Table 3.

Supporting information for the framework interventions.

Intervention	Example outcome of intervention on risk factor	Key source(s) of evidence of effectiveness and effect estimate(s)	Key considerations	Further planning and implementation guidance
(T1) Increase excise taxes and prices on tobacco products	10% increase in price results in 4–5% relative reduction in consumption	Ortegón et al., 2012. Cost effectiveness of strategies to combat cardiovascular disease, diabetes, and tobacco use in sub-Saharan Africa and South East Asia: mathematical modelling study. BMJ WHO, 2021. WHO Technical manual on tobacco tax administration	Recognition that there are different types of taxation. Comprehensive assessment of this question available in WHO manual on tobacco tax policy (most recently updated 2021) which recognises that different countries have different taxation systems and should make appropriate decisions for their local context. However, excise taxes (specific taxes on tobacco products), which are regularly updated to keep up with inflation and progressively make cigarettes less affordable, are recommended as the most effective measure. Must be implemented alongside other work to ensure reductions in illegal tobacco trade which bypasses excise taxation. Tobacco has become more affordable in LMICs in recent years, debunking concerns raised by industry that taxes will lower overall tax revenue, or drive inequalities	WHO, 2021. WHO technical manual on tobacco tax policy and administration
(T2) Implement plain/standardized packaging and/or large graphic health warnings on all tobacco packages	5% relative reduction in smoking prevalence Assumed baseline prevalence of 25%, there is a 5% (credible range 2%–8%) relative reduction in prevalence, using a 5-year time horizon. Using a 40-year time horizon, the estimate is 10% relative prevalence reduction (credible range 5%–15%)	Levy et al. 2017. The Impact of Implementing Tobacco Control Policies: The 2017 Tobacco Control Policy Scorecard. J Public Health Manag Pract. Synthesises empirical evidence from HICs on tobacco policy from US taskforce reports, reviews, and primary articles McNeill et al., 2017. Tobacco packaging design for reducing tobacco use. Cochrane Review	Unless updated on a regular basis with new content, the effectiveness of graphic warning labels may wane over time as consumers become too accustomed to their appearance. Messages can be reinforced by mass media campaigns. Evidence stronger for graphic health warnings than for plain packaging	WHO, 2016. Plain packaging of tobacco products: evidence, design and implementation
(T3) Enact and enforce comprehensive bans on tobacco advertising, promotion and sponsorship	4% relative reduction in smoking prevalence Assumed baseline prevalence of 25%, there is a 4% (credible range 2%–6%) relative reduction in prevalence, using a 5-year time horizon. Using a 40-year time horizon, the estimate is 6% relative prevalence reduction (credible range 3%–9%)	Levy et al., 2017. The Impact of Implementing Tobacco Control Policies: The 2017 Tobacco Control Policy Scorecard. J Public Health Manag Pract Lovato et al., 2011. Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours. Cochrane Review	Include bans on direct advertising, such as TV, radio, magazine, newspaper, billboard, and retail point-of-sale advertising, and bans on indirect marketing, such as free distribution of products, promotional discounts, the appearance of tobacco products in TV or films, sponsorship of sports and music occasions, and the distribution of nontobacco products identified with tobacco brand names. Online advertising and indirect marketing efforts not included by the interventions which have been evaluated, and may offset these effects unless these channels are also targeted. Evidence that younger people and those with higher education benefit more	WHO, 2003. Framework Convention on Tobacco Control
(T4) Eliminate exposure to second-hand tobacco smoke in all indoor workplaces, public places, public transport	10% relative reduction in smoking prevalence Assumed baseline prevalence of 25%, there is a 10% (credible range 5%–15%) relative reduction in prevalence, using a 5-year time horizon. Using a 40-year time horizon, the estimate is 12.5% relative prevalence reduction (credible range 7%–19%)	Levy et al., 2017. The Impact of Implementing Tobacco Control Policies: The 2017 Tobacco Control Policy Scorecard. J Public Health Manag Pract Frazer et al., 2016. Legislative smoking bans for reducing harms from secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Review Frazer et al., 2016. Impact of institutional smoking bans on reducing harms and secondhand smoke exposure. Cochrane Review	May have smaller effects if smoke-free policies are already prominent in private worksites; or if there is low compliance due to weak enforcement or a lack of antitobacco social norms	WHO, 2003. Framework Convention on Tobacco Control
(A1) Increase excise taxes on alcoholic beverages	10% increase in price results in 5.1%–7.7% relative reduction in consumption	Chisholm et al., 2018. Are the “Best Buys” for alcohol control still valid? An update on the comparative cost-effectiveness of alcohol control strategies at the global level. J Stud Alcohol Drugs WHO, 2017. Resource tool on alcohol taxation and pricing policies	Levying taxes should be combined with other price measures, such as bans on discounts or promotions; and work to reduce illegal alcohol consumption which bypasses taxation. Detailed discussion of mechanism of excise taxation - i.e., taxation rate based on strength, quantity, or cost - in the 2017 resource, with conclusion that each has their strengths and weaknesses but the overall effect will consistently be reduced alcohol consumption (but differences in the effect on overall tax revenue and rate of substitutions)	WHO, 2019. SAFER - A world free from alcohol related harms. The Technical Package WHO, 2017. Resource tool on alcohol taxation and pricing policies
(A2) Establish minimum prices for alcohol	10% increase in minimum price results in a 3.4% (95% CI 1.4%–8.0%) relative reduction in total alcohol sales	Robinson et al., 2021. Evaluating the impact of minimum unit pricing (MUP) on off-trade alcohol sales in Scotland: an interrupted time–series study. Addiction. Interrupted time series analysis estimating the effect of the 2018 MUP in Scotland on off-trade alcohol sales, compared to England (no MUP). Supported by a similar analysis from a different set of academics (O'Donnell, BMJ, 2019) which reached similar conclusions using consumer panel data. A further paper (Wyper, Lancet, 2023) found an associated reduction in alcohol-attributable hospital mortality Stockwell et al., 2012. Does minimum pricing reduce alcohol consumption? The experience of a Canadian province. Addiction	SAFER package frames MUP as an adjunct to excise taxation, which may have the effect of causing retailers to lower the cost of their products and absorb the increased taxation (or in the case of ad valorem taxes, avoid them)	WHO, 2019. SAFER - A world free from alcohol related harms. The Technical Package WHO, 2017. Resource tool on alcohol taxation and pricing policies
(A3) Enact and enforce bans or comprehensive restrictions on exposure to alcohol advertising (across multiple types of media) - including in connection with sponsorships and activities targeting young people	1.2% absolute reduction in prevalence of hazardous/harmful drinking (Source study find a 3.0% (95% CI 1.0%–6.0%) reduction in drinking volume per additional unit (none, voluntary or self-regulation, partial statutory restriction, ban) of marketing restriction for beer, wine and spirits combined across 4 types of media (national TV, national radio, print media, and billboards). WHO team have then simulated this effect size to all world regions, accounting for their existing level of policy in place)	Cook et al., 2014. Are alcohol policies associated with alcohol consumption in Low and Middle income countries? Addiction Rossow et al., 2021. The alcohol advertising ban in Norway: effects on recorded alcohol sales. Drug Alcohol Rev Brown et al., 2016. Association Between Alcohol Sports Sponsorship and Consumption: A Systematic Review, Alcohol and Alcoholism	Effect estimate doesn't include bans on web advertising, sponsorship; or the differentiation between domestic and cross-border marketing. SAFER package notes that: restricting only one aspect of the marketing mix often results in an expansion of activity in other parts of the mix. In general, the more complete the regulation on marketing activities, the easier it will be to implement the regulation and the more effective it will be in reducing alcohol-related harm. That is why a comprehensive ban or set of restrictions is preferred. Such frameworks should ideally incorporate all forms of new and emerging media as well as existing media and other promotional channels There is a need for supra-national co-operation to effectively tackle the global advertising landscape, with legislative implications. There is comprehensive evidence that alcohol industry self-regulation is not an effective tool for reducing alcohol-related harm, and these endeavours should be led by governments. Newer options need to be evaluated, such as removing tax exemptions for alcohol advertising spending, and blocking any collection of consumer data for the purposes of alcohol marketing	WHO, 2019. SAFER - A world free from alcohol related harms. The Technical Package WHO, 2022. Reducing the harm from alcohol by regulating cross-border alcohol marketing, advertising and promotion. A technical report
(A4) Enact and enforce restrictions on the physical availability of retailed alcohol (via reduced hours of sale)	1.8–2.1% (male), 4% (female) relative reduction in prevalence of hazardous/harmful drinking (Source study reports a regression coefficient for restricted hours of sale of −0.88 (95% CI −1.44, 0.32). WHO team have them simulated this effect size to all world regions, assuming a gamma distribution, to assess for the reduction in hazardous and harmful drinking that would be achieved)	Cook et al., 2014. Are alcohol policies associated with alcohol consumption in Low and Middle income countries? Addiction	Alongside restricting hours of sale, other mechanisms described in the SAFER package include: regulate the number, density and location of retail alcohol outlets; establish a national legal minimum age for purchase and consumption of alcohol; and restrict the use of alcohol in public places	WHO, 2019. SAFER - A world free from alcohol related harms. The Technical Package
(O1) Use effective taxation measures to reduce consumption of unhealthy products such as sugar-sweetened beverages	10% increase in price results in 8%–15.9% relative reduction in consumption of sugar-sweetened beverages	Sugar-Sweetened Beverages: World Bank, 2020. ‘Taxes on Sugar-Sweetened Beverages: International Evidence and Experiences' Andreyeva et al., 2022. Outcomes Following Taxation of Sugar-Sweetened Beverages: A Systematic Review and Meta-analysis. JAMA Network Open WHO, 2022. Policy brief on fiscal policies to promote healthy diets WHO, 2022. WHO manual on sugar-sweetened beverage taxation policies to promote healthy diets	Clear evidence of a healthy equity effects of the taxation, with the greatest reductions in purchasing found in lower SES groups WHO modelling included: carbonated soft drinks, non-carbonated soft drinks, fruit and vegetable juices, liquid powder concentrates, flavoured water, energy and sports drinks, ready-to-drink tea and coffee, flavoured milk drinks; and excluded: low calorie/low sugar product categories as these contained a variable mix of products with or without added sugars, and/or artificial sweeteners. WHO assumed no substitution to untaxed beverages (based on systematic review by Andreyeva, 2022). For research purposes, SSB consumption volume is converted into the number of daily servings per capita, assuming a serving size of 355 ml.	WHO, 2022. WHO manual on sugar-sweetened beverage taxation policies to promote healthy diets WHO, 2022. Policy brief on fiscal policies to promote healthy diets WHO, 2022. SSB taxes in the WHO European region: success through lessons learned and challenges faced
(O2) Implement policies to protect children from the harmful impact of food marketing	60 kcal (95% CI 3.1–116.9) absolute reduction/day/person	Russell et al., 2019. The effect of screen advertising on children's dietary intake: A systematic review and meta-analysis. Obes Rev WHO, 2022. Protecting children from the harmful impact of food marketing: policy brief	The evidence for policies to reduce the power of, and children's exposure to, food and non-alcoholic beverage marketing is still emerging; however, there is clear evidence that such marketing practices are abundant for unhealthy food high in fats, sugars and salt; and evidence on the impact of marketing on children is unequivocal and has recently been updated in a new systematic review The 2022 policy brief states the importance of comprehensive (all forms of media), and mandated marketing restrictions, over partial and voluntary approaches which were historically employed, and are less likely to be effective (and industry are likely to lobby for). As for alcohol marketing, important to recognise the cross-national nature of digital media. Also importance of protecting children up to the age of 18, rather than just under 12s	WHO, 2016. Tackling food marketing to children in a digital world: trans-disciplinary perspectives WHO, 2020. Regional action framework on protecting children from the harmful impact of food marketing in WPRO WHO, UNICEF, 2018. A Child Rights-Based Approach to Food Marketing: A Guide for Policy Makers
(O3) Menu labelling in food service to promote healthy diets (e.g., reduce total energy intake (kcal) and/or intake of sugars)	7.8% relative reduction in calories consumed per sitting Meta-analysis of the restaurant-based RCTs found a reduction in energy purchased of 47 kcal (95% CI 15–78) equating to a relative reduction of 7.8% (95% CI 2.5%–13.1%). Evidence from other high-quality real-world studies, and the lab-based experiments, supported this finding	Crockett et al., 2018. Nutritional labelling for healthier food or non-alcoholic drink purchasing and consumption. Cochrane Review Updated Cochrane review in progress	Most studies evaluated labelling on menus or menu boards, where a range of products were available. Other studies evaluated settings which provided only one food/drink option, but included a nutritional label on the packaging. Some assessed absolute energy labels, with no other information/formatting, others assessed traffic light formats, or energy labels with further information on nutritional content or exercise equivalents	Guidance from WHO in print
(O4) Limiting portion and package size to reduce energy intake and the risk of overweight/obesity	8.5%–13.5% relative reduction in calories Meta-analysis of 58 studies found a small to moderate effect of portion, package, or tableware size on consumption (SMD 0.38, 95% CI 0.29–0.46), with effects consistent for adults and children. Which would equate to an 8.5%–13.5% (144–228 kcal) reduction in calories, if achieved across the whole diet; and an absolute reduction of 144–228 kcal per day in the UK population	Hollands et al., 2015. Portion, package or tableware size for changing selection and consumption of food, alcohol and tobacco. Cochrane Review Updated Cochrane review in progress	Likely to have greatest effect by reducing size at the larger end of the scale, than changes to already smaller portions/packages/tableware
(O5) Public food procurement and service policies to promote healthy diets (e.g., to reduce the intake of free sugars; and to increase the consumption of legumes, wholegrains, fruits and vegetables)	0.18 (95% CI 0.05–0.31) reduction in servings per day of SSB (serving = 355 mls), 0.76 (95% CI 0.37–1.16) additional servings per day of fruit (serving = 80 g)	Micha et al., 2018. Effectiveness of school food environment policies on children's dietary behaviours: A systematic review and meta-analysis. PloS One Driessen et al., 2014. Effect of changing the school food environment. Obes Rev Niebylski et al., 2014. Healthy Food Procurement Policies and Their Impact. Int J Environ Res Public Health	Evidence strongest for schools, but empirical evidence also shows effectiveness in other settings such as workplaces, hospitals, and nursing homes. These interventions do not generally impact consumption outside of the setting, and should therefore be considered as part of broader food environment policy 2021 action framework suggests that public food procurement could influence private sector employers to follow suit. It also points to evidence from Brazil where such policies have had co-benefits of guaranteed income for local farmers, and reducing climate footprint	WHO, 2021. Action framework for developing and implementing public food procurement and service policies for a healthy diet
(O6) Reformulation policies for healthier food and beverage products (e.g., reduction of free sugars)	2–11% relative reduction in dietary sugar per person per day (resulting in average 1.04 kg absolute reduction in body weight)	Hashem et al., 2019. Effects of product reformulation on sugar intake and health-a systematic review and meta-analysis. Nutr Rev	Reformulation may result from policies setting mandatory limits or voluntary targets for nutrient content in food and beverage products, or it may happen in the absence of a specific reformulation policy, as result of industry response to e.g., a FOPL or food or beverage tax policy. Evidence from the contributing systematic reviews suggest that mandatory limits have been more effective than voluntary/industry-led ones
(P1) Implement urban and transport planning and design, at all levels of government, to provide compact neighbourhoods providing mixed-land use and connected networks for walking and cycling and equitable access to safe, quality public open spaces that enable and promote physical activity and active mobility (including wheelchairs, scooters and skates) by people of all ages and abilities	20% relative increase in cycling journeys	The WHO Europe 2006 report ‘Physical activity and health in Europe: evidence for action’ presents two case studies: the 2003 introduction of a congestion charge in London, England, and the 1999–2002 major investment in cycling infrastructure (alongside mass media campaign) in Odense, Denmark. Both are reported to have been associated with a 20% increase in cycling journeys. No references to peer-reviewed literature with detailed methodology are available	Clear overlap with this recommendation, and policies to reduce air pollution	WHO, 2018. ACTIVE: a technical package for increasing physical activity WHO Europe, 2018. Towards More Physical Activity in Cities WHO, 2022. Compendium of WHO and other UN guidance on health and environment
(H1) Public food procurement and service policies to reduce the intake of sodium	0.17 g (95% CI 0.10–0.24) absolute reduction/person/day in dietary sodium	Micha et al., 2018. Effectiveness of school food environment policies on children's dietary behaviors: A systematic review and meta-analysis. PloS One Driessen et al., 2014. Effect of changing school food environment. Obes Rev Niebylski et al., 2014. Healthy Food Procurement Policies and Their Impact. Int J Environ Res Public Health McLaren et al., 2016. Population-level interventions in government jurisdictions for dietary sodium reduction. Cochrane Review	2021 action framework suggests that public food procurement could influence private sector employers to follow suit. It also points to evidence from Brazil where such policies have had co-benefits of guaranteed income for local farmers, and reducing climate footprint	Action framework for developing and implementing public food procurement and service policies for a healthy diet WHO, 2021. Global sodium benchmarks for different food categories WHO, 2016. SHAKE the salt habit: technical package for salt reduction
(H2) Reformulation policies for reduction of sodium content	5–10% (−0.57 g) reduction/person/day in dietary sodium, (resulting in approximate −0.53 mmHg absolute reduction of SBP)	Gressier et al., 2021. What is the impact of food reformulation on individuals' behaviour, nutrient intakes and health status? A systematic review of empirical evidence. Obes Rev McLaren et al., 2016. Population-level interventions in government jurisdictions for dietary sodium reduction. Cochrane review	Reformulation may result from policies setting mandatory limits or voluntary targets for nutrient content in food and beverage products, or it may happen in the absence of a specific reformulation policy, as result of industry response to e.g., a FOPL or tax policy. Evidence from the contributing systematic reviews suggest that mandatory limits have been more effective	WHO, 2021. Global sodium benchmarks for different food categories WHO, 2016. SHAKE the salt habit: technical package for salt reduction
(Tr1) Mandate the use of motorcycle helmets (all aged passengers)	54% absolute reduction in head injuries requiring hospitalisation Median reduction of −54% (95% CI –49% to −59%) in head injuries	WHO, 2023. Helmets: a road safety manual for decision-makers and practitioners, 2nd edition. Includes a systematic review of legislation for mandatory motorcycle helmet use (Peng, 2017, Am J Prev Med) reports 5 studies from the USA. The WHO report also cites several single studies from a mix of other countries including LMICs demonstrating effectiveness of legislation	Importance of appropriate accompanying enforcement, education/promotion, and availability of helmets is stressed, in order for legislation to be effective. Evidence suggests full face helmets, and firm fitting helmets, are relatively more protective than alternatives	WHO, 2023. Helmets: a road safety manual for decision-makers and practitioners, 2nd edition
(Tr2) Mandate the use of bicycle helmets (children)	18% (95% CI 11.5–24.3) absolute reduction in head injuries requiring hospitalisation	MacPherson, 2008. Bicycle helmet legislation for the uptake of helmet use and prevention of head injuries. Cochrane review	Importance of appropriate accompanying enforcement, education/promotion, and availability of helmets is stressed, in order for legislation to be effective. Provision of free bicycle helmets to children aged under 12, has been estimated to increase odds of wearing a helmet by 4.35 times, which in turn could reduce the risk of head injury by 63–88% in the event of an accident (Owen, 2011. Non-legislative interventions for the promotion of cycle helmet wearing by children. Cochrane review)	WHO, 2023. Helmets: a road safety manual for decision-makers and practitioners, 2nd edition
(E1) Provide financial support (including removing school fees, conditional payments to schools, conditional cash transfers to households) for children to attend school, where financial barriers would otherwise exist	2%–75% absolute increase in primary school enrolment (immediate effect of policy) - heavily dependent on baseline enrolment rate Additional 0.72 years of extra schooling 30% relative increase (from 9% to 11.8%) in secondary school completion rate 11.4% absolute increase in rate of higher education enrolment	Grogan et al., 2009. Universal primary education and school entry in Uganda. Journal of African Economies Keats et al., 2018. Women's schooling, fertility, and child health outcomes: Evidence from Uganda's free primary education program. Journal of Development Economics Psaki, S. et al., 2022. Policies and interventions to remove gender-related barriers to girls' school participation and learning in low- and middle-income countries: A systematic review of the evidence. Campbell Systematic Reviews Patel-Campillo et al., 2022. Breaking the poverty cycle? Condit'onal cash transfers and higher education attainment. International Journal of Educational Development	School infrastructure must be adequately prepared to maintain educational standards, given the potentially large increases in numbers of students Evidence of universal effects, and closing the gap between socioeconomic groups
(E2) Provide free lunches in primary schools, where a lack of adequate food would otherwise be a barrier to school attendance	18.5%–26% absolute increase in primary school enrolment 0.41 additional grades completed (either by extra years of education, or by reducing grade repetition rate)	Kaur et al., 2017. Essays in human capital development Kazianga et al., 2013. The effects of “girl-friendly” schools: Evidence from the BRIGHT school construction program in Burkina Faso. American Economic Journal: Applied Economics Kazianga et al., 2016. The Medium-Term Impacts of Girl-Friendly Schools: 7-Year Evidence from School Construction in Burkina Faso (No. 1609). Oklahoma State University, Department of Economics and Legal Studies in Business	Evidence of universal effects, and closing the gap between genders and socioeconomic groups
(E3) Raise the mandatory school leavers age in HICs	0.25–0.3 absolute increase in average years of education (national average) – consistent effect across three studies of 14 European countries, from reforms in late 20th century	Aakvik et al., 2010. Measuring heterogeneity in the returns to education using an education reform. European Economic Review Brunello et al., 2009. Changes in Compulsory Schooling, Education and the Distribution of Wages in Europe. Economic Journal Meghir et al., 2005. Educational Reform, Ability, and Family Background. American Economic Review	Reliant on sufficient provision of educational infrastructure and opportunities, and economic considerations of the effects of young people being later to join the workforce and paid employment. Evidence of universal effects, and closing the gap between socioeconomic groups
(Ai1) Replacement and maintenance programmes providing cleaner cooking stoves for those currently using biomass fuels on traditional stoves or open fires	Absolute reduction in kitchen PM2.5 of −0.46 μg/m3 (95% CI 0.33–0.60), and CO of 5.7 μg/m3 (95% CI 3.9–7.5) from solid fuel stoves with chimneys.	WHO, 2014. WHO guidelines for indoor air quality: household fuel combustion. Development of these guidelines included an SR of clean fuel interventions for people currently using biomass or coal as the primary cooking fuel, with open fires or traditional stoves Ye et al., 2022. Effects of a Liquefied Petroleum Gas Stove Intervention on Gestational Blood Pressure: Intention-to-Treat and Exposure-Response Findings From the HAPIN Trial. Hypertension	A review of contextual factors finds that no factors guarantee success, but to be widely adopted, interventions must take relevant contextual factors into account e.g., can the traditional foods be cooked on the provided stove, is there long-term support for replacing parts, is the fuel supply reliable to that setting	WHO, 2014. WHO guidelines for indoor air quality: household fuel combustion WHO, 2022. Compendium of WHO and other UN guidance on health and environment
(Ai2) Urban interventions to reduce density of traffic, including: low emission zones, even-odd restrictions on cars	10.4% reduction in PM2.5, 6.8%–27% reduction in PM10, 2.2–3.5% reduction in NO2, and 9% reduction in CO	Burns, 2019. Interventions to reduce ambient particulate matter air pollution and their effect on health. Cochrane review		PHE, 2020. Review of interventions to improve outdoor air quality and public health: principal interventions for local authorities WHO, 2022. Compendium of WHO and other UN guidance on health and environment
(Ai3) Postponement of non-essential polluting activities on high-pollution days	16.9% reductions in PM10, achieved by multi-component restrictions on high-polluting days (driving restrictions, shutdown of certain major stationary emitters, street sweeping, traffic enforcement activities, and restriction on the use of biomass combustion for residential heating)	Burns, 2019. Interventions to reduce ambient particulate matter air pollution and their effect on health. Cochrane review		PHE, 2020. Review of interventions to improve outdoor air quality and public health: principal interventions for local authorities WHO, 2022. Compendium of WHO and other UN guidance on health and environment
(He1) Worksites exceeding recognised noise thresholds should reduce noise through improving equipment where feasible, and should provide and mandate the use of adequate hearing protection, with regular monitoring	60% reduction in occupationally-acquired hearing impairment Avoidance of hearing loss OR 0.4 (95% CI 0.23–0.69), at 5 years	Tikka et al., 2017. Interventions to prevent occupational noise-induced hearing loss. Cochrane review	Worksites exceeding recognised thresholds (80 dB(A)) should provide and mandate the use of adequate hearing protection, with regular audiometric monitoring of those working in areas which continue to exceed thresholds despite installation of quieter equipment	WHO, 2018. Addressing the rising prevalence of hearing loss

95% CI = 95% Confidence Interval. LMICs = low- and middle-income countries. SES = socioeconomic status. SSB = sugar-sweetened beverages. SMD = standardised mean difference. SBP = systolic blood pressure. PM = particular matter. CO = carbon monoxide. NO2 = nitrous oxide. OR = odds ratios.

N.B. “credible ranges” are quoted from the source literature by Levy et al., and are defined as “credible ranges for effect sizes based on the number of studies conducted, variation in results, and strength of evidence.”