Air pollution and weather-related health impacts: methodological study based on spatiotemporally disaggregated multi-pollutant models

有大量令人信服的流行病学证据表明，短期接触室外空气污染物会对健康产生不利影响。然而，这些证据大多来自将城市环境中的单一污染物与健康联系起来的研究。人们日益认识到，通过集中研究和政策而不是针对个别污染物，而是采用多种污染物的办法，可以更好地防止空气污染对健康的不利影响。此外，污染物浓度的空间变化及其对健康的影响，特别是在农村地区和英国大部分人口居住的大城市以外地区，还没有得到很好的确定。社会经济影响（以及环境正义的有关问题）和其他地理上决定的因素，包括住房特征（室内污染），也是暴露于室外空气污染的潜在改变因素。科学研究的日益复杂与制定、证明和实施适当的监管政策的困难相匹配。这项建议建立在环境和卫生学科研究人员之间现有合作的基础上，并增加了来自政策和社会科学领域的研究人员和实践者。我们的建议旨在为暴露于多种污染物对健康的影响提供新的流行病学证据；研究这些证据对规管和管制空气质素的影响；并评估证据的不确定性如何影响将其转化为可操作的循证政策，以及评估其成本和收益。我们的研究中有几个独特的创新：1)开发了一系列高分辨率（5公里）数据集，用于一系列污染物的每日浓度和天气数据，与地理参考健康数据（包括每日死亡率、住院人数和心脏病发作数据）相关联；2)检查室内环境作为室外污染物暴露的调节因素的贡献，以提供短期暴露于空气污染的健康风险的综合评估；3)综合评估2030年各种近期空气质量和气候政策对健康的影响，以及英国选定的减排政策；4)开发一种“决策分析”工具，包括对不确定性的评估，并可用于推断这些不同政策选择的可能结果。

There is a large and convincing body of epidemiological evidence linking short term exposure to outdoor air pollutants to adverse health effects. However, most of this evidence is derived from studies that have linked single pollutants to health in urban environments. There is increasing recognition that greater protection against the adverse health effects of air pollution could be achieved by focusing research and policy not on individual pollutants, but by a multi-pollutant approach. Furthermore, the spatial variation in pollutant concentrations and their health impacts, especially in rural areas and areas outside the larger cities where much of the UK population reside, are not-well established. Socio-economic impacts (and related issues of environmental justice) and other geographically-determined factors, including housing characteristics (indoor pollution), are also potential modifiers of exposure to outdoor air pollution. The increasing complexity of the scientific inquiry is matched by the difficulties of formulating, proving and implementing appropriate regulatory policy. This proposal builds upon an existing collaboration between researchers in the environmental and health disciplines, with the addition of investigators and practitioners from the policy and social science fields. Our proposal aims to provide new epidemiological evidence on the health impacts of exposure to multiple pollutants; to examine the implications of such evidence for regulation and control of air quality; and to assess how uncertainties in evidence affect its translation into actionable evidence-based policies and the evaluation of their costs and benefits. There are several unique innovations in our study: 1) the development of long series of high resolution (5 km) datasets for daily concentrations of a range of pollutants and weather data, linked to geo-referenced health data including daily mortality, hospital admissions and data on heart attacks; 2) an examination of the contribution of the indoor environment as a modifier of exposure to outdoor pollutants to provide an integrated assessment of the risks to health of short term exposure to air pollution; 3) an integrated assessment of the health effects of various near-term future air quality and climate policies in 2030 as well as selected emissions reduction policies for the UK; 4) the development of a 'decision analysis' tool that includes assessment of uncertainties and can be used to infer the likely outcomes of these various policy choices.