Effects of air pollution on cardiopulmonary disease in urban and peri-urban residents in Beijing

In the last few decades China's rising energy requirements have led to increased air pollution emissions from coal-fired power plants. Its motorized transport growth is the fastest in the world with the number of motor vehicles projected to quadruple in the next two decades, reaching over 380 million by 2030. Meanwhile, nearly half of all Chinese still cook and heat their homes with highly polluting biomass and coal fuels. The resulting particulate matter (PM) concentrations in the majority of Chinese cities routinely exceed the World Health Organization's (WHO) annual Air Quality Guideline of 10 microgrammes/m3 by a factor of 10 or more.

Epidemiologic studies undertaken in China increasingly confirm links between poor air quality and a range of health risks previously observed in the West. Moreover, they confirm that the number of Chinese that are vulnerable to air pollution is increasing, as evidenced by a large and growing burden of disease from chronic non-communicable diseases - such as ischemic heart disease (IHD), cerebrovascular disease, chronic obstructive pulmonary disease (COPD), and cancer. Research to enhance the understanding of the impact of environmental exposures on human health is needed to influence both government policy on pollution and also individual behaviours. The outcomes of the research described in this proposal will extend our understanding of the impact of air pollution on human health to a megacity in the world's largest country and promote evidence-based policies that in turn may greatly improve the health and quality of life of China's ageing population - both of which are important sustainable development aims.

Working closely with Chinese scientists we will recruit a panel of 240 subjects from urban and peri-urban Beijing. Subjects will be recruited from two existing populations cohorts (PRC-USA and INTERMAP) ensuring a rich source of baseline data and stored samples for access. Across the project period we will obtain detailed information on the current health status of the subjects, details of the personal exposure to air pollution and biosamples for biomarker analysis.

The UK has been at the heart of the scientific study of air pollution issues over many decades, whereas such scientific studies are much newer in China. Although the Chinese teams have developed a high level of expertise in some areas, the UK team will provide strong complementary expertise, in particular in personal exposure air pollution measurements and biomarker analysis. Inherent throughout however is the synergistic combination of Chinese expertise and capability, complementary UK air quality instrumentation and health expertise. Therefore, this project will serve as a new platform to further enhance the research capacity of the Chinese teams in air pollution and its impact on health, which will leave a legacy beyond the project lifetime, thus contributing to the continuous improvement of life and welfare of more than a billion people.

We will develop three specific impact activities within the project.
1. Support Chinese collaborators in their role as influencers of policy and practice in Beijing and China
2. Public understanding of the science and impacts of urban air pollution.
3. Translation of AIRLESS science to other megacities in Asia.

1. Supporting impact pathways for Chinese collaborators
With the top Chinese officials showing a strong political will and suggesting it is the time to win the war against air pollution. (Premier Keqiang Li declared a war against air pollution in early 2014) the playing field is set for strong science to play a leading role in this challenge. Within the modest resources available and constraints of the project our focus on impact will be through engagement with decision makers. Our role as an influencer and by extension our route to impact is via our Chinese collaborators at Peking University. We will use our considerable experiences of working with agencies in the UK, Defra, EA, and GLA to help guide our input.. A policymakers project summary document and presentation will be produced in collaboration with Chinese partners, and delivered to key decision makers at the end of the project at a dedicated meeting hosted by Chinese collaborators.
Costs: - Policymakers summary, materials and joint meeting in Beijing (£1540 UK Travel and £1,000 contribution to meeting costs).

2. Public understanding of science
The public profile of air pollution is currently high, both in China and the UK. Hardly a week passes without articles in the media mentioning the 'haze;' in China or the NO2 problem in the UK. Such high profile media attention provides opportunities for potential engagement with the public on the underlying science, and also potentially with a range of NGOs. Our experience in operating the London Air Quality Network (LAQN) has shown us that the best approach is to provide the public with a clear message and to make all underlying data freely available to instil confidence.

All the UK PI's are already active players in science dissemination with media appearances, talks at high profile science events as well as school visits and production of outreach materials. This work is ongoing and enduring and we identify that the most effective role for AIRLESS is to provide new data to illustrate the challenges facing those living and working in developing Megacities. All supporting materials produced will be open access, scientifically robust, but neutral on policy, they have the potential to be used effectively by others engaged in similar activities in the UK, China and elsewhere.
Key outputs - new visual and demonstration materials for use in existing outreach programmes (no staff cost, £1,000 for production of materials).

3. Translating AIRLESS science to other megacities
The PI's of this project have a track record of successful engagement in the UK and at a European level. This project focusing on air quality and health in China's capital city, Beijing, provides some special opportunities in terms of scale of impact. Any science that leads to a change in policy or practice that results in cleaner air in China has the potential to have a vast health and economic benefit.

Whilst no two cities are identical, many of the underlying causes of air pollution in Beijing can be found in other developing cities, and much of the science and capability developed may have applicability in other locations. We will work with the other themes to host a (London) event targeted at overseas development agencies such as DfID and key aid and policy organisations highlighting the state of the science, and how this may be used to help countries identify their particular air quality challenges and most effective interventions for their subjects.
Key Outputs: - End of project event targeting development and overseas aid organisations (£1,000 meeting costs, but with expected contributions from other projects