Imperial College London

DrAudreyde Nazelle

Faculty of Natural SciencesCentre for Environmental Policy

Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 7594 7319anazelle Website

 
 
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Location

 

20416 Prince's GardensSouth Kensington Campus

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Summary

 

Publications

Publication Type
Year
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93 results found

Gascon M, Götschi T, de Nazelle A, Gracia E, Ambròs A, Márquez S, Marquet O, Avila-Palencia I, Brand C, Iacorossi F, Raser E, Gaupp-Berghausen M, Dons E, Laeremans M, Kahlmeier S, Sánchez J, Gerike R, Anaya-Boig E, Panis LI, Nieuwenhuijsen Met al., 2019, Correlates of walking for travel in seven European cities: The PASTA project., Environmental Health Perspectives, Vol: 127, Pages: 097003-1-097003-13, ISSN: 0091-6765

BACKGROUND: Although walking for travel can help in reaching the daily recommended levels of physical activity, we know relatively little about the correlates of walking for travel in the European context. OBJECTIVE: Within the framework of the European Physical Activity through Sustainable Transport Approaches (PASTA) project, we aimed to explore the correlates of walking for travel in European cities. METHODS: The same protocol was applied in seven European cities. Using a web-based questionnaire, we collected information on total minutes of walking per week, individual characteristics, mobility behavior, and attitude ( N = 7,875 ). Characteristics of the built environment (the home and the work/study addresses) were determined with geographic information system (GIS)-based techniques. We conducted negative binomial regression analyses, including city as a random effect. Factor and principal component analyses were also conducted to define profiles of the different variables of interest. RESULTS: Living in high-density residential areas with richness of facilities and density of public transport stations was associated with increased walking for travel, whereas the same characteristics at the work/study area were less strongly associated with the outcome when the residential and work/study environments were entered in the model jointly. A walk-friendly social environment was associated with walking for travel. All three factors describing different opinions about walking (ranging from good to bad) were associated with increased minutes of walking per week, although the importance given to certain criteria to choose a mode of transport provided different results according to the criteria. DISCUSSION: The present study supports findings from previous research regarding the role of the built environment in the promotion o

Journal article

Keidel D, Maria Anto J, Basagana X, Bono R, Burte E, Carsin A-E, Forsberg B, Fuertes E, Galobardes B, Heinrich J, de Hoogh K, Jarvis D, Kunzli N, Leynaert B, Marcon A, Le Moual N, de Nazelle A, Schindler C, Siroux V, Stempfelet M, Sunyer J, Temam S, Tsai M-Y, Varraso R, Jacquemin B, Probst-Hensch Net al., 2019, The role of socioeconomic status in the association of lung function and air pollution - A pooled analysis of three adult ESCAPE cohorts, International Journal of Environmental Research and Public Health, Vol: 16, ISSN: 1660-4601

Ambient air pollution is a leading environmental risk factor and its broad spectrum ofadverse health effects includes a decrease in lung function. Socioeconomic status (SES) is knownto be associated with both air pollution exposure and respiratory function. This study assesses therole of SES either as confounder or effect modifier of the association between ambient air pollutionand lung function. Cross-sectional data from three European multicenter adult cohorts were pooledto assess factors associated with lung function, including annual means of home outdoor NO2.Pre-bronchodilator lung function was measured according to the ATS-criteria. Multiple mixedlinear models with random intercepts for study areas were used. Three different factors (education,occupation and neighborhood unemployment rate) were considered to represent SES. NO2 exposurewas negatively associated with lung function. Occupation and neighborhood unemployment rateswere not associated with lung function. However, the inclusion of the SES-variable education improvedthe models and the air pollution-lung function associations got slightly stronger. NO2 associationswith lung function were not substantially modified by SES-variables. In this multicenter Europeanstudy we could show that SES plays a role as a confounder in the association of ambient NO2 exposurewith lung function.

Journal article

Avila-Palencia I, Laeremans M, Hoffmann B, Anaya-Boig E, Carrasco-Turigas G, Cole-Hunter T, de Nazelle A, Dons E, Götschi T, Int Panis L, Orjuela JP, Standaert A, Nieuwenhuijsen MJet al., 2019, Effects of physical activity and air pollution on blood pressure, Environmental Research, Vol: 173, Pages: 387-396, ISSN: 0013-9351

AIM: To assess the main and interaction effects of black carbon and physical activity on arterial blood pressure in a healthy adult population from three European cities using objective personal measurements over short-term (hours and days) and long-term exposure. METHODS: A panel study of 122 healthy adults was performed in three European cities (Antwerp, Barcelona, and London). In 3 seasons between March 2015 and March 2016, each participant wore sensors for one week to objectively measure their exposure to black carbon and monitor their physical activity continuously. Blood pressure was assessed three times during the week: at the beginning (day 0), in the middle (day 4), and at the end (day 7). Associations of black carbon and physical activity with blood pressure and their interactions were investigated with linear regression models and multiplicative interaction terms, adjusting for all the potential confounders. RESULTS: In multiple exposure models, we did not see any effects of black carbon on blood pressure but did see effects on systolic blood pressure of moderate-to-vigorous physical activity effect that were statistically significant from 1 h to 8 h after exposure and for long-term exposure. For a 1METhour increase of moderate-to-vigorous physical activity, the difference in the expected mean systolic blood pressure varied from -1.46 mmHg (95%CI -2.11, -0.80) for 1 h mean exposure, to -0.29 mmHg (95%CI -0.55, -0.03) for 8 h mean exposure, and -0.05 mmHg (95%CI -0.09, -0.00) for long-term exposure. There were little to no interaction effects. CONCLUSIONS: Results from this study provide evidence that short-term and long-term exposure to moderate-to-vigorous physical activity is associated with a decrease in systolic blood pressure levels. We did not find evidence for a consistent main effect of black carbon on blood pressure, nor any interaction between black carbon and physical activity levels.

Journal article

Gaupp-Berghausen M, Raser E, Anaya-Boig E, Avila-Palencia I, de Nazelle A, Dons E, Franzen H, Gerike R, Gtschi T, Iacorossi F, Hssinger R, Nieuwenhuijsen M, Rojas-Rueda D, Sanchez J, Smeds E, Deforth M, Standaert A, Stigell E, Cole-Hunter T, Int Panis Let al., 2019, Evaluating different recruitment methods in a longitudinal survey: Findings from the pan-European PASTA project, Journal of Medical Internet Research, Vol: 21, ISSN: 1438-8871

Background: Sufficient sample size and minimal sample bias are core requirements for empirical data analyses. Combining opportunistic recruitment with a Web-based survey and data-collection platform yields new benefits over traditional recruitment approaches.Objective: This paper aims to report the success of different recruitment methods and obtain data on participants’ characteristics, participation behavior, recruitment rates, and representativeness of the sample.Methods: A longitudinal, Web-based survey was implemented as part of the European PASTA (Physical Activity through Sustainable Transport Approaches) project, between November 2014 and December 2016. During this period, participants were recruited from 7 European cities on a rolling basis. A standardized guide on recruitment strategy was developed for all cities, to reach a sufficient number of adult participants. To make use of the strengths and minimize weakness, a combination of different opportunistic recruitment methods was applied. In addition, the random sampling approach was applied in the city of Örebro. To reduce the attrition rate and improve real-time monitoring, the Web-based platform featured a participant’s and a researchers’ user interface and dashboard.Results: Overall, 10,691 participants were recruited; most people found out about the survey through their workplace or employer (2300/10691, 21.51%), outreach promotion (2219/10691, 20.76%), and social media (1859/10691, 17.39%). The average number of questionnaires filled in per participant varied significantly between the cities (P<.001), with the highest number in Zurich (11.0, SE 0.33) and the lowest in Örebro (4.8, SE 0.17). Collaboration with local organizations, the use of Facebook and mailing lists, and direct street recruitment were the most effective approaches in reaching a high share of participants (P<.001). Considering the invested working hours, Facebook was one of the most time-efficient me

Journal article

Gaupp-Berghausen M, Raser E, Anaya-Boig E, Avila-Palencia I, de Nazelle A, Dons E, Franzen H, Gerike R, Goetschi T, Iacorossi F, Hossinger R, Nieuwenhuijsen M, Rojas-Rueda D, Sanchez J, Smeds E, Deforth M, Standaert A, Stigell E, Cole-Hunter T, Panis LIet al., 2019, Evaluation of different recruitment methods: Longitudinal, web-based, pan-European physical activity through sustainable transport approaches (PASTA) project, Journal of Medical Internet Research, Vol: 21, ISSN: 1438-8871

Background:Sufficient sample size and minimal sample bias are core requirements in empirical data analyses. Combining opportunistic recruitment with an online survey and data collection platform yields new benefits compared to traditional recruitment approaches.Objective:The objective of this paper is to report on the success of different recruitment methods to obtain participants’ characteristics, participation behavior, recruitment rates, and representativeness of the sample.Methods:A longitudinal online survey was implemented as part of the European PASTA project, which was online between November 2014 and December 2016. During this period participants in seven European cities were recruited on a rolling basis. For all cities to reach a sufficient number of adult participants a standardized guide on recruitment strategy was developed. In order to make use of the strengths and to minimize weakness a combination of different opportunistic recruitment methods was applied. In addition, the city of Oerebro applied random sampling approach. In order to reduce attrition rate and improve real-time monitoring the online platform featured a participant and a researchers` user interface and dashboard.Results:A total of 10,691 participants were recruited. Most people found out about the survey through their workplace or employer (21.5 %), outreach promotion (20.8 %), and social media (17.4 %). The average number of questionnaires filled-in per participant varied between the cities, with the highest number in Zurich (11.0 ± 0.33) and the lowest in Oerebro (4.8 ± 0.17). Collaboration with local organizations, the use of Facebook and mailing lists, and direct street recruitment were the most effective approaches in reaching a high share of participants (p = <.001). Under consideration of invested working hours Facebook (p = <.001) was one of the most time-efficient methods. Compared to the cities census data, the composition

Journal article

Avila-Palencia I, Int Panis L, Dons E, Gaupp-Berghausen M, Raser E, Götschi T, Gerike R, Brand C, de Nazelle A, Orjuela JP, Anaya-Boig E, Stigell E, Kahlmeier S, Iacorossi F, Nieuwenhuijsen MJet al., 2018, The effects of transport mode use on self-perceived health, mental health, and social contact measures: a cross-sectional and longitudinal study, Environment International, Vol: 120, Pages: 199-206, ISSN: 0160-4120

BACKGROUND: Transport mode choice has been associated with different health risks and benefits depending on which transport mode is used. We aimed to evaluate the association between different transport modes use and several health and social contact measures. METHODS: We based our analyses on the Physical Activity through Sustainable Transport Approaches (PASTA) longitudinal study, conducted over a period of two years in seven European cities. 8802 participants finished the baseline questionnaire, and 3567 answered the final questionnaire. Participants were 18 years of age or older (16 years of age or older in Zurich) and lived, worked and/or studied in one of the case-study cities. Associations between transport mode use and health/social contact measures were estimated using mixed-effects logistic regression models, linear regression models, and logistic regression models according to the data available. All the associations were assessed with single and multiple transport mode models. All models were adjusted for potential confounders. RESULTS: In multiple transport mode models, bicycle use was associated with good self-perceived health [OR (CI 95%) = 1.07 (1.05, 1.08)], all the mental health measures [perceived stress: coef (CI 95%) = -0.016 (-0.028, -0.004); mental health: coef (CI 95%) = 0.11 (0.05, 0.18); vitality: coef (CI 95%) = 0.14 (0.07, 0.22)], and with fewer feelings of loneliness [coef (CI 95%) = -0.03 (-0.05, -0.01)]. Walking was associated with good self-perceived health [OR (CI 95%) = 1.02 (1.00, 1.03)], higher vitality [coef (CI 95%) = 0.14 (0.05, 0.23)], and more frequent contact with friends/family [OR (CI 95%) = 1.03 (1.00, 1.05)]. Car use was associated with fewer feelings of loneliness [coef (CI 95%) = -0.04 (-0.06, -0.02)]. The results for e-bike and public transport use were non-significant, and the results for motorbike use were inconclusive. CONCLUSIONS: Similarity of findings across cities suggested that active transport, especially bic

Journal article

Dons E, Rojas-Rueda D, Anaya-Boig E, Avila-Palencia I, Brand C, Cole-Hunter T, de Nazelle A, Eriksson U, Gaupp-Berghausen M, Gerike R, Kahlmeier S, Laeremans M, Mueller N, Nawrot T, Nieuwenhuijsen MJ, Orjuela JP, Racioppi F, Raser E, Standaert A, Int Panis L, Götschi Tet al., 2018, Transport mode choice and body mass index: Cross-sectional and longitudinal evidence from a European-wide study., Environment International, Vol: 119, Pages: 109-116, ISSN: 0160-4120

BACKGROUND: In the fight against rising overweight and obesity levels, and unhealthy urban environments, the renaissance of active mobility (cycling and walking as a transport mode) is encouraging. Transport mode has been shown to be associated to body mass index (BMI), yet there is limited longitudinal evidence demonstrating causality. We aimed to associate transport mode and BMI cross-sectionally, but also prospectively in the first ever European-wide longitudinal study on transport and health. METHODS: Data were from the PASTA project that recruited adults in seven European cities (Antwerp, Barcelona, London, Oerebro, Rome, Vienna, Zurich) to complete a series of questionnaires on travel behavior, physical activity levels, and BMI. To assess the association between transport mode and BMI as well as change in BMI we performed crude and adjusted linear mixed-effects modeling for cross-sectional (n = 7380) and longitudinal (n = 2316) data, respectively. RESULTS: Cross-sectionally, BMI was 0.027 kg/m2 (95%CI 0.015 to 0.040) higher per additional day of car use per month. Inversely, BMI was -0.010 kg/m2 (95%CI -0.020 to -0.0002) lower per additional day of cycling per month. Changes in BMI were smaller in the longitudinal within-person assessment, however still statistically significant. BMI decreased in occasional (less than once per week) and non-cyclists who increased cycling (-0.303 kg/m2, 95%CI -0.530 to -0.077), while frequent (at least once per week) cyclists who stopped cycling increased their BMI (0.417 kg/m2, 95%CI 0.033 to 0.802). CONCLUSIONS: Our analyses showed that people lower their BMI when starting or increasing cycling, demonstrating the health benefits of active mobility.

Journal article

Laeremans M, Dons E, Avila-Palencia I, Carrasco-Turigas G, Orjuela-Mendoza JP, Anaya-Boig E, Cole-Hunter T, De Nazelle A, Nieuwenhuijsen M, Standaert A, Van Poppel M, De Boever P, Int Panis Let al., 2018, Black Carbon Reduces the Beneficial Effect of Physical Activity on Lung Function, MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, Vol: 50, Pages: 1875-1881, ISSN: 0195-9131

Introduction When physical activity is promoted in urban outdoor settings (e.g., walking and cycling), individuals are also exposed to FEV<sub xmlns:mrws="http://webservices.ovid.com/mrws/1.0">1</sub>|AIR POLLUTION|ACTIVE MOBILITY. It has been reported that short-term lung function increases as a response to physical activity, but this beneficial effect is hampered when elevated FEV<sub xmlns:mrws="http://webservices.ovid.com/mrws/1.0">1</sub>|AIR POLLUTION|ACTIVE MOBILITY concentrations are observed. Our study assessed the long-term impact of FEV<sub xmlns:mrws="http://webservices.ovid.com/mrws/1.0">1</sub>|AIR POLLUTION|ACTIVE MOBILITY on the pulmonary health benefit of physical activity.Methods Wearable sensors were used to monitor physical activity levels (SenseWear) and exposure to black carbon (microAeth) of 115 healthy adults during 1 wk in three European cities (Antwerp, Barcelona, London). The experiment was repeated in three different seasons to approximate long-term behavior. Spirometry tests were performed at the beginning and end of each measurement week. All results were averaged on a participant level as a proxy for long-term lung function. Mixed effect regression models were used to analyze the long-term impact of physical activity, black carbon and their interaction on lung function parameters, forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC, forced expiratory flow (FEF)25–75, and peak expiratory flow. Interaction plots were used to interpret the significant interaction effects.Results Negative interaction effects of physical activity and black carbon exposure on FEV1 (P = 0.07), FEV1/FVC (P = 0.03), and FEF25–75 (P = 0.03) were observed. For black carbon concentrations up to approximately 1 μg·m−3, an additional MET·h−1·wk−1 resulted in a trend toward lung function increases (FEV1, FEV1/F

Journal article

Laeremans M, Dons E, Avila-Palencia I, Carrasco-Turigas G, Orjuela JP, Anaya E, Cole-Hunter T, de Nazelle A, Nieuwenhuijsen M, Standaert A, Van Poppel M, De Boever P, Panis LIet al., 2018, Short-term effects of physical activity, air pollution and their interaction on the cardiovascular and respiratory system, ENVIRONMENT INTERNATIONAL, Vol: 117, Pages: 82-90, ISSN: 0160-4120

Physical activity (PA) in urban environments may lead to increased inhalation of air pollutants. As PA and air pollution (AP) have respectively beneficial and detrimental effects on the cardiorespiratory system, the responses to these exposures can interact. Therefore, we assessed the short-term effects of PA, AP and their interaction on a set of subclinical cardiovascular and respiratory outcomes in a panel of healthy adults: heart rate variability (HRV), retinal vessel diameters, lung function and fractional exhaled nitric oxide (FeNO).One hundred twenty two participants measured their PA level and exposure to black carbon (BC), a marker of AP exposure, with wearable sensors during an unscripted week in three different seasons. The study was part of the PASTA project in three European cities (Antwerp: 41 participants, Barcelona: 41 participants, London: 40 participants). At the end of each measurement week, the health outcomes were evaluated. Responses to PA, BC and their interaction were assessed with mixed effect regression models. Separate models were used to account for a 2-h and 24-h time window.During the 2-h time window, HRV and lung function changed statistically significantly in response to PA (METhours) and logarithmic BC (%change). Changes in HRV marked an increased sympathetic tone with both PA (logarithmic LF/HF: +7%; p < 0.01) and BC (logarithmic HF: −19%; p < 0.05). In addition, PA provoked bronchodilation which was illustrated by a significant increase in lung function (FEV1: +15.63 mL; p < 0.05). While a BC %increase was associated with a significant lung function decrease (PEF: −0.10 mL; p < 0.05), the interaction indicated a potential protective effect of PA (p < 0.05). We did not observe a response of the retinal vessel diameters. Most subclinical outcomes did not change in the 24-h time window (except for a few minor changes in LF/HF, FeNO and PEF).Our results on the separate and combined effects of short-term PA and

Journal article

Riley R, de Nazelle A, 2018, Barriers and enablers of integrating health evidence into transport and urban planning and decision making, Integrating Human Health into Urban and Transport Planning A Framework, Editors: Nieuwenhuijsen, Khreis, Publisher: Springer, Pages: 641-655, ISBN: 9783319749839

Global rates of urbanisation are on the rise. By 2050 around 70% of the ten billion global population is expected to be living in cities. Whilst cities are centres of education, wealth creation, innovation and progress they are simultaneously characterized by pollution, congestion, noise, heat and overcrowding, adversely impacting human health on a global scale. Strategic and comprehensive urban and transport planning and policy that integrates health can ameliorate some of these negative impacts. The evidence base for how we should be building our cities of the future is there. Nonetheless, current urban and transport planning fails to optimise health outcomes. This chapter discusses the barriers and enablers to effectively integrating health evidence into urban and transport planning decision making. These barriers are discussed under the themes of (1) differing understandings of health between sectors (2) differing understandings of evidence and difficulties around evidence translation (3) governance and politics and (4) institutional context. The second part of the chapter puts forward solutions to overcoming these barriers and suggests that enabling factors reside in improving communication and collaboration across sectors and disciplines. Such collaboration is likely to be facilitated by changes both to the institutional context in which decisions are made and to the way research is developed and communicated.

Book chapter

Iwinska K, Blicharska M, Pierotti L, Tainio M, de Nazelle Aet al., 2018, Cycling in Warsaw, Poland - perceived enablers and barriers according to cyclists and non-cyclists, Transportation Research Part A: Policy and Practice, Vol: 113, Pages: 291-301, ISSN: 0965-8564

Cycling in urban environments provides many benefits to people. However, planning of cycling infrastructures in large cities faces numerous challenges and requires better understanding of both the factors enabling cycling as well as barriers to it, determined by particular local context. While there is a growing body of research that tackle the bike transport related questions in Western Europe and the USA, there is relatively little research on that in Central Eastern Europe (CEE), in post-communist countries. In this study we used qualitative and quantitative methods to explore urban cyclists and non-cyclists opinions about the cycling, the perceived problems and obstacles, and perception of the on-going changes in bicycle transportation system in Warsaw, Poland. Although many people see potential advantages of cycling, it is mostly perceived as a leisure time activity. Those who do utilitarian cycling are more acutely aware of the benefits, such as rapidity and flexibility of this mean of transport. The main perceived barriers are linked to lack of good cycling infrastructure in the city, the feeling of insecurity linked to the behaviour of drivers, and to maintenance during winter. In conclusion, our research highlights both the opportunities and challenges linked to the development of improved cycle transportation system, suggesting the need for a range of policies, from the infrastructure improvements and comprehensive planning of the whole transportation system, to improving the driving culture that would support feeling of security of the cyclists.

Journal article

Dons E, Laeremans M, Anaya-Boig E, Avila-Palencia I, Brand C, de Nazelle A, Gaupp-Berghausen M, Götschi T, Nieuwenhuijsen M, Orjuela JP, Raser E, Standaert A, Int Panis Let al., 2018, Concern over health effects of air pollution is associated to NO<inf>2</inf>in seven European cities, Air Quality, Atmosphere and Health, Vol: 11, Pages: 591-599, ISSN: 1873-9318

Subjective perception of air pollution is important and can have impacts on health in its own rights, can lead to protective behaviour, or it can be leveraged to engage citizens and stakeholders in support of cleaner air policies. The aim of the current analysis was to examine associations between level of concern over health effects of air pollution and personal and environmental factors. In seven European cities, 7622 adult participants were recruited to complete an online questionnaire on travel and physical activity behaviour, perceptions and attitudes on active mobility and the environment, and sociodemographics. Air pollution at the home address was determined using Europe-wide PM2.5and NO2land use regression models. Mixed effects logistic regression was used to model concern over air pollution (worried versus not worried; city as random effect). Fifty-eight percent of participants were worried over health effects of air pollution with large differences across cities (Antwerp 78%, Barcelona 81%, London 64%, Orebro 11%, Rome 72%, Vienna 43%, Zurich 33%). Linking mean modelled air pollution to mean level of concern per city gave a good correlation for NO2(r2= 0.75), and a lower correlation for PM2.5(r2= 0.49). In the regression model, sex, having children in the household, levels of physical activity, and NO2at the home address were significantly linked to individual concern over health effects of air pollution. We found that NO2but not PM2.5at the home address was associated with concern over health effects of air pollution.

Journal article

Mueller N, Rojas-Rueda D, Salmon M, Martinez D, Ambros A, Brand C, de Nazelle A, Dons E, Gaupp-Berghausen M, Gerike R, Götschi T, Iacorossi F, Panis LI, Kahlmeier S, Raser E, Nieuwenhuijsen M, PASTA consortiumet al., 2018, Health impact assessment of cycling network expansions in European cities., Preventive Medicine, Vol: 109, Pages: 62-70, ISSN: 0091-7435

We conducted a health impact assessment (HIA) of cycling network expansions in seven European cities. We modeled the association between cycling network length and cycling mode share and estimated health impacts of the expansion of cycling networks. First, we performed a non-linear least square regression to assess the relationship between cycling network length and cycling mode share for 167 European cities. Second, we conducted a quantitative HIA for the seven cities of different scenarios (S) assessing how an expansion of the cycling network [i.e. 10% (S1); 50% (S2); 100% (S3), and all-streets (S4)] would lead to an increase in cycling mode share and estimated mortality impacts thereof. We quantified mortality impacts for changes in physical activity, air pollution and traffic incidents. Third, we conducted a cost-benefit analysis. The cycling network length was associated with a cycling mode share of up to 24.7% in European cities. The all-streets scenario (S4) produced greatest benefits through increases in cycling for London with 1210 premature deaths (95% CI: 447-1972) avoidable annually, followed by Rome (433; 95% CI: 170-695), Barcelona (248; 95% CI: 86-410), Vienna (146; 95% CI: 40-252), Zurich (58; 95% CI: 16-100) and Antwerp (7; 95% CI: 3-11). The largest cost-benefit ratios were found for the 10% increase in cycling networks (S1). If all 167 European cities achieved a cycling mode share of 24.7% over 10,000 premature deaths could be avoided annually. In European cities, expansions of cycling networks were associated with increases in cycling and estimated to provide health and economic benefits.

Journal article

Cole-Hunter T, de Nazelle A, Donaire-Gonzalez D, Kubesch N, Carrasco-Turigas G, Matt F, Foraster M, Martínez T, Ambros A, Cirach M, Martinez D, Belmonte J, Nieuwenhuijsen Met al., 2017, Estimated effects of air pollution and space-time-activity on cardiopulmonary outcomes in healthy adults: A repeated measures study., Environment International, Vol: 111, Pages: 247-259, ISSN: 0160-4120

BACKGROUND: Exposure to air pollution is known to affect both short and long-term outcomes of the cardiopulmonary system; however, findings on short-term outcomes have been inconsistent and often from isolated and long-term rather than coexisting and short-term exposures, and among susceptible/unhealthy rather than healthy populations. AIMS: We aimed to investigate separately the annual, daily and daily space-time-activity-weighted effect of ambient air pollution, as well as confounding or modification by other environmental (including noise) or space-time-activity (including total daily physical activity) exposures, on cardiopulmonary outcomes in healthy adults. METHODS: Participants (N=57: 54% female) had indicators of cardiopulmonary outcomes [blood pressure (BP), pulse (HR) and heart rate variability (HRV {SDNN}), and lung function (spirometry {FEV1, FVC, SUM})] measured on four different mornings (at least five days apart) in a clinical setting between 2011 and 2014. Spatiotemporal ESCAPE-LUR models were used to estimate daily and annual air pollution exposures (including PM10, PMCoarse, but not Ozone {derived from closest station}) at participant residential and occupational addresses. Participants' time-activity diaries indicated time spent at either address to allow daily space-time-activity-weighted estimates, and capture total daily physical activity (total-PA {as metabolic-equivalents-of-task, METs}), in the three days preceding health measurements. Multivariate-adjusted linear mixed-effects models (using either annual or daily estimates) were adjusted for possible environmental confounders or mediators including levels of ambient noise and greenness. Causal mediation analysis was also performed separately considering these factors as well as total-PA. All presented models are controlled by age, height, sex and season. RESULTS: An increase in 5μg/m3 of daily space-time-activity-weighted PMCoarse exposure was statistically significantly associated with

Journal article

Götschi T, de Nazelle A, Brand C, Gerike Ret al., 2017, Towards a comprehensive conceptual framework of active travel behavior: a review and synthesis of published frameworks, Current Environmental Health Reports, Vol: 4, Pages: 286-295, ISSN: 2196-5412

Purpose of ReviewThis paper reviews the use of conceptual frameworks in research on active travel, such as walking and cycling. Generic framework features and a wide range of contents are identified and synthesized into a comprehensive framework of active travel behavior, as part of the Physical Activity through Sustainable Transport Approaches project (PASTA). PASTA is a European multinational, interdisciplinary research project on active travel and health.Recent FindingsAlong with an exponential growth in active travel research, a growing number of conceptual frameworks has been published since the early 2000s. Earlier frameworks are simpler and emphasize the distinction of environmental vs. individual factors, while more recently several studies have integrated travel behavior theories more thoroughly.SummaryBased on the reviewed frameworks and various behavioral theories, we propose the comprehensive PASTA conceptual framework of active travel behavior. We discuss how it can guide future research, such as data collection, data analysis, and modeling of active travel behavior, and present some examples from the PASTA project.

Journal article

Jerrett M, Donaire-Gonzalez D, Popoola O, Jones R, Cohen RC, Almanza E, de Nazelle A, Mead I, Carrasco-Turigas G, Cole-Hunter T, Triguero-Mas M, Seto E, Nieuwenhuijsen Met al., 2017, Validating novel air pollution sensors to improve exposure estimates for epidemiological analyses and citizen science, Environmental Research, Vol: 158, Pages: 286-294, ISSN: 0013-9351

Low cost, personal air pollution sensors may reduce exposure measurement errors in epidemiological investigations and contribute to citizen science initiatives. Here we assess the validity of a low cost personal air pollution sensor. Study participants were drawn from two ongoing epidemiological projects in Barcelona, Spain. Participants repeatedly wore the pollution sensor − which measured carbon monoxide (CO), nitric oxide (NO), and nitrogen dioxide (NO2). We also compared personal sensor measurements to those from more expensive instruments. Our personal sensors had moderate to high correlations with government monitors with averaging times of 1-h and 30-min epochs (r ~ 0.38–0.8) for NO and CO, but had low to moderate correlations with NO2 (~0.04–0.67). Correlations between the personal sensors and more expensive research instruments were higher than with the government monitors. The sensors were able to detect high and low air pollution levels in agreement with expectations (e.g., high levels on or near busy roadways and lower levels in background residential areas and parks). Our findings suggest that the low cost, personal sensors have potential to reduce exposure measurement error in epidemiological studies and provide valid data for citizen science studies.

Journal article

Avila-Palencia I, de Nazelle A, Cole-Hunter T, Donaire-Gonzalez D, Jerrett M, Rodriguez DA, Nieuwenhuijsen MJet al., 2017, The relationship between bicycle commuting and perceived stress: a cross-sectional study, BMJ Open, Vol: 7, ISSN: 2044-6055

Introduction Active commuting — walking and bicycling for travel to and/or from work or educational addresses — may facilitate daily, routine physical activity. Several studies have investigated the relationship between active commuting and commuting stress; however, there are no studies examining the relationship between solely bicycle commuting and perceived stress, or studies that account for environmental determinants of bicycle commuting and stress. The current study evaluated the relationship between bicycle commuting, among working or studying adults in a dense urban setting, and perceived stress.Methods A cross-sectional study was performed with 788 adults who regularly travelled to work or study locations (excluding those who only commuted on foot) in Barcelona, Spain. Participants responded to a comprehensive telephone survey concerning their travel behaviour from June 2011 through to May 2012. Participants were categorised as either bicycle commuters or non-bicycle commuters, and (based on the Perceived Stress Scale, PSS-4) as either stressed or non-stressed. Multivariate Poisson regression with robust variance models of stress status based on exposures with bicycle commuting were estimated and adjusted for potential confounders.Results Bicycle commuters had significantly lower risk of being stressed than non-bicycle commuters (Relative Risk; RR (95% CI)=0.73 (0.60 to 0.89), p=0.001). Bicycle commuters who bicycled 4 days per week (RR (95% CI)=0.42 (0.24 to 0.73), p=0.002) and those who bicycled 5 or more days per week (RR (95% CI)=0.57 (0.42 to 0.77), p<0.001) had lower risk of being stressed than those who bicycled less than 4 days. This relationship remained statistically significant after adjusting for individual and environmental confounders and when using different cut-offs of perceived stress.Conclusions Stress reduction may be an important consequence of routine bicycle use and should be considered

Journal article

Laeremans M, Dons E, Avila-Palencia I, Carrasco-Turigas G, Pablo Orjuela J, Anaya E, Brand C, Cole-Hunter T, de Nazelle A, Gotschi T, Kahlmeier S, Nieuwenhuijsen M, Standaert A, De Boever P, Panis LIet al., 2017, Physical activity and sedentary behaviour in daily life: A comparative analysis of the Global Physical Activity Questionnaire (GPAQ) and the SenseWear armband, PLOS One, Vol: 12, ISSN: 1932-6203

Reduction of sedentary time and an increase in physical activity offer potential to improve public health. However, quantifying physical activity behaviour under real world conditions is a major challenge and no standard of good practice is available. Our aim was to compare the results of physical activity and sedentary behaviour obtained with a self-reported instrument (Global Physical Activity Questionnaire (GPAQ)) and a wearable sensor (SenseWear) in a repeated measures study design. Healthy adults (41 in Antwerp, 41 in Barcelona and 40 in London) wore the SenseWear armband for seven consecutive days and completed the GPAQ on the final day. This was repeated three times. We used the Wilcoxon signed rank sum test, Spearman correlation coefficients, mixed effects regression models and Bland-Altman plots to study agreement between both methods. Mixed models were used to assess the effect of personal characteristics on the absolute and relative difference between estimates obtained with the GPAQ and SenseWear. Moderate to vigorous energy expenditure and duration derived from the GPAQ were significantly lower (p<0.05) compared to the SenseWear, yet these variables showed significant correlations ranging from 0.45 to 0.64. Estimates of vigorous-intensity physical activity in particular showed high similarity (r>0.59). Results for sedentary behaviour did not differ, yet were poorly correlated (r<0.25). The differences between all variables were reproducible across repeated measurements. In addition, we observed a relationship between these differences and BMI, body fat and physical activity domain. Due to the lack of a standardized protocol, results from different studies measuring physical activity and sedentary behaviour are difficult to compare. Therefore, we suggested an easy-to-implement approach for future studies adding the GPAQ to the wearable of choice as a basis for comparisons.

Journal article

Dons E, Laeremans M, Orjuela JP, Avila-Palencia I, Carrasco-Turigas G, Cole-Hunter T, Anaya-Boig E, Standaert A, De Boever P, Nawrot T, Gotschi T, de Nazelle A, Nieuwenhuijsen M, Panis LIet al., 2017, Wearable sensors for personal monitoring and estimation of inhaled traffic-related air pollution: evaluation of methods, Environmental Science and Technology, Vol: 51, Pages: 1859-1867, ISSN: 0013-936X

Physical activity and ventilation rates have an effect on an individual’s dose and may be important to consider in exposure–response relationships; however, these factors are often ignored in environmental epidemiology studies. The aim of this study was to evaluate methods of estimating the inhaled dose of air pollution and understand variability in the absence of a true gold standard metric. Five types of methods were identified: (1) methods using (physical) activity types, (2) methods based on energy expenditure, METs (metabolic equivalents of task), and oxygen consumption, (3) methods based on heart rate or (4) breathing rate, and (5) methods that combine heart and breathing rate. Methods were compared using a real-life data set of 122 adults who wore devices to track movement, black carbon air pollution, and physiological health markers for 3 weeks in three European cities. Different methods for estimating minute ventilation performed well in relative terms with high correlations among different methods, but in absolute terms, ignoring increased ventilation during day-to-day activities could lead to an underestimation of the daily dose by a factor of 0.08–1.78. There is no single best method, and a multitude of methods are currently being used to approximate the dose. The choice of a suitable method for determining the dose in future studies will depend on both the size and the objectives of the study.

Journal article

de Nazelle A, Bode O, Orjuela JP, 2016, Comparison of air pollution exposures in active vs. passive travel modes in European cities: A quantitative review, Environment International, Vol: 99, Pages: 151-160, ISSN: 0160-4120

Background:Transport microenvironments tend to have higher air pollutant concentrations than other settings most people encounter in their daily lives. The choice of travel modes may affect significantly individuals' exposures; however such considerations are typically not accounted for in exposure assessment used in environmental health studies. In particular, with increasing interest in the promotion of active travel, health impact studies that attempt to estimate potential adverse consequences of potential increased pollutant inhalation during walking or cycling have emerged. Such studies require a quantification of relative exposures in travel modes.Methods:The literature on air pollution exposures in travel microenvironments in Europe was reviewed. Studies which measured various travel modes including at least walking or cycling in a simultaneous or quasi-simultaneous design were selected. Data from these studies were harmonized to allow for a quantitative synthesis of the estimates. Ranges of ratios and 95% confidence interval (CI) of air pollution exposure between modes and between background and transportation modes were estimated.Results:Ten studies measuring fine particulate matter (PM2.5), black carbon (BC), ultrafine particles (UFP), and/or carbon monoxide (CO) in the walk, bicycle, car and/or bus modes were included in the analysis. Only three reported on CO and BC and results should be interpreted with caution. Pedestrians were shown to be the most consistently least exposed of all across studies, with the bus, bicycle and car modes on average 1.3 to 1.5 times higher for PM2.5; 1.1 to 1.7 times higher for UFP; and 1.3 to 2.9 times higher for CO; however the 95% CI included 1 for the UFP walk to bus ratio. Only for BC were pedestrians more exposed than bus users on average (bus to walk ratio 0.8), but remained less exposed than those on bicycles or in cars. Car users tended to be the most exposed (from 2.9 times higher than pedestrians for BC down to si

Journal article

Jedynska A, Hoek G, Wang M, Yang A, Eeftens M, Cyrys J, Keuken M, Ampe C, Beelen R, Cesaroni G, Forastiere F, Cirach M, de Hoogh K, De Nazelle A, Nystad W, Akhlaghi HM, Declercq C, Stempfelet M, Eriksen KT, Dimakopoulou K, Lanki T, Meliefste K, Nieuwenhuijsen M, Yli-Tuomi T, Raaschou-Nielsen O, Janssen NAH, Brunekreef B, Kooter IMet al., 2016, Spatial variations and development of land use regression models of oxidative potential in ten European study areas, ATMOSPHERIC ENVIRONMENT, Vol: 150, Pages: 24-32, ISSN: 1352-2310

Journal article

Donaire-Gonzalez D, Valentin A, de Nazelle A, Ambros A, Carrasco-Turigas G, Seto E, Jerrett M, Nieuwenhuijsen MJet al., 2016, Benefits of Mobile Phone Technology for Personal Environmental Monitoring, JMIR mHealth and uHealth, Vol: 4, ISSN: 2291-5222

Background: Tracking individuals in environmental epidemiological studies using novel mobile phone technologies can provide valuable information on geolocation and physical activity, which will improve our understanding of environmental exposures.Objective: The objective of this study was to assess the performance of one of the least expensive mobile phones on the market to track people's travel-activity pattern.Methods: Adults living and working in Barcelona (72/162 bicycle commuters) carried simultaneously a mobile phone and a Global Positioning System (GPS) tracker and filled in a travel-activity diary (TAD) for 1 week (N=162). The CalFit app for mobile phones was used to log participants’ geographical location and physical activity. The geographical location data were assigned to different microenvironments (home, work or school, in transit, others) with a newly developed spatiotemporal map-matching algorithm. The tracking performance of the mobile phones was compared with that of the GPS trackers using chi-square test and Kruskal-Wallis rank sum test. The minute agreement across all microenvironments between the TAD and the algorithm was compared using the Gwet agreement coefficient (AC1).Results: The mobile phone acquired locations for 905 (29.2%) more trips reported in travel diaries than the GPS tracker (P<.001) and had a median accuracy of 25 m. Subjects spent on average 57.9%, 19.9%, 9.0%, and 13.2% of time at home, work, in transit, and other places, respectively, according to the TAD and 57.5%, 18.8%, 11.6%, and 12.1%, respectively, according to the map-matching algorithm. The overall minute agreement between both methods was high (AC1 .811, 95% CI .810-.812).Conclusions: The use of mobile phones running the CalFit app provides better information on which microenvironments people spend their time in than previous approaches based only on GPS trackers. The improvements of mobile phone technology in microenvironment determination are because the m

Journal article

de Hoogh K, Gulliver J, van Donkelaar A, Martin RV, Marshall JD, Bechle MJ, Cesaroni G, Cirach Pradas M, Dedele A, Eeftens M, Forsberg B, Galassi C, Heinrich J, Hoffmann B, Jacquemin B, Katsouyanni K, Korek M, Kunzli N, Lindley SJ, Lepeule J, Meleux F, de Nazelle A, Nieuwenhuijsen M, Nystad W, Raaschou-Nielsen O, Peters A, Peuch V-H, Rouil L, Udvardy O, Slama R, Stempfelet M, Stephanou EG, Tsai MY, Yli-Tuomi T, Weinmayr G, Brunekreef B, Vienneau D, Hoek Get al., 2016, Development of West-European PM2.5 and NO2 land use regression models incorporating satellite-derived and chemical transport modelling data, ENVIRONMENTAL RESEARCH, Vol: 151, Pages: 1-10, ISSN: 0013-9351

Journal article

Braun LM, Rodriguez DA, Cole-Hunter T, Ambros A, Donaire-Gonzalez D, Jerrett M, Mendez MA, Nieuwenhuijsen MJ, de Nazelle Aet al., 2016, Short-term planning and policy interventions to promote cycling in urban centers: Findings from a commute mode choice analysis in Barcelona, Spain, Transportation Research Part A: Policy and Practice, Vol: 89, Pages: 164-183, ISSN: 0965-8564

Background: Cycling for transportation has become an increasingly important component of strategies to address public health, climate change, and air quality concerns in urban centers. Within this context, planners and policy makers would benefit from an improved understanding of available interventions and their relative effectiveness for cycling promotion. We examined predictors of bicycle commuting that are relevant to planning and policy intervention, particularly those amenable to short- and medium-term action. Methods: We estimated a travel mode choice model using data from a survey of 765 commuters who live and work within the municipality of Barcelona. We considered how the decision to commute by bicycle was associated with cycling infrastructure, bike share availability, travel demand incentives, and other environmental attributes (e.g., public transport availability). Self-reported and objective (GIS-based) measures were compared. Point elasticities and marginal effects were calculated to assess the relative explanatory power of the independent variables considered. Results: While both self-reported and objective measures of access to cycling infrastructure were associated with bicycle commuting, self-reported measures had stronger associations. Bicycle commuting had positive associations with access to bike share stations but inverse associations with access to public transport stops. Point elasticities suggested that bicycle commuting has a mild negative correlation with public transport availability (-0.136), bike share availability is more important at the work location (0.077) than at home (0.034), and bicycle lane presence has a relatively small association with bicycle commuting (0.039). Marginal effects suggested that provision of an employer-based incentive not to commute by private vehicle would be associated with an 11.3% decrease in the probability of commuting by bicycle, likely reflecting the typical emphasis of such incentives on public tran

Journal article

Tainio M, de Nazelle AJ, Götschi T, Kahlmeier S, Rojas-Rueda D, Nieuwenhuijsen MJ, de Sá TH, Kelly P, Woodcock Jet al., 2016, Can air pollution negate the health benefits of cycling and walking?, Preventive Medicine, Vol: 87, Pages: 233-236, ISSN: 1096-0260

Active travel (cycling, walking) is beneficial for the health due to increased physical activity (PA). However, active travel may increase the intake of air pollution, leading to negative health consequences. We examined the risk–benefit balance between active travel related PA and exposure to air pollution across a range of air pollution and PA scenarios.The health effects of active travel and air pollution were estimated through changes in all-cause mortality for different levels of active travel and air pollution. Air pollution exposure was estimated through changes in background concentrations of fine particulate matter (PM2.5), ranging from 5 to 200 μg/m3. For active travel exposure, we estimated cycling and walking from 0 up to 16 h per day, respectively. These refer to long-term average levels of active travel and PM2.5 exposure.For the global average urban background PM2.5 concentration (22 μg/m3) benefits of PA by far outweigh risks from air pollution even under the most extreme levels of active travel. In areas with PM2.5 concentrations of 100 μg/m3, harms would exceed benefits after 1 h 30 min of cycling per day or more than 10 h of walking per day. If the counterfactual was driving, rather than staying at home, the benefits of PA would exceed harms from air pollution up to 3 h 30 min of cycling per day. The results were sensitive to dose–response function (DRF) assumptions for PM2.5 and PA.PA benefits of active travel outweighed the harm caused by air pollution in all but the most extreme air pollution concentrations.

Journal article

Rojas-Rueda D, de Nazelle A, Andersen ZJ, Braun-Fahrlaender C, Bruha J, Bruhova-Foltynova H, Desqueyroux H, Praznoczy C, Ragettli MS, Tainio M, Nieuwenhuijsen MJet al., 2016, Health impacts of active transportation in Europe, PLOS One, Vol: 11, ISSN: 1932-6203

Policies that stimulate active transportation (walking and bicycling) have been related to heath benefits. This study aims to assess the potential health risks and benefits of promoting active transportation for commuting populations (age groups 16–64) in six European cities. We conducted a health impact assessment using two scenarios: increased cycling and increased walking. The primary outcome measure was all-cause mortality related to changes in physical activity level, exposure to fine particulate matter air pollution with a diameter <2.5 μm, as well as traffic fatalities in the cities of Barcelona, Basel, Copenhagen, Paris, Prague, and Warsaw. All scenarios produced health benefits in the six cities. An increase in bicycle trips to 35% of all trips (as in Copenhagen) produced the highest benefits among the different scenarios analysed in Warsaw 113 (76–163) annual deaths avoided, Prague 61 (29–104), Barcelona 37 (24–56), Paris 37 (18–64) and Basel 5 (3–9). An increase in walking trips to 50% of all trips (as in Paris) resulted in 19 (3–42) deaths avoided annually in Warsaw, 11(3–21) in Prague, 6 (4–9) in Basel, 3 (2–6) in Copenhagen and 3 (2–4) in Barcelona. The scenarios would also reduce carbon dioxide emissions in the six cities by 1,139 to 26,423 (metric tonnes per year). Policies to promote active transportation may produce health benefits, but these depend of the existing characteristics of the cities. Increased collaboration between health practitioners, transport specialists and urban planners will help to introduce the health perspective in transport policies and promote active transportation.

Journal article

Curto A, de Nazelle A, Donaire-Gonzalez D, Cole-Hunter T, Garcia-Aymerich J, Martínez D, Anaya E, Rodríguez D, Jerrett M, Nieuwenhuijsen MJet al., 2016, Private and public modes of bicycle commuting: a perspective on attitude and perception., European Journal of Public Health, Vol: 26, Pages: 717-723, ISSN: 1464-360X

BACKGROUND: Public bicycle-sharing initiatives can act as health enhancement strategies among urban populations. The aim of the study was to determine which attitudes and perceptions of behavioural control toward cycling and a bicycle-sharing system distinguish commuters with a different adherence to bicycle commuting.  METHODS: The recruitment process was conducted in 40 random points in Barcelona from 2011 to 2012. Subjects completed a telephone-based questionnaire including 27 attitude and perception statements. Based on their most common one-way commute trip and willingness to commute by bicycle, subjects were classified into Private Bicycle (PB), public bicycle or Bicing Bicycle (BB), Willing Non-bicycle (WN) and Non-willing Non-bicycle (NN) commuters. After reducing the survey statements through principal component analysis, a multinomial logistic regression model was obtained to evaluate associations between attitudinal and commuter sub-groups.  RESULTS: We included 814 adults in the analysis [51.6% female, mean (SD): age 36.6 (10.3) years]. BB commuters were 2.0 times [95% confidence interval (CI) = 1.1-3.7] less likely to perceive bicycle as a quick, flexible and enjoyable mode compared to PB. BB, WN and NN were 2.5 (95% CI = 1.46-4.24), 2.6 (95% CI = 1.53-4.41) and 2.3 times (95% CI = 1.30-4.10) more likely to perceive benefits of using public bicycles (bicycle maintenance and parking avoidance, low cost and no worries about theft and vandalism) than did PB.  CONCLUSION: Willing non-bicycle and public-bicycle commuters had more favourable perception toward public-shared bicycles compared to private cyclists. Hence, public bicycles may be the impetus for those willing to start bicycle commuting, thereby increasing physical activity levels.

Journal article

Guxens M, Ghassabian A, Gong T, Garcia-Esteban R, Porta D, Giorgis-Allemand L, Almqvist C, Aranbarri A, Beelen R, Badaloni C, Cesaroni G, de Nazelle A, Estarlich M, Forastiere F, Forns J, Gehring U, Ibarluzea J, Jaddoe VW, Korek M, Lichtenstein P, Nieuwenhuijsen MJ, Rebagliato M, Slama R, Tiemeier H, Verhulst FC, Volk HE, Pershagen G, Brunekreef B, Sunyer Jet al., 2016, Air Pollution Exposure during Pregnancy and Childhood Autistic Traits in Four European Population-Based Cohort Studies: The ESCAPE Project., Environmental Health Perspectives, Vol: 124, Pages: 133-140, ISSN: 1552-9924

BACKGROUND: Prenatal exposure to air pollutants has been suggested as a possible etiologic factor for the occurrence of autism spectrum disorder. OBJECTIVES: We aimed to assess whether prenatal air pollution exposure is associated with childhood autistic traits in the general population. METHODS: Ours was a collaborative study of four European population-based birth/child cohorts-CATSS (Sweden), Generation R (the Netherlands), GASPII (Italy), and INMA (Spain). Nitrogen oxides (NO2, NOx) and particulate matter (PM) with diameters of ≤ 2.5 μm (PM2.5), ≤ 10 μm (PM10), and between 2.5 and 10 μm (PMcoarse), and PM2.5 absorbance were estimated for birth addresses by land-use regression models based on monitoring campaigns performed between 2008 and 2011. Levels were extrapolated back in time to exact pregnancy periods. We quantitatively assessed autistic traits when the child was between 4 and 10 years of age. Children were classified with autistic traits within the borderline/clinical range and within the clinical range using validated cut-offs. Adjusted cohort-specific effect estimates were combined using random-effects meta-analysis. RESULTS: A total of 8,079 children were included. Prenatal air pollution exposure was not associated with autistic traits within the borderline/clinical range (odds ratio = 0.94; 95% CI: 0.81, 1.10 per each 10-μg/m3 increase in NO2 pregnancy levels). Similar results were observed in the different cohorts, for the other pollutants, and in assessments of children with autistic traits within the clinical range or children with autistic traits as a quantitative score. CONCLUSIONS: Prenatal exposure to NO2 and PM was not associated with autistic traits in children from 4 to 10 years of age in four European population-based birth/child cohort studies. CITATION: Guxens M, Ghassabian A, Gong T, Garcia-Esteban R, Porta D, Giorgis-Allemand L, Almqvist C, Aranbarri A, Beelen R, Badaloni C, Cesaroni G, de Nazelle A, Estarlich M, Fora

Journal article

Gerike R, de Nazelle A, Nieuwenhuijsen M, Panis LI, Anaya E, Avila-Palencia I, Boschetti F, Brand C, Cole-Hunter T, Dons E, Eriksson U, Gaupp-Berghausen M, Kahlmeier S, Laeremans M, Mueller N, Orjuela JP, Racioppi F, Raser E, Rojas-Rueda D, Schweizer C, Standaert A, Uhlmann T, Wegener S, Goetschi Tet al., 2016, Physical Activity through Sustainable Transport Approaches (PASTA): a study protocol for a multicentre project, BMJ Open, Vol: 6, ISSN: 2044-6055

Journal article

Donaire-Gonzalez D, de Nazelle A, Cole-Hunter T, Curto A, Rodriguez DA, Mendez MA, Garcia-Aymerich J, Basagana X, Ambros A, Jerrett M, Nieuwenhuijsen MJet al., 2015, The Added Benefit of Bicycle Commuting on the Regular Amount of Physical Activity Performed, American Journal of Preventive Medicine, Vol: 49, Pages: 842-849, ISSN: 0749-3797

IntroductionPhysical inactivity is a leading cause of death and disability globally. Active transportation such as bicycling may increase physical activity levels. It is currently uncertain whether a shift from motorized transport modes to bicycle commuting leads to increased physical activity overall or substitutes other forms of physical activity. The study aims to disentangle whether bicycle commuting adds to or replaces other physical activities by comparing the physical activity performed by bicycle and motorized commuters.MethodsPhysical activity, travel behavior, health status, sociodemographic, and built environment characteristics were assessed for 752 adults, between June 2011 and May 2012, in Barcelona, Spain. Statistical analyses, performed in 2013–2014, included linear, non-linear, and mixture models to estimate disparities and the dose–response relationship between physical activity duration and commute mode.ResultsRegular bicycle commuters traveled by bicycle an average of 3.1 (SD=2.5) hours in the previous week. Bicycle commuting contributed positively to physical activity duration across participants (p<0.05). It amounted to 2.1 (95% CI=0.84, 3.55) hours/week extra of physical activity for bicycle commuters versus motorized commuters. Among bicycle travelers, there was a positive dose–response relationship between bicycle commuting and physical activity duration, with an average extra physical activity duration of 0.5 (95% CI=0.4, 0.6) hours/week for every additional 1 hour/week of bicycle commuting.ConclusionsBicycle commuting likely adds to overall physical activity. The extra physical activity performed by bicycle commuters is undertaken as moderate physical activity and follows a sigmoidal dose–response relationship with bicycle duration.

Journal article

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