MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Box 285, Cambridge, UK.
Centre for Primary Care, Wolfson Institute of Population Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Int J Behav Nutr Phys Act. 2024 Sep 5;21(1):89. doi: 10.1186/s12966-024-01621-7.
The Ultra-Low Emission Zone (ULEZ), introduced in Central London in April 2019, aims to enhance air quality and improve public health. The Children's Health in London and Luton (CHILL) study evaluates the impact of the ULEZ on children's health. This analysis focuses on the one-year impacts on the shift towards active travel to school.
CHILL is a prospective parallel cohort study of ethnically diverse children, aged 6-9 years attending 84 primary schools within or with catchment areas encompassing London's ULEZ (intervention) and Luton (non-intervention area). Baseline (2018/19) and one-year follow-up (2019/20) data were collected at school visits from 1992 (58%) children who reported their mode of travel to school 'today' (day of assessment). Multilevel logistic regressions were performed to analyse associations between the introduction of the ULEZ and the likelihood of switching from inactive to active travel modes, and vice-versa. Interactions between intervention group status and pre-specified effect modifiers were also explored.
Among children who took inactive modes at baseline, 42% of children in London and 20% of children in Luton switched to active modes. For children taking active modes at baseline, 5% of children in London and 21% of children in Luton switched to inactive modes. Relative to the children in Luton, children in London were more likely to have switched from inactive to active modes (OR 3.64, 95% CI 1.21-10.92). Children in the intervention group were also less likely to switch from active to inactive modes (OR 0.11, 0.05-0.24). Moderator analyses showed that children living further from school were more likely to switch from inactive to active modes (OR 6.06,1.87-19.68) compared to those living closer (OR 1.43, 0.27-7.54).
Implementation of clean air zones can increase uptake of active travel to school and was particularly associated with more sustainable and active travel in children living further from school.
超低排放区（ULEZ）于 2019 年 4 月在伦敦市中心推出，旨在改善空气质量和公众健康。伦敦和卢顿儿童健康（CHILL）研究评估了 ULEZ 对儿童健康的影响。本分析重点关注 ULEZ 对儿童上学转向积极出行的一年影响。
CHILL 是一项针对不同种族儿童的前瞻性平行队列研究，年龄在 6-9 岁，在伦敦 ULEZ（干预区）和卢顿（非干预区）的 84 所小学就读或其招生范围内。在学校访问中收集了 1992 名（58%）儿童的基线（2018/19 年）和一年随访（2019/20 年）数据，这些儿童报告了他们“今天”（评估日）上学的出行方式。使用多水平逻辑回归分析 ULEZ 引入与从非活跃交通方式向活跃交通方式转变的可能性之间的关联，反之亦然。还探索了干预组状况与预先指定的效应修饰符之间的交互作用。
在基线时采用非活跃模式的儿童中，伦敦有 42%的儿童和卢顿有 20%的儿童转为活跃模式。对于基线时采用活跃模式的儿童，伦敦有 5%的儿童和卢顿有 21%的儿童转为非活跃模式。与卢顿的儿童相比，伦敦的儿童更有可能从非活跃模式转变为活跃模式（OR3.64，95%CI1.21-10.92）。干预组的儿童也不太可能从活跃模式转为非活跃模式（OR0.11，0.05-0.24）。调节分析显示，与住在较近的儿童相比，住在较远的儿童更有可能从非活跃模式转变为活跃模式（OR6.06，1.87-19.68）。
清洁空气区的实施可以增加儿童上学的积极出行率，特别是与住在较远的儿童更可持续和积极的出行方式相关。
