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Aims: In this study, the aim was to develop and test an urban green space indicator for public health, as proposed by the World Health Organisation (WHO) Regional Office for Europe, in order to support health and environmental policies. Methods: We defined the indicator of green space accessibility as a proportion of an urban population living within a certain distance from a green space boundary. We developed a Geographic Information System (GIS)-based method and tested it in three case studies in Malmö, Sweden; Kaunas, Lithuania; and Utrecht, The Netherlands. Land use data in GIS from the Urban Atlas were combined with population data. Various population data formats, maximum distances to green spaces, minimum sizes of green spaces, and different definitions of green spaces were studied or discussed. Results: Our results demonstrated that with increasing size of green space and decreased distance to green space, the indicator value decreased. As compared to Malmö and Utrecht, a relatively bigger proportion of the Kaunas population had access to large green spaces, at both shorter and longer distances. Our results also showed that applying the method of spatially aggregated population data was an acceptable alternative to using individual data. Conclusions: Based on reviewing the literature and the case studies, a 300 m maximum linear distance to the boundary of urban green spaces of a minimum size of 1 hectare are recommended as the default options for the indicator. The indicator can serve as a proxy measure for assessing public accessibility to urban green spaces, to provide comparable data across Europe and stimulate policy actions that recognise the importance of green spaces for sustainable public health.

BackgroundThere are limited studies on the health effects of street trading in spite of common knowledge that individuals engaged in the trade are exposed to high levels of traffic-related air pollution per their mode of operation, and also the fact that the venture is a dominant occupation in cities of Sub-Saharan Africa (SSA) and other developing regions.ObjectiveWe characterized particulate matter (PM) pollution levels at traffic hotspots of Accra, Ghana during the dry and wet seasons, and assessed exposure experiences of street traders.MethodsA cross-sectional study was conducted among 236 street traders operating along six selected traffic routes of Accra and a comparison group of 186 office workers. PurpleAir PA-II monitors were used to measure PM levels at the selected traffic routes. We estimated annual PM2.5 exposure of street traders using assigned seasonal PM2.5 levels, and information collected in a structured questionnaire on their activity patterns. Outcomes investigated were self-reported respiratory and cardiovascular symptoms.ResultsPM levels at Accra traffic hotspots were high in both seasons. 1 ug/m3 increase in PM2.5 exposure increased respiratory, cardiovascular, and overall symptoms by a factor of 0.00027 (95% CI: 0.00012, 0.00041), 0.00022 (95% CI: 0.00007, 0.00036), and 0.00048 (95% CI: 0.00023, 0.00073), respectively. Compared to office workers, high PM2.5 exposure among street traders was associated with increased odds of coughing, catarrh (postnasal drip), sneezing, rapid heart beating, irregular heartbeat, sharp chest pains, fainting spells, headaches, and dizziness. Low and medium PM2.5 exposure was associated with increased odds of dermatitis, rapid heart beating, and irregular heartbeat, and sharp chest pains, respectively.ConclusionsWe found consistent evidence that PM2.5 exposure among street traders increases the occurrence of respiratory and cardiovascular symptoms. We also provide indicative measurements of PM levels at traffic hotspots of a rapidly growing SSA city with heavy vehicular traffic and yet, limited air quality monitoring capacity.

In Sub-Saharan Africa and other developing regions, there has been very little systematic attempt to document the uses and perceived health benefits of urban green spaces in cities and the factors influencing usage. We therefore sought to establish the availability, accessibility and use of urban green spaces, and the perceived health benefits in an African population. We also ascertained the factors influencing use and development of green spaces at home. A population-based survey was conducted in Accra, the capital city of Ghana, spanning 11 Municipal and 3 Sub-Metropolitan areas. Multivariable binary logistic regression adjusting for potential confounders was used to establish the association between green space use and development at home, and socio-demographic, neighbourhood and health factors. Odds ratios and their corresponding 95% confidence intervals were estimated from the models. Several socio-demographic (gender, age, marital status, occupation, ethnicity, religion) and district-level (population density, income level, neighbourhood greenness) factors were associated with use of green spaces and development of green spaces at home in Accra. Residents who were worried about depletion of green spaces in their community were more likely to develop green spaces at home. In neighbourhoods with moderate and high level of greenness, residents were less likely to develop green spaces at home. Five-percent and 47% of green space users in Accra reported witnessing an improvement in their physical and mental health, respectively, from use of green spaces. The study findings can inform policy action for promoting use and development of green spaces in African cities and for mitigating depletion and degradation of the limited urban greenery.

Scientific evidence spanning experimental and epidemiologic studies has shown that air pollution exposures can lead to a range of health effects. Quantitative approaches that allow for the estimation of the adverse health impacts attributed to air pollution enable researchers and policy analysts to convey the public health impact of poor air quality. Multiple tools are currently available to conduct such analyses, which includes software packages designed by the World Health Organization (WHO): AirQ+, and the U.S. Environmental Protection Agency (U.S. EPA): Environmental Benefits Mapping and Analysis Program—Community Edition (BenMAP—CE), to quantify the number and economic value of air pollution-attributable premature deaths and illnesses. WHO’s AirQ+ and U.S. EPA’s BenMAP—CE are among the most popular tools to quantify these effects as reflected by the hundreds of peer-reviewed publications and technical reports over the past two decades that have employed these tools spanning many countries and multiple continents. Within this paper we conduct an analysis using common input parameters to compare AirQ+ and BenMAP—CE and show that the two software packages well align in the calculation of health impacts. Additionally, we detail the research questions best addressed by each tool.

The AirQ+ software tool for health risk assessment of air pollution, developed by the World Health Organization, helps quantify the effects of exposure to air pollution. Specifically, AirQ+ can estimate the effects of short-term changes in air pollution (based on risk estimates from time-series studies) and the effects of long-term exposures (using life-tables approach and based on risk estimates from cohort studies). AirQ+ is available in English, French, German and Russian. In this presentation, AirQ+ will be loaded with air pollution data from the European Environment Agency datasets for a quick evaluation of health effects from air pollution in an European city.

Urban green space and urban compactness are each important principles for designing healthy, climate-resilient cities. The principles can co-exist, but greening may come at density’s expense if not considered deliberately. Existing studies estimating health impacts of greening scenarios have not considered what level of greenness is attainable for different population densities. Here, using the square kilometer as the unit of analysis, we estimate non-accidental mortality that could be prevented among adults older than 30 by greening that small area to a level of greenness assumed to be attainable based on its broader urban area (N = 15,917 globally), population density, and ecological zone. Results suggest a large potential for urban greening even in the most population-dense parts of cities such that on average 54 deaths per 100,000 could be prevented per year in those areas. That estimate may be about 25% higher or lower due to uncertainty in the underlying model. Greening urban areas to attainable levels for their population density and ecological zone could decrease nonaccidental mortality by about 50 deaths per year per 100,000 adults older than 30, according to epidemiologic analyses from 15,917 urban areas.

Africa is a particularly vulnerable continent to the effects of climate and environmental changes. Several tree planting projects were launched as one of the plausible solutions to climate action. This paper reviews the recent tree planting projects in African cities, initiated between 2009 to 2021, focusing on analyzing the expected benefits to the populations. Indeed, these projects have become a widespread instrument to promise planning solutions for many African countries given the expected improvements to mitigate air pollution, carbon sequestration, and the conditions of cities for the health and wellbeing of their citizens. The consequences of uncontrolled urbanization in Africa also stress the importance of better planning of green spaces. African cities should reconsider urban planning with a clear focus on the role of green infrastructures because of their extensive social benefits and supportive capacity for any significant sustainable development. While these projects seem to be a promising initiative and are expected to deliver beneficial ecosystem services to citizens, there are still some loopholes that this paper highlights.

Global assessments of air quality and health require comprehensive estimates of the exposures to air pollution that are experienced by populations in every country. However, there are many countries in which measurements from ground-based monitoring are sparse or non-existent, with quality-control and representativeness providing additional challenges. While ground-based monitoring provides a far from complete picture of global air quality, there are other sources of information that provide comprehensive coverage across the globe. The World Health Organization developed the Data Integration Model for Air Quality (DIMAQ) to combine information from ground measurements with that from other sources, such as atmospheric chemical transport models and estimates from remote sensing satellites in order to produce the information that is required for health burden assessment and the calculation of air pollution-related Sustainable Development Goals indicators. Here, we show an example of the use of DIMAQ with the Copernicus Atmosphere Monitoring Service Re-Analysis (CAMSRA) of atmospheric composition, which represents the best practices in meteorology and climate monitoring that were developed under the World Meteorological Organization’s Global Atmosphere Watch programme. Estimates of PM2.5 from CAMSRA are integrated within the DIMAQ framework in order to produce high-resolution estimates of air pollution exposure that can be aggregated in a coherent fashion to produce country-level assessments of exposures.

IntroductionThe European climate is getting warmer and the impact on childhood health and development is insufficiently understood. Equally, how heat-related health risks can be reduced through nature-based solutions, such as exposure to urban natural environments, is unknown. Green CURe In Outdoor CITY spaces (Green CURIOCITY) will analyse how heat exposure during pregnancy affects birth outcomes and how long-term heat exposure may influence children’s neurodevelopment. We will also investigate if adverse effects can be mitigated by urban natural environments. A final goal is to visualise intraurban patterns of heat vulnerability and assist planning towards healthier cities.Methods and analysisWe will use existing data from the Human Early-Life Exposure cohort, which includes information on birth outcomes and neurodevelopment from six European birth cohorts. The cohort is linked to data on prenatal heat exposure and impact on birth outcomes will be analysed with logistic regression models, adjusting for air pollution and noise and sociobehavioural covariates. Similarly, impact of cumulative and immediate heat exposure on neurodevelopmental outcomes at age 5 will be assessed. For both analyses, the potentially moderating impact of natural environments will be quantified. For visualisation, Geographical information systems data will be combined to develop vulnerability maps, demonstrating urban ‘hot spots’ where the risk of negative impacts of heat is aggravated due to sociodemographic and land use patterns. Finally, geospatial and meteorological data will be used for informing GreenUr, an existing software prototype developed by the WHO Regional Office for Europe to quantify health impacts and augment policy tools for urban green space planning.Ethics and disseminationThe protocol was approved by the Comité Ético de Investigación Clínica Parc de Salut MAR, Spain. Findings will be published in peer-reviewed journals and presented at policy events. Through stakeholder engagement, the results will also reach user groups and practitioners.

Well-being impact assessments of urban interventions are a difficult challenge, as there is no agreed methodology and scarce evidence on the relationship between environmental conditions and well-being. The European Union (EU) project “Urban Reduction of Greenhouse Gas Emissions in China and Europe” (URGENCHE) explored a methodological approach to assess traffic noise-related well-being impacts of transport interventions in three European cities (Basel, Rotterdam and Thessaloniki) linking modeled traffic noise reduction effects with survey data indicating noise-well-being associations. Local noise models showed a reduction of high traffic noise levels in all cities as a result of different urban interventions. Survey data indicated that perception of high noise levels was associated with lower probability of well-being. Connecting the local noise exposure profiles with the noise-well-being associations suggests that the urban transport interventions may have a marginal but positive effect on population well-being. This paper also provides insight into the methodological challenges of well-being assessments and highlights the range of limitations arising from the current lack of reliable evidence on environmental conditions and well-being. Due to these limitations, the results should be interpreted with caution.