the symptom was possibly due to ambient air pollution exposure.
    [Show full text]
  • Reproductive Outcomes Associated with Noise Exposure — a Systematic Review of the Literature
    Int. J. Environ. Res. Public Health 2014, 11, 7931-7952; doi:10.3390/ijerph110807931 OPEN ACCESS International Journal of Environmental Research and Public Health ISSN 1660-4601 www.mdpi.com/journal/ijerph Review Reproductive Outcomes Associated with Noise Exposure — A Systematic Review of the Literature Gordana Ristovska 1,*, Helga Elvira Laszlo 2 and Anna L. Hansell 2,3 1 Department for Environmental Health, Institute of Public Health of Republic of Macedonia, 50 Divizija No. 6, Skopje 1000, Republic of Macedonia 2 MRC-PHE Centre for Environment and Health, Imperial College London, London W2 1PG, UK; E-Mails: [email protected] (H.L.); [email protected] (A.H.) 3 Imperial College Healthcare NHS Trust, London W2 1PG, UK * Author to whom correspondence should be addressed; E-Mail: [email protected]; Tel.: +389-70-285-465. Received: 17 April 2014; in revised form: 8 July 2014 / Accepted: 16 July 2014 / Published: 6 August 2014 Abstract: Introduction: High noise exposure during critical periods in gestation is a potential stressor that may result in increased risk of implantation failure, dysregulation of placentation or decrease of uterine blood flow. This paper systematically reviews published evidence on associations between reproductive outcomes and occupational and environmental noise exposure. Methods: The Web of Science, PubMed and Embase electronic databases were searched for papers published between 1970 to June 2014 and via colleagues. We included 14 epidemiological studies related to occupational noise exposure and nine epidemiological studies related to environmental noise exposure. There was some evidence for associations between occupational noise exposure and low birthweight, preterm birth and small for gestational age, either independently or together with other occupational risk factors.
    [Show full text]
  • Fetal Growth, Stillbirth, Infant Mortality and Other Birth Outcomes Near UK Municipal Waste Incinerators
    Environment International xxx (xxxx) xxx–xxx Contents lists available at ScienceDirect Environment International journal homepage: www.elsevier.com/locate/envint Fetal growth, stillbirth, infant mortality and other birth outcomes near UK municipal waste incinerators; retrospective population based cohort and case-control study Rebecca E. Ghosha, Anna Freni-Sterrantinoa, Philippa Douglasa,b,c, Brandon Parkesa, Daniela Fechta,d, Kees de Hooghe,f, Gary Fullerg, John Gulliverd,h, Anna Fontg, Rachel B. Smithd, ⁎ ⁎ ⁎ Marta Blangiardod, Paul Elliotta,c,d,i,j, , Mireille B. Toledanoc,d, , Anna L. Hansella,c,d,h,j, a UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK b Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, SW3 6LR, UK c National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards, Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK d MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK e Swiss Tropical and Public Health Institute, Basel, Switzerland f University of Basel, Basel, Switzerland g MRC-PHE Centre for Environment and Health, Environmental Research Group, School of Population Health and Environment Sciences, King's College London, London
    [Show full text]
  • ENVIRONMENTAL NOISE GUIDELINES for the European Region Abstract Noise Is an Important Public Health Issue
    ENVIRONMENTAL NOISE GUIDELINES for the European Region Abstract Noise is an important public health issue. It has negative impacts on human health and well-being and is a growing concern. The WHO Regional Office for Europe has developed these guidelines, based on the growing understanding of these health impacts of exposure to environmental noise. The main purpose of these guidelines is to provide recommendations for protecting human health from exposure to environmental noise originating from various sources: transportation (road traffic, railway and aircraft) noise, wind turbine noise and leisure noise. They provide robust public health advice underpinned by evidence, which is essential to drive policy action that will protect communities from the adverse effects of noise. The guidelines are Environmental Noise Guidelines published by the WHO Regional Office for Europe. In terms of their health implications, the recommended exposure levels can be considered applicable in other regions and suitable for a global audience. for the European Region Keyword NOISE – ADVERSE EFFECTS, PREVENTION AND CONTROL ENVIRONMENTAL EXPOSURE – ADVERSE EFFECTS, PREVENTION AND CONTROL GUIDELINES EUROPE Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe UN City, Marmorvej 51 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office website (http://www.euro.who.int/pubrequest). ISBN 978 92 890 5356 3 © World Health Organization 2018 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full.
    [Show full text]
  • Aviation Noise Impacts: State of the Science
    Review Article Aviation Noise Impacts: State of the Science Mathias Basner1, Charlotte Clark1, Anna Hansell3,4, James I. Hileman5, Sabine Janssen6, Kevin Shepherd7, Victor Sparrow8 1Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, 2Centre for Psychiatry, Barts & The London School of Medicine, Queen Mary University of London, 3MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, 4Public Health and Primary Care, Imperial College Healthcare NHS Trust, St. Mary’s Hospital, London, United Kingdom, 5Office of Environment and Energy (AEE-3), Federal Aviation Administration, Washington, DC, USA, 6Urban Environment and Safety, TNO (Netherlands Organization for Applied Scientific Research), Delft, The Netherlands, 7M.S. 463 Structural Acoustics Branch, NASA Langley Research Center, Hampton, VA, 8Penn State, University Park, PA, USA Abstract Noise is defined as “unwanted sound.” Aircraft noise is one, if not the most detrimental environmental effect of aviation. It can cause community annoyance, disrupt sleep, adversely affect academic performance of children, and could increase the risk for cardiovascular disease of people living in the vicinity of airports. In some airports, noise constrains air traffic growth. This consensus paper was prepared by the Impacts of Science Group of the Committee for Aviation Environmental Protection of the International Civil Aviation Organization and summarizes the state of the science of noise effects research in the areas of noise measurement and prediction, community annoyance, children’s learning, sleep disturbance, and health. It also briefly discusses civilian supersonic aircraft as a future source of aviation noise.
    [Show full text]
  • Final Report ENNAH – European Network on Noise and Health
    FINAL REPORT FP7‐ENV‐2008‐1, no. 226442 0 Final Report ENNAH – European Network on Noise and Health EU Project no. 226442 FP-7-ENV-2008-1 Editors: Jurgita Lekaviciute, Stylianos Kephalopoulos, Stephen Stansfeld, Charlotte Clark 2013 Report EUR 25809 EN FINAL REPORT FP7‐ENV‐2008‐1, no. 226442 European Commission Joint Research Centre Institute for Health and Consumer Protection Contact information Stylianos Kephalopoulos Address: Joint Research Centre, Via Enrico Fermi 2749, TP 281, 21027 Ispra (VA), Italy E‐mail: [email protected] Tel.: +39 0332 78 9871 Fax: +39 0332 78 5867 http://ihcp.jrc.ec.europa.eu/ http://www.jrc.ec.europa.eu/ This publication is a Scientific and Policy Report by the Joint Research Centre of the European Commission. Legal Notice Neither the European Commission nor any person acting on behalf of the Commission is responsible for the use which might be made of this publication. Europe Direct is a service to help you find answers to your questions about the European Union Freephone number (*): 00 800 6 7 8 9 10 11 (*) Certain mobile telephone operators do not allow access to 00 800 numbers or these calls may be billed. A great deal of additional information on the European Union is available on the Internet. It can be accessed through the Europa server http://europa.eu/. JRC77642 EUR 25809 EN ISBN 978‐92‐79‐28593‐6 (online) ISBN 978‐92‐79‐28594‐3 (print) ISSN 1831‐9424 (online) ISSN 1018‐5593 (print) DOI: 10.2788/83694 (online) Luxembourg: Publications Office of the European Union, 2013 © European Union, 2013 Reproduction is authorised provided the source is acknowledged.
    [Show full text]
  • Quantification of Heaith Impacts of Air Poiiution Reduction in Kensington & Cheisea and Westminster
    Quantification of heaith impacts of air poiiution reduction in Kensington & Cheisea and Westminster Dr Jennifer Susan Mindell Thesis for Doctorate of Phiiosophy (PhD) imperiai Coliege of Science, Technology and Medicine, University of London ProQuest Number: U643768 All rights reserved INFORMATION TO ALL U SE R S The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. uest. ProQuest U643768 Published by ProQuest LLC(2016). Copyright of the Dissertation is held by the Author. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code. Microform Edition © ProQuest LLC. ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 To David, Judith and William Abstract Health Impact Assessment (HIA) is an assessment of the health effects, positive or negative, of a project, programme or policy. However, the quality of the evidence base currently available for HIA may limit the soundness and completeness of the conclusions, and consequently the capacity to achieve health gain. I developed a four-stage framework of the information required to quantify health impacts: evidence for causality, magnitude of response, baseline event rate, and change in exposure. The UK National Air Quality Strategy requires local authorities to achieve targets for seven outdoor air pollutants. I conducted systematic literature reviews and evaluated the epidemiological evidence relating ambient particulates and nitrogen dioxide (the pollutants relevant to central London) to various health outcomes.
    [Show full text]
  • Linked Electronic Health Records for Research on a Nationwide Cohort Including Over 54 Million People in England
    medRxiv preprint doi: https://doi.org/10.1101/2021.02.22.21252185; this version posted February 26, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-ND 4.0 International license . Linked electronic health records for research on a nationwide cohort including over 54 million people in England CVD-COVID-UK consortium* 3 tables, 3 figures 6 Supplementary tables Key Words: Electronic Health Records, England, administrative health datasets, nationwide, population-scale, trusted research environment, NHS Digital, primary care, hospital admissions, Covid-19 Word count = 4342 *Contributions to this manuscript: Manuscript drafting and revising: Angela Wood (writing committee chair) 4,5,8,13,19, Rachel Den- holm2,10,14, Sam Hollings16, Jennifer Cooper2,10,14, Samantha Ip4, Venexia Walker7,12, Spiros De- naxas3,11,15,19, Ashley Akbari18, Jonathan Sterne†2,10,14, Cathie Sudlow†9,21 †equal contributions Data wrangling, QA and analysis (including generating phenotype definitions): Angela Wood (chair), Rachel Denholm, Sam Hollings, Jennifer Cooper, Samantha Ip, Venexia Walker, Spiros De- naxas, Amitava Banerjee1,11,20, William Whiteley6,17 Figures/graphics: Alvina Lai11 Consortium coordination (BHF Data Science Centre core team): Rouven Priedon9, Cathie Sudlow9, Lynn Morrice9, Debbie Ringham9 NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.1 medRxiv preprint doi: https://doi.org/10.1101/2021.02.22.21252185; this version posted February 26, 2021.
    [Show full text]