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Background: Emerging evidence points to the beneficial role of greenspace exposure in promoting cardiovascular health. Most studies have evaluated such associations with conventional cardiovascular endpoints such as mortality, morbidity, or macrovascular markers. In comparison, the microvasculature, a crucial compartment of the vascular system where early subclinical signs of cardiovascular problems appear, has not been studied in association with greenspace exposure. The current study assessed the association between surrounding greenness and microvascular status, as assessed by retinal vessel diameters., Methods: This study included a sample of healthy adults (n = 114 and 18-65 years old) residing in three European cities [Antwerp (Belgium), Barcelona (Spain), and London (UK)]. The exposures to greenspace at the home and work/school locations were characterized as average surrounding greenness [normalized difference vegetation index (NDVI)] within buffers of 100 m, 300 m, and 500 m. The central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were calculated from fundus pictures taken at three different time points. We developed linear mixed-effect models to estimate the association of greenspace exposure with indicators of retinal microvasculature, adjusted for relevant individual and area-level covariates., Results: We observed the most robust associations with CRVE. Higher levels of greenspace at work/school were associated with smaller retinal venules [(seasonal NDVI) 300m: 3.85, 95%CI -6.67,-1.03; 500m: 5.11, 95%CI -8.04, -2.18]. Findings for surrounding greenness and CRAE were not conclusive., Conclusion: Our study suggests an association of greenspace exposure with better microvascular status, specifically for retinal venules. Future research is needed to confirm our findings across different contextual settings., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

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. Augmented Outcome Regression (AOR) models indicate that greenspace exposure and the presence of walking or cycling infrastructure could reduce stress. None of these effects are statistically significant for people in motorized transport. These findings add to a growing evidence-base on health benefits of policies aimed at decreasing air pollution, improving active travel infrastructure and increasing greenspace in cities., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Many aspects of our life are related to our mobility patterns and individuals can exhibit strong tendencies towards routine in their daily lives. Intrapersonal day-to-day variability in mobility patterns has been associated with mental health outcomes. The study aims were: (a) calculate intrapersonal day-to-day variability in mobility metrics for three cities; (b) explore interpersonal variability in mobility metrics by sex, season and city, and (c) describe intrapersonal variability in mobility and their association with perceived stress. Data came from the Physical Activity through Sustainable Transport Approaches (PASTA) project, 122 eligible adults wore location measurement devices over 7-consecutive days, on three occasions during 2015 (Antwerp: 41, Barcelona: 41, London: 40). Participants completed the Short Form Perceived Stress Scale (PSS-4). Day-to-day variability in mobility was explored via six mobility metrics using distance of GPS point from home (meters:m), distance travelled between consecutive GPS points (m) and energy expenditure (metabolic equivalents:METs) of each GPS point collected (n = 3,372,919). A Kruskal-Wallis H test determined whether the median daily mobility metrics differed by city, sex and season. Variance in correlation quantified day-to-day intrapersonal variability in mobility. Levene's tests or Kruskal-Wallis tests were applied to assess intrapersonal variability in mobility and perceived stress. There were differences in daily distance travelled, maximum distance from home and METS between individuals by sex, season and, for proportion of time at home also, by city. Intrapersonal variability across all mobility metrics were highly correlated; individuals had daily routines and largely stuck to them. We did not observe any association between stress and mobility. Individuals are habitual in their daily mobility patterns. This is useful for estimating environmental exposures and in fuelling simulation studies., Competing Interests: None., (© 2022 The Authors.)

Background: In Belgium, the first COVID-19 death was reported on 10 March 2020. Nursing home (NH) residents are particularly vulnerable for COVID-19, making it essential to follow-up the spread of COVID-19 in this setting. This manuscript describes the methodology of surveillance and epidemiology of COVID-19 cases, hospitalizations and deaths in Belgian NHs., Methods: A COVID-19 surveillance in all Belgian NHs (n = 1542) was set up by the regional health authorities and Sciensano. Aggregated data on possible/confirmed COVID-19 cases and hospitalizations and case-based data on deaths were reported by NHs at least once a week. The study period covered April-December 2020. Weekly incidence/prevalence data were calculated per 1000 residents or staff members., Results: This surveillance has been launched within 14 days after the first COVID-19 death in Belgium. Automatic data cleaning was installed using different validation rules. More than 99% of NHs participated at least once, with a median weekly participation rate of 95%. The cumulative incidence of possible/confirmed COVID-19 cases among residents was 206/1000 in the first wave and 367/1000 in the second wave. Most NHs (82%) reported cases in both waves and 74% registered ≥10 possible/confirmed cases among residents at one point in time. In 51% of NHs, at least 10% of staff was absent due to COVID-19 at one point. Between 11 March 2020 and 3 January 2021, 11,329 COVID-19 deaths among NH residents were reported, comprising 57% of all COVID-19 deaths in Belgium in that period., Conclusions: This surveillance was crucial in mapping COVID-19 in this vulnerable setting and guiding public health interventions, despite limitations of aggregated data and necessary changes in protocol over time. Belgian NHs were severely hit by COVID-19 with many fatal cases. The measure of not allowing visitors, implemented in the beginning of the pandemic, could not avoid the spread of SARS-CoV-2 in the NHs during the first wave. The virus was probably often introduced by staff. Once the virus was introduced, it was difficult to prevent healthcare-associated outbreaks. Although, in contrast to the first wave, personal protective equipment was available in the second wave, again a high number of cases were reported., (© 2022. The Author(s).)

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. Using a web-based questionnaire, we collected information on total minutes of walking per week, individual characteristics, mobility behavior, and attitude ( N = 7,875 ). Characteristics of the built environment (the home and the work/study addresses) were determined with geographic information system (GIS)-based techniques. We conducted negative binomial regression analyses, including city as a random effect. Factor and principal component analyses were also conducted to define profiles of the different variables of interest., Results: Living in high-density residential areas with richness of facilities and density of public transport stations was associated with increased walking for travel, whereas the same characteristics at the work/study area were less strongly associated with the outcome when the residential and work/study environments were entered in the model jointly. A walk-friendly social environment was associated with walking for travel. All three factors describing different opinions about walking (ranging from good to bad) were associated with increased minutes of walking per week, although the importance given to certain criteria to choose a mode of transport provided different results according to the criteria., Discussion: The present study supports findings from previous research regarding the role of the built environment in the promotion of walking for travel and provides new findings to help in achieving sustainable, healthy, livable, and walkable cities. https://doi.org/10.1289/EHP4603.

Introduction: Air pollution, a risk factor for cardiovascular diseases, can exert its effects through the microcirculation. Retinal blood vessel width is considered a marker for microvascular health and is associated with short-term PM10 exposure. microRNAs are key regulators of complex biological processes in cardiovascular health and disease and miRNA expression can be affected by air pollution exposure. Studies investigating the effect of ambient air pollution exposure on miRNA expression in combination with an assessment of the microvasculature do not exist., Methods: 50 healthy adults (50% women, 23-58 years old) were examined once a month from December 2014 until April 2015 in Flanders (Belgium). Fundus photos and venous blood samples were collected during the study visits. PM10 data were obtained from a nearby monitoring station. Image analysis was used to calculate the width of retinal blood vessels, represented as the Central Retinal Arteriolar/Venular Equivalent (CRAE/CRVE). Total miRNA was isolated from blood and the expression of miR-21, -146a and, -222 were measured using quantitative real-time PCR. Mixed models were used for statistical analysis., Results: Each short-term increase of 10µg/m(3) PM10 during the 24h preceding the study visit was associated with a 0.58µm decrease (95% CI: -1.16, -0.0005; p=0.056) in CRAE, a 0.99µm increase (95% CI: 0.18, 1.80; p=0.021) in CRVE, a 6.6% decrease (95% CI: -11.07, -2.17; p=0.0038) in miR-21 expression and a 6.7% decrease (95% CI: -10.70, -2.75; p=0.0012) in miR-222 expression. Each 10% increase in miR-21 was associated with a 0.14µm increase (95% CI: 0.0060, 0.24; p=0.046) in CRAE whereas a similar increase in miR-222 expression was associated with a 0.28µm decrease (95% CI: -0.50, -0.062; p=0.016) in CRVE. These associations were also found in exposure windows ranging from 2h to 1 week. Finally, we observed that the association between PM10 exposure and CRAE was mediated by miRNA-21 expression., Conclusion: PM10 exposure was associated with retinal arteriolar narrowing and venular widening. PM10 exposure affected miRNAs that are involved in inflammatory and oxidative stress pathways. We suggest that miRNA changes may be relevant to explain the association between PM10 and retinal vessel calibers., (Copyright © 2016 Elsevier Inc. All rights reserved.)

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. The European research project Physical Activity through Sustainable Transport Approaches (PASTA) pursues the following aims: (1) to investigate correlates and interrelations of AM, PA, air pollution and crash risk; (2) to evaluate the effectiveness of selected interventions to promote AM; (3) to improve health impact assessment (HIA) of AM; (4) to foster the exchange between the disciplines of public health and transport planning, and between research and practice., Methods and Analysis: PASTA pursues a mixed-method and multilevel approach that is consistently applied in seven case study cities. Determinants of AM and the evaluation of measures to increase AM are investigated through a large scale longitudinal survey, with overall 14,000 respondents participating in Antwerp, Barcelona, London, Örebro, Rome, Vienna and Zurich. Contextual factors are systematically gathered in each city. PASTA generates empirical findings to improve HIA for AM, for example, with estimates of crash risks, factors on AM-PA substitution and carbon emissions savings from mode shifts. Findings from PASTA will inform WHO's online Health Economic Assessment Tool on the health benefits from cycling and/or walking. The study's wide scope, the combination of qualitative and quantitative methods and health and transport methods, the innovative survey design, the general and city-specific analyses, and the transdisciplinary composition of the consortium and the wider network of partners promise highly relevant insights for research and practice., Ethics and Dissemination: Ethics approval has been obtained by the local ethics committees in the countries where the work is being conducted, and sent to the European Commission before the start of the survey. The PASTA website (http://www.pastaproject.eu) is at the core of all communication and dissemination activities., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Background: Ultrafine particles (UFP) may contribute to the cardiovascular effects of particulate air pollution, partly because of their relatively efficient alveolar deposition., Objective: In this study, we assessed associations between blood pressure and short-term exposure to air pollution in a population of schoolchildren., Methods: In 130 children (6-12 years of age), blood pressure was determined during two periods (spring and fall 2011). We used mixed models to study the association between blood pressure and ambient concentrations of particulate matter and ultrafine particles measured in the schools' playground., Results: Independent of sex, age, height, and weight of the child, parental education, neighborhood socioeconomic status, fish consumption, heart rate, school, day of the week, season, wind speed, relative humidity, and temperature on the morning of examination, an interquartile range (860 particles/cm3) increase in nano-sized UFP fraction (20-30 nm) was associated with a 6.35 mmHg (95% CI: 1.56, 11.14; p = 0.01) increase in systolic blood pressure. For the total UFP fraction, systolic blood pressure was 0.79 mmHg (95% CI: 0.07, 1.51; p = 0.03) higher, but no effects on systolic blood pressure were found for the nano-sized fractions with a diameter > 100 nm, nor PM2.5, PMcoarse, and PM10. Diastolic blood pressure was not associated with any of the studied particulate mass fractions., Conclusion: Children attending school on days with higher UFP concentrations (diameter < 100 nm) had higher systolic blood pressure. The association was dependent on UFP size, and there was no association with the PM2.5 mass concentration.

Exposure to ambient particulate matter and elevated blood pressure are risk factors for cardiovascular morbidity and mortality. Microvascular changes might be an important pathway in explaining the association between air pollution and blood pressure. The objective of the study was to evaluate the role of the retinal microcirculation in the association between black carbon (BC) exposure and blood pressure. We estimated subchronic BC exposure based on 1-week personal measurements (μ-Aethalometer, AethLabs) in 55 healthy nurses. Blood pressure and retinal microvasculature were measured on four different days (range: 2-4) during this week. Subchronic BC exposure averaged (± SD) 1334±631ng/m(3) and ranged from 338ng/m(3) to 3889ng/m(3). An increased exposure of 631ng/m(3) BC was associated with a 2.77mmHg (95% CI: 0.39 to 5.15, p=0.027) increase in systolic blood pressure, a 2.35mmHg (95% CI: 0.52 to 4.19, p=0.016) increase in diastolic blood pressure and with 5.65μm (95% CI: 1.33 to 9.96, p=0.014) increase in central retinal venular equivalent. Mediation analysis failed to reveal an effect of retinal microvasculature in the association between blood pressure and subchronic BC exposure. In conclusion, we found a positive association between blood pressure and subchronic black carbon exposure in healthy adults. This finding adds evidence to the association between black carbon exposure and cardiovascular health effects, with elevated blood pressure as a plausible intermediate effector. Our results suggest that the changes in a person's blood pressure as a result of subchronic black carbon exposure operate independently of the retinal microcirculation., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Several studies show that a significant portion of daily air pollution exposure, in particular black carbon (BC), occurs during transport. In a previous work, a model for the in-traffic exposure of bicyclists to BC was proposed based on spectral evaluation of mobile noise measurements and validated with BC measurements in Ghent, Belgium. In this paper, applicability of this model in a different cultural context with a totally different traffic and mobility situation is presented. In addition, a similar modeling approach is tested for particle number (PN) concentration. Indirectly assessing BC and PN exposure through a model based on noise measurements is advantageous because of the availability of very affordable noise monitoring devices. Our previous work showed that a model including specific spectral components of the noise that relate to engine and rolling emission and basic meteorological data, could be quite accurate. Moreover, including a background concentration adjustment improved the model considerably. To explore whether this model could also be used in a different context, with or without tuning of the model parameters, a study was conducted in Bangalore, India. Noise measurement equipment, data storage, data processing, continent, country, measurement operators, vehicle fleet, driving behavior, biking facilities, background concentration, and meteorology are all very different from the first measurement campaign in Belgium. More than 24h of combined in-traffic noise, BC, and PN measurements were collected. It was shown that the noise-based BC exposure model gives good predictions in Bangalore and that the same approach is also successful for PN. Cross validation of the model parameters was used to compare factors that impact exposure across study sites. A pooled model (combining the measurements of the two locations) results in a correlation of 0.84 when fitting the total trip exposure in Bangalore. Estimating particulate matter exposure with traffic noise measurements was thus shown to be a valid approach across countries and cultures., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Introduction: This explorative study examines personal and neighbourhood characteristics associated with short-distance trips made by car, bicycle or walking in order to identify target groups for future interventions., Methods: Data were derived from 'Mobility Research Netherlands (2004-2009; MON)', a dataset including information regarding trips made by household members (n = ±53,000 respondents annually). Using postal codes of household addresses, MON data were enriched with data on neighbourhood typologies. Multilevel logistic modelling was used to calculate odds ratio (OR) of active transport versus car use associated with four different trip purposes (shopping (reference), commuting, taking or bringing persons or sports). A total of 277,292 short distance trips made by 102,885 persons were included in analyses., Results: Compared to women shopping, women less often take active transport to sports clubs (OR = 0.88) and men less often take active transport for shopping (OR = 0.92), or for bringing or taking persons (OR = 0.76). Those aged 25-34 years (OR = 0.83) and 35-44 years (OR = 0.96) were more likely to use active transport for taking or bringing persons than persons belonging to the other age groups (relative to trips made for shopping by those 65 years or over). A higher use of active transport modes by persons with an university or college degree was found and particularly persons living in urban-centre neighbourhoods were likely to use active transport modes., Conclusion: IN DEVELOPING POLICIES PROMOTING A MODE SHIFT SPECIAL ATTENTION SHOULD BE GIVEN TO THE FOLLOWING GROUPS: a) men making short distance trips for taking or bringing persons, b) women making short distance trips to sport facilities, c) persons belonging to the age groups of 25-44 years of age, d) Persons with a primary school or lower general secondary education degree and persons with a high school or secondary school degree and e) persons living in rural or urban-green neighbourhoods.

Background: Microcirculation plays an important role in the physiology of cardiovascular health. Air pollution is an independent risk factor for the development and progression of cardiovascular diseases, but the number of studies on the relation between air pollution and the microcirculation is limited., Objectives: We examined the relationship between short-term changes in air pollution and microvascular changes., Methods: We measured retinal microvasculature using fundus image analysis in a panel of 84 healthy adults (52% female), 22-63 years of age, during January-May 2012. Blood vessels were measured as central retinal arteriolar/venular equivalent (CRAE/CRVE), with a median of 2 measurements (range, 1-3). We used monitoring data on particulate air pollution (PM10) and black carbon (BC). Mixed-effect models were used to estimate associations between CRAE/CRVE and exposure to PM10 and BC using various exposure windows., Results: CRAE and CRVE were associated with PM10 and BC concentrations, averaged over the 24 hr before the retinal examinations. Each 10-µg/m3 increase in PM10 was associated with a 0.93-µm decrease (95% CI: -1.42, -0.45; p = 0.0003) in CRAE and a 0.86-µm decrease (95% CI: -1.42, -0.30; p = 0.004) in CRVE after adjusting for individual characteristics and time varying conditions such as ambient temperature. Each 1-µg/m3 increase in BC was associated with a 1.84-µm decrease (95% CI: -3.18, -0.51; p < 0.001) in CRAE., Conclusions: Our findings suggest that the retinal microvasculature responds to short-term changes in air pollution levels. These results support a mechanistic pathway through which air pollution can act as a trigger of cardiovascular events at least in part through effects on the microvasculature.

An attempt has been made to make a comprehensive emission inventory of particulate matter (PM) of various size fractions and also of heavy metals (HMs) emitted from mobile sources (both exhaust and non-exhaust) from the road transport of Delhi, India (1991-2006). COPERT-III and 4 models were mainly used toestimate these emissions. Results show that the annual exhaust emission of PM of size upto 2.5 micrometer (PM2.5) has increased from 3Gg to 4.5Gg during 1991-2006 irrespective of'improvement in vehicle-technology and fuel use. PM emission from exhaust and non-exhaust sources in general has increased. Heavy commercial vehicles-need attention to control particulate emission as it emerged as a predominant source of PM emissions. Among non-exhaust emissions of total suspended particulate matter (TSP), road-surface wear (~49%) has the prime contribution. As a result of-introduction of unleaded gasoline Pb has significantly reduced (~8 fold) whereas share of Cu and Zn are still considerable. Among non-exhaust sources, Pb release was the most significant one from tyre-wear whereas from break-wear, Cu release was found to be the most significant followed by Pb and Cr + Zn. Because of public health concerns further policies need to be developed to reduce emissions of PM and HMs from the road transport of megacity Delhi.

Purpose: Particulate matter (PM) exposure is linked to inflammation, neuroinflammation, and cognitive decline, whereas aerobic training improves cognition. We investigated the effects of PM exposure during aerobic training on inflammatory biomarkers, serum brain-derived neurotrophic factor (BDNF), an assumed mediator of exercise-induced cognitive improvements, and cognitive performance., Methods: Two groups of untrained volunteers completed an aerobic training program of 12 wk, 3 sessions a week: one group (n = 15) in an urban and another group (n = 9) in a rural environment. Ultrafine PM (UFPM) concentrations were measured during each training session. Aerobic fitness (Cooper test), BDNF serum levels, blood total and differential leukocyte counts, exhaled nitric oxide levels, and cognitive performance (Stroop task, Operation Span, and Psychomotor Vigilance task) were analyzed before and after the program., Results: UFPM concentrations were significantly higher in the urban environment compared with the rural environment (P = 0.006). Fitness levels improved equally (P < 0.0001) in both groups. Leukocyte counts (P = 0.02), neutrophil counts (P = 0.04), and exhaled nitric oxide levels (P = 0.002) increased after training in the urban group, whereas these parameters did not change in the rural group. The changes in these markers' levels after training showed a positive correlation with the personal average UFPM exposure during training. Reaction times on the Stroop task improved in the rural group (P = 0.001), but not in the urban group. No effects were found on BDNF levels, Operation Span, and Psychomotor Vigilance test performances., Conclusion: Aerobic training in an urban environment with high traffic-related air pollution increased inflammatory biomarkers, and, in contrast to aerobic training in a rural environment, cognitive performance on the Stroop task did not improve.

Context: Air pollution has been suggested to have an impact on the brain., Objective: The objective was to assess the expression of inflammation-related genes in the brains of mice that had been exposed for 5 days to a well-characterized traffic-polluted environment, i.e. a highway tunnel., Materials and Methods: Twenty C57BL6 mice were randomly allocated to four groups of five animals. Two groups were placed in the tunnel for 5 days (mean PM 2.5, 55.1 μg/m³, mean elemental carbon, EC 13.9 μg/m³) in cages with or without filter, two control groups were housed outside the tunnel. Animals were assessed within 24 hours after the last exposure day. Lung injury and inflammation were assessed by bronchoalveolar lavage (BAL) and histology. Blood leukocytosis and coagulation parameters were determined in peripheral blood. The olfactory bulb and hippocampus were analyzed for changes in expression of inflammatory genes and brain-derived neurotrophic factor (BDNF)., Results and Discussion: Although carbon particles were abundant in alveolar macrophages of exposed mice and absent in non-exposed mice, there was no evidence of pulmonary or systemic inflammation. There was an increased expression of genes involved in inflammatory response (COX2, NOS2, NOS3, and NFE2L2) in the hippocampus of the exposed mice. In the olfactory bulb, a downregulation was found for IL1α, COX2, NFE2L2, IL6, and BDNF., Conclusion: Although this short-term exposure to traffic-related pollution did not induce pulmonary or systemic inflammation, the expression of inflammatory genes was affected in different brain areas. The decreased BDNF expression in the olfactory bulb suggests lower brain neurotrophic support in response to traffic-related air pollution.

Background: Substantial policy changes to control obesity, limit chronic disease, and reduce air pollution emissions, including greenhouse gasses, have been recommended. Transportation and planning policies that promote active travel by walking and cycling can contribute to these goals, potentially yielding further co-benefits. Little is known, however, about the interconnections among effects of policies considered, including potential unintended consequences., Objectives and Methods: We review available literature regarding health impacts from policies that encourage active travel in the context of developing health impact assessment (HIA) models to help decision-makers propose better solutions for healthy environments. We identify important components of HIA models of modal shifts in active travel in response to transport policies and interventions., Results and Discussion: Policies that increase active travel are likely to generate large individual health benefits through increases in physical activity for active travelers. Smaller, but population-wide benefits could accrue through reductions in air and noise pollution. Depending on conditions of policy implementations, risk tradeoffs are possible for some individuals who shift to active travel and consequently increase inhalation of air pollutants and exposure to traffic injuries. Well-designed policies may enhance health benefits through indirect outcomes such as improved social capital and diet, but these synergies are not sufficiently well understood to allow quantification at this time., Conclusion: Evaluating impacts of active travel policies is highly complex; however, many associations can be quantified. Identifying health-maximizing policies and conditions requires integrated HIAs., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Background: Numerous epidemiological studies have demonstrated adverse health effects of a sedentary life style, on the one hand, and of acute and chronic exposure to traffic-related air pollution, on the other. Because physical exercise augments the amount of inhaled pollutants, it is not clear whether cycling to work in a polluted urban environment should be encouraged or not. To address this conundrum we investigated if a bicycle journey along a busy commuting road would induce changes in biomarkers of pulmonary and systematic inflammation in a group of healthy subjects., Methods: 38 volunteers (mean age: 43 ± 8.6 years, 26% women) cycled for about 20 minutes in real traffic near a major bypass road (road test; mean UFP exposure: 28,867 particles per cm3) in Antwerp and in a laboratory with filtered air (clean room; mean UFP exposure: 496 particles per cm3). The exercise intensity (heart rate) and duration of cycling were similar for each volunteer in both experiments. Exhaled nitric oxide (NO), plasma interleukin-6 (IL-6), platelet function, Clara cell protein in serum and blood cell counts were measured before and 30 minutes after exercise., Results: Percentage of blood neutrophils increased significantly more (p = 0.004) after exercise in the road test (3.9%; 95% CI: 1.5 to 6.2%; p = 0.003) than after exercise in the clean room (0.2%; 95% CI: -1.8 to 2.2%, p = 0.83). The pre/post-cycling changes in exhaled NO, plasma IL-6, platelet function, serum levels of Clara cell protein and number of total blood leukocytes did not differ significantly between the two scenarios., Conclusions: Traffic-related exposure to particles during exercise caused a small increase in the distribution of inflammatory blood cells in healthy subjects. The health significance of this isolated change is unclear.

Emissions from ships have recently received more attention since they have become a significant concern for air quality in harbours and port cities. This paper presents the methodology for a comprehensive maritime transport database of activity data, specific energy consumption, emission factors, and total emissions that have been developed within the European EX-TREMIS project. The model is built upon 3 modules: the fleet module, the transport activity module, and the emission module. The fleet module defines the ship categories, the loading capacities, and the engine characteristics of the different vessels by using EUROSTAT data, Sea Web Lloyd's database, and international literature. The transport activity module transforms total cargo handled (mainly based on EUROSTAT data and CEMT statistics) into ship-equivalents. These ship-equivalents are further transformed into ship-hours. The emission module calculates energy uses and CO(2), NO(X), SO(2), CO, HC, CH(4), NMHC, PM emissions from the resulting maritime activities. We have used technology based emission factors to take into account the technological evolution of vessels. To illustrate this new methodology, we present some results (emissions, fuel consumption and emission factors) for different countries. The overall methodology as well as the results and the country specific energy consumption and emission factors per ship type and size class can be extracted from the EX-TREMIS website (www.ex-tremis.eu). Our results contribute to more accurate estimates of emissions and air quality assessments in coastal cities and ports.