Skip to main content
Log in

Progress in research to assess the effectiveness of air quality interventions towards improving public health

  • Published:
Air Quality, Atmosphere & Health Aims and scope Submit manuscript

Abstract

This paper describes progress made in research to evaluate whether actions taken to improve air quality have resulted in reduced ambient concentrations of relevant air pollutants, exposure, and adverse health effects, also known as air quality health outcomes or accountability research. The past two decades have seen a number of accountability studies that have started to tackle the many difficulties encountered in conducting such research. Difficulties may range from a lack of good quality data on air quality and health outcomes, interventions that are part of complex programs affecting air quality in different ways and the need for advanced statistical approaches that can address confounding issues, especially when evaluating regulations that are implemented over an extended period of time. Substantial progress has been made on many fronts. Early studies of short to medium-term interventions (e.g., shutting down a steel mill) have shown dramatic, sudden improvements in air quality with clear improvements in health outcomes. However, in many cases, the changes in air quality may be more subtle (e.g., measures to reduce traffic congestion). Studies of complex regulations that are implemented in multiple-year programs (e.g., national ambient air quality standards for particulate matter) remain challenging due to the need to correct for other changes that occur over the same time frame, such as changes in smoking and demographic characteristics. We describe recent progress to study the effectiveness of air quality regulations, using examples from around the globe, and discuss the challenges inherent in this type of research. Common study design issues that remain important for future studies are the selection of appropriate control populations, counterfactual air quality scenarios, and time periods surrounding the implementation of the regulatory action, as well as appropriately adjusting for unmeasured and potentially confounding factors or regional meteorological effects. Continued exploration of alternative approaches and additional methods development, especially for evaluating complex long-term regulatory actions, is recommended.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Atkinson RW, Barratt B, Armstrong B, Anderson HR, Beevers SD, Mudway IS, Green D, Derwent RG, Wilkinson P, Tonne C, Kelly FJ (2009) The impact of the congestion charging scheme on ambient air pollution concentrations in London. Atmos Environ 43:5493–5500

    Article  CAS  Google Scholar 

  • Auffhammer M, Bento AM, Lowe SE (2009) Measuring the effects of the clean air act amendments on ambient PM10 concentrations: the critical importance of a spatially disaggregated analysis. J Environ Econ Manage 58:15–26

    Article  Google Scholar 

  • California Air Resources Board (2006) Emission reduction plan for ports and goods movement. Available at http://www.arb.ca.gov/gmp/gmp.htm. Accessed 3 August 2010

  • Chay K, Greenstone M (2003) The impact of air pollution on infant mortality: evidence from geographic variation in pollution shocks induced by a recession. Quart J Econom 3:1121–1167

    Article  Google Scholar 

  • Chay K, Dobkin C, Greenstone M (2003) The clean air act of 1970 and adult mortality. J Risk Uncertain 27(3):279–300

    Article  Google Scholar 

  • Clancy L, Goodman P, Sinclair H, Dockery DW (2002) Effect of air-pollution control on death rates in Dublin, Ireland: an intervention study. Lancet 360:1210–1214

    Article  Google Scholar 

  • Dockery DW, Rich DQ, Goodman PG, Clancy L, Ohman-Strickland P, George P, Kotlov T (2011) Effect of air pollution control on mortality and hospital admissions in Ireland. HEI Research Report, Health Effects Institute, Boston MA (in press)

  • Ezzati M, Friedman AB, Kulkarni SC, Murray CJ (2008) The reversal of fortunes: trends in county mortality and cross-county mortality disparities in the United States. PLoS Med 5(4):e66

    Article  Google Scholar 

  • Friedman MS, Powell KE, Hutwagner L, Graham LM, Teague WG (2001) Impact of changes in transportation and commuting behaviors during the 1996 Summer Olympic Games in Atlanta on air quality and childhood asthma. JAMA 285:897–905

    Article  CAS  Google Scholar 

  • Friel S, Dangour AD, Garnett T, Lock K, Chalabi Z, Roberts I, Butler A, Butler CD, Waage J, McMichael AJ, Haines A (2009) Public health benefits of strategies to reduce greenhouse-gas emissions: food and agriculture. Lancet 374(9706):2016–2025

    Article  Google Scholar 

  • Greenstone M (2004) Did the clean air act cause the remarkable decline in sulfur dioxide concentrations? J Environ Econ Manage 47:585–611

    Article  Google Scholar 

  • Greenstone M, Gayer T (2009) Quasi-experimental and experimental approaches to environmental economics. J Environ Econ Manage 57:21–44

    Article  Google Scholar 

  • Harrington W, Morgenstern RD, Shih JS, Bell ML (2009) Using statistical methods to link stationary source emissions to ambient PM2.5 concentrations in the eastern United States. Health Effects Institute Annual Conference, 2009

  • Health Effects Institute (2003) Assessing health impact of air quality regulations: concepts and methods for accountability research. HEI Communication 11. Health Effects Institute, Boston. Available at http://pubs.healtheffects.org/view.php?id=153. Accessed 14 September 2010

  • Health Effects Institute (2010a) Proceedings of an HEI workshop on further research to assess the health impacts of actions taken to improve air quality. HEI Communication 15. Health Effects Institute, Boston. Available at http://pubs.healtheffects.org/view.php?id=346. Accessed 14 September 2010

  • Health Effects Institute (2010b) Outdoor Air Pollution and Health in the Developing Countries of Asia: A Comprehensive Review. HEI Special Report 18. Health Effects Institute, Boston. Available at http://pubs.healtheffects.org/view.php?id=349. Accessed 3 January 2011

  • Hedley AJ, Wong CM, Thach TQ, Ma S, Lam TH, Anderson HR (2002) Cardiorespiratory and all-cause mortality after restrictions on sulphur content of fuel in Hong Kong: an intervention study. Lancet 360:1646–1652

    Article  Google Scholar 

  • Hidy GM, Brook JR, Demerjian KL, Molina LT, Pennell WT, Scheffe RD (2011) Technical challenges of multipollutant air quality management. Springer, Dordrecht (in press). Available at http://www.narsto.org/section.src?SID=89. Accessed 13 September 2010

  • Janes H, Dominici F, Zeger SL (2007) Trends in air pollution and mortality: an approach to the assessment of unmeasured confounding. Epidemiol 18(4):416–423

    Article  Google Scholar 

  • Kelly FJ, Anderson HR, Armstrong B, Atkinson R, Barratt B, Beevers S, Cook D, Derwent R, Duggan S, Green D, Mudway IS, Wilkinson P (2011) Congestion charging scheme in London: assessing its impact on air quality. Research report 155. Health Effects Institute, Boston

    Google Scholar 

  • Krämer U, Behrendt H, Dolgner R, Ranft U, Ring J, Willer H, Schlipköter HW (1999) Airway diseases and allergies in East and West German children during the first 5 years after reunification: time trends and the impact of sulphur dioxide and total suspended particles. Int J Epidemiol 28:865–873

    Article  Google Scholar 

  • Laden F, Schwartz J, Speizer FE, Dockery DW (2006) Reduction in fine particulate air pollution and mortality: extended follow-up of the Harvard six cities study. Am J Respir Crit Care Med 173(6):667–672

    Article  CAS  Google Scholar 

  • Markandya A, Armstrong BG, Hales S, Chiabai A, Criqui P, Mima S, Tonne C, Wilkinson P (2009) Public health benefits of strategies to reduce greenhouse-gas emissions: low-carbon electricity generation. Lancet 374(9706):2006–2015

    Article  CAS  Google Scholar 

  • Mathers CD, Loncar D (2006) Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 3(11):e442

    Google Scholar 

  • Matte TD, Cohen A, Dimmick F, Samet J, Sarnat J, Yip F, Jones N (2009) Summary of the workshop on methodologies for environmental public health tracking of air pollution effects. Air Qual Atmos Health 2(4):177–184

    Article  Google Scholar 

  • National Research Council US (2004) Air quality management in the United States. National Academy Press, Washington DC

    Google Scholar 

  • Peel JL, Klein, M, Flanders, WD, Mulholland, JA, Tolbert, PE (2010) Impact of improved air quality during the 1996 summer Olympic games in Atlanta on multiple cardiovascular and respiratory outcomes. HEI Research Report 148. Health Effects Institute, Boston. Available at http://pubs.healtheffects.org/view.php?id=337. Accessed 14 September 2010

  • Peters A, Breitner S, Cyrys J, Stölzel M, Pitz M, Wölke G, Heinrich J, Kreyling W, Küchenhoff H, Wichmann HE (2009) The influence of improved air quality on mortality risks in Erfurt, Germany. HEI Research Report 137. Health Effects Institute, Boston. Available at http://pubs.healtheffects.org/view.php?id=299. Accessed 3 January 2011

  • Pope CA III (1989) Respiratory disease associated with community air pollution and a steel mill, Utah Valley. Am J Public Health 79(5):623–628

    Article  Google Scholar 

  • Pope CA III, Ezzati M, Dockery DW (2009) Fine-particulate air pollution and life expectancy in the United States. N Engl J Med 360:376–386

    Article  CAS  Google Scholar 

  • Smith KR, Jerrett M, Anderson HR, Burnett RT, Stone V, Derwent R, Atkinson RW, Cohen A, Shonkoff SB, Krewski D, Pope CA 3rd, Thun MJ, Thurston G (2009) Public health benefits of strategies to reduce greenhouse-gas emissions: health implications of short-lived greenhouse pollutants. Lancet 374(9707):2091–2103

    Article  Google Scholar 

  • Tonne C, Beevers S, Armstrong B, Kelly F, Wilkinson P (2008) Air pollution and mortality benefits of the London congestion charge: spatial and socioeconomic inequalities. Occup Environ Med 65(9):620–627

    Article  CAS  Google Scholar 

  • Transport for London (2004) Central London congestion charging. Impacts monitoring. Second Annual Report. The Mayor of London, Greater London Authority, London. Available at http://www.tfl.gov.uk/assets/downloads/Impacts-monitoring-report-2.pdf. Accessed 14 September 2010

  • van Erp AM, Cohen AJ (2009) HEI’s research program on the impact of actions to improve air quality: interim evaluation and future directions. Communication 14. Health Effects Institute, Boston. Available at http://pubs.healtheffects.org/view.php?id=326. Accessed 14 September 2010

  • Wilkinson P, Smith KR, Davies M, Adair H, Armstrong BG, Barrett M, Bruce N, Haines A, Hamilton I, Oreszczyn T, Ridley I, Tonne C, Chalabi Z (2009) Public health benefits of strategies to reduce greenhouse-gas emissions: household energy. Lancet 374(9705):1917–1929

    Article  Google Scholar 

  • Woodcock J, Edwards P, Tonne C, Armstrong BG, Ashiru O, Banister D, Beevers S, Chalabi Z, Chowdhury Z, Cohen A, Franco OH, Haines A, Hickman R, Lindsay G, Mittal I, Mohan D, Tiwari G, Woodward A, Roberts I (2009) Public health benefits of strategies to reduce greenhouse-gas emissions: urban land transport. Lancet 374(9705):1930–1943

    Article  Google Scholar 

Download references

Acknowledgment

We wish to thank Douglas Dockery, Richard Morgenstern, and co-author Frank Kelly for allowing us to include the approaches, preliminary results, and main challenges of their HEI-funded studies for which the final results will become available in 2011. We also thank an anonymous reviewer for helpful suggestions.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Annemoon M. van Erp.

Rights and permissions

Reprints and permissions

About this article

Cite this article

van Erp, A.M., Kelly, F.J., Demerjian, K.L. et al. Progress in research to assess the effectiveness of air quality interventions towards improving public health. Air Qual Atmos Health 5, 217–230 (2012). https://doi.org/10.1007/s11869-010-0127-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11869-010-0127-y

Keywords

Navigation