The UK's Clean Air Hospital Framework: The Role of Hospitals as Anchor Institutions in Achieving Improved Air Quality Within the Communities They Serv

空气污染与医院中哮喘、中风、心血管疾病、肺癌等健康病例的增加有关(坎帕和卡斯塔纳斯2008年、大奥蒙德街医院和2021年计划)。英国政府承认糟糕的空气质量是对公众健康的最大环境风险，并给出了2010年空气质量对英国经济影响的下限财务估计为80亿GB(Brunekreef和Holgate 2002，下议院环境审计委员会2010)。医疗保健系统负责满足社会中的医疗保健需求，其本身承担着全球温室气体排放和相关环境空气污染物的4%-5%的责任(Watts，Amann等人)。2019年)。超过2000家医疗中心和200家医院所在地区的细颗粒物(PM2.5)平均水平高于世界卫生组织建议的年平均10微克/立方米，这让情况变得更糟(英国肺脏基金会，2018年)。因此，NHS认为有必要向内审视减少空气污染和碳排放，2019年纽卡斯尔on Tyne医院NHS基金会信托基金(Nuth)宣布气候紧急情况成为世界上第一家做出此类承诺的医疗机构。作为Nuth气候应急战略的一部分，并符合英国政府的法规要求(例如，《2010年健康与护理法案》)，Nuth正在实施清洁空气医院框架(CAHF)，以有效解决其室内和环境空气污染问题。因此，本项目旨在监测CAHF的实施情况，并评估CAHF在Nuth的两家成员医院--皇家维多利亚医院和The Freeman实现清洁空气方面的有效性。本项目将寻求回答以下问题。1.CAHF作为NHS和其他高级人力资源组织内有效和可持续的空气污染和碳减排模式的优势和劣势是什么？2.CAHF的实施对Nuth医院和更广泛地区的空气质量有何影响？3.医院工作人员、患者、来访者、这个项目的总体目标是首次研究以CAHF为基础的综合净零碳和清洁空气战略如何改善主要城市医院的环境和室内空气质量，同时为实现医院的净零碳目标做出贡献。此外，它还将调查医院作为支柱机构在改善其服务的社区内的空气质量方面的作用，以及这将带来的健康好处。该项目将利用CAHF指南的七个重点领域提供的活动数据的计算分析：旅行、采购和供应、设计和施工、能源生产、当地空气质量、沟通和培训以及推广和领导。将制定以空气质量模拟和监测为基础的方法，以评估实施CAHF对当地和更广泛地区空气质量的影响。总体而言，这项工作将使工作人员、患者和更广泛的社区能够估计健康改善情况(按每日调整寿命年计算)。该项目还将考虑将CAHF战略整合到更广泛的NHS和纽卡斯尔市改善空气质量战略中的机会和挑战。这项研究与EPSRC转变健康和医疗保健战略优先事项保持一致，通过其对可持续医疗保健未来发展、清洁空气环境和实现英国净零目标的贡献

Air pollution has been associated with an increase in the number of health cases such as asthma, stroke, cardiovascular diseases, lung cancer, and others, in hospitals (Kampa and Castanas 2008, Great Ormond Street Hospital and Plan 2021). The UK government acknowledges poor air quality as the largest environmental risk to public health and gave a lower limit financial estimate of £8 billion as the cost of its impact on the UK economy in 2010 (Brunekreef and Holgate 2002, House of Commons Environmental Audit Committee 2010). The healthcare system, which is responsible for catering to the health care needs within society, is itself responsible for about 4-5% of global Greenhouse Gas emissions and associated ambient air pollutants (Watts, Amann et al. 2019). The situation is made worse with over 2000 health centres and 200 hospitals are in areas with average fine particulate matter (PM2.5) levels above World Health Organisation recommended annual average of 10ug/m3(British Lung Foundation 2018). Consequently, the NHS has seen a need to look inwards to reduce air pollution and carbon emissions, and in 2019 Newcastle upon Tyne Hospitals NHS Foundation Trust (NuTH) declared a Climate Emergency becoming the first healthcare institution in the world to make such commitment. This declaration commits the NuTH to actively reducing their carbon footprint and improving on air quality towards a sustainable healthcare system.As part of NuTH Climate Emergency Strategy and in compliance with UK government regulatory requirements (e.g Health and Care Act 2010), the NuTH is implementing the Clean Air Hospital Framework (CAHF) to effectively address its indoor and ambient air pollution. This project, therefore, seeks to monitor implementation and evaluate the effectiveness of CAHF as a tool towards achievement of clean air within two member hospitals of the NuTH, the Royal Victoria Hospital and the Freeman.This project will seek to answer the following questions.1.What are the strengths and weaknesses of the CAHF as an effective and sustainable model for air pollution and carbon reduction within the NHS and other high human resource organizations using the participating hospitals as case studies?2.What is the impact of CAHF implementation on air quality at the NuTH hospital sites and in the wider locality?3.What are the health improvement opportunities for hospital staff, patients, visitors, and the wider community that is provided by the CAHF implementation?The overall aim of this project is to study, for the first time, how an integrated net-zero carbon, and clean air strategy, based on the CAHF, can improve ambient and indoor air quality at major urban hospital sites, whilst at the same time contributing to achievement of the hospitals' net-zero carbon targets. Further, it will investigate the role of hospitals as anchor institutions in improving air quality within the communities that they serve, and the health benefits this will bring. This project will draw on computational analysis of data from activities that are informed by the seven focus areas of the CAHF guideline: Travel, Procurement & Supply, Design & Construction, Energy Generation, Local Air Quality, Communication & Training, and Outreach & Leadership. Methodologies based on air quality modelling and monitoring will be developed to evaluate the impact of CAHF implementation on air quality in the local and wider areas. Overall, the work will allow the estimation of health improvements (in terms of Daily Adjusted Life Years) to staff, patients, and the wider community. The project will also consider opportunities and challenges of integrating the CAHF strategies into the wider NHS and Newcastle city strategies for improving air quality.This study is aligned with the EPSRC's transforming health and healthcare strategic priority through its contribution to the development of a sustainable healthcare future,a clean air environment,and achievement of the UK's net-zero target