A presentation from RTCA17, held on 24th-25th October 2017. Professor Cosford's presentation explores the role of the Public Health England in improving air quality within the UK. Raising public and professional awareness through sustained public health engagement with local authorities and other stakeholders.

1. Air Quality and the Public’s
Health
Professor Paul Cosford
Director for Health Protection & Medical Director, Public Health England
Routes to Clean Air 2017

2. Air pollution - still a problem
Public Health England
© Royal College of Physicians 2016
Latest WHO urban air quality database shows more than 80% of people living in urban areas are exposed
to air quality levels that exceed the WHO limits (WHO 2016)

3. 3

4. PHE’s Role inAir Quality
Programme of work in support of national and local
government to reduce health effects of air pollution
Evidence development of the mortality and morbidity effects
associated with both indoor and outdoor air pollution
Advising those who are in a position to take action to
improve air quality at local, national and international level
o to reduce emissions of pollutants
o to help reduce exposure of the population to these
emissions

5. PHE’s Role in air quality
Raising public and professional awareness through
sustained public health engagement with local authorities
and other stakeholders
Assessing interventions to reduce exposure to air pollution,
and improve health and wellbeing
To focus on measures that have co-benefits for air pollution
with other PH priorities

6. Developing the evidence base

7. Current work
Advice to Defra on quantifying the mortality effects of
NO2
Long-term exposure to air pollution and cardiovascular
morbidity
Dementia
Public health risks associated with exposure to dust
particles in the London Underground

8. Guidance on estimating mortality attributable PM2.5 at Local
Authority level
Gowers et al, 2014 https://www.gov.uk/government/publications/estimating-local-mortality-burdens-associated-with-particulate-air-pollution
Public Health Outcomes Framework http://www.phoutcomes.info/
Local mortality burdens

9. The Health Impact of Environmental Hazards
Environmental Change and Health
Cover a wide range of issues around air pollution, including
• Exposure to low levels of carbon monoxide
• Optimising the assessment of health impacts of air pollution
• Nanoparticle exposure assessment
• Diesel exhaust particles and cerium nanoparticles
• Assessing interventions
www.hpru-ech.nihr.ac.uk
www.hieh.hpru.ac.uk
Health Protection Research Units

10. Developing the evidence base
Costs to the NHS and social care
PHE has commissioned a consortium led by the UK Health Forum to carry out
a project on the estimation of costs due to the health impacts of air pollution
Other examples

11. Raising Awareness and
Supporting Action by Local
Government

12. Abriefing for Directors of Public Health
Overview
• Updated resource pack (first
launched in 2015)
• A suite of information,
guidance and
communication tools in six
easily accessed guides
• Recognises the vital role of
local authorities
• Designed to make it easier
for local authorities to be as
effective as possible in
improving local air quality
http://www.local.gov.uk/web/guest/publications/-/journal_content/56/10180/8324922/PUBLICATION

13. Volume 1.
Getting to grips with air pollution
A digest of latest evidence
and techniques
• Describes the key air
pollutants of concern
• Sets out current
understanding of health
impacts
• What are sources of air
pollution and exposure?
• Describes how local measures
can improve public health
• Provides case studies of local
action
• Introduces a ‘First Steps‘ -
Action Plan

14. Volume 2.
Understanding air pollution in your area
How to conduct a basic local
air quality assessment:
• A step by step guide to
understanding local air
quality issues
• How to identify higher risk
locations and key sources of
pollution
• How to do a comparative
assessment to aid
prioritisation

15. Volume 3.
Engaging local decision makers
How to make the case
for action
• Explaining contemporary air
pollution
• Checklist of local
stakeholders and their roles
• Potential synergies
between air quality and
other local policies
Every director of public health will want to
ensure that local air pollution is
appropriately assessed and prioritised
What action you they take next, however,
will depend on an assessment of the scale
of the problem.

16. Volume 4. Communicating during air
pollution episodes
Guidance on how to
communicate balanced and
accurate messages during
short term periods of high air
pollution. Includes:
• Background information on
air pollution episodes
• Appropriate health messages
to enable residents to make
informed decisions, e.g. on
how to reduce their exposure.
• Ideas for new communication
approaches
Helps to build awareness of
everyone’s role in tackling air
pollution

17. Volume 5. Communicating the long
term impacts of air pollution
Provides guidance and
key messages around:
• Explaining long–term air
pollution
• Risks
• Explaining the mortality
effect of long term
exposure
• Sources of air pollution
• Engaging the media
Includes 6 key principles for
communication about air
pollution
The public can play a critical role through
reducing their personal contribution to air
pollution and supporting local actions but..
Communication needs to be handled
carefully

18. Organised by Global Action Plan
PHE advised on the communication messages regarding health effects
of air pollutants and actions that people can take to reduce their
exposure and to reduce emissions
Over 200 events, 550 media and broadcast items and 28,000 tweets,
messages about air pollution and how to tackle it had a reach of 86
million
https://www.cleanairday.org.uk/celebration-report
National CleanAir Day

19. Support to Local government
To continue to support and, where necessary, co-ordinate local air
quality networks bringing together public health professional, planners
and other interested parties
The air quality plan for NO2 extended the number of local authorities
required to undertake local feasibility studies and draw up local plans to
reduce NO2 concentrations
Our local leads on air quality will consult with local authorities on the
appropriate indicators of success in developing and implementing
CAZs to enable local authorities to monitor their progress

20. Interventions

21. Air pollution: outdoor air quality and health
Focus on the cost-effectiveness of local interventions which aim to reduce
exposure to transport related air pollution The recommendations are
related to:
1. Planning
2. Clean air zones
3. Reducing emissions from public sector transport services and
vehicle fleets
4. Smooth driving and speed reduction
5. Cycle routes
6. Awareness raising
NICE Guidelines

22. Review of health impact assessment
methods for active travel/local travel plans
• Investigate methods that evaluate the
health outcomes from transport
interventions and active travel plans.
• Review modelling tools available for health
impact assessments of interventions at
different spatial scales.
Assessing interventions

23. PHE Evidence Review
Commissioned by the Department of Health
Practical recommendations for any actions not currently included in
the stratify, where possible, by health and economic impacts
The work will build on the UK’s 2017 plan for reducing roadside NO2
concentrations and the NICE guidelines
Wider remit to cover the pollutants that will be in the Clean Air
Strategy (NO2, SO2, VOCs, ammonia and PM) and other sources of
pollutants

24. PHE Evidence Review
PHE is commissioning 5 rapid evidence assessments
Planning/structural design interventions
Vehicle/fuel interventions
Social science/behavioural interventions
Industrial regulations/factory design/location
Agricultural regulations/ design/location
Report to be submitted to Ministers in August 2018

25. Head of Environmental Hazards and Emergencies Department: Naima Bradley
Air Quality and Public Health Group: Karen Exley (Group Leader), Alison
Gowers, Sani Dimitroulopoulou, Sarah Robertson, Christina Mitsakou
Local air quality leads: Alec Dobney, Lydia Izon-Cooper, Charlotte Landeg-Cox,
Adrienne Dunne, Amanda Craswell, Stuart Aldridge, Jamie Bond
Air Quality Review project manager James Stewart-Evans
Many others at PHE
Funding for NIHR Health Protection Research Units, Eurohealthy
Acknowledgements