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Up to 38 percent of all annual childhood asthma cases in Bradford may be caused by air pollution

March 27, 2018

New research highlights the impact of traffic-related air pollution on childhood asthma.

The study also shows traffic-related air pollution could be specifically responsible for up to 24% of the total number of cases.

An international team of researchers has used a newly developed model to assess the impact exposure to nitrogen oxides - gases that make up air pollution - has on the development of childhood asthma.

Their study, published today in Environment International, used a model that knits together four distinct models of traffic, emissions, atmospheric dispersion and health impact assessments in Bradford. This allowed the researchers to chart the full chain of impact -- from the source of air pollution through the pathways in which it impacts children's health.

The results indicate that up to 38% of all annual childhood asthma cases in Bradford may be attributable to air pollution. More specifically, the model estimates showed that 12% of the annual childhood asthma cases would be attributable to traffic related air pollution.

"However, we knew our model was underestimating the traffic related fraction of air pollution. When we adjusted our results using actual measurements of air pollutants we saw that up to 24% of the annual cases could be attributable to traffic related air pollution," said study co-author, Professor Mark Nieuwenhuijsen, Director of the Urban Planning, Environment and Health Initiative at ISGlobal, a centre supported by The "la Caixa" Foundation.

Study lead author Dr Haneen Khreis carried out this research while at the Institute for Transport Studies at Leeds. She said: "Overall rates of childhood asthma cases in Bradford are higher than the national average as were emergency hospital admissions for asthmatic children under 16 years of age. Traffic-related air pollution is a real concern to the community.

"Our team's previous research has shown that children exposed to high levels of traffic-related air pollution have a higher risk of developing asthma. Quantifying the number of childhood asthma cases that are directly attributable to traffic-related air pollution has not been done in the past and as we show now, a significant portion of cases is largely preventable."

She added: "Our work demonstrates that while popular initiatives such as stopping vehicles from idling outside schools or providing walking routes away from roads are important, proposed solutions to mitigate traffic pollution shouldn't be restricted to localised areas.

"New policies aimed at reducing the effects of traffic-related air pollution need to target each link in the full chain of events -- from traffic volume and type, to exhaust and non-exhaust emissions, to dispersion to exposure."

The models used in the study allowed the team to chart how much air pollution is present in the city, and how much of that can be traced back to road traffic. By examining estimates of nitrogen oxide concentrations in Bradford they were also able to estimate the levels of nitrogen dioxide. Nitrogen dioxide are air pollutants produced as a result of road traffic. High concentrations of nitrogen dioxide can cause irritation to the respiratory system and significantly exacerbate existing respiratory problems.

Professor Nieuwenhuijsen said: "There is very little research that explores the impact of different exposure assessments. Cases of childhood asthma have been steadily increasing since the 1950s. Future progress with childhood asthma requires a focus beyond controlling and treating the disease toward asthma prevention starting with reducing traffic related air pollution."

The team's research is part of ongoing work in Bradford assessing emissions and air quality profile in the region and the associated childhood health effects and impacts on the community.

Professor John Wright, Director of the Bradford Institute for Health Research and chief investigator of Born in Bradford, said: "This important study adds to the overwhelming evidence that air pollution is harming our children. The air in our cities has become a tragedy of the commons whereby a common good is being poisoned by collective neglect.

"The good news is that we can all save lives by driving less and using cleaner fuels."
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Further information:

Image available for download: https://goo.gl/KCK5Ye

Credit: Center for Advancing Research in Transportation Emissions, Energy, and Health http://www.carteeh.org

The paper Full-Chain Health Impact Assessment of Traffic-Related Air Pollution and Childhood Asthma by Haneen Khreis, Kees de Hoogh, and Mark J Nieuwenhuijsen is published in Environment International

Professor John Wright, Director of the Bradford Institute for Health Research and chief investigator of Born in Bradford, is available for interview.

Dr Khreis is available for interview by phone or Skype.

Please contact University of Leeds press officer Anna Harrison at a.harrison@leeds.ac.uk or +44 (0)113 34 34196 to arrange interviews or for any additional information.

Dr Khreis is currently a research scientist at the Texas A&M Transportation Institute's Center for Advancing Research in Transportation Emissions, Energy, and Health (CARTEEH) and at the Barcelona Institute for Global Health (ISGlobal).

Additional information for editors:

The recorded prevalence of asthma in Bradford was found to be higher than both the national average (5.9%), and the regional average (6.2%), at 6.3% or 33,568 people (Quality and Outcomes Framework, 2012).

The complex nature of asthma, its challenging diagnosis, and public health modelling strongly suggest that these figures are conservative estimates.

In year 2009/2010 there were 846 admissions for asthma in NHS Bradford & Airedale with the total admissions cost equating to a payment by results (PbR) tariff of £0.8 million (Quality and Outcomes Framework, 2012).

Data from previous years (2002-2009), indicate that emergency hospital admissions for asthmatic children under 16 years of age were consistently higher than the national and the regional averages peaked in September every year coinciding with the autumn return to school and in line with previous observations (Dales et al., 1996), and children aged between 0 and 4 made up its highest proportions (National Health Service, 2012).

The research team's previous work Exposure to traffic-related air pollution and risk of development of childhood asthma: A systematic review and meta-analysis is available online at https://goo.gl/36upv1

The team is currently investigating the impacts of other pollutants in Bradford including black carbon and particulate matter and is linking the exposure estimates to detailed health data from the Born in Bradford study.

Citations, tables and figures available on request.

University of Leeds

The University of Leeds is one of the largest higher education institutions in the UK, with more than 33,000 students from more than 150 different countries, and a member of the Russell Group of research-intensive universities.

We are a top ten university for research and impact power in the UK, according to the 2014 Research Excellence Framework, and are in the top 100 for academic reputation in the QS World University Rankings 2018.

Additionally, the University was awarded a Gold rating by the Government's Teaching Excellence Framework in 2017, recognising its 'consistently outstanding' teaching and learning provision. Twenty-six of our academics have been awarded National Teaching Fellowships - more than any other institution in England, Northern Ireland and Wales - reflecting the excellence of our teaching. http://www.leeds.ac.uk

ISGlobal

The Barcelona Institute for Global Health (ISGlobal) is an innovative alliance between academic, government, and philanthropic institutions to contribute to the efforts of the international community to address the challenges in global health. ISGlobal is a centre of excellence that has grown out of work first started in the world of health care by the Hospital Clínic and environmental public health at the Parc de Salut MAR and in the academic sphere by the University of Barcelona and Pompeu Fabra University. A pivotal role of its work model is the transfer of knowledge generated by scientific research to practice, a task undertaken by the institute's Training and Policy and Global Development departments. http://www.isglobal.org

University of Leeds

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