Investigating the Impact of London's Ultra Low Emission Zone on Children's Respiratory Health
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 3,312
- 试验地点
- 2
- 主要终点
- Lung function growth as change in forced expiratory volume in one second (FEV1) per year
研究概览
简要总结
Investigating the impact of London's Ultra Low Emission Zone on children's respiratory health
详细描述
Strong evidence links urban air pollution to restrictions in children's lung growth and development and other adverse effects, including increases in respiratory and allergy symptoms, respiratory infections, asthma, and health care use. Effective interventions are urgently needed that reduce air pollution and improve child health. Low Emission Zones (LEZ) are becoming widespread but are expensive to implement and of unproven health benefit. London has some of the worst air pollution in Europe. London's Ultra Low Emission Zone (ULEZ) is the central component of London's air quality strategy. Its implementation provides a unique opportunity to test the impact of a city-wide LEZ on children's health.
The intervention:
The ULEZ is an area within which all vehicles must meet exhaust emission standards or pay a daily charge to travel. It will be implemented and paid for by Transport for London. Starting in 2019, the ULEZ will initially cover London's central Congestion Charging Zone, an area bounded by the London Inner Ring Road, that includes the City of London plus adjacent areas of eight radially adjoining Boroughs. It is projected to deliver for central London by 2020 emission reductions of -49% for NOx; - 47% for NO2; and -11% for PM10. Subject to consultation, the ULEZ will subsequently extend to include an inner London area (within London's North and South Circular roads), and a London-wide area, for heavy vehicles only.
Questions:
- What is the impact of the ULEZ on children's lung growth (the primary outcome)?
- What is the impact of the ULEZ on secondary outcomes, including self-reported symptoms, respiratory infection, health care use and costs?
- Does the ULEZ reduce health inequalities? 4) Is the ULEZ good value for money?
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 9 Years 至 9 Years（Child）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Inclusion criteria for schools:
- •Primary schools within, or with catchment areas that include, the Central London ULEZ.
- •Primary schools within the Borough of Luton and town of Dunstable.
- •State or independent sectors.
- •Inclusion criteria for children:
- •Children attending a study school, in years 2, 3, or 4, at study inception.
排除标准
- •Exclusion criteria for schools:
- •Schools that are not primary schools within the above boundaries.
- •Exclusion criteria for children:
- •Children with learning or physical disabilities sufficient for them to be unable to give informed assent to the study, or to carry out study procedures.
- •Children with major lung disease (not including asthma).
研究组 & 干预措施
London (intervention)
1606 children aged 6-9 yrs old, recruited in 44 London primary schools (years 2-4) within the Central London ULEZ area
干预措施: Ultra Low Emission Zone (ULEZ) (Other)
Luton (comparison)
1706 children aged 6-9 yrs old, recruited in 41 Luton and Dunstable primary schools (years 2-4)
结局指标
主要结局
Lung function growth as change in forced expiratory volume in one second (FEV1) per year
时间窗: Four years, 2018 -2021
Measured by annual spirometry, as annual change in FEV1/year over 4 years
次要结局
- Air quality, nitrogen dioxide (NO2) concentration derived from the the KCLUrban dispersion model(Four years, 2018 -2021)
- Annual prevalence of wheeze, as proportion (%) of respondents reporting wheeze(Four years, 2018 -2021)
- Annual prevalence/participant of upper respiratory tract infections(Four years, 2018 -2021)
- Annual prevalence/participant of lower respiratory tract infections(Four years, 2018 -2021)
- Air quality, oxides of nitrogen (NOx) concentration derived from the KCLUrban dispersion model(Four years, 2018 -2021)
- Lung capacity as FVC (forced vital capacity)(Four years, 2018 -2021)
- Annual prevalence of rhinitis, as proportion (%) of respondents reporting rhinitis(Four years, 2018 -2021)
- Cognitive function as average Movement Time in seconds (MT) on the Clinical Kinematic Assessment Test(Three years, 2019 -2021)
- Annual prevalence of eczema, as proportion (%) of respondents reporting eczema(Four years, 2018 -2021)
- Annual health care costs per participant(Four years, 2018 -2021)
- Physical activity, as Percentage time in Moderate to Vigorous Physical activity per participant (MVPA)(Four years, 2018 -2021)
- Annual health care use per participant(Four years, 2018 -2021)
- Child Quality of Life as score out of 40(Four years, 2018 -2021)
- Air quality, particulate matter diameter <2.5microns derived from the KCLUrban dispersion model(Four years, 2018 -2021)