InSPIRE: Innovating UK clean air policies to prevent cognitive disorders across the lifespan, particularly for vulnerable urban populations

InSPIRE：创新英国清洁空气政策，以预防整个生命周期的认知障碍，特别是弱势城市人口

• 批准号: MR/T045221/1
• 负责人: Brian Castellani
• 金额: $ 5.24万
• 依托单位: Durham University
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FT045221%2F1
• 关键词: InSPIRE; Innovating; UK; clean; air

THE PROBLEMPublic health prevention today faces a serious challenge: new research suggests that breathing high levels of air pollutants at critical points in our lives, particularly in early life, can lead to significant cognitive disorders, including dementia. This causal link, however, from a public health standpoint, is not the primary challenge. Instead, the challenge is in figuring out how best to prevent it. What new research tentatively suggests, and here is the real public health challenge, is that the factors that account for which populations are most likely to develop air-pollution-based cognitive disorders has less to do with 'how' they live and more to do with 'where' they live. In other words, it appears that, from a prevention standpoint, the complex social and environmental systems in which certain populations live makes air pollution a health vulnerability for them. Air pollution is a form of cognitive health inequality.What is not clear, however, is specifically 'how' these complex systems make air pollution a cognitive health vulnerability? From policies for traffic management and urban congestion to the un-equitable sharing of benefits derived from clean air strategies, we do not entirely understand the pathways by which the social and environmental determinants of air pollution lead to cognitive disorders. In turn, therefore, we do not entirely know how to effectively intervene into these complex systems. In other words, from a primary prevention standpoint it is not clear which air policies or interventions best mitigate against the negative impact these determinants have on cognitive health, particularly for the most socioeconomically vulnerable populations in the UK's major conurbations. Hence the purpose of InSPIRE.OUR COMPLEXITY APPROACHInSPIRE will develop innovative primary prevention strategies for improving air quality, so that where one lives in the UK is no longer a cognitive health vulnerability. InSPIRE (which is comprised of 22 academics working across 9 universities with a network of partnerships) will engage in a highly ambitious research programme using the latest developments in systems science methods for public health to do the following:1.Develop a cutting-edge UK air pollution model (1970-2020) of what is known as PM2.5. These air pollutants are hazardous because they enter the bloodstream and travel to the brain to cause cognitive impairment.2.Work with the Dementias Platform to link our air pollution model to the cognitive health outcomes of three different highly regard UK cohorts.3.Work with regional and national partners to evaluate previous and current clean air strategies (1970 - 2020) to identify the most successful (for our cohorts) at mitigating the negative impact place has on cognitive health.4.Create a catalogue of these policy strategies and evaluate them further for 4 conurbations: London, Birmingham, Tyne-Wear and greater Manchester. 5.Use these results to produce high quality policy information and strategies to inform end-users on preventing air-pollution-based cognitive disorders and health inequalities.OUR TOOLKIT/SIMULATION PLATFORMInSPIRE will also launch an online evaluation toolkit and scenario simulation platform similar to the UK Multiple Deprivation Index and 2050 DECC Energy Calculator. With impact at the forefront of our partnership with the public and stakeholders, our simulation platform and toolkit will be immediately fit for purpose. Additionally, central and local end-users will be able to fine tune their platform as the world changes around them. Linking with national or local data and regional services, they will also be empowered to determine what will work and what is cost effective in the short and long term. Together, InSPIRE will help mitigate the effect of air pollution on cognitive health, both opening prospects and closing pathways to this cognitive barrier for the good of our population.

当今的公共健康预防面临着一个严峻的挑战：新的研究表明，在我们生命的关键时刻，特别是在生命的早期，呼吸高水平的空气污染物可能导致严重的认知障碍，包括痴呆症。然而，从公共卫生的角度来看，这种因果关系并不是主要的挑战。新的研究初步表明，哪些人群最有可能患上基于空气污染的认知障碍，与其说与他们的“生活方式”有关，不如说与他们的“生活地点”有关。这才是真实的公共卫生挑战。换句话说，从预防的角度来看，某些人口所生活的复杂的社会和环境系统似乎使空气污染成为他们健康的一个弱点。空气污染是认知健康不平等的一种形式。然而，尚不清楚的是，这些复杂的系统是如何使空气污染成为认知健康的脆弱性的？从交通管理和城市拥堵的政策到清洁空气战略带来的利益的不公平分享，我们并不完全理解空气污染的社会和环境决定因素导致认知障碍的途径。因此，我们并不完全知道如何有效地干预这些复杂的系统。换句话说，从一级预防的角度来看，目前尚不清楚哪些空气政策或干预措施最能减轻这些决定因素对认知健康的负面影响，特别是对于英国主要大都市中社会经济最脆弱的人群。我们的复杂性方法InSPIRE将制定创新的一级预防策略，以改善空气质量，使人们在英国生活的地方不再是认知健康的脆弱点。InspIRE（由9所大学的22名学者组成，拥有合作伙伴关系网络）将利用公共卫生系统科学方法的最新发展开展一项雄心勃勃的研究计划，以实现以下目标：1.开发一个尖端的英国空气污染模型（1970-2020），即所谓的PM2.5。这些空气污染物是危险的，因为它们进入血液并进入大脑，导致认知障碍。2.与痴呆症平台合作，将我们的空气污染模型与三个不同的高度重视的英国群体的认知健康结果联系起来。3.与区域和国家合作伙伴合作，评估以前和当前的清洁空气战略（1970 - 2020），以确定最成功的（为我们的队列）在减轻负面影响的地方对认知健康。4.创建这些政策策略的目录，并进一步评估他们的4个大都市：伦敦，伯明翰，泰恩-威尔和大曼彻斯特。5.我们的工具包/模拟平台我们的工具包/模拟平台InSPIRE还将推出一个在线评估工具包和情景模拟平台，类似于英国多重延迟指数和2050年DECC能源计算器。随着我们与公众和利益相关者合作伙伴关系的最前沿影响，我们的模拟平台和工具包将立即适合目的。此外，中央和本地最终用户将能够随着周围世界的变化而微调他们的平台。通过与国家或地方数据和区域服务相联系，它们还将有权确定短期和长期内哪些做法可行，哪些做法具有成本效益。总之，InSPIRE将有助于减轻空气污染对认知健康的影响，为我们的人口打开前景并关闭通往这一认知障碍的道路。

项目成果

A Scoping Review of the Effects of Ambient Air Quality on Cognitive Frailty

• DOI: 10.3390/environments11010004
• 发表时间: 2023-12
• 期刊: Environments
• 影响因子: 3.7
• 作者: James Robert Hodgson;Charlotte Benkowitz;Brian C. Castellani;Amanda Ellison;Rammina Yassaie;Helen Twohig;R. Bhudia;O. Jutila;Sally Fowler-Davis