The Health Economic Assessment Tool (HEAT) for walking and cycling - experiences from 10 years of application of a health impact assessment tool in policy and practice.

Introduction: In recent years, walking and cycling have moved into the focus as promising approaches to achieve public health, sustainable transport, climate goals and better urban resilience. However, they are only realistic transport and activity options for a large proportion of the population when they are safe, inclusive and convenient. One way to increase their recognition in transport policy is the inclusion of health impacts of walking and cycling into transport economic appraisals.

The impact of black carbon (BC) on mode-specific galvanic skin response (GSR) as a measure of stress in urban environments.

Previous research has shown that walking and cycling could help alleviate stress in cities, however there is poor knowledge on how specific microenvironmental conditions encountered during daily journeys may lead to varying degrees of stress experienced at that moment. We use objectively measured data and a robust causal inference framework to address this gap. Using a Bayesian Doubly Robust (BDR) approach, we find that black carbon exposure statistically significantly increases stress, as measured by Galvanic Skin Response (GSR), while cycling and while walking.

The MOBIS dataset: a large GPS dataset of mobility behaviour in Switzerland.

Unlabelled: This article presents the MOBIS dataset and underlying survey methods used in its collection. The MOBIS study was a nation-wide randomised controlled trial (RCT) of transport pricing in Switzerland, utilising a combination of postal recruitment, online surveys, and GPS tracking. 21,571 persons completed the first online survey, and 3680 persons completed 8 weeks of GPS tracking.

Integrated Impact Assessment of Active Travel: Expanding the Scope of the Health Economic Assessment Tool (HEAT) for Walking and Cycling.

The World Health Organization's Health Economic Assessment Tool (HEAT) for walking and cycling is a user-friendly web-based tool to assess the health impacts of active travel. HEAT, developed over 10 years ago, has been used by researchers, planners and policymakers alike in appraisals of walking and cycling policies at both national and more local scales. HEAT has undergone regular upgrades adopting the latest scientific evidence.

Cyclist crash rates and risk factors in a prospective cohort in seven European cities.

Increased cycling uptake can improve population health, but barriers include real and perceived risks. Crash risk factors are important to understand in order to improve safety and increase cycling uptake. Many studies of cycling crash risk are based on combining diverse sources of crash and exposure data, such as police databases (crashes) and travel surveys (exposure), based on shared geography and time.

Comparing the lung cancer burden of ambient particulate matter using scenarios of air quality standards versus acceptable risk levels.

Objectives: Ambient particulate matter (PM) is regulated with science-based air quality standards, whereas carcinogens are regulated with a number of "acceptable" cases. Given that PM is also carcinogenic, we identify differences between approaches.

Methods: We assessed the lung cancer deaths for Switzerland attributable to exposure to PM up to 10 µm (PM) and to five particle-bound carcinogens.

Correlates of Walking for Travel in Seven European Cities: The PASTA Project.

Background: Although walking for travel can help in reaching the daily recommended levels of physical activity, we know relatively little about the correlates of walking for travel in the European context.

Objective: Within the framework of the European Physical Activity through Sustainable Transport Approaches (PASTA) project, we aimed to explore the correlates of walking for travel in European cities.

Methods: The same protocol was applied in seven European cities.

Evaluation of Different Recruitment Methods: Longitudinal, Web-Based, Pan-European Physical Activity Through Sustainable Transport Approaches (PASTA) Project.

Background: Sufficient sample size and minimal sample bias are core requirements for empirical data analyses. Combining opportunistic recruitment with a Web-based survey and data-collection platform yields new benefits over traditional recruitment approaches.

Objective: This paper aims to report the success of different recruitment methods and obtain data on participants' characteristics, participation behavior, recruitment rates, and representativeness of the sample.

Effects of physical activity and air pollution on blood pressure.

Aim: To assess the main and interaction effects of black carbon and physical activity on arterial blood pressure in a healthy adult population from three European cities using objective personal measurements over short-term (hours and days) and long-term exposure.

Methods: A panel study of 122 healthy adults was performed in three European cities (Antwerp, Barcelona, and London). In 3 seasons between March 2015 and March 2016, each participant wore sensors for one week to objectively measure their exposure to black carbon and monitor their physical activity continuously.

The effects of transport mode use on self-perceived health, mental health, and social contact measures: A cross-sectional and longitudinal study.

Background: Transport mode choice has been associated with different health risks and benefits depending on which transport mode is used. We aimed to evaluate the association between different transport modes use and several health and social contact measures.

Methods: We based our analyses on the Physical Activity through Sustainable Transport Approaches (PASTA) longitudinal study, conducted over a period of two years in seven European cities.

Transport mode choice and body mass index: Cross-sectional and longitudinal evidence from a European-wide study.

Background: In the fight against rising overweight and obesity levels, and unhealthy urban environments, the renaissance of active mobility (cycling and walking as a transport mode) is encouraging. Transport mode has been shown to be associated to body mass index (BMI), yet there is limited longitudinal evidence demonstrating causality. We aimed to associate transport mode and BMI cross-sectionally, but also prospectively in the first ever European-wide longitudinal study on transport and health.

Health impact assessment of cycling network expansions in European cities.

We conducted a health impact assessment (HIA) of cycling network expansions in seven European cities. We modeled the association between cycling network length and cycling mode share and estimated health impacts of the expansion of cycling networks. First, we performed a non-linear least square regression to assess the relationship between cycling network length and cycling mode share for 167 European cities.

Towards a Comprehensive Conceptual Framework of Active Travel Behavior: a Review and Synthesis of Published Frameworks.

Purpose Of Review: This paper reviews the use of conceptual frameworks in research on active travel, such as walking and cycling. Generic framework features and a wide range of contents are identified and synthesized into a comprehensive framework of active travel behavior, as part of the Physical Activity through Sustainable Transport Approaches project (PASTA). PASTA is a European multinational, interdisciplinary research project on active travel and health.

Policies to Promote Active Travel: Evidence from Reviews of the Literature.

Purpose Of Review: While many levels of government recognize that walking and cycling (active travel) are critical to healthy cities, a continued challenge is to identify and prioritize strategies that will increase walking and cycling for transportation. We review evidence on policies that can increase active travel.

Recent Findings: The reviews included here conclude that policies related to active travel may operate at various levels of the socio-ecological framework, including society, cities, routes or individuals.

Physical activity and sedentary behaviour in daily life: A comparative analysis of the Global Physical Activity Questionnaire (GPAQ) and the SenseWear armband.

Reduction of sedentary time and an increase in physical activity offer potential to improve public health. However, quantifying physical activity behaviour under real world conditions is a major challenge and no standard of good practice is available. Our aim was to compare the results of physical activity and sedentary behaviour obtained with a self-reported instrument (Global Physical Activity Questionnaire (GPAQ)) and a wearable sensor (SenseWear) in a repeated measures study design.

Health benefits of a reduction of PM and NO exposure after implementing a clean air plan in the Agglomeration Lausanne-Morges.

Exposure to urban air pollution has been associated with adverse effects on cardio-vascular and respiratory health, both short and long term. Consequently, governments have applied policies to reduce air pollution. Quantitative health impact assessments of hypothetic changes in air pollution have been conducted at national and global level, but assessments of observed air pollution changes associated with specific clean air policies at a local or regional scale remain scarce.

Wearable Sensors for Personal Monitoring and Estimation of Inhaled Traffic-Related Air Pollution: Evaluation of Methods.

Physical activity and ventilation rates have an effect on an individual's dose and may be important to consider in exposure-response relationships; however, these factors are often ignored in environmental epidemiology studies. The aim of this study was to evaluate methods of estimating the inhaled dose of air pollution and understand variability in the absence of a true gold standard metric. Five types of methods were identified: (1) methods using (physical) activity types, (2) methods based on energy expenditure, METs (metabolic equivalents of task), and oxygen consumption, (3) methods based on heart rate or (4) breathing rate, and (5) methods that combine heart and breathing rate.

Can air pollution negate the health benefits of cycling and walking?

Active travel (cycling, walking) is beneficial for the health due to increased physical activity (PA). However, active travel may increase the intake of air pollution, leading to negative health consequences. We examined the risk-benefit balance between active travel related PA and exposure to air pollution across a range of air pollution and PA scenarios.

Physical Activity through Sustainable Transport Approaches (PASTA): a study protocol for a multicentre project.

Introduction: Only one-third of the European population meets the minimum recommended levels of physical activity (PA). Physical inactivity is a major risk factor for non-communicable diseases. Walking and cycling for transport (active mobility, AM) are well suited to provide regular PA.

Physical Activity through Sustainable Transport Approaches (PASTA): protocol for a multi-centre, longitudinal study.

Background: Physical inactivity is one of the leading risk factors for non-communicable diseases, yet many are not sufficiently active. The Physical Activity through Sustainable Transport Approaches (PASTA) study aims to better understand active mobility (walking and cycling for transport solely or in combination with public transport) as an innovative approach to integrate physical activity into individuals' everyday lives. The PASTA study will collect data of multiple cities in a longitudinal cohort design to study correlates of active mobility, its effect on overall physical activity, crash risk and exposure to traffic-related air pollution.

Health impact assessment of active transportation: A systematic review.

Objective: Walking and cycling for transportation (i.e. active transportation, AT), provide substantial health benefits from increased physical activity (PA).

Contrasts in active transport behaviour across four countries: how do they translate into public health benefits?

Objective: Countries and regions vary substantially in transport related physical activity that people gain from walking and cycling and in how this varies by age and gender. This study aims to quantify the population health impacts of differences between four settings.

Method: The Integrated Transport and Health Model (ITHIM) was used to estimate health impacts from changes to physical activity that would arise if adults in urban areas in England and Wales adopted travel patterns of Switzerland, the Netherlands, and California.

Systematic review and meta-analysis of reduction in all-cause mortality from walking and cycling and shape of dose response relationship.

Background And Objective: Walking and cycling have shown beneficial effects on population risk of all-cause mortality (ACM). This paper aims to review the evidence and quantify these effects, adjusted for other physical activity (PA).

Data Sources: We conducted a systematic review to identify relevant studies.

Active transport, physical activity, and body weight in adults: a systematic review.

Context: Physical activity has various health benefits. Active transport can contribute to total physical activity and thus affect body weight because of increased energy expenditure. This review summarizes published evidence on associations of active transport, general physical activity, and body weight in adults.

Costs and benefits of bicycling investments in Portland, Oregon.

Background: Promoting bicycling has great potential to increase overall physical activity; however, significant uncertainty exists with regard to the amount and effectiveness of investment needed for infrastructure. The objective of this study is to assess how costs of Portland's past and planned investments in bicycling relate to health and other benefits.

Methods: Costs of investment plans are compared with 2 types of monetized health benefits, health care cost savings and value of statistical life savings.