IRAS Institute for Risk Assessment Sciences Utrecht, The Netherlands
Utrecht University
Gezondheidseffecten van luchtverontreinging en bewegen
Gerard Hoek
October 28, 2010 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Onderzoeksteam Moniek Zuurbier, Peter v.d. Hazel Jeroen de Hartog, Hanna Boogaard, Marieke Oldenwening, Kees Meliefste, Bert Brunekreef (IRAS) Hans Nijland (PBL)
Institute for Risk Assessment Sciences
2 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Institute for Risk Assessment Sciences
De Boris Bike Londen moet gaan fietsen
De Londense burgemeester Boris Johnson met de zogenoemde Boris Bikes, waarvan er vijfduizend worden ingezet om het autoverkeer in Londen te verminderen (EPA) 3 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Institute for Risk Assessment Sciences
Fietsen geldt als gevaarlijk, want Londense automobilisten zijn niet op de aanwezigheid van de ‘cycling nazi’s’ ingesteld, zoals autogoeroe Jeremy Clarkson ze graag noemt. In de lokale media staan regelmatig berichten over overreden (en overleden) fietsers.
Bovendien is fietsen met al die dieselbussen en taxi’s geen frisse aangelegenheid; niet voor niets dragen veel fietskoeriers liever mondkapjes. De lucht in Londen is immers een van de meest vervuilde in Europa.
4 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Motieven voor stimuleren fietsen Congestie Luchtkwaliteit Reductie broeikasgassen (klimaat) Obesitas
Institute for Risk Assessment Sciences
5 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Problemen voor fietsers Verkeersongelukken Blootstelling aan luchtverontreiniging Institute for Risk Assessment Sciences
6 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Fietsen ongezonder dan autorijden? (de Hartog et al, EHP 2010)
Institute for Risk Assessment Sciences
Vraag: weegt gezondheidswinst t.g.v fysieke activiteit op tegen verhoogd risico op ongelukken en verhoogde inhalatie van luchtverontreiniging?
7 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Methode Vervanging van korte autoritten door fiets Aanname 500,000 personen 7.5 km per dag Effect uitgedrukt in verandering van levensverwachting
Institute for Risk Assessment Sciences
8 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Institute for Risk Assessment Sciences
Luchtverontreiniging
9 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
City
Pollutant
London
PM2.5 EC EC PM2.5 UFP Abs
Institute for Risk Assessment Sciences
London London Huddersfield 11 Dutch cities Arnhem, the Netherlands Mean Mean Mean
UFP PM2.5 UFP PM2.5 Abs PM2.5 EC UFP
Ratio Reference Mean Mean concentration concentration car/cycle car (µg/m3) cycling (µg/m3) Adams 2001 37 28 1.32 Adams 2002 29 18 1.6 Gegisian 2003 39 25 1.6 Kaur 2005 38 34 1.12 Kaur 2005 99736 93968 1.06 Kingham 1998 7.6 2.7 2.6 6.3 1.2 Boogaard 2009 25545 24329 1.05 Boogaard 2009 49 45 1.11 Zuurbier 2010 40351 44258 0.91 Zuurbier 2010 78 72 1.09 Zuurbier 2010 8.8 6.0 1.48 1.16 1.65 1.01
10 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Geinhaleerde dosis Twee Nederlandse studies ademminuutvolume 2.1 – 2.3 keer hoger in fietsers dan in automobilisten (Belgische studie 4x hoger o.a. vanwege hogere fietssnelheid) Netto wordt dus inderdaad meer luchtverontreiniging ingeademd Wat zijn daarvan de gezondheidseffecten?
Institute for Risk Assessment Sciences
11 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Institute for Risk Assessment Sciences
Respiratory Effects of Exposure to Diesel Traffic in Persons with Asthma. N Engl J Med 2007;357:2348-58.
12 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Institute for Risk Assessment Sciences
Utrecht University
•2.9 x meer in traffic in uur voor infarct •Voor alle vervoersmiddelen •Luchtverontreiniging? 13 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Opmerkingen luchtkwaliteit Weinig studies Vooral fysiologische effecten, geen sterfte Geen lange termijn effecten Benadering nodig
Institute for Risk Assessment Sciences
14 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Schatting effect luchtkwaliteit Lange termijnstudies PM2.5 en zwarte rook Op basis van literatuur schatten van verschil in ingehaleerde dosis tussen auto en fiets Bijdrage van dosis aan totale dagelijkse dosis Resultaat verlies aan levensverwachting door fietsen ipv auto rijden: 1-40 dagen
Institute for Risk Assessment Sciences
15 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Institute for Risk Assessment Sciences
Verkeersongelukken
16 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Traffic deaths per age category per billion passenger km by bicycle and car in the Netherlands a (CBS, 2008)
Institute for Risk Assessment Sciences
Age category
Bicycle
Car
Ratio
<15
4.9
0.6
8.6
15-20
5.4
7.4
0.7
20-30
4.2
4.6
0.9
30-40
3.9
2.0
2.0
40-50
6.6
1.0
6.9
50-60
9.6
1.2
7.9
60-70
18.6
1.6
11.7
70-80
117.6
7.6
15.4
>80
139.6
8.1
17.1
Total average (all ages)
12.2
2.2
5.5
Total average (20 – 70)
8.2
1.9
4.3 17
interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Institute for Risk Assessment Sciences
Supplement material, Table 4 Mortality rates for being involved in a fatal traffic accident per billion kilometers traveled in the Netherlands, excluding motorways (European Commission, 1999). Age category
Bicycle
Car
12-14
16.8
-
15-17
18.2
-
18-24
7.7
33.5
25-29
8.2
17.0
30-39
7.0
9.7
40-49
9.2
9.7
50-59
17.2
5.9
60-64
32.1
10.4
> 64
79.1
39.9
21.0
20.8
Total
a
18 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Institute for Risk Assessment Sciences
Fysieke activiteit
19 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Table Potential impact of physical activity on all cause mortality in various reviews a and cohort studies Relative risk b
Source
Meeting moderate PA recommendation
0.70 – 0.80
(Lee and Skerrett 2001)
Expending of 1000 kcal/week
0.70
(Kesaniemi et al. 2001)
Meeting PA recommendation
0.70
(Bauman 2004)
Different definitions of physical activity:
0.70-0.87 (moderate)
(Bucksch , Schlicht 2006)
Definition of physical activity (PA)
Institute for Risk Assessment Sciences
Reviews
0.46-0.92 (vigorous) Meeting PA activity recommendation
0.65 – 0.80
(Warburton et al. 2006)
Different definitions
0.50-0.77
(Vogel et al. 2009)
Cycling studies (Andersen et al. 2000)
Cycling to work for 3 hours per week
0.55-0.72
Walking and cycling to work
0.71-0.79
(Hu et al. 2004)
Cycling to work (MET-hours/day)
0.66 – 0.79
(Matthews et al. 2007)
20 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Risks and benefits of cycling vs car driving 300 Life gained (days)
Institute for Risk Assessment Sciences
250 200 150 100 50 0 -50 Air pollution
Accidents
Physical activity 21
interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
Utrecht University
Commentaar Voor fietsers benefits veel groter dan risks Voor samenleving voordelen nog groter (luchtverontreiniging, ongelukken) Begeleidende maatregelen om risks verder te beteugelen
Institute for Risk Assessment Sciences
Contact met gemotoriseerd verkeer verminderen Routeplanner 22 interfacultary institute within the faculties Medicine, Veterinary Medicine and within the faculty of Science the deparments Biology and Pharmaceutical Sciences
