TY - JOUR
T1 - Regional Impact Assessment of Air Quality Improvement
T2 - The Air Quality Lifecourse Assessment Tool (AQ-LAT) for the West Midlands Combined Authority (WMCA)
AU - Hall, James
AU - Zhong, Jian
AU - Jowett, Sue
AU - Mazzeo, Andrea
AU - Thomas, G Neil
AU - Bryson, John R.
AU - Dewar, Steve
AU - Inglis, Nadia
AU - Wolstencroft, Mark
AU - Muller, Catherine
AU - Bloss, William
AU - Harrison, Roy
AU - Bartington, Suzanne
PY - 2024/9/1
Y1 - 2024/9/1
N2 - Poor air quality is the largest environmental health risk in England. In the West Midlands, UK, ~2.9 million people are affected by air pollution with an average loss in life expectancy of up to 6 months. The 2021 Environment Act established a legal framework for local authorities in England to develop regional air quality plans, generating a policy need for predictive environmental impact assessment tools. In this context, we developed a novel Air Quality Lifecourse Assessment Tool (AQ-LAT) to estimate electoral ward-level impacts of PM2.5 and NO2 exposure on outcomes of interest to local authorities, namely morbidity (asthma, coronary heart disease (CHD), stroke, lung cancer), mortality, and associated healthcare costs. We apply the Tool to assess the health economic burden of air pollutant exposure and estimate benefits that would be generated by meeting WHO 2021 Global Air Quality Guidelines (AQGs) (annual average concentrations) for NO2 (10 μg/m3) and PM2.5 (5 μg/m3) in the West Midlands Combined Authority Area. All West Midlands residents live in areas which exceed WHO AQGs, with 2070 deaths, 2070 asthma diagnoses, 770 CHD diagnoses, 170 lung cancers and 650 strokes attributable to air pollution exposure annually. Reducing PM2.5 and NO2 concentrations to WHO AQGs would save 10700 lives reducing regional mortality by 1.8%, gaining 92,000 quality-adjusted life years (QALYs), and preventing 20500 asthma, 7400 CHD, 1400 lung cancer, and 5700 stroke diagnoses, with economic benefits of £3.2 billion over 20 years. Significantly, we estimate 30% of QALY gains relate to reduced disease burden. The AQ-LAT has major potential to be replicated across local authorities in England and applied to inform regional investment decisions.
AB - Poor air quality is the largest environmental health risk in England. In the West Midlands, UK, ~2.9 million people are affected by air pollution with an average loss in life expectancy of up to 6 months. The 2021 Environment Act established a legal framework for local authorities in England to develop regional air quality plans, generating a policy need for predictive environmental impact assessment tools. In this context, we developed a novel Air Quality Lifecourse Assessment Tool (AQ-LAT) to estimate electoral ward-level impacts of PM2.5 and NO2 exposure on outcomes of interest to local authorities, namely morbidity (asthma, coronary heart disease (CHD), stroke, lung cancer), mortality, and associated healthcare costs. We apply the Tool to assess the health economic burden of air pollutant exposure and estimate benefits that would be generated by meeting WHO 2021 Global Air Quality Guidelines (AQGs) (annual average concentrations) for NO2 (10 μg/m3) and PM2.5 (5 μg/m3) in the West Midlands Combined Authority Area. All West Midlands residents live in areas which exceed WHO AQGs, with 2070 deaths, 2070 asthma diagnoses, 770 CHD diagnoses, 170 lung cancers and 650 strokes attributable to air pollution exposure annually. Reducing PM2.5 and NO2 concentrations to WHO AQGs would save 10700 lives reducing regional mortality by 1.8%, gaining 92,000 quality-adjusted life years (QALYs), and preventing 20500 asthma, 7400 CHD, 1400 lung cancer, and 5700 stroke diagnoses, with economic benefits of £3.2 billion over 20 years. Significantly, we estimate 30% of QALY gains relate to reduced disease burden. The AQ-LAT has major potential to be replicated across local authorities in England and applied to inform regional investment decisions.
KW - air quality
KW - particulate matter
KW - nitrogen dioxide
KW - health impact assessment
KW - health economics
KW - decision model
U2 - 10.1016/j.envpol.2024.123871
DO - 10.1016/j.envpol.2024.123871
M3 - Article
C2 - 38729507
SN - 0269-7491
VL - 356
JO - Environmental Pollution
JF - Environmental Pollution
M1 - 123871
ER -