01/12/2011 Transport & Health: some major issues 2011 Annual Polis conference Brussels Luc Int Panis

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1 01/12/2011 Transport & Health: some major issues 2011 Annual Polis conference Brussels Luc Int Panis Research coordinator Environmental Risk & Health at the Flemish Institute for Technological Research Transport Transportation Research Institute (Univ. Hasselt)

2 Issues» What fraction of PM causes health effects?» Traffic» Black Carbon» What are the major health impacts of cycling?» Not air quality» Minor accidents: need to quantify risk and costs» How can we effectively solve both problems? and achieve a major health benefit 01/12/2011 2

3 Traffic is not healthy (may be PM, noise, stress,.,?) Acute effect 01/12/2011 3

4 Diesel: Hyde park vs Oxford street Walking in Oxford street vs Hyde park Acute effect 01/12/ McCreanor et al. New Engl J Med. 2007

5 Gauderman et al The Lancet Chronic effect 01/12/2011 5

6 Asthma incidence and prevalence related to air pollution (causes new cases not just exacerbation, confirms HEI, 2009 consensus Acute & Chronic effect 01/12/2011 6

7 01/12/2011 7

8 Could it be the tiny black fraction? EC Measured PM composition in Flanders Source VMM, ChemKar, 2009 City of Antwerp (Borgerhout) Black Carbon Bron VMM, ChemKar PM10 HotSpots, /12/2011 8

9 Personal exposure to Black Carbon Car commute Bicycle ride 01/12/2011 9

10 Social & Leisure; 6,3% Shopping; 1,1% Personal exposure to Black Carbon Work; 17,0% Time-activity Other; 3,9% Sleep; 35,5% Homebased activities; 29,9% Social & Leisure; 12,8% In transport; 6,3% Social & Leisure; 8,9% Contribution to dose Shopping; 3,2% Other; 5,6% In transport; 29,8% Contribution to exposure Shopping; 2,0% Work; 12,2% Sleep; 25,0% Other; 4,3% In transport; 21,0% Homebased activities; 26,7% Black Carbon Work; 12,8% Sleep; 13,9% Homebased activities; 21,8% 01/12/

11 01/12/

12 Does a very brief exposure to high peaks of Black Carbon really cause health effects in healthy people? 01/12/

13 Looking for health effects 01/12/

14 Jacobs et al (2010) Bos et al. (2011) Differences in clinical endpoints per location Endpoint Near ring road Clean room Difference P-value Difference P-value Log Exhaled NO, ppb -2.9% (-3.0% to -2.7%) % (-3.1% to 3.5%) 0.63 Log PFA closure time, s ( to 0.060) ( to 0.048) 0.11 Log Il-6, pg/ml ( to 0.17) ( to 0.064) 0.71 Clara cell protein, µg/l 2.8% (-8.0% to 13.7%) % (-6.6% to 11.7%) 0.58 Leukocyte counts, per µl 1.3% (-2.0% to 4.6%) % (-1.1% to 6.1%) 0.19 Neutrophil counts, per µl 4.6% (0.51% to 13.1%) % (-2.3% to 7.2%) 0.33 Percentage neutrophils, % 3.9% (1.5% to 6.2%) % (-1.8% to 2.2%) 0.83 Subclinical responses in healthy cyclists briefly exposed to traffic-related air pollution: an intervention study Lotte Jacobs, Tim S Nawrot, Bas de Geus, Romain Meeusen, Bart Degraeuwe, Alfred Bernard, Muhammad Sughis, Benoit Nemery, Luc Int Panis Environmental Health :64 01/12/

15 Very preliminary indications for Neurological effects? 01/12/

16 Cycling is very healthy 01/12/

17 But perhaps not always? 01/12/

18 Reduce the cost of minor accidents TAPAS based on SHAPES Source: Rabl & De Nazelle /12/

19 Costs of minor accidents (SHAPES project) (Aertsens et al, 2010) Type of injury & consequences Acute Body Injuries Light injuries No injuries Cost category Long term Short term Direct Costs Medical costs non medical costs Indirect costs Productivity loss Leisure time loss Intangible costs Other costs permanent invalidity WTP to avoid pain WTP to avoid psych. conseq. costs for 3rd parties TOTAL Minor accidents, major health costs 01/12/

20 Costs of minor accidents (SHAPES project) Avg. cost ( ) CI_low ( ) CI_high ( ) NO_Injury LIGHT_Injury Acute Injury _Short Term Acute Injury _Long Term minor accident Minor accident risk is 155 per million kilometers cycled (1 accident each 6500 km) Injury risk is 121 per million kilometers cycled (1 injury each 8264 km) Average cost of minor accident is 841 euro (0.125 euro/ km) Total cost of minor cycling accidents in Belgium is million Much higher than expected BUT Major benefits 01/12/2011 can result from avoiding accidents 20

21 How can we increase the modal share of cycling? (Vandenbulcke, 2011) Share of commuter cyclists 22% 20% 18% 16% 14% 12% 10% 8% 6% 4% 2% 0% Units associated with the correspondent explanatory variables Commuting distance Accident risk Slopes Traffic volume 2 (municipal network) Figure 1: Variation of the dependant variable (i.e. share of commuter cyclists) as several explanatory variables change while holding all others constant at their means 01/12/

22 How can we effectively solve the BC and accident problems and maximise the health benefits? Share of commuter cyclists 22% 20% 18% 16% 14% 12% 10% 8% 6% 4% 2% 0% 01/12/ Units associated with the correspondent explanatory variables Commuting distance Accident risk Slopes Traffic volume 2 (municipal network) Figure 1: Variation of the dependant variable (i.e. share of commuter cyclists) as several explanatory variables change while holding all others constant at their means luc.intpanis@vito.be luc.intpanis@uhasselt.be

23 Black carbon (ng/m³) Persoonlijke blootstelling aan roet N= N= N=2259 N=72406 N= /12/

24 Black carbon (ng/m³) Persoonlijke blootstelling aan roet in het verkeer N=3190 N= N= N=1167 N=1161 N= N= /12/

25 BDNF 01/12/