Health impact assessment of active transportation: A systematic review

Mueller, Natalie; Rojas-Rueda, David; Cole‐Hunter, Tom; Nazelle, Audrey de; Dons, Evi; Gerike, Regine; Götschi, Thomas; Panis, Luc Int; Kahlmeier, Sonja; Nieuwenhuijsen, Mark

doi:10.1016/j.ypmed.2015.04.010

Cited by 614 publications

(399 citation statements)

References 83 publications

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“…Our finding that long‐term benefits of physical activities on MI incidence and recurrence are not statistically significantly modified by exposure to higher levels of NO 2 is novel. Our results strengthen and complement a growing number of health impact assessment studies, supporting the evidence that health benefits because of increased physical activities levels generally outweigh the risks related to increases in inhaled air pollution doses during physical activity 44. However, given the limitations of our study, we cannot exclude potentially higher net effects of physical activities, when predominantly performed in low air pollution.…”

Section: Discussionsupporting

confidence: 85%

Effects of Leisure‐Time and Transport‐Related Physical Activities on the Risk of Incident and Recurrent Myocardial Infarction and Interaction With Traffic‐Related Air Pollution: A Cohort Study

Kubesch

Jørgensen

Hoffmann

et al. 2018

JAHA

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BackgroundPhysical activity enhances the uptake of air pollutants, possibly reducing its beneficial effects. We examined the effects of leisure‐time and transport‐related physical activities on the risk of myocardial infarction (MI), and whether potential benefits on MI are reduced by exposure to traffic‐related air pollution.Methods and ResultsA group of 57 053 participants (50–65 years of age) from the Danish Diet, Cancer, and Health cohort reported physical activity at baseline (1993–1997) and were linked to registry data on hospital contacts and out‐of‐hospital deaths caused by MI, until December 2015. Nitrogen dioxide levels were estimated at participants’ baseline residences. We used Cox regressions to associate participation in sports, cycling, walking, and gardening with incident and recurrent MI, and tested for interaction by nitrogen dioxide. Of 50 635 participants without MI at baseline, 2936 developed incident MI, and of 1233 participants with MI before baseline, 324 had recurring MI during follow‐up. Mean nitrogen dioxide concentration was 18.7 μg/m3 at baseline (1993–1997). We found inverse statistically significant associations between participation in sports (hazard ratio; 95% confidence interval: 0.85; 0.79–0.92), cycling (0.91; 0.84–0.98), gardening (0.87; 0.80–0.95), and incident MI, while the association with walking was statistically nonsignificant (0.95; 0.83–1.08). Recurrent MI was statistically nonsignificantly inversely associated with cycling (0.80; 0.63–1.02), walking (0.82, 0.57–1.16), and gardening (0.91; 0.71–1.18), and positively with sports (1.06; 0.83–1.35). There was no effect modification of the associations between physical activity and MI by nitrogen dioxide.ConclusionsBenefits of physical activity on both the incidence and the recurrence of MI are not reduced by exposure to high levels of air pollution.

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Section: Discussionsupporting

confidence: 85%

Effects of Leisure‐Time and Transport‐Related Physical Activities on the Risk of Incident and Recurrent Myocardial Infarction and Interaction With Traffic‐Related Air Pollution: A Cohort Study

Kubesch

Jørgensen

Hoffmann

et al. 2018

JAHA

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“…To date, very little work has been done in order to understand the different aspects of moving from motorized transport to bicycling. Even though different reviewers have investigated the health and economic benefits of active transportation [28–30], to the best of our knowledge there are only three systematic reviews investigating the health impacts of active transportation, one focusing on health risks and benefits [31] and two focusing on methodological issues [30,32]. Each of the aspects, or health pathways, listed above are important to consider in such HIAs, but these are quite complicated and can be dealt with in more or less sophisticated ways.…”

Section: Introductionmentioning

confidence: 99%

Air pollution as a risk factor in health impact assessments of a travel mode shift towards cycling

Raza

Forsberg

Johansson

et al. 2018

Global Health Action

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Background: Promotion of active commuting provides substantial health and environmental benefits by influencing air pollution, physical activity, accidents, and noise. However, studies evaluating intervention and policies on a mode shift from motorized transport to cycling have estimated health impacts with varying validity and precision. Objective: To review and discuss the estimation of air pollution exposure and its impacts in health impact assessment studies of a shift in transport from cars to bicycles in order to guide future assessments. Methods: A systematic database search of PubMed was done primarily for articles published from January 2000 to May 2016 according to PRISMA guidelines. Results: We identified 18 studies of health impact assessment of change in transport mode. Most studies investigated future hypothetical scenarios of increased cycling. The impact on the general population was estimated using a comparative risk assessment approach in the majority of these studies, whereas some used previously published cost estimates. Air pollution exposure during cycling was estimated based on the ventilation rate, the pollutant concentration, and the trip duration. Most studies employed exposure-response functions from studies comparing background levels of fine particles between cities to estimate the health impacts of local traffic emissions. The effect of air pollution associated with increased cycling contributed small health benefits for the general population, and also only slightly increased risks associated with fine particle exposure among those who shifted to cycling. However, studies calculating health impacts based on exposure-response functions for ozone, black carbon or nitrogen oxides found larger effects attributed to changes in air pollution exposure. Conclusion: A large discrepancy between studies was observed due to different health impact assessment approaches, different assumptions for calculation of inhaled dose and different selection of dose-response functions. This kind of assessments would improve from more holistic approaches using more specific exposure-response functions.

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“…A recent systematic review of the health impacts of active transportation, conducted by Mueller et al (2015), emphasized that active transport provides health benefits despite the risks of traffic accidents and exposure to air pollution, which are outweighed by the positive outcomes. Active forms of transportation are linked to increased physical activity and social interaction.…”

Section: Transportation Mobility and Physical Activitymentioning

confidence: 99%

How can ecological urbanism promote human health?

Fajersztajn

Alves

Coelho³

et al. 2015

urbe, Rev. Bras. Gest. Urbana

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This special issue of URBE dedicated to Ecological Urbanism focuses on the role architects, landscape designers and urban planners can play in promoting healthier cities in Latin America. In this paper, we survey some of the empirical evidence that links the built environment with particular health outcomes. For many centuries, urban settlements were associated with adverse health outcomes, especially related to untreatable epidemics. As the science of disease transmission developed throughout the nineteenth century, the infrastructure of cities was transformed to promote improved public health. Significant gains were made, but in much of the world -Latin America included -urban health still remains a major challenge, all the more so as drug resistant strains of disease have become more prevalent. We believe Ecological Urbanism offers a promising framework for addressing these challenges. Distinguished by its integrated, multi-disciplinary foundation, Ecological Urbanism directly links both population and habitat health. This creates a natural opportunity for the design professions to play a more consequential role in shaping the health of urban settlements and, by extension, the regions they center.

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Health impact assessment of active transportation: A systematic review

Abstract: Despite different HIA methodologies being applied with distinctive assumptions on key parameters, AT can provide substantial net health benefits, irrespective of geographical context.

Cited by 614 publications

References 83 publications

Effects of Leisure‐Time and Transport‐Related Physical Activities on the Risk of Incident and Recurrent Myocardial Infarction and Interaction With Traffic‐Related Air Pollution: A Cohort Study

Effects of Leisure‐Time and Transport‐Related Physical Activities on the Risk of Incident and Recurrent Myocardial Infarction and Interaction With Traffic‐Related Air Pollution: A Cohort Study

Air pollution as a risk factor in health impact assessments of a travel mode shift towards cycling

How can ecological urbanism promote human health?

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