Research and analysis

HPR volume 13 issue 9: news (15 March)

Updated 20 December 2019

Evidence review of air quality improvement interventions

Public Health England (PHE) has published the results of a major evidence review on effective air quality improvement interventions, including practical recommendations for action by UK local authorities to fulfil their public heath remit and inform national actions in support of local authorities [1,2].

The review, commissioned by the Department of Health and Social Care (DHSC), involved commissioning rapid evidence assessments, covering five types of intervention believed to offer good prospects for cost-effectiveness.

These interventions related to:

• vehicles and fuels
• spatial planning
• industry
• agriculture
• behavioural change

The main sections of the review report consider each of these five areas in turn, covering:

• key messages
• research questions
• how best to maximise the benefits for public health
• limitations of the available evidence
• further work emerging from the assessment

The review report notes that ‘studies examining the cost-benefits of interventions are unfortunately very limited’, and that more work is needed to understand the detailed health impact of interventions and their costs and benefits.

However, it goes on to say that ‘There is sufficient evidence to recommend action. We know that air pollution has a substantial impact on health, and even where evidence of effectiveness cannot be exactly quantified; there are a wide range of interventions that can reduce emissions, and reduce people’s exposure and consequent health impacts’.

The review report includes principles to guide action on air quality improvement interventions, for example that:

• different air pollutants should be considered and tackled together
• employers, private and public sector organisations need to engage with local initiative
• the public sector should lead by example
• national government should ensure a policy environment which supports local action and creates incentives

A ‘hierarchy of interventions’ is also presented, that prioritises prevention or reduction of polluting activities (emission reduction), as opposed to taking steps to reduce air pollution once it has occurred (concentration reduction) or relying on avoidance (exposure reduction).

However, it is acknowledged that concentration and exposure reduction measures can be cost-effective, and have a critical role to play to supplement emission reduction interventions.

The evidence review follows the Air quality plan for nitrogen dioxide (NO2) in UK (2017) report from the Department for Environment, Food & Rural Affairs (Defra) and the Department for Transport (DfT).

The work completed here expands on the scope of the Air pollution: outdoor air quality and health (2017) report, published by the National Institute for Health and Care Excellence (NICE).

The review was used to support the development of Defra’s final Clean Air Strategy published in January 2019.

Reference

1. Review of interventions to improve outdoor air quality and public health, PHE (11 March 2019)
2. PHE publishes air pollution evidence review, GOV.UK news story (11 March 2019)

Infection reports in this issue

This issue of HPR includes:

• Common animal associated infections quarterly report (England and Wales), fourth quarter 2018.

• Suspected and laboratory-confirmed reported norovirus outbreaks in hospitals (England) and norovirus laboratory reports (England and Wales): weeks 5 to 8, 2019.

• Routine reports of gastrointestinal infections in humans, England and Wales: January and February, 2019.