Table 2.
Summary of the included studies.
| Study & Publish Time | Country & Geographical Scale | Time Period Covered | Strategy or Intervention Description and Study Type (I,II,III) | Methods for Measuring Air Pollution Concentration and Health Outcome, and Brief Study Description | Assessed Air Pollutants a | Health Variables | If Co-Benefit b, Assessment Term, and Cofounders | Target Group |
|---|---|---|---|---|---|---|---|---|
| Aunan, K. et al. 1998 [35] | Hungary National level Urban |
1992–1993 to the following 5 years | The energy saving program, from National Energy Efficiency Improvement and Energy conservation Programs. (Energy savings of 64 PJ/year c were expected in a 5 year target period since 1994) II |
|
NO2, SO2, TSP d, Dust fallout, PM10, | Reduced air pollution attributed annual excess death for >65 and ≤65 years; Reduced air pollution attributed annual excess infant death (0–1 year); Reduced annual acute respiratory symptom days for children and adults; Reduced non-accidental and non-violent mortality; Reduced annual lung cancer cases; Monetary health benefit | Co-benefit Long-term Frequency baseline of the health outcomes |
All population, stratified by age group |
| ||||||||
| The study simulated the possible reduced damage to public health and other benefits obtained from reducing emissions of key air pollutants | ||||||||
| Clancy, L. et al. 2002 [36] | Ireland Dublin, city level Urban |
1984–1990 1990–1996 |
Ban of coal sales. (The Irish Government banned the marketing, sale, and distribution of bituminous coal within the city of Dublin from 1 September 1990) II |
|
Black smoke, SO2 |
Annual total non-trauma death; Respiratory death; Car-cerebrovascular death; Other non-trauma death(total minus cardiovascular and respiratory) | Short-term Temperature, relative humidity, day of week, epidemic, standardised cause specific death rate, and age groups |
All population, stratified by age group |
| ||||||||
| The study compared the air pollution concentrations and health before and after the ban of coal sales in Dublin (1990) | ||||||||
| Burr, M.L. et al. 2004 [37] | UK North Wales, district level Urban |
Intermittent 1996–2000 |
By-pass construction in congested area. (A by-pass was opened in an area with severely congested traffic) II |
|
PM10, PM2.5 | Frequency of symptoms, including wheeze, winter cough, phlegm, consulted doctor, and rhinitis, and peak expiratory flow rate | Short-term Symptom frequency baseline before the intervention |
All population, in the experimental area |
| ||||||||
| The study compared the air pollution concentrations and health outcomes (indicated by the prevalence of respiratory symptoms) between a congested street with a by-pass and uncongested street area | ||||||||
| Hutchinson, E.J. et al. 2004 [38] | UK Country level Urban |
1993–1998 1998–2005 |
Vehicle exhausts catalysts (VECs) (UK mandatorily introduced VECs to gasoline fuelled vehicles since 1993) II |
Simulated | PM10, NO2, O3 d, VOCs d, CO d | Monetary health value (all-cause mortality and respiratory hospital admission) | Short-term Population change, underlying mortality rate and underlying hospital admission rate |
All population |
| Calculated from mortality rate and hospital admission rate | ||||||||
| The study evaluated the environmental and health benefits of the emission reduction from VECs with available data for exposure assessment and projection for ex ante assessment (1998) | ||||||||
| Mindell, J. and Joffe, M. 2004 [39] | UK Westminster, district level Urban |
(1996–1998) 2004–2009 | UK National Air Quality Strategy Objectives for 2004 and 2009 I |
Monitored and targeted | PM10 | Delayed non-traumatic premature death; Emergency hospital admissions and consultations for respiratory diseases, including asthma, COPD, LRTI, and IHD e | Short and long-term Mortality number and hospital admission baseline |
All population, stratified by age groups |
| Calculated from routine mortality and hospital admission data | ||||||||
| The study modelled the health impacts of PM10 reduction from the current levels (1996–1998) to the UK 2004 and 2009 target levels | ||||||||
| Tonne, C. et al. 2008 [40] | UK London Central, city level Urban |
February 2003–February 2007 | Congestion Charging Scheme (CCS) (London Mayor introduced CCS in February 2003) II |
Simulated | NO2, PM10 | All-cause mortality, indicated by YLG | Co-benefit Long-term Baseline mortality rate, geographic distribution of population and deprivation |
All population, stratified by socioeconomic position |
| Calculated from mortality data | ||||||||
| The study modelled the air pollutant concentrations before and after the implementation of CCS, and then used exposure-response coefficients to predict the health gain indicated by years of life gained. | ||||||||
| Ballester, F. et al. 2008 [41] | 26 EU cities EU level Urban |
European Directive, European Parliament, U.S. Environmental Protection Agency and the World Health Organization on PM2.5 guideline (25 μg/m3, 20 μg/m3, 15 μg/m3, and 10 μg/m3, respectively) III |
Monitored & calculated | PM2.5 | Reduction in all-cause premature deaths; Total burden of all-cause mortality | Long-term Baseline mortality rate |
30 years and older | |
| Calculated from the total mortality data | ||||||||
| The study estimated the mortality reduction if the PM2.5 concentration reduced to the targeted levels | ||||||||
| Perez, L. et al. 2009 [42] | Spain Barcelona 57 municipalities Urban |
Post 2004 | Directive 2008/50/EC and WHO guidelines for PM10 (annual mean concentration of 20 μg/m3 and 40 μg/m3) III |
Targeted | PM10 | Monetary health value, indicated by VOLY f from all-cause mortality, morbidity (chronic bronchitis and asthma related symptoms), and hospital admissions of respiratory and cardiovascular causes | Short and long-term Population and baseline frequency of mortality and morbidity |
All population, with infant death |
| Calculated | ||||||||
| The study estimated the avoided mortality and morbidity under the scenarios examined the annual mean PM10 concentration decreased to the WHO recommended level or to the European Union regulatory level | ||||||||
| Johansson, C. et al. 2009 [43] | Sweden Stockholm, city level Urban |
2003–2007 | Congestion tax system (Stockholm Trial) (Vehicles travelling into and out of the charge cordon were charged for every passage during weekdays) II |
Monitored and simulated | NOx, PM10 | Premature death, indicated by YLG f | Co-benefit Long-term Baseline mortality rate, geographic distribution of population |
All population |
| Calculated from the mortality rate | ||||||||
| The study uses a test trial to measure and model the reduction of road use and then to model the reduction of traffic related PM10 and NOx; and using epidemiological mortality risk from NOx, calculates the avoidable premature death | ||||||||
| Woodcock, J. et al. 2009 [44] | UK London, city level Urban |
2010–2030 | Road transport interventions (Combination of active travel and lower-carbon emission motor vehicles) g
II |
Simulated | PM2.5 | Premature deaths from cardio-respiratory diseases and lung cancer in adults and acute respiratory infections for children DALYs f | Co-benefit Short and long term Physical activity and road traffic accidents |
All population stratified by age groups |
| Simulated | ||||||||
| The study compared business as usual and with the interventions, and modelled the health benefit from reduction in PM2.5 concentration | ||||||||
| Boldo, E. et al. 2011 [45] | Spain National level Urban and rural |
2004–2011 | Spain pollution control policies (Spain’s National Emissions Inventory, a baseline 2004 scenario and a projected 2011 scenario on a reduction of primary PM2.5, due to technological measures targeting the road transport sector, industry, agriculture, and power generation) III |
Targeted | PM2.5 | Avoided all-cause mortality | Long-term Population baseline and mortality baseline stratified by age |
30–99 years group; 25–74 years group |
| Calculated from the all-cause mortality and population data | ||||||||
| The study assessed the health benefit under the assumption that specific air quality policies were implemented successfully. | ||||||||
| Cesaroni, G. et al. 2011 [46] | Italy Rome, city level Urban |
2001–2005 | Limited traffic zone (LTZ) (Without policy scenario, optimistic scenario which assumed that all Euro 0 cars were replaced by Euro 4 cars, and pessimistic scenario which assumed that 10% of Euro 0 cars still running, and the rest 90% of Euro 0 were replaced by Euro 1–4 cars) II |
Simulated | NO2, PM10 | Total mortality, indicated by YLG | Long-term Distance to the intervention, age groups, education levels |
People over 30 years old living along high-traffic road, stratified by the distance of 50 m, 50–100 m and 100–150 m, and stratified by SEP |
| Simulated | ||||||||
| The study calculated the pollution concentration according to the traffic data, and used a concentration-response function to assess the health benefit in two LTZs under the three scenarios | ||||||||
| Chanel, O. et al. 2014 [33] | EU 20 EU cities, EU level Urban |
Post 2000 | Three European Commission Directives to reduce the sulphur content in liquid fuels for vehicles (1994, 1996, 1999/2000) EC Directive 93/12/EEC, EC Directive 98/70/EC, Council Directive 99/32/EC (Aphekom project). I |
Monitored & simulated | SO2 | Annual avoided respiratory, cardiovascular and total premature death (non- external); monetary health benefit indicated by VOLY | Short-term Temperature, day of the week, seasonality, time trend and number of death |
All population, in 20 cities in EU |
| Calculated from the number of deaths | ||||||||
| The study compared the emission reduction and health gain before and after the intervention | ||||||||
| Cyrys, J. et al. 2014 [47] | German Berlin, city level Urban |
Post 2010 | Low emission zones (LEZs) since 2010 II |
Observed & targeted | Black smoke, PM10 | Annual avoided total death | Long-term No confounder |
All population |
| Calculated | ||||||||
| The study analysed the scientific literatures on the effectiveness of LEZs to PM in German cities and then calculated the avoided death attributable to black smoke due to LEZs in Berlin | ||||||||
| Schucht, S. et al. 2015 [48] | EU EU level Urban and rural |
2005–2050 | EU air pollution legislation and climate policies I |
Simulated | PM2.5, O3 | Premature death from acute mortality of respiratory hospital admissions (65+ year) and minor restricted activity days (15–64 year); YLL f from chronic mortality of all ages; Monetary health benefit, indicated by cost of GDP h | Co-benefit Short and long terms The population change |
All population, stratified by age groups |
| Simulated | ||||||||
| The study compared the pollution change and health benefit under the scenario only with air pollution legislation and the scenario with both air pollution legislation and climate policies. |
a For assessed pollutants, we only included the pollutants that were used for health impact evaluation (excluding CO2). b Co-benefit was defined as the additional benefit of strategies which was above or beyond the direct aim of the strategies. c PJ, petajoule. d TSP, total suspended particles; O3, ozone; VOCs, volatile organic compounds; CO, carbon monoxide. e COPD, chronic obstructive pulmonary disease; LRTI, lower respiratory tract infection; IHD, ischaemic heart disease. f YLG, years of life gained; VOLY, value of a life year; DALYs, disability adjusted life years; YLL, years of life lost. g For strategy A, B and A+B, we only included the one with the highest air pollution concentration reduction and health impact. h GDP, gross domestic product.