Air Quality, Health, Wellbeing and Behaviour.

This report presents the findings from evidence reviews of the health and wellbeing impacts of air pollution and of behaviour change related to air pollution, which were carried out as part of a programme aimed at developing key messages for use to promote improvements in air quality and in public health, and thus contribute to addressing health inequalities in Scotland. For the investigation of air pollution and physical health, which has been studied intensively in recent times, it was decided to focus on recent major reviews in this area: the REVIHAAP (World Health Organisation, 2013) report and the Health Effects Institute report on transport-related air pollution (HEI, 2010). The reviews of air pollution in relation to wellbeing and of behaviour change were carried out using systematic searches of the published and grey literature, including peerreviewed papers, government reports and theses. Results from the review of health and wellbeing in relation to air pollution showed that air pollution is causally linked to a range of adverse health outcomes mostly affecting the heart and lungs (cardio-respiratory system). It acts as one of many factors which increase the risks of these conditions. Long-term exposure to particulate matter (PM) results in a 3% increase mortality in adults per 5µg/m3 of PM <2.5 micrometres in diameter (PM2.5), mortality from heart attacks, stroke, lung cancer, and chronic non-cancer lung disease are most affected; short-term exposure to particulate matter is associated with asthma attacks, increased visits to doctors, increased hospital admissions and earlier death and short term exposure to ozone is associated with a range of respiratory conditions including earlier death (from cardiovascular as well as respiratory causes). There were relatively few studies on air pollution and wellbeing. A few studies show a tentative link between air pollution and subjective measures (from happiness surveys or self-reported life satisfaction), and there is some limited evidence that living in a neighbourhood which provides infrastructure and green spaces encouraging walking and cycling is associated with better mental health and quality of life. The review of behaviour change showed that reductions in pollutant levels are amongst the public health benefits likely to be associated with an increase in active travel. Actions shown to be effective included increasing road charges which is likely to reduce car use and increase public transport use; preferential taxes for lower emission cars results in increased sales and a potential reduction in air pollution and use of travel plans with individualised information is found to increase public transport use. In addition, the presence of crossing areas increases the likelihood of primary school age boys walking to school and feelings of safety and security increased the likelihood of girls walking to school.