Developing an air pollution exposure surveillance system in England; a new national vulnerability indicator

Abstract

BACKGROUND AND AIM: Air pollution is a serious public health issue and stakeholders (in particular local authorities (LA)) require more detailed information to protect those at risk. Public Health England was tasked to develop enhanced surveillance for air pollution, as part of the Environmental Public Health Tracking programme, and this may include surveillance of hazards (such as air pollution), exposures (concentrations of PM2.5 and NO2) and susceptibility (pre-existing demographic, social and health conditions). AIMS: 1) To scope and develop feasibility of air pollution exposure surveillance for stakeholders in England, 2) To design, pilot and trial potential new indicators to represent human vulnerabilities to air pollution, to help identify areas with populations who are sensitive, i.e. by age or socio-economic status (SES). METHODS: Following extensive consultation with stakeholders, vulnerability indicator development was conducted in two stages: 1) choice of exposure data and susceptibility indicator, and 2) linkage of the exposure and susceptibility indicators to produce population vulnerability that can be provided in a useful output format, e.g. map, rating index or indicator. We interviewed pilot LA’s to gain feedback on local application. RESULTS:We focused on susceptibility to ambient air pollution: age, SES and location, and related these to air pollution (PM2.5 and NO2) concentrations. We combined the exposure data and susceptibility to derive the vulnerabilities indicator plotted in a GIS. LA’s interpreted the maps for their areas and fed back how the indicator supported local decision-making processes. CONCLUSIONS:An air pollution exposure surveillance system is piloted for England. LAs welcomed the novel public health application and new datasets. The indicator shows where exposure needs to be tackled to reduce health effects including morbidity associated with exposure to outdoor air pollution. Next, the indicator needs to track the impact of interventions where changes in air pollution occur. KEYWORDS: Air pollution, Environmental disparities, Policy and Practice, methodological study design, exposures, multi-pollutants.