Mebrahtu Teumzghi F, Santorelli Gillian, Yang Tiffany C, Tate James E, Jones Sally, Wright John, McEachan Rosemary R C
Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK.
Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK; Population Health Improvement UK (PHI-UK), UK.
Environ Res. 2025 Apr 1;270:120988. doi: 10.1016/j.envres.2025.120988. Epub 2025 Jan 28.
There is limited evidence of the health impact of Low Emission Zones (also known as Clean Air Zones, CAZ). This study examines the impact of the Bradford Clean Air Plan (CAP), including a CAZ, on health and nitrogen dioxide (NO) in the first two years of implementation using an interrupted time series design. Primary care and emergency department visits for respiratory and cardiovascular illness in Bradford were recorded between January 2018 to September 2023 with diabetic footcare and head injury visits as controls. A total of 157,623 primary care, and 37,865 emergency department visits for respiratory and cardiovascular conditions were recorded. At the start of implementation respiratory primary care visits decreased by 25% (RR = 0.75; 95%CI: 0.68 to 0.82) and cardiovascular visits by 24% (RR = 0.76; 95%CI: 0.64 to 0.92) compared to a pre-COVID-19 baseline (January 2018-February 2020). Post-implementation monthly respiratory and cardiovascular visits declined by 598 (95%CI: -614 to -583) and 134 (95%CI: -137 to -131), respectively, with continued downward trends (both: RR = 0.99; 95% CI: 0.99 to 0.99). Diabetic foot-care decreased (RR = 0.69; 95%CI: 0.60-0.80) but showed upward trends post-implementation (RR = 1.01; 95%CI: 1.00-1.01). Emergency department visits showed minimal changes across all outcomes. NO concentration decreased by 11.5 μg/m (95%CI: -23.2 to 0.2) and continued to decrease by 0.2 μg/m (95%CI: -0.4 to -0.1) post-implementation. Policies which restrict the movement of polluting vehicles have the potential to reduce air pollution and improve health, although evaluating their impact is challenging. Studying the longer-term impact of these initiatives is warranted.
关于低排放区（也称为清洁空气区，CAZ）对健康影响的证据有限。本研究采用中断时间序列设计，考察了包括清洁空气区在内的布拉德福德清洁空气计划（CAP）在实施的头两年对健康和二氧化氮（NO）的影响。记录了2018年1月至2023年9月期间布拉德福德因呼吸道和心血管疾病到初级保健机构和急诊科就诊的情况，并将糖尿病足护理和头部受伤就诊情况作为对照。共记录了157,623次因呼吸道和心血管疾病到初级保健机构就诊以及37,865次到急诊科就诊的情况。与2019年新冠疫情前基线（2018年1月至2020年2月）相比，实施初期呼吸道初级保健就诊次数下降了25%（相对风险RR = 0.75；95%置信区间CI：0.68至0.82），心血管疾病就诊次数下降了24%（RR = 0.76；95%CI：0.64至0.92）。实施后，每月呼吸道和心血管疾病就诊次数分别下降了598次（95%CI：-614至-583）和134次（95%CI：-137至-131），且呈持续下降趋势（两者RR = 0.99；95%CI：0.99至0.99）。糖尿病足护理就诊次数减少（RR = 0.69；95%CI：0.60至0.80），但实施后呈上升趋势（RR = 1.01；95%CI：1.00至1.01）。急诊科就诊情况在所有结果中变化最小。二氧化氮浓度下降了11.5μg/m³（95%CI：-23.2至0.2），实施后继续下降0.2μg/m³（95%CI：-0.4至-0.1）。限制污染车辆行驶的政策有可能减少空气污染并改善健康状况，尽管评估其影响具有挑战性。有必要研究这些举措的长期影响。
