Research and analysis

COMEAP Statement: Overview of advice provided to the Air Quality Information System (AQIS) review Steering Group

Published 18 March 2025

Summary

This statement summarises advice provided by the Committee on the Medical Effects of Air Pollutants (COMEAP) to the steering group for the review of the UK Air Quality Information System (AQIS). The intention of the AQIS review is to ensure that appropriate information on air quality is received by those who would most benefit from it. The project, which is overseen by the Department for Environment, Food and Rural Affairs (Defra) and the UK Health Security Agency (UKHSA), is being steered by a multidisciplinary AQIS Steering Group.

Our advice is based on four working papers developed by a COMEAP AQIS Sub-group. Three of these working papers relate to the behavioural advice that accompanies the UK Daily Air Quality Index (DAQI) which is used to provide information regarding short-term air pollution episodes.

These working papers cover:

• the susceptibility of different groups to adverse health effects
• the lag between short-term exposure and the occurrence of health outcomes
• the effects of exposure to air pollution during physical activity

The other working paper considers a possible approach to providing accessible information on long-term air pollution levels in the context of potential effects on health.

We recommend that the DAQI should continue to give separate behavioural advice to children with asthma, older people and those with respiratory and cardiovascular conditions. The available evidence indicates that these groups are more likely to be susceptible to the adverse health effects of short-term exposure to air pollution.

We recommend that the advice accompanying the DAQI should encourage individuals in these ‘at risk’ groups to monitor their symptoms for at least a week after exposure to elevated levels of air pollution. This is because symptoms and adverse health effects can occur several days after short-term exposure to air pollutants.

We recommend that the DAQI advice should focus on reducing personal exposure to air pollution, particularly when levels are elevated, rather than discouraging physical activity. In the context of this statement, ‘physical activity’ is used to cover the broad variety of activities that may contribute towards national recommendations for daily/ or weekly physical activity levels for children and adults. This includes activity undertaken as part of daily life, such as cycling to school, as well as sport or planned exercise. For most people in the UK, the long-term benefits of taking regular physical activity outweigh the risks of experiencing adverse symptoms from physical activity during short-term periods of elevated air pollution.

Those in susceptible groups should be encouraged to monitor their symptoms on the day of physical activity and following days, and to respond in accordance with their physician’s advice. For those who regularly achieve more than the minimum recommended amount of physical activity per week, advice could focus on the timing, intensity and location of the activity. For mass participation sporting events, advice should raise awareness of the potential health impacts of short-term exposure to air pollution.

The sub-group proposed the concept of a long-term air quality statement (LTAQS) which would provide the public with information on air quality over a longer timescale than the DAQI. Reporting annual concentrations and comparing them to legislative limits and other standards and guidelines was suggested. We also think it will be important to include information about sources of indoor air pollution.

The sub-group also identified a number of recommendations for further research that would help inform the refinement of future advice. These are listed in this statement and are intended for those funding and undertaking research.

Introduction

The AQIS review

There is growing awareness of the need to improve the provision of air quality information to better engage the public and, specifically, groups who may be particularly at risk of effects of air pollution.

Defra and UKHSA launched the AQIS review, in response to matters of concern raised in the prevention of future deaths report (April 2021) issued following the inquest into the death of Ella Adoo-Kissi-Debrah. The AQIS review is guided by an external steering group consisting of multi-disciplinary experts spanning air quality science, health science, behavioural science and digital communications, as well as clinicians, lay representation, representation from health charities and members from local and central government. The role of the steering group is to provide direction and oversight to the review, and ultimately to propose a series of actionable and evidence-based recommendations for changes that could be made to improve the government’s provision of air quality information.

Both long- and short-term exposures to air pollutants have adverse effects on health, and the AQIS steering group has highlighted the need to ensure that the information system communicates this clearly. Advice on who is most at risk is also needed. Different groups within the population may be at increased risk of adverse effects from air pollution for a number of reasons, and the most relevant information and advice might differ between these groups.

The AQIS review is set out in 5 workstreams covering:

• health science (who is at risk of air pollution and what advice is appropriate to give to different groups?)
• air quality data considerations (including the accuracy and precision of air quality monitoring, modelling and forecasting)
• communication (tailored to the target audiences)
• influencing behaviour change (in response to air quality information)
• dissemination of air pollution information (expanding reach)

COMEAP’s input to the AQIS review was primarily focused on the health science workstream and was discussed by the AQIS steering group at a number of its meetings. In addition, the chair of COMEAP was a member of the AQIS Steering Group.

The Daily Air Quality Index and London Alerts

Defra’s UK-AIR website is a major source of air quality information in the UK. UK-AIR hosts the Daily Air Quality Index (DAQI), which provides information on current and forecasted levels of air pollution in the UK. The index is based on concentrations of 5 pollutants: Nitrogen Dioxide (NO₂); Sulphur Dioxide (SO₂); Ozone (O₃); Particles less than 2.5µm (PM_2.5) and Particles less than 10µm (PM₁₀); and is communicated via a 10-point scale divided into 4 bands of Low, Moderate, High and Very High. The bandings are colour coded for ease of interpretation and are each associated with accompanying health advice.

The DAQI was developed by COMEAP (COMEAP, 2011) to provide accessible information to those who may be particularly likely to experience adverse effects during short-term episodes of elevated concentrations of air pollutants, as well as to the general population. It is intended to enable individuals to make appropriate changes to their behaviour in order to reduce their risk of experiencing adverse health effects. The DAQI currently defines at-risk groups as adults and children with lung problems, adults with heart problems, and older people. The advice includes reducing or avoiding strenuous activity outdoors and provides reminders regarding asthma medication use. The advice given to the general public and ‘at-risk’ groups differs depending upon the specific air pollution ‘bands’ being experienced across different geographical areas.

A new alert system for London healthcare professionals was launched by the London Air Quality and Health Programme Office in early 2024. To increase patient awareness about the health impacts of air pollution, the new alert system directly notifies London’s healthcare professionals of High and Very High pollution episodes as defined in the current DAQI. Further information can be found in Annexe A.

The role of the COMEAP AQIS Sub-group

A cross-disciplinary sub-group of COMEAP members and invited external experts (Annexe B) was established to advise on specific aspects relevant to the AQIS project. These included clinicians, epidemiologists, toxicologists, policy analysts and exercise physiologists. The role of the AQIS Sub-group was to provide advice to the AQIS Steering Group within COMEAP’s remit. The sub-group looked at the following topics, which are relevant to AQIS Workstream 1 (health science):

1. What is the evidence for susceptibility of different groups to adverse health effects from short- and long-term exposures to air pollutants?

2. What are the lag structures after short-term exposure to air pollution for different health conditions, and what implications does this have for health messaging?

3. What are the effects of exposure to air pollution during physical activity, and how does this affect those that are more susceptible to air pollution?

4. What might a long-term air quality statement (LTAQS) look like?

The sub-group’s views on these topics are presented as a series of working papers with recommendations to the AQIS Steering Group. This format was chosen, instead of a longer, more comprehensive statement or report, as the sub-group had a prescribed timeline to provide recommendations to the steering group. Below is a summary of each piece of work and the sub-group’s recommendations to the AQIS Steering Group.

Ways of Working

Small working groups of sub-group members led on drafting the working papers, addressing the different topics under consideration. The draft working papers were then brought to the sub-group meetings for discussion and then revised in line with the sub-group’s suggestions. For some topics, the sub-group heard from invited academics who were undertaking relevant research in the area (Annexe C).

Additionally, the sub-group also examined reports commissioned by the AQIS Secretariat to inform the discussions of the AQIS Steering Group. Some sub-group consideration of these reports has been included in the working papers.

The working papers were then discussed by the full COMEAP committee and revised, based on these discussions. The working papers were then provided to the AQIS steering group to inform their discussions.

Working papers

Evidence regarding groups susceptible to adverse health effects from exposure to air pollution

This working paper focused on the susceptibility of individuals in at-risk groups from exposure to air pollution. This initially focused on 2 sources, COMEAP’s statement ‘Advice on the health evidence relevant to the setting of the PM_2.5 targets’ (COMEAP, 2021) and the United States Environmental Protection Agency (US EPA) Integrated Science Assessments (ISA) for particulate matter (US EPA, 2019; 2022), nitrogen oxides (US EPA, 2016), ozone and photochemical oxidants (US EPA, 2020), and sulphur oxides (US EPA, 2017). Comment was also provided on the report on susceptibility, conducted by the Environmental Research Group (ERG) at Imperial College London, which was commissioned to inform the discussions of the AQIS Steering Group (Evangelopoulos and co-authors, 2023).

The evidence assessed suggests that children with asthma, older people and those with respiratory or cardiovascular conditions are likely to be more susceptible to adverse health effects of short-term exposure to air pollution than healthy reference groups. However, much of the focus for respiratory disease was on asthma: the evidence base outlined in the US EPA ISAs is smaller for chronic obstructive pulmonary disease (COPD) than for asthma, and COPD was not within the scope of the review by the Environmental Research Group. Hypertension is covered under the umbrella of cardiovascular disease in the US EPA ISAs; however, we consider that a systematic review is needed to fully assess this as a risk factor which could make individuals more susceptible to both cardiovascular and non-cardiovascular effects of short-term exposure to air pollutants.

Note: The US EPA define short-term exposures as hours up to 1 month and long-term exposures as 1 month to years.

COMEAP’s view was that the evidence reviewed for individuals with obesity or metabolic syndrome/diabetes was not sufficiently strong, at this stage, to justify identifying these groups within the DAQI as being at increased risk. Nonetheless, there may be value in providing further information in a secondary layer of the DAQI webpages, for those that may be interested in the available evidence.

There was insufficient evidence to determine whether there are particular sub-types of asthma that confer a heightened susceptibility to air pollutants. Similarly, there were very few studies looking at the effects of short-term exposures on the health of the mother during pregnancy, for example, considering pre-eclampsia or gestational diabetes. Most studies on these conditions examine associations with medium to long-term exposures (for instance, trimester or whole pregnancy duration), reviewed by Mazmuder and co-authors (2024). We note that there is growing evidence of effects of air pollutants during pregnancy on birth outcomes and the child’s health in later life, but this was beyond the scope of the present review.

The evidence for increased susceptibility of at-risk groups is stronger for some pollutants than for others. This might be important to consider for the DAQI as the behavioural advice which accompanies the DAQI is based on the pollution band, regardless of which air pollutant is elevated.

COMEAP recommends that the advice accompanying the DAQI should continue to give separate behavioural advice to susceptible individuals and the general population.

Those with respiratory and cardiovascular diseases, older people, and children with asthma should continue to be regarded as groups likely to be susceptible to adverse health effects following short-term exposures to air pollutants.

COMEAP suggests that further information could be made available, on the DAQI website, on the current evidence regarding whether other medical conditions may also increase susceptibility to the effects of air pollution.

Recommendations for further research

We recommend that further research is undertaken to examine the extent to which other groups might also have increased susceptibility to the short-term effects of air pollutants. This could include an appraisal of the evidence for respiratory conditions other than asthma and COPD (such as childhood wheeze), and individual cardiovascular conditions, further exploration of obesity and diabetes as susceptibility factors, as well as emerging associations for conditions such as kidney disease, neurological conditions and mental health, and factors such as ethnicity. We also recommend future research on effects of short-term exposure to air pollution on the health of the mother during pregnancy.

Other considerations for future research include whether susceptibility may manifest across different organ systems (for example, does asthma influence the impact of short-term exposure to air pollution on cardiovascular parameters?), and to what degree tailoring lifestyle, diet and medication plays a part in moderating an individual’s response to air pollution.

Lag structures for different health conditions after exposure to air pollution

The aim of this working paper was to review the lag between short-term exposures to elevated levels of air pollution and subsequent adverse health effects (the ‘lag structure’). Lag structures for different health conditions were examined. The possible implications for the advice provided with the DAQI, which is intended to reduce exposures and mitigate against adverse health consequences, were outlined.

For this working paper, a limited literature search was undertaken using broad search terms. This was a rapid review, and also drew on Members’ knowledge of the literature, and therefore conclusions drawn should be regarded as preliminary. Papers were selected that examined the relationship between short-term air pollution exposures and cardiovascular or respiratory effects, and compared several lags. It was found that there could be persistent effects extending beyond 24 hours post-exposure (up to 5 days) for a range of cardiovascular endpoints. For respiratory diseases, morbidity effects were reported for at least one week after exposure. For some mortality studies (respiratory and cardiovascular) there was evidence for longer lag periods.

Current advice accompanying the DAQI indicates that symptoms may occur when air pollution is elevated and suggests actions that can be taken by individuals to reduce exposure and the risk of effects. However, if there is a time lag (for instance, of a few days) between exposure and the onset of symptoms, this might indicate a need to revise the DAQI advice. The evidence reviewed clearly indicates that the risk of a range of adverse health effects persists beyond 24-hours after exposure. This supports the need for revision of the advice which accompanies the DAQI.

In the light of this evidence, we recommend that the DAQI advice should be modified to encourage individuals in ‘at risk’ groups to monitor their symptoms for at least a week and, if symptoms are experienced, to follow their self-management care plan, including consulting their healthcare professional if necessary.

COMEAP recommends that advice accompanying the DAQI should encourage individuals in ‘at-risk’ groups (older people, children with asthma and those with known respiratory and cardiovascular conditions) to monitor their symptoms for at least a week after exposure to elevated levels of pollution. If symptoms are experienced, they should follow the pre-arranged care plan in accordance with their clinician’s advice, contacting their healthcare professional if necessary.

Recommendations for further research

We recommend that more consideration of lag structures in epidemiological studies is needed to allow evaluation and refinement of the public health messaging used to mitigate health risks following periods of elevated air pollution. Furthermore, studies need a more detailed consideration of multipollutant impacts; this could also include consideration of other environmental risks: for instance, temperature, pollen, viruses. It is also important to identify how lag structures vary for each pollutant, specific pollutant-effect relationships, and how these may change when combining the effects of different pollutants. Other potentially susceptible groups should also be considered.

Exposure to air pollution during physical activity, including susceptible groups

The aim of this working paper was to consider whether the advice on physical activity accompanying the current DAQI remains appropriate. The current behavioural advice indicates, depending on the air pollution band, whether individuals should ‘consider reducing’, ‘reduce’ or ‘avoid’ strenuous physical exertion.

We commented on a review on physical activity and exposure to air pollution undertaken by The University of Leicester Centre for Environmental Health and Sustainability, which was commissioned by UKHSA to inform discussions by the AQIS steering group (Panayi and co-authors, 2023). We also examined recent reviews, including reviews on the effect of air pollution exposure during physical activity for the general population and groups that may be considered susceptible, including older people and children. We also looked at general physical activity advice (regardless of air pollution) for susceptible groups.

In the context of this statement, ‘physical activity’ is used to cover the broad variety of activities that may contribute towards national recommendations for daily or weekly physical activity levels for children and adults. This includes activity undertaken as part of daily life, such as cycling to school, as well as sport or planned exercise. 

The available evidence indicates that, for most people, in the UK, the long-term benefits of regular physical activity outweigh the possible risks of experiencing adverse symptoms from undertaking physical activity during short-term periods of elevated air pollution. A loss of the benefits of physical activity, for both the general population and susceptible groups, is one of the possible unintended consequences of the current DAQI advice that suggests reducing activity during episodes of elevated air pollution. In addition, responses to air pollution are likely to vary markedly between individuals. This supports the need for some revision of the advice which accompanies the DAQI. We suggest this should focus more on avoiding exposure when undertaking physical activity, and on monitoring symptoms and responding in accordance with clinicians’ advice.

Evidence suggests that health outcomes may be affected for at least a week after short-term exposure to air pollution, as outlined in the working paper focussing on lag structures for different health conditions after exposure to air pollution. Therefore, advising individuals to monitor their symptoms for several days following physical activity is appropriate.

Other considerations relevant to the current advice include the potential impacts of indoor air pollution (if individuals choose to undertake physical activity indoors, in response to encouragement to avoid outdoor air pollution) and of other environmental triggers such as pollen (if they choose to exercise in green spaces to avoid pollution).

Advice may also need to consider those who regularly achieve more than the minimum recommended physical activity target per week. At the time of writing, this is typically upwards of 300 minutes of moderate-intensity physical activity per week for adults (WHO, 2022). These individuals may have increased exposure when training at high intensity, or for extended duration, in environments with elevated air pollution levels. In addition, there is a high prevalence of asthma among endurance athletes.

For mass participation sporting events, organisers should be advised to raise awareness of the potential health impacts of short-term exposure to air pollution when pollution levels are elevated. This would enable participants to make informed choices regarding participation, based on their individual circumstances, and allow them to monitor symptoms.

COMEAP’s role has been to consider the scientific evidence and how this might inform the advice that should be given. Further consideration, and research, will be needed regarding how best to word and communicate the advice to the various target audiences.

COMEAP recommends that advice accompanying the DAQI should focus on reducing personal exposure to outdoor air pollution, rather than on discouraging physical activity. It may be more appropriate to advise people to monitor their symptoms on days when air pollution is elevated, and for at least the following week, and respond in accordance with their clinician’s advice.

Advice should also mention other triggers and environmental exposures (for example, indoor air pollution and pollen) which may exacerbate symptoms, to avoid possible unintended consequences.

Specific advice on where and when air pollution is most likely to be high would help individuals reduce exposure.

For those who regularly achieve more than the minimum recommended physical activity target per week, advice could focus on the timing, intensity and location of their activity.

For mass participation sporting events, advice should raise awareness of the potential health impacts of short-term exposure (hours or days) to air pollution.

Recommendations for further research

We recommend that future research looking at the effects of physical activity during air pollution episodes needs to assess defined clinical outcomes. Many of the available studies on physical activity and exposure to air pollution examine surrogate endpoints which may not be of direct clinical relevance.

While it is acknowledged that human experimental studies can be resource intensive, the inclusion of multiple control groups in future studies would help the interpretation of their findings. For example:

• a group undertaking physical activity in polluted air
• a control group undertaking physical activity but not exposed to polluted air
• a control group not undertaking physical activity and not exposed to polluted air
• a control group exposed to polluted air but not undertaking physical activity

We recommend that further research into the relationship between acute air pollution-induced responses and physical activity includes a focus on dosimetry in susceptible groups and an understanding of underlying physiological, immunological, antioxidant and xenobiotic responses in children, older people, and individuals with chronic respiratory and cardiovascular conditions.

We recommend that further research is undertaken to examine air quality in gyms and other indoor physical activity environments, to determine the level of exposure to indoor air pollutants and the effect of physical activity on the health effects of exposure to indoor air pollutants.

Long-term air quality statement (LTAQS)

Our proposal for a long-term air quality statement (LTAQS) is intended to provide a different perspective to the DAQI. A focus on providing information to the public based on the likely effects of short-term exposure (the DAQI), could lead to a lack of understanding, among the public, of the health burden of long-term exposure to air pollution. A LTAQS might help address this.

We have developed a proposal which aims to provide sound guidance, based on current scientific understanding that would give interested parties validated information on longer-term air quality. We suggest that the information in the LTAQS provides a link to legislative limits and other air quality standards (for instance, WHO guidelines). We also suggest it includes additional information on indoor air pollution, for example, information on sources of indoor air pollution and factors that can affect indoor air pollutant concentrations.

A number of options for the basis of a LTAQS system were considered. These options included:

• a cumulative DAQI – identifying communities at higher risk (option 1)
• an approach based on percentile ranking addresses in the UK (option 2)
• reporting annual concentration values (option 3)
• reporting annual concentration values with an additional risk scale (option 4)
• averaging annual concentrations over several years (option 5)
• conversion to a scale using the WHO Air Quality Guideline levels (option 6)

Presenting annual concentrations of key pollutants in comparison with legislative limits and other standards or guidelines (option 3) was suggested as the most appropriate basis for an information system, together with signposting advice on how to reduce emissions of air pollutants. Originally, we referred to the LTAQS as a Long-term Air Quality Index (LTAQI). We note that it is not appropriate to describe the proposed approach as an ‘index’; instead, this is best regarded as a Long-term Air Quality Statement (LTAQS), as it does not involve converting concentrations into another (index) scale. Initial testing with a panel drawn from the general public revealed that simpler formats were needed to display air pollution concentration data. Nonetheless, it is possible that some users might appreciate access to the detailed information. Therefore, we recommend that consideration should be given to providing multiple layers of information, which people could choose to access, depending on how interested they are in air quality, and what they intend to use the LTAQS for. The public panel found the inclusion of additional information on sources of indoor air pollution useful.

COMEAP recommends that the AQIS steering group develops a framework for providing accessible information that presents annual concentrations of outdoor air pollutants in comparison with WHO Air Quality Guidelines and legal limits.

Information on indoor air pollution should also be included to improve awareness of potential indoor sources.

Information with different levels of detail should be made available to meet the needs of different audiences.

References

Committee on the Medical Effects of Air Pollutants (COMEAP). 2011 ‘Review of the air quality index’ (viewed November 13 2024)

Committee on the Medical Effects of Air Pollutants (COMEAP). 2021 ‘Advice on the health evidence relevant to setting PM2.5 targets’ (viewed 13 November 2024)

Courts and Tribunals Judiciary. 2021 ‘Prevention of Future Deaths Report - Ella Kissi-Debrah’ (viewed 13 November 2024)

Evangelopoulos D and co-authors. 2023 ‘Identifying and defining “At Risk” groups to better target air quality information: Evidence assessment for diabetes, obesity, subtypes of asthma and life-stage’. A report from the Environmental Research Group, Imperial College London, commissioned by Defra to inform the AQIS project.

Mazmuder H and co-authors. ‘Maternal health outcomes associated with ambient air pollution: An umbrella review of systematic reviews and meta-analyses’ Science of the Total Environment, 2024: volume 914, article number 169792 (viewed 13 November 2024)

Panayi M and co-authors. 2023 ‘Physical activity and exposure to air pollution’ A report from the Centre for Environmental Health and Sustainability, University of Leicester, commissioned by UKHSA to inform the AQIS project

United States Environmental Protection Agency (US EPA). 2016 ‘Integrated Science Assessment (ISA) for Oxides of Nitrogen’ (viewed 13 November 2024)

United States Environmental Protection Agency (US EPA). 2017 ‘Integrated Science Assessment (ISA) for Sulfur Oxides’ (viewed 13 November 2024)

United States Environmental Protection Agency (US EPA). 2019 Integrated Science Assessment (ISA) for Particulate Matter (viewed 13 November 2024)

United States Environmental Protection Agency (US EPA). 2020 ‘Integrated Science Assessment (ISA) for Ozone and Related Photochemical Oxidants’ (viewed 13 November 2024)

United States Environmental Protection Agency (US EPA). 2022 ‘Supplement to the Integrated Science Assessment (ISA) for Particulate Matter’ (viewed 13 November 2024)

World Health Organisation (2022) ‘Physical Activity’ (viewed 13 November 2024)

Annexe A

Recent developments in air pollution alert systems in the UK

In early 2024, the London Air Quality and Health Programme Office launched an air pollution alert system targeted at healthcare professionals in London. The new alert system directly notifies London’s health professionals of ‘High’ and ‘Very High’ air pollution episodes (as defined in the current DAQI), to allow them to increase patient awareness about the health impacts of air pollution.

The advice in the London alert system (at the time of publication of this statement) centres around encouraging patients to follow their asthma/COPD plan, take their prescribed preventer medication and carry their reliever inhalers. Physical activity is encouraged, but the advice suggests that susceptible groups may need to reduce vigorous activity during episodes of elevated air pollution. Advice is also given to patients as to how they can reduce their exposure to, and their contribution to, air pollution. This includes the encouragement of active travel and using public transport, but avoiding busy roads and times if possible, and avoiding unnecessary burning at home (for example, in a wood burning stove or open fire) unless it is the only source of heat.  

We note that our recommendations, outlined in this statement, also encourage people to monitor their symptoms during an air pollution episode and focus on reducing personal exposure to air pollution rather than discouraging physical activity.

As evidence suggests a lag, we recommend that people should be advised to monitor their symptoms for at least a week after exposure to elevated levels of air pollution. We have also considered indoor air pollution. This includes a recommendation that people are informed about sources of indoor air pollutants. We have also considered the possible implications of undertaking physical activity in indoor environments, if the behavioural advice encourages people to avoid outdoor air.

Annexe B

COMEAP AQIS Sub-group

Chair

Professor Martin Clift (Swansea University)

Members

Dr Mike Holland (Ecometrics Research and Consulting (EMRC))

Professor Klea Katsouyanni (Imperial College London)

Dr Mark Miller (University of Edinburgh)

Dr Ian Mudway (Imperial College London)

Dr Paul Pfeffer (Queen Mary University of London) (co-opted)

Secretariat

Eve Draper (UK Health Security Agency)

Alison Gowers (UK Health Security Agency)

Dr Naomi Earl (UK Health Security Agency)

COMEAP Chair

Professor Anna Hansell (University of Leicester)

Acknowledgement: The AQIS Sub-group would also like to acknowledge valuable input from Professor Gavin Shaddick (Cardiff University).

Annexe C

Academics invited to discuss and contribute to specific working papers

Physical activity working paper

COMEAP and the AQIS Sub-group would like to thank the following individuals for their valuable input to the work on the topic of physical activity and air pollution:

Dr Gavin Devereux (University of Suffolk)

Scarlett Moloney (Anglia Ruskin University)

Dr Eda Tonga (University of Leicester)