title: Air Quality Strategies on Public Health and Health Equity in Europe-A Systematic Review.
abstract: Air pollution is an important public health problem in Europe and there is evidence that it exacerbates health inequities. This calls for effective strategies and targeted interventions. In this study, we conducted a systematic review to evaluate the effectiveness of strategies relating to air pollution control on public health and health equity in Europe. Three databases, Web of Science, PubMed, and Trials Register of Promoting Health Interventions (TRoPHI), were searched for scientific publications investigating the effectiveness of strategies on outdoor air pollution control, public health and health equity in Europe from 1995 to 2015. A total of 15 scientific papers were included in the review after screening 1626 articles. Four groups of strategy types, namely, general regulations on air quality control, road traffic related emission control interventions, energy generation related emission control interventions and greenhouse gas emission control interventions for climate change mitigation were identified. All of the strategies reviewed reported some improvement in air quality and subsequently in public health. The reduction of the air pollutant concentrations and the reported subsequent health benefits were more significant within the geographic areas affected by traffic related interventions. Among the various traffic related interventions, low emission zones appeared to be more effective in reducing ambient nitrogen dioxide (NO₂) and particulate matter levels. Only few studies considered implications for health equity, three out of 15, and no consistent results were found indicating that these strategies could reduce health inequity associated with air pollution. Particulate matter (particularly fine particulate matter) and NO₂ were the dominant outdoor air pollutants examined in the studies in Europe in recent years. Health benefits were gained either as a direct, intended objective or as a co-benefit from all of the strategies examined, but no consistent impact on health equity from the strategies was found. The strategy types aiming to control air pollution in Europe and the health impact assessment methodology were also discussed in this review.
authors.affiliation: Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht 6200 MD, The Netherlands. li.wang@maastrichtuniversity.nl.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China. zhongbq@craes.org.cn.
authors.forename: Buqing
authors.initials: B
authors.lastname: Zhong
authors.affiliation: Environmental Change Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, London WC1E 7HT, UK. Sotiris.Vardoulakis@phe.gov.uk.
authors.forename: Sotiris
authors.initials: S
authors.lastname: Vardoulakis
authors.affiliation: Department of Environmental Quality Comprehensive Assessment, China National Environmental Monitoring Center, Beijing 100012, China. zhangfy@cnemc.cn.
authors.forename: Fengying
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht 6200 MD, The Netherlands. eva.pilot@maastrichtuniversity.nl.
authors.forename: Eva
authors.initials: E
authors.lastname: Pilot
authors.affiliation: Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China. yhli@igsnrr.ac.cn.
authors.forename: Yonghua
authors.initials: Y
authors.lastname: Li
authors.affiliation: Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China. yangls@igsnrr.ac.cn.
authors.forename: Linsheng
authors.initials: L
authors.lastname: Yang
authors.affiliation: Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China. wangwy@igsnrr.ac.cn.
authors.forename: Wuyi
authors.initials: W
authors.lastname: Wang
authors.affiliation: Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht 6200 MD, The Netherlands. thomas.krafft@maastrichtuniversity.nl.
authors.forename: Thomas
authors.initials: T
authors.lastname: Krafft
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects; D000397:Air Pollution / Q000009:adverse effects / Q000517:prevention & control*; D057231:Climate Change; D005060:Europe; D000069576:Health Equity; D006801:Humans; D011634:Public Health
chemical_list: D000393:Air Pollutants
keywords: air quality; assessment; health; health equity; strategy; systematic review