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
to

114 results found

Heydari S, Tainio M, Woodcock J, de Nazelle Aet al., 2020, Estimating traffic contribution to particulate matter concentration in urban areas using a multilevel Bayesian meta-regression approach, Environment International, Vol: 141, Pages: 1-8, ISSN: 0160-4120

Quantifying traffic contribution to air pollution in urban settings is required to inform traffic management strategies and environmental policies that aim at improving air quality. Assessments and comparative analyses across multiple urban areas are challenged by the lack of datasets and methods available for global applications. In this study, we quantify the traffic contribution to particulate matter concentration in multiple cities worldwide by synthesising 155 previous studies reported in the World Health Organization (WHO)’s air pollution source apportionment data for PM10 and PM2.5. We employed a Bayesian multilevel meta-regression that accounts for uncertainties and captures both within- and between-study variations (in estimation methods, study protocols, etc.) through study-specific and location-specific explanatory variables. The final sample analysed in this paper covers 169 cities worldwide. Based on our analysis, traffic contribution to air pollution (particulate matter) varies from 5% to 61% in cities worldwide, with an average of 27%. We found that variability in the traffic contribution estimates reported worldwide can be explained by the region of study, publication year, PM size fraction, and population. Specifically, traffic contribution to air pollution in cities located in Europe, North America, or Oceania is on average 36% lower relative to the rest of the world. Traffic contribution is 28% lower among studies published after 2005 than those published on or before 2005. Traffic contribution is on average 24% lower among cities with less than 500,000 inhabitants and 19% higher when estimated based on PM10 relative to PM2.5. This quantitative summary overcomes challenges in the data and provides useful information for health impact modellers and decision-makers to assess impacts of traffic reduction policies.

Journal article

Branion-Calles M, Gotschi T, Nelson T, Anaya-Boig E, Avila-Palencia I, Castro A, Cole-Hunter T, de Nazelle A, Dons E, Gaupp-Berghausen M, Gerike R, Panis LI, Kahlmeier S, Nieuwenhuijsen M, Rojas-Rueda D, Winters Met al., 2020, Cyclist crash rates and risk factors in a prospective cohort in seven European cities, Accident Analysis and Prevention, Vol: 141, Pages: 1-12, ISSN: 0001-4575

Increased cycling uptake can improve population health, but barriers include real and perceived risks. Crash risk factors are important to understand in order to improve safety and increase cycling uptake. Many studies of cycling crash risk are based on combining diverse sources of crash and exposure data, such as police databases (crashes) and travel surveys (exposure), based on shared geography and time. When conflating crash and exposure data from different sources, the risk factors that can be quantified are only those variables common to both datasets, which tend to be limited to geography (e.g. countries, provinces, municipalities) and a few general road user characteristics (e.g. gender and age strata). The Physical Activity through Sustainable Transport Approaches (PASTA) project was a prospective cohort study that collected both crash and exposure data from seven European cities (Antwerp, Barcelona, London, Örebro, Rome, Vienna and Zürich). The goal of this research was to use data from the PASTA project to quantify exposure-adjusted crash rates and model adjusted crash risk factors, including detailed sociodemographic characteristics, attitudes about transportation, neighbourhood built environment features and location by city. We used negative binomial regression to model the influence of risk factors independent of exposure. Of the 4,180 cyclists, 10.2 % reported 535 crashes. We found that overall crash rates were 6.7 times higher in London, the city with the highest crash rate, relative to Örebro, the city with the lowest rate. Differences in overall crash rates between cities are driven largely by crashes that did not require medical treatment and that involved motor-vehicles. In a parsimonious crash risk model, we found higher crash risks for less frequent cyclists, men, those who perceive cycling to not be well regarded in their neighbourhood, and those who live in areas of very high building density. Longitudinal collection of crash a

Journal article

Branion-Calles M, Winters M, Nelson T, de Nazelle A, Int Panis L, Avila-Palencia I, Anaya-Boig E, Rojas-Rueda D, Dons E, Gotschi Tet al., 2019, Impacts of study design on sample size, participation bias, and outcome measurement: A case study from bicycling research, Journal of Transport and Health, Vol: 15, Pages: 1-12, ISSN: 2214-1405

IntroductionMeasuring bicycling behaviour is critical to bicycling research. A common study design question is whether to measure bicycling behaviour once (cross-sectional) or multiple times (longitudinal). The Physical Activity through Sustainable Transport Approaches (PASTA) project is a longitudinal cohort study of over 10,000 participants from seven European cities over two years. We used PASTA data as a case study to investigate how measuring once or multiple times impacted three factors: a) sample size b) participation bias and c) accuracy of bicycling behaviour estimates.MethodsWe compared two scenarios: i) as if only the baseline data were collected (cross-sectional approach) and ii) as if the baseline plus repeat follow-ups were collected (longitudinal approach). We compared each approach in terms of differences in sample size, distribution of sociodemographic characteristics, and bicycling behaviour. In the cross-sectional approach, we measured participants long-term bicycling behaviour by asking for recall of typical weekly habits, while in the longitudinal approach we measured by taking the average of bicycling reported for each 7-day period.ResultsRelative to longitudinal, the cross-sectional approach provided a larger sample size and slightly better representation of certain sociodemographic groups, with worse estimates of long-term bicycling behaviour. The longitudinal approach suffered from participation bias, especially the drop-out of more frequent bicyclists. The cross-sectional approach under-estimated the proportion of the population that bicycled, as it captured ‘typical’ behaviour rather than 7-day recall. The magnitude and directionality of the difference between typical weekly (cross-sectional approach) and the average 7-day recall (longitudinal approach) varied depending on how much bicycling was initially reported.ConclusionsIn our case study we found that measuring bicycling once, resulted in a larger sample with better repres

Journal article

Yang L, van Dam KH, Anvari B, de Nazelle Aet al., 2019, Evaluating the impact of an integrated urban design of transport infrastructure and public space on human behavior and environmental quality: a case study in Beijing, Social Simulation Conference 2017, Publisher: Springer International Publishing, Pages: 121-133, ISSN: 2213-8684

Urban transport infrastructure can result in the physical, psychological and environmental separation of neighborhoods, public spaces and pedestrian networks, leading to negative impacts on citizens’ daily commutes, social activities and the quality of the ecosystem. An integrated design of transport infrastructure and public space is beneficial for mediating these negative impacts. In this paper, we propose an integrated methodology, which combines urban design, computational scenario evaluation and decision-making processes, based on a conceptual model of human and ecological needs-driven planning. To evaluate the impacts of the road network and public space design on individual outdoor activities, travel behavior and air pollution, an agent-based model is demonstrated. This model is then applied to a case study in Beijing, leading to hourly traffic volume maps and car-related air pollution heat maps of a baseline road network-public space design.

Conference paper

Dons E, Laeremans M, Orjuela JP, Avila-Palencia I, de Nazelle A, Nieuwenhuijsene M, Van Poppel M, Carrasco-Turigas G, Standaert A, De Boever P, Nawrot T, Panis LIet al., 2019, Transport most likely to cause air pollution peak exposures in everyday life: Evidence from over 2000 days of personal monitoring, Atmospheric Environment, Vol: 213, Pages: 424-432, ISSN: 1352-2310

BackgroundAir quality standards are typically based on long term averages – whereas a person may encounter exposure peaks throughout the day. Exposure peaks may contribute meaningfully to health impacts beyond their contribution to long term averages, and therefore should be considered alongside longer-term exposures. We aim to define and explain peak exposure to black carbon air pollution and look at the relationship between short peak exposures and longer term personal exposure.MethodsA peak detection algorithm was applied to pooled data from two independent studies. High-resolution personal black carbon monitoring was performed in 175 healthy adult volunteers for a minimum of two 24-h periods per person. At the same time, we retrieved information on the time-activity pattern. Data covered Belgium, Spain, and the United Kingdom. In total, 2053 monitoring days were included.ResultsExposure profiles revealed 2.8 ± 1.6 (avg ± SD) peaks per person per day. The average black carbon concentration during a peak was 4206 ng/m³. On 5.5% of the time participants were exposed to peak concentrations, but this contributed to 21.0% of their total exposure. The short time in transport (8%), was responsible for 32.7% of the peaks. 24.1% of the measurements in transport were categorized as peak exposure; while sleeping this was only 0.9%. When considering transport modes, participants were most likely to encounter peaks while cycling (34.0%). Most peaks were encountered at rush hour, from Monday through Friday, and in the cold season. Gender and age had no impact on the presence of peaks. Daily average black carbon exposure showed only a moderate correlation with peak frequency (r = 0.44). This correlation coefficient increased when considering longer term exposure to r > 0.60 from 10 days onward.ConclusionsThe occurrence of peaks varied substantially over time, across microenvironments and transport modes. Daily average exposure was moderately correlat

Journal article

An R, Shen J, Ying B, Tainio M, Andersen ZJ, de Nazelle Aet al., 2019, Impact of ambient air pollution on physical activity and sedentary behavior in China: A systematic review, Environmental Research, Vol: 176, Pages: 1-9, ISSN: 0013-9351

This study systematically reviewed scientific evidence linking ambient air pollution to physical activity and sedentary behavior in China. A keyword and reference search was conducted in PubMed, Web of Science, and the Cochrane Library. Predetermined selection criteria included—study designs: interventions or experiments, retrospective or prospective cohort studies, cross-sectional studies, and case-control studies; subjects: people of all ages; exposures: specific air pollutants and/or overall air quality; outcomes: physical activity and/or sedentary behavior; and country/area: mainland China. Ten studies met the selection criteria and were included in the review. Six adopted a cross-sectional design and the remaining four adopted a prospective cohort design. Four studies assessed a specific air pollutant namely particulate matter with diameter <2.5 μg/m3 (PM2.5), whereas the remaining six focused on overall air quality, defined using air quality indexes. Decline in overall air quality and increase in PM2.5 concentration were found to be associated with reduced daily/weekly duration of outdoor leisure-time and/or transportation-related physical activity such as walking but increased duration of daytime/nighttime sleeping among Chinese residents. In contrast, evidence linking overall air quality and PM2.5 concentration to sedentary behavior remains mixed and inconclusive. In conclusion, preliminary evidence indicates that ambient air pollution impacts Chinese residents’ daily physical activity-related behaviors. Future studies adopting objective measures of physical activity and a longitudinal or experimental study design are warranted to examine the impact of air pollution on sensitive sub-populations such as children, older adults and people with pre-existing conditions, and in locations outside China.

Journal article

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

Castro A, Gaupp-Berghausen M, Dons E, Standaert A, Laeremans M, Clark A, Anaya-Boig E, Cole-Hunter T, Avila-Palencia I, Rojas-Rueda D, Nieuwenhuijsen M, Gerike R, Panis LI, de Nazelle A, Brand C, Raser E, Kahlmeier S, Götschi Tet al., 2019, Physical activity of electric bicycle users compared to conventional bicycle users and non-cyclists: Insights based on health and transport data from an online survey in seven European cities, Transportation Research Interdisciplinary Perspectives, Vol: 1, Pages: 1-10, ISSN: 2590-1982

Physical activity has been widely associated with beneficial health effects. The use of electric-assist bicycles (e-bikes) can lead to increased or decreased physical activity, depending on the transport mode substituted.This study aimed to compare physical activity levels of e-bikers and conventional bicycle users (cyclists) as well as across e-bike user groups based on the transport mode substituted by e-bike. Physical activity, transport and user related parameters were analysed. Data from the longitudinal on-line survey of the PASTA project were used. The survey recruited over 10,000 participants in seven European cities.Physical activity levels, measured in Metabolic Equivalent Task minutes per week (MET min/wk), were similar among e-bikers and cyclists (4463 vs. 4085). E-bikers reported significantly longer trip distances for both e-bike (9.4 km) and bicycle trips (8.4 km) compared to cyclists for bicycle trips (4.8 km), as well as longer daily travel distances for e-bike than cyclists for bicycle (8.0 vs. 5.3 km per person, per day, respectively). Travel-related activities of e-bikers who switched from cycling decreased by around 200 MET min/wk., while those switching from private motorized vehicle and public transport gained around 550 and 800 MET min/wk. respectively.Therefore, this data suggests that e-bike use leads to substantial increases in physical activity in e-bikers switching from private motorized vehicle and public transport, while net losses in physical activity in e-bikers switching from cycling were much less due to increases in overall travel distance.

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, 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

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

Gerike R, de Nazelle A, Wittwer R, Parkin Jet al., 2019, Special issue "walking and cycling for better transport, health and the environment", Transportation Research Part A: Policy and Practice, Vol: 123, Pages: 1-6, ISSN: 0191-2607

Journal article

Haddad H, de Nazelle A, 2018, The role of personal air pollution sensors and smartphone technology in changing travel behaviour, Journal of Transport and Health, Vol: 11, Pages: 230-243, ISSN: 2214-1405

Exposure to air pollution is affected by human behaviour, and has consequences for individual and collective health. One way to lessen the health effects of air pollution is to change personal travel behaviour with the help of new information, communication and sensing technologies. Our social research tracked the experiences of participants, air quality and technology enthusiasts, based in London who financially contributed to participate in an early-stage technical trial of a new air pollution sensor and app providing individuals with air pollution information (specifically levels of NO2 and VOCs). This paper reports the results of a before and after survey (returning respondents n = 22) and 12 in-depth interviews with individuals who took part in the beta test of the sensor and phone app. The survey results show that travel-related behaviours and attitudes relevant to air pollution did not change after using the technology. In contrast, expectations of technology performance and the extent it would influence behaviours were significantly lower after the trial than before. Further exploration during semi-structured interviews found that the participants, given their already high level of engagement with the topic, felt the capacity for immediate individual behaviour change was limited. As well as time and practical constraints, most people in this sample felt they were already doing what they could to avoid high levels of air pollution in their daily lives. Despite this, they had some recommendations to improve the app, such as the inclusion of real-time and historic maps, and the ability to make self and other comparisons. Overwhelmingly, people saw a broader role for the technology to engage the public with air pollution through raising awareness, and harnessing citizen science to collect diverse reliable data to inform policy and influence local policymakers to reduce air pollution levels.

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

de Nazelle A, Northover G, Heydari S, 2018, Air pollution exposures while walking and cycling, Publisher: HUMAN KINETICS PUBL INC, Pages: S9-S9, ISSN: 1543-3080

Conference paper

Kahlmeier S, Boig EA, Smeds E, de Nazelle Aet al., 2018, Developing a score to assess the policy environment for cycling and walking promotion in cities: Results of a feasibility study, Publisher: HUMAN KINETICS PUBL INC, Pages: S79-S80, ISSN: 1543-3080

Conference paper

Forns J, Sunyer J, Garcia-Esteban R, Porta D, Ghassabian A, Giorgis-Allemand L, Gong T, Gehring U, Sorensen M, Standl M, Sugiri D, Almqvist C, Andiarena A, Badaloni C, Beelen R, Berdel D, Cesaroni G, Charles M-A, Eriksen KT, Estarlich M, Fernandez MF, Forhan A, Jaddoe VWV, Korek M, Lichtenstein P, Lertxundi A, Lopez-Espinosa M-J, Markevych I, de Nazelle A, Raaschou-Nielsen O, Nieuwenhuijsen M, Perez-Lobato R, Philippat C, Slama R, Tiesler CMT, Verhulst FC, von Berg A, Vrijkotte T, Andersen A-MN, Heude B, Kramer U, Heinrich J, Tiemeier H, Forastiere F, Pershagen G, Brunekreef B, Guxens Met al., 2018, Air Pollution Exposure During Pregnancy and Symptoms of Attention Deficit and Hyperactivity Disorder in Children in Europe, EPIDEMIOLOGY, Vol: 29, Pages: 618-626, ISSN: 1044-3983

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

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