Health impacts related to urban and transport planning: A burden of disease assessment. (October 2017)

• Record Type: Journal Article
• Authors: Mueller, Natalie; Rojas-Rueda, David; Basagaña, Xavier; Cirach, Marta; Cole-Hunter, Tom; Dadvand, Payam; Donaire-Gonzalez, David; Foraster, Maria; Gascon, Mireia; Martinez, David; Tonne, Cathryn; Triguero-Mas, Margarita; Valentín, Antònia; Nieuwenhuijsen, Mark
• Is Part Of: Environment international. Volume 107(2017)
• Page Start: 243
• Page End: 257
• Publication Date: 2017-10
• Subjects: CVD cardiovascular disease -- DALYs disability-adjusted life-years -- dB(A) A-weighted decibel -- EBD Environmental Burden of Disease -- ERF exposure response function -- ESCAPE LUR European Study of Cohorts for Air Pollution Effects Land Use Regression model -- GBD Global Burden of Disease -- HIA health impact assessment -- ICD-10 international classification of disease, version 2010 -- LAeq, 16 h day time (7:00–23:00 h) equivalent sound pressure level -- Lden day-evening-night EU indicator with 5 and 10 dB weights for the evening and the night time -- Ldn day-night indicator with a 10 dB weight for the night time only -- Lnight night time (7:00–23:00 h) equivalent sound pressure level -- METs metabolic equivalents of task -- NDVI Normalized Differenced Vegetation Index -- NO2 nitrogen dioxides -- OECD Organization for Economic Cooperation and Development -- OLI Operational Land Imager -- O3 ozone -- PA physical activity -- PAF population attributable fraction -- PM2.5 particulate matter with a diameter ≤ 2.5 μm -- RR relative risk -- SDGs Sustainable Development Goals -- TIRS Thermal Infrared Sensor -- TRAP traffic-related air pollution -- UHI urban heat island -- UTOPHIA Urban and TranspOrt Planning Health Impact Assessment tool -- WHO World Health Organization -- YLDs years lived with disability -- YLLs years of life lost -- %HA percentage of population highly annoyed -- %HSD percentage of population highly sleep disturbed; Burden of disease -- Disability-adjusted life-years -- Health impact assessment -- Morbidity -- Transport planning -- Urban planning; Environmental protection -- Periodicals; Environmental health -- Periodicals; Environmental monitoring -- Periodicals; Environmental Monitoring -- Periodicals; Environnement -- Protection -- Périodiques; Hygiène du milieu -- Périodiques; Environnement -- Surveillance -- Périodiques; Environmental health; Environmental monitoring; Environmental protection; Periodicals; 333.705
• DOI: 10.1016/j.envint.2017.07.020
• Languages: English
• ISSNs: 0160-4120

Abstract

Abstract: Introduction: Until now, estimates of the Global Burden of Disease (GBD) have mainly been produced on national or regional levels. These general estimates, however, are less useful for city governments who have to take decisions on local scales. To address this gap, we focused on the city-level burden of disease (BD) due to exposures affected by urban and transport planning. We conducted a BD assessment using the Urban and Transport Planning Health Impact Assessment (UTOPHIA) tool to estimate annual preventable morbidity and disability-adjusted life-years (DALYs) under compliance with international exposure recommendations for physical activity (PA), exposure to air pollution, noise, heat, and access to green spaces in Barcelona, Spain. Methods: Exposure estimates and morbidity data were available for 1, 357, 361 Barcelona residents ≥ 20 years (2012). We compared recommended with current exposure levels to estimate the associated BD. We quantified associations between exposures and morbidities and calculated population attributable fractions to estimate the number of attributable cases. We calculated DALYs using GBD Study 2015 background DALY estimates for Spain, which were scaled to Barcelona considering differences in population size, age and sex structures. We also estimated annual health costs that could be avoided under compliance with exposure recommendations. Results: Not complying with recommended levels for PA, air pollution, noise, heat and access to green spaces was estimated to generate a large morbidity burden and resulted in 52, 001 DALYs (95% CI: 42, 866–61, 136) in Barcelona each year (13% of all annual DALYs). From this BD 36% (i.e. 18, 951 DALYs) was due to traffic noise with sleep disturbance and annoyance contributing largely (i.e. 10, 548 DALYs). Non-compliance was estimated to result in direct health costs of 20.10 million € (95% CI: 15.36–24.83) annually. Conclusions: Non-compliance of international exposure recommendations was estimated to result in a considerable BD and in substantial economic expenditure each year in Barcelona. Our findings suggest that (1) the reduction of motor traffic together with the promotion of active transport and (2) the provision of green infrastructure would result in a considerable BD avoided and substantial savings to the public health care system, as these measures can provide mitigation of noise, air pollution and heat as well as opportunities for PA promotion. Highlights: Failure to meet recommended levels of physical activity, air pollution, noise, heat and green spaces linked to poor health. Compliance with recommendations was estimated to prevent >50, 000 DALYs each year in Barcelona, Spain. Compliance was also estimated to result in direct health care cost savings of >20 million € annually. The largest share in burden of disease was attributable to traffic noise exposure. Especially noise related annoyance and sleep disturbance contributed largely to the burden of disease (>10, 000 DALYs).