Air Pollution in Cities: Urban and Transport Planning Determinants and Health in Cities

Abstract

The city is the most frequently inhabited environment for most people worldwide. Cities can influence health and disease in many ways, encompassing benefits for health as well as promoting risk factors for morbidity and mortality, among them sedentary lifestyles and exposure to air pollution, noise, heat islands and lack of green space. Among environmental risk factors, ambient air pollution is the most important cause of disease, leading to more than four million premature deaths and more than 100 million DALYs annually worldwide. Important health effects of ambient air pollution include, but are not limited to, cardiovascular and cerebrovascular disease, chronic respiratory disease and infections, and lung cancer, with ischemic heart disease being responsible for most of the estimated annual premature deaths. Anthropogenic sources of air pollution include combustion products from energy production, motorized traffic, and household heating with wood, coal or oil, waste incineration, tire and break wear, industrial emissions, and emissions from surrounding agricultural areas. Among those, traffic is the most important determinant of within-city exposure contrasts, since people live, work, and commute in close proximity to traffic. Interventions to reduce health effects of urban air pollution can be accomplished on different regulatory levels and will in most cases also have synergistic effects in terms of climate change, heat stress, noise exposure mitigation and increasing physical activity. The promotion of a modal shift to more public and active transportation seems to be the most promising avenue for healthy city planning.