Meteorology, air quality, and health in London: the ClearfLo project

The ClearfLo project provides integrated measurements of the meteorology, composition and particulate loading of London's urban atmosphere to improve predictive capability for air quality. Air quality and heat are strong health drivers and their accurate assessment and forecast are important in densely populated urban areas. However, the sources and processes leading to high concentrations of main pollutants such as ozone, nitrogen dioxide, and fine and coarse particulate matter in complex urban areas are not fully understood, limiting our ability to forecast air quality accurately. This paper introduces the ClearfLo project's interdisciplinary approach to investigate the processes leading to poor air quality and elevated temperatures. Within ClearfLo (www.clearflo.ac.uk), a large multi-institutional project funded by the UK Natural Environment Research Council (NERC), integrated measurements of meteorology, gaseous and particulate composition/loading within London's atmosphere were undertaken to understand the processes underlying poor air quality. Long-term measurement infrastructure installed at multiple levels (street and elevated), and at urban background, kerbside and rural locations were complemented with high-resolution numerical atmospheric simulations . Combining these (measurement/modeling) enhances understanding of seasonal variations in meteorology and composition together with the controlling processes. Two intensive observation periods (winter 2012 and summer Olympics 2012) focus upon the vertical structure and evolution of the urban boundary layer, chemical controls on nitrogen dioxide and ozone production, in particular the role of volatile organic compounds, and processes controlling the evolution, size, distribution and composition of particulate matter. The paper shows that mixing heights are deeper over London than in the rural surroundings and the seasonality of the urban boundary layer evolution controls when concentrations peak. The composition also reflects the seasonality of sources such as domestic burning and biogenic emissions.

Remarkable dynamics of nanoparticles in the urban atmosphere

Nanoparticles emitted from road traffic are the largest source of respiratory exposure for the general public living in urban areas. It has been suggested that adverse health effects of airborne particles may scale with airborne particle number, which if correct, focuses attention on the nanoparticle (less than 100 nm) size range which dominates the number count in urban areas. Urban measurements of particle size distributions have tended to show a broadly similar pattern dominated by a mode centred on 20–30 nm diameter emitted by diesel engine exhaust. In this paper we report the results of measurements of particle number concentration and size distribution made in a major London park as well as on the BT Tower, 160 m aloft. These measurements taken during the REPARTEE project (Regents Park and BT Tower experiment) show a remarkable shift in particle size distributions with major losses of the smallest particle class as particles are advected away from the traffic source. In the Park, the traffic related mode at 20–30 nm diameter is much reduced with a new mode at <10 nm. Size distribution measurements also revealed higher number concentrations of sub-50 nm particles at the BT Tower during days affected by higher turbulence as determined by Doppler Lidar measurements and are indicative of loss of nanoparticles from air aged during less turbulent conditions. These results are suggestive of nanoparticle loss by evaporation, rather than coagulation processes. The results have major implications for understanding the impacts of traffic-generated particulate matter on human health.

Urban-scale Environmental Prediction Systems

Weather, climate, water and related environmental conditions, including air quality, all have profound effects on cities. A growing importance is being attached to understanding and predicting atmospheric conditions and their interactions with other components of the Earth System in cities, at multiple scales. We highlight the need for: (1) development of high-resolution coupled environmental prediction models that include realistic city-specific processes, boundary conditions and fluxes; (2) enhanced observational systems to support (force, constrain, evaluate) these models to provide high quality forecasts for new urban services; (3) provision of meteorological and related environmental variables to aid protection of human health and the environment; (4) new targeted and customized delivery platforms using modern communication techniques, developed with users to ensure that services, advice and warnings result in appropriate action; and (5) development of new skill and capacity to make best use of technologies to deliver new services in complex, challenging and evolving city environments. We highlight the importance of a coordinated and strategic approach that draws on, but does not replicate, past work to maximize benefits to stakeholders.

The Birmingham Urban Climate Laboratory: an open meteorological test bed and challenges of the smart city

Existing urban meteorological networks have an important role to play as test beds for inexpensive and more sustainable measurement techniques that are now becoming possible in our increasingly smart cities. The Birmingham Urban Climate Laboratory (BUCL) is a near-real-time, high-resolution urban meteorological network (UMN) of automatic weather stations and inexpensive, nonstandard air temperature sensors. The network has recently been implemented with an initial focus on monitoring urban heat, infrastructure, and health applications. A number of UMNs exist worldwide; however, BUCL is novel in its density, the low-cost nature of the sensors, and the use of proprietary Wi-Fi networks. This paper provides an overview of the logistical aspects of implementing a UMN test bed at such a density, including selecting appropriate urban sites; testing and calibrating low-cost, nonstandard equipment; implementing strict quality-assurance/quality-control mechanisms (including metadata); and utilizing preexisting Wi-Fi networks to transmit data. Also included are visualizations of data collected by the network, including data from the July 2013 U.K. heatwave as well as highlighting potential applications. The paper is an open invitation to use the facility as a test bed for evaluating models and/or other nonstandard observation techniques such as those generated via crowdsourcing techniques.

Dying young: a palaeopathological analysis of child health in Roman Britain

Children represent the most vulnerable members of society, and as such provide valuable insight into past lifeways. Adverse environmental conditions translate more readily into the osteological record of children, making them primary evidence for the investigation of ill-health in the past. To date, most information on growing up in Roman Britain has been based on the Classical literature, or discussed in palaeopathological studies with a regional focus, e.g. Dorset or Durnovaria. Thus, the lifestyles and everyday realities of children throughout Britannia remained largely unknown. This study sets out to fill this gap by providing the first large scale analysis of Romano-British children from town and country. The palaeopathological analysis of 1643 non-adult (0-17 years) skeletons, compiled from the literature (N=690) and primary osteological analysis (N=953), from 27 urban and rural settlements has highlighted diverse patterns in non-adult mortality and morbidity. The distribution of ages-at-death suggest that older children and adolescents migrated from country to town, possibly for commencing their working lives. True prevalence rates suggest that caries (1.8%) and enamel hypoplasia (11.4%) were more common in children from major urban towns, whereas children in the countryside displayed higher frequencies of scurvy (6.9%), cribra orbitalia (27.7%), porotic hyperostosis (6.2%) and endocranial lesions (10.9%). Social inequality in late Roman Britain may have been the driving force behind these urban-rural dichotomies. The results may point to exploitation of the peasantry on the one hand, and higher status of the urban population as a more ‘Romanised’ group on the other. Comparison with Iron Age and post-medieval non-adults also demonstrated a decline in health in the Roman period, with some levels of ill-health, particularly in the rural children, similar to those from post-medieval London. This research provides the most comprehensive study of non-adult morbidity and mortality in Roman Britain to date. It has provided new insights into Romano-British lifeways and presents suggestions for further work.

How do green roofs mitigate urban thermal stress under heat waves?

As the climate warms, heat waves (HW) are projected to be more intense and to last longer, with serious implications for public health. Urban residents face higher health risks because urban heat islands (UHIs) exacerbate HW conditions. One strategy to mitigate negative impacts of urban thermal stress is the installation of green roofs (GRs) given their evaporative cooling effect. However, the effectiveness of GRs and the mechanisms by which they have an effect at the scale of entire cities are still largely unknown. The Greater Beijing Region (GBR) is modeled for a HW scenario with the Weather Research and Forecasting (WRF) model coupled with a state-of-the-art urban canopy model (PUCM) to examine the effectiveness of GRs. The results suggest GR would decrease near-surface air temperature (ΔT2max = 2.5 K) and wind speed (ΔUV10max = 1.0 m s-1) but increase atmospheric humidity (ΔQ2max = 1.3 g kg-1). GRs are simulated to lessen the overall thermal stress as indicated by apparent temperature (ΔAT2max = 1.7 °C). The modifications by GRs scale almost linearly with the fraction of the surface they cover. Investigation of the surface-atmosphere interactions indicate that GRs with plentiful soil moisture dissipate more of the surface energy as latent heat flux and subsequently inhibit the development of the daytime planetary boundary layer (PBL). This causes the atmospheric heating through entrainment at the PBL top to be decreased. Additionally, urban GRs modify regional circulation regimes leading to decreased advective heating under HW.

Prevalence of untreated caries in deciduous teeth in urban and rural areas in the state of Sao Paulo, Brazil

Objectives. To describe the prevalence of dental caries in children with deciduous teeth in urban and rural areas in the state of Sao Paulo, Brazil, and to identify associated factors. Methods. The study included 24 744 children ( 5 - 7 years of age) examined as part of an epidemiological survey on oral health carried out in the state of Sao Paulo ( Levan-tamento Epidemiologico de Sa de Bucal do Estado de Sao Paulo). Multilevel analysis was used to investigate whether the prevalence of untreated caries was associated with the sociodemographic characteristics of the children examined or with the socioeconomic aspects of the participating cities. Results. Being black or brown ( adjusted odds ratio ( OR) = 1.27), attending school in rural areas ( adjusted OR = 1.88), and attending public school ( adjusted OR = 3.41) were identified as determinants for an increased probability of presenting deciduous teeth with untreated caries. Being a female ( adjusted OR = 0.83) was identified as a protective factor. The negative coefficients obtained for second- level independent variables indicate that the oral health profile of the cities included in the study were positively impacted by a higher municipal human development index ( beta = - 0.47) and fluoridated drinking water ( beta = - 0.32). Conclusions. The prevalence of untreated caries is influenced by individual and sociodemographic factors. The present study provides epidemiological information concerning the rural areas in the state of Sao Paulo. This information is useful for strategic planning and for establishing guidelines for oral health actions in local health systems, thereby contributing to oral health equity.

Risk of Giardia infection for drinking water and bathing in a peri-urban area in Sao Paulo, Brazil

A high incidence of waterborne diseases is observed worldwide and in order to address contamination problems prior to an outbreak, quantitative microbial risk assessment is a useful tool for estimating the risk of infection. The objective of this paper was to assess the probability of Giardia infection from consuming water from shallow wells in a peri-urban area. Giardia has been described as an important waterborne pathogen and reported in several water sources, including ground waters. Sixteen water samples were collected and examined according to the US EPA (1623, 2005). A Monte Carlo method was used to address the potential risk as described by the exponential dose response model. Giardia cysts occurred in 62.5% of the samples (0.1-36.1 cysts/l). A median risk of 10-1 for the population was estimated and the adult ingestion was the highest risk driver. This study illustrates the vulnerability of shallow well water supply systems in peri-urban areas.

Methods and background characteristics of the TOHNN study : a population-based study of oral health conditions in northern Norway

OBJECTIVES: The aim of the Tromstannen - Oral Health in Northern Norway (TOHNN) study was to investigate oral health and dental-related diseases in an adult population. This article provides an overview of the background of the study and a description of the sample characteristics and methods employed in data collection. STUDY DESIGN: Cross-sectional population-based study including a questionnaire and clinical dental examination. METHODS: A randomly selected sample of 2,909 individuals (20-79 years old) drawn from the population register was invited to participate in the study. The data were collected between October 2013 and November 2014 in Troms County in northern Norway. The questionnaire focused on oral health-related behaviours and attitudes, oral health-related quality of life, sense of coherence, dental anxiety and symptoms from the temporomandibular joint. The dental examinations, including radiographs, were conducted by 11 dental teams in 5 dental offices. The examination comprised of registration of dental caries, full mouth periodontal status, temporomandibular disorders, mucosal lesions and height and weight. The participants were grouped by age (20-34, 35-49, 50-64 and 65-79) and ethnicity (Norwegian, Sámi, other European and other world). RESULTS: From the original sample of 2,909 individuals, 1,986 (68.3%) people participated, of whom 1,019 (51.3%) were women. The highest attendance rate was among women 20-34 years old (80.3%) and the lowest in the oldest age group of women (55.4%). There was no difference in response rate between rural and urban areas. There was a positive correlation between population size and household gross income (p < 0.001) and education level (p < 0.001). The majority of Sámi resided in smaller municipalities. In larger cities, most participants used private dental health care services, whereas, in rural areas, most participants used the public dental health care service. CONCLUSION: The TOHNN study has the potential to generate new knowledge on a wide range of oral health conditions beneficial to the population in Troms County. Due to the high participation rate, generalization both nationally and to the circumpolar area ought to be possible.

An `upside-down` view of rural health care

Access to high quality health care services plays an important part in the health of rural communities and individuals. This fact is reflected in efforts by governments to improve the quality of such services through better targeting of funds and more efficient management of services. In Australia, the difficulties experienced by rural communities in attracting and retaining doctors has long been recognized as a contributing factor to the relatively higher levels of morbidity and mortality in rural areas. However, this paper, based on a study of two small rural communities in Australia, suggests that resolving the health problems of rural communities will require more than simply increasing the quality and accessibility of health services. Health and well-being in such communities relates as much to the sense of community cohesion as it does to the direct provision of medical services. Over recent years, that cohesion has diminished, undermined in part by government policies that have fuelled an exodus from small rural communities to urban areas. Until governments begin to take an 'upside-down' perspective, focusing on building healthy communities rather than simply on building hospitals to make communities healthy, the disadvantages faced by rural people will continue to be exacerbated.

Playing their part: the role of physical activity and sport in sustaining the health and well being of small rural communities

It is widely recognised that the health of rural Australians is poor in comparison with their urban counterparts. Similarly, the role played by physical activity in maintaining health has been well researched and is well documented. However, little appears to have been published in recent years about the links between physical activity and health in rural communities. The objective of this article was to begin to address that gap. To achieve this, the article drew on research conducted in two small rural communities in Victoria Australia, and highlighted the role that physical activity and sport played in sustaining the health and wellbeing of individuals and communities in rural areas. Taking the World Health Organisation's definition of health (a state of complete physical, mental and social well-being and not merely the absence of disease) as its measure, the paper highlighted the many ways in which physical activity and sport in rural communities contribute to physical health, mental wellbeing and social cohesiveness. Based this finding, the authors suggest that physical activity and sport make a significant contribution to the health and wellbeing of rural people and their communities and suggest that further research is necessary to better define this apparent contribution.

Multiple sclerosis and economic well being: role of health, age, and duration of illness

This study used quantitative and qualitative techniques to examine the role of health, age, and duration of illness among people with multiple sclerosis (MS) in their economic well-being. Participants were 113 adults (31 males and 82 females) with MS who lived in urban and rural regions of Australia. The results demonstrated that health and age had a significant impact on both the economic well-being and psychological adjustment of people who contract this disorder. Different health variables predicted different aspects of economic well-being. Fatigue was the major health variable that predicted costs of MS and economic pressure, with age also predicting economic pressure, whereas income levels were predicted by cognitive confusion and mobility problems. Duration of illness, gender, and urban/rural location were not significant predictors of the economic variables. These results demonstrate the importance of obtaining multiple measures of economic well-being, as well as a broad range of health-related measures, in determining the impact of MS on the economic well-being of people with this disorder.

Healthy nature healthy people: 'contact with nature' as an upstream health promotion intervention for populations

Whilst urban-dwelling individuals who seek out parks and gardens appear to intuitively understand the personal health and well-being benefits arising from `contact with nature', public health strategies are yet to maximize the untapped resource nature provides, including the benefits of nature contact as an upstream health promotion intervention for populations. This paper presents a summary of empirical, theoretical and anecdotal evidence drawn from a literature review of the human health benefits of contact with nature. Initial findings indicate that nature plays a vital role in human health and well-being, and that parks and nature reserves play a significant role by providing access to nature for individuals. Implications suggest contact with nature may provide an effective population-wide strategy in prevention of mental ill health, with potential application for sub-populations, communities and individuals at higher risk of ill health. Recommendations include further investigation of `contact with nature' in population health, and examination of the benefits of nature-based interventions. To maximize use of `contact with nature' in the health promotion of populations, collaborative strategies between researchers and primary health, social services, urban planning and environmental management sectors are required. This approach offers not only an augmentation of existing health promotion and prevention activities, but provides the basis for a socio-ecological approach to public health that incorporates environmental sustainability.