Dr Ian Mudway, a researcher at MRC-HPA Centre for Environment and Health, King's College London in the UK, showed these slides as part of his presentation at 'Cities for Clean Air : London 2012' on July 14 2012 in London, UK. The meeting was hosted by Network for Clean Air (http://www.cleanairuk.org). Note: The sound quality changes markedly after 22 minutes & 10 seconds - don't be alarmed! This was due to equipment failure. Dr Ian Mudway's talk followed-on from one other at the conference. There is a news report about this here: http://www.airqualitynews.com/2012/07/20/lungs-of-london-schoolchildren-damaged-by-poor-air-quality/ Further information about Dr Ian Mudway see http://www.kcl.ac.uk/biohealth/research/divisions/aes/about/people/Mudway/index.aspx

1. Why is i
Wh i air pollution bad
ll i b d
for human health?
Dr Ian S Mudway
MRC-HPA Centre for Environment &
Health, King’s
Health King s College London

3. Who died?
Deaths Registered in London Administrative County Classified by Age
(Bates, 1995)
<1 1-12 1-14 15-44 45-64 65-74 75+
Month Mo. Years Years Years Years Years
of Age Old of Age of Age of Age of Age of Age
Week
Before 16 12 10 61 237 254 335
the
Episode
Week
After the 28 26 13 99 652 717 949
Episode
Before/
After 1.75 2.17 1.3 1.62 2.75 2.82 2.83
Episode
E i d
Ratio
The greatest relative increase in mortality was from bronchitis,
which rose nine fold
nine-fold

4. Health Effects of Ambient Pollution
1952 London Fog
Death
• Hospital admissions
Hospital
H it l
rose by 50%
everity
Admissions
• Respiratory
Doctor visits
admissions by 160%
Se
Asthma attacks, medication use,
symptoms
lung function changes, immune cell responses,
heart rate or heart rate variability responses
Proportion of effected population

6. Health impact of fine particulate
pollution
Total particles Fine particles Sulfate particles
(μg/m3) (μg/m3) (μg/m3)
Steubenville 89 9
89.9 29.6
29 6 12.8
12 8
St. Louis 72.5 19.0 8.1
Harrimen 49.4 20.8 8.1
Watertown 49.2 14.9 6.5
Topeka 56.6 12.5 4.8
Portage 34.1 11.0 5.3
Dockery DW, et al. N Engl J Med 1993;329(24):1753-9
6

7. The Six Cities t d
Th Si Citi study
Dockery DW, et al. N Engl J Med 1993 Dec 9;329(24):1753-9

8. 2nd October 2011

9. Controlled Diesel Exposures
C i
Exposure to DE: PM10 300µg/m3 and filtered air for 1 hour &
p µg
100µg/m3 and filtered air for 2 hours

10. Diesel induces inflammation
Neutrophils
after air
Neutrophils
N hil
after DE

11. Responses to PM in the Real World
Does short term exposure to real world atmospheres (diesel traffic and
background) cause respiratory effects in asthmatics?
Oxford Street
Hyde Park
PM10 =72 µg m-3, PM2.5 =11.2 µg m-3, PM10 =125 µg m-3, PM2.5 =28.3 µg m-3,
11.7 ppb NO2 18,300 particles cm-3 76.5 ppb NO2 63,700 particles cm-3
McCreanor al. (2007) New Eng J Med 357: 2348-2358.

12. Responses t PM in the Real World
R to i th R l W ld
Impaired l
I i d lung f
function
i Inflammation
I fl i
McCreanor J et al. N Engl J Med. 2007 Dec 6;357(23):2348-58

13. PM Concentration Near a Major Road
j
Prevailing Wind 50m
100m
500m
NO2
Fine, PM2.5
Ultrafine, PM0.1
Beckerman et al. (2008) Atmos Enviro. 42:275-290.

14. Children s
Children’s respiratory health
Postcodes in the Tower Hamlets area
within 100 m of major road
14

15. Linkage at residential address
Linkage at residential address
level to estimated modelled
exposures (NOx, NO2, PM10,
PM2.5)
15

17. How does the choice of route impact on an
individuals
i di id l exposure? ?

18. Summary
• Prolonged exposure to elevated PM is associated with significant
g p g
life-shortening and poor respiratory health. Acute episodes can
precipitate death in sensitive subjects.
• S bj
Subjects with pre-existing cardiopulmonary conditions are
ih i i di l di i
particularly sensitive.
• Reductions in ambient PM provide measurable health benefits
• Human chamber and field exposures have provided a mechanistic
evidence to underpin the validity of the epi-observations
• Individual exposures can be limited by informed use of the urban
environment
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