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Abstract Globally, climate change represents the most significant threat to the environment and socio-economic development, endangering lives and livelihoods. Within the UN’s current 17 Sustainable Development Goals (SDGs), climate action is explicitly covered under Goal 13, “to take urgent action to combat climate change and its impacts”. This perspective considers how to re-frame the SDGs and their successor towards mainstreaming climate action within the targets and indicators of all the development goals.

Abstract The World Health Organization estimates that air pollution causes approximately seven million premature deaths worldwide each year. Solutions to air pollution are well known, yet this rarely equates to easily actionable. Here we demonstrate how art science collaboration can successfully highlight the issue of air pollution and create wider civic discourse around its amelioration. We document a light painting photographic technique that uses data from calibrated low-cost particulate matter sensors to measure and depict air pollution. We also use a postcard technique to grasp individuals’ sentiments regarding air pollution. The photographs from three countries, Ethiopia, India and United Kingdom, visually highlight the importance of location and occupation upon human exposure. The photographs are used as a proxy to communicate and create dialogues, spaces and places about air pollution. The sentiment analysis shows how this approach can foster awareness and create agency for stakeholders to take actions to tackle air pollution.

Background: In May 2019, Ulaanbaatar, Mongolia introduced a city-wide raw coal ban (RCB) to improve ambient air quality. Air pollution exposure particularly affects child health and is associated with acute respiratory disease. We assessed the effects of the RCB on air quality and child respiratory health. Methods: An interrupted time-series analysis was conducted on air quality (PM2.5, PM10, SO2, CO) and child (10 significantly decreased by −34.3 µg/m3 (95% CI −62.9, −5.8, p = 0.02) and PM2.5 by −17.1 µg/m3 (95% CI −26.3, −7.9, p < 0.01), immediately post-intervention. The subgroup analysis showed SO2 increased by 81.6 µg/m3 (95% CI 45.2, 117.9, p < 0.01) in the first month and by 4.9 µg/m3 (95% CI 2.6, 7.3, p < 0.01) monthly afterwards. CO increased by 56.1 µg/m3 (95% CI 13.5, 98.7, p = 0.01). Child respiratory health showed no significant change after adjusting for the COVID-19 effect. Discussion: The RCB successfully reduced key pollutants (PM), almost instantly. Long-term increases in SO2 and CO and limited health effects highlight the need for further air quality improvements. Outputs from Mongolia’s continuous air quality mitigation efforts provide useful insights for countries facing similar challenges.

This study explores indoor air pollutant (PM1, PM2.5 and NO2) concentrations over a 15-week period during the COVID-19 pandemic in a typical suburban household in Oxford, UK. A multi-room intensive monitoring study was conducted in a single dwelling using 10 air quality sensors measuring real-time pollutant concentrations at 10 second intervals to assess temporal and spatial variability in PM1, PM2.5 and NO2 concentrations, identify pollution-prone areas, and investigate the impact of residents' activities on indoor air quality. Significant spatial variations in PM concentrations were observed within the study dwelling, with highest hourly concentrations (769.0 & 300.9 μg m−3 for PM2.5, and PM1, respectively) observed in the upstairs study room, which had poor ventilation. Cooking activities were identified as a major contributor to indoor particulate pollution, with peak concentrations aligning with cooking events. Indoor NO2 levels were typically higher than outdoor levels, particularly in the kitchen where a gas-cooking appliance was used. There was no significant association observed between outdoor and indoor PM concentrations; however, a clear correlation was evident between kitchen PM emissions and indoor levels. Similarly, outdoor NO2 had a limited influence on indoor air quality compared to kitchen activities. Indoor sources were found to dominate for both PM and NO2, with higher Indoor/Outdoor (I/O) ratios observed in the upstairs bedroom and the kitchen. Overall, our findings highlight the contribution of indoor air pollutant sources and domestic activities to indoor air pollution exposure, notably during the COVID-19 pandemic when people were typically spending more time in domestic settings. Our novel findings, which suggest high levels of pollutant concentrations in upstairs (first floor) rooms, underscore the necessity for targeted interventions. These interventions include the implementation of source control measures, effective ventilation strategies and occupant education for behaviour change, all aimed at improving indoor air quality and promoting healthier living environments.

Objective. To estimate the point prevalence and likely ranges of pregnancy-induced hypertension, preeclampsia, gestational diabetes, low birth weight and preterm delivery in Latin America and the Caribbean, and evaluate the heterogeneity of the estimates. Methods. We conducted a systematic review and meta-analysis of observational studies reporting the prevalence of maternal and perinatal adverse outcomes in populations in Latin American and the Caribbean published between 2000 and 2019 in English, Spanish, or Portuguese. We searched PubMed, Embase, and LILACS. We estimated the point prevalence and evaluated overall heterogeneity and, in sub-group analyses, heterogeneity by study design and level of bias. Results. Of 1087 records retrieved, 50 articles were included in the review: two on hypertensive disorders of pregnancy, 14 on pre-eclampsia, six on gestational diabetes, nine on low birth weight and 19 on preterm birth. No meta-analysis for hypertensive disorders of pregnancy could be done because of the small number of studies. Point prevalence estimates and 95% confidence intervals (CIs) for pre-eclampsia, gestational diabetes, low birth weight, and preterm birth were: 6.6% (95% CI: 4.9%, 8.6%), 8.5% (95% CI: 3.9%, 14.7%), 8.5% (95% CI: 7.2%, 9.8%), and 10.0% (95% CI: 8.0%, 12.0%), respectively. We observed substantial heterogeneity overall and by study design. No major differences in estimates were observed by level of bias. Conclusions. The results of this study provide updated estimates of some of the most prevalent adverse pregnancy and perinatal outcomes in Latin America and the Caribbean. They highlight that important heterogeneity exists in prevalence estimates, which may reflect the diversity of populations in the region.

Abstract Background Smoke from solid biomass cooking is often stated to reduce household mosquito levels and, therefore, malarial transmission. However, household air pollution (HAP) from solid biomass cooking is estimated to be responsible for 1.67 times more deaths in children aged under 5 years compared to malaria globally. This cross-sectional study investigates the association between malaria and (i) cleaner fuel usage; (ii) wood compared to charcoal fuel; and, (iii) household cooking location, among children aged under 5 years in sub-Saharan Africa (SSA). Methods Population-based data was obtained from Demographic and Health Surveys (DHS) for 85,263 children within 17 malaria-endemic sub-Saharan countries who were who were tested for malaria with a malarial rapid diagnostic test (RDT) or microscopy. To assess the independent association between malarial diagnosis (positive, negative), fuel type and cooking location (outdoor, indoor, attached to house), multivariable logistic regression was used, controlling for individual, household and contextual confounding factors. Results Household use of solid biomass fuels and kerosene cooking fuels was associated with a 57% increase in the odds ratio of malarial infection after adjusting for confounding factors (RDT adjusted odds ratio (AOR):1.57 [1.30–1.91]; Microscopy AOR: 1.58 [1.23–2.04]) compared to cooking with cleaner fuels. A similar effect was observed when comparing wood to charcoal among solid biomass fuel users (RDT AOR: 1.77 [1.54–2.04]; Microscopy AOR: 1.21 [1.08–1.37]). Cooking in a separate building was associated with a 26% reduction in the odds of malarial infection (RDT AOR: 0.74 [0.66–0.83]; Microscopy AOR: 0.75 [0.67–0.84]) compared to indoor cooking; however no association was observed with outdoor cooking. Similar effects were observed within a sub-analysis of malarial mesoendemic areas only. Conclusion Cleaner fuels and outdoor cooking practices associated with reduced smoke exposure were not observed to have an adverse effect upon malarial infection among children under 5 years in SSA. Further mixed-methods research will be required to further strengthen the evidence base concerning this risk paradigm and to support appropriate public health messaging in this context.

Taking holistic actions to improve urban air quality is central to reducing the health risks associated with urbanisation, yet local evidence-based and institutional frameworks to achieve this are still challenging especially in many low-and middle-income countries (LMICs). This paper develops and applies an integrated systemic approach to explore the state of air quality management in Nairobi, Kenya; as an LMIC exemplar city. The urban diagnostics approach developed assesses current particulate matter air pollution in Nairobi; quantifies anthropogenic emissions for the years 2015 and 2020 and projects scenarios of impacts of actions and inactions to 2030. This was combined with a review of grey literature on air quality policies, urban development and interviews with key stakeholders. The analysis suggests that commendable progress has been made to improve air quality in Nairobi but continuing hazardous levels of air pollution still require concerted policy efforts. Data available for numerical simulations have low spatial resolution and are generated from global emission inventories that can miss or misrepresent local emission sources. The current air quality data gap that needs to be addressed are highlighted. Strong political support is required to ensure that current air quality improvement approaches are evidence based to achieve long-term sustainability goals.

Abstract Background A variety of public health interventions have been undertaken in low- and middle-income countries (LMICs) to prevent morbidity and mortality associated with household air pollution (HAP) due to cooking, heating and lighting with solid biomass fuels. Pregnant women and children under five are particularly vulnerable to the effects of HAP, due to biological susceptibility and typically higher exposure levels. However, the relative health benefits of interventions to reduce HAP exposure among these groups remain unclear. This systematic review aims to assess, among pregnant women, infants and children (under 5 years) in LMIC settings, the effectiveness of interventions which aim to reduce household air pollutant emissions due to household solid biomass fuel combustion, compared to usual cooking practices, in terms of health outcomes associated with HAP exposure. Methods This protocol follows standard systematic review processes and abides by the PRISMA-P reporting guidelines. Searches will be undertaken in MEDLINE, EMBASE, CENTRAL, WHO International Clinical Trials Registry Platform (ICTRP), The Global Index Medicus (GIM), ClinicalTrials.gov and Greenfile, combining terms for pregnant women and children with interventions or policy approaches to reduce HAP from biomass fuels or HAP terms and LMIC countries. Included studies will be those reporting (i) pregnant women and children under 5 years; (ii) fuel transition, structural, educational or policy interventions; and (iii) health events associated with HAP exposure which occur among pregnant women or among children within the perinatal period, infancy and up to 5 years of age. A narrative synthesis will be undertaken for each population-intervention-outcome triad stratified by study design. Clinical and methodological homogeneity within each triad will be used to determine the feasibility for undertaking meta-analyses to give a summary estimate of the effect for each outcome. Discussion This systematic review will identify the effectiveness of existing HAP intervention measures in LMIC contexts, with discussion on the context of implementation and adoption, and summarise current literature of relevance to maternal and child health. This assessment reflects the need for HAP interventions which achieve measurable health benefits, which would need to be supported by policies that are socially and economically acceptable in LMIC settings worldwide. Systematic review registration PROSPERO CRD42020164998

Abstract Background Tobacco control policies have potential to be an effective strategy for the reduction of smoking prevalence and secondhand smoke (SHS) exposure in tertiary educational settings worldwide. The aims of this study were to collect baseline data among staff and students, to measure smoking behaviours and attitudes towards introduction of campus-wide tobacco control policies within a UK higher education setting. Methods Cross-sectional study using data collected by web-based questionnaire administered to employed staff and enrolled students (undergraduate/postgraduate) at the University of Birmingham from May 2016 to April 2017. Information was obtained regarding demographic characteristics, tobacco usage patterns and attitudes towards a revised campus tobacco control policy using a 21-item survey tool. Logistic regression analyses were used to explore associations between participant characteristics and support for smoke-free or tobacco-free campus policy options, evaluated by crude and adjusted Odds Radios (OR) after controlling for confounding factors (significance level: P

In a drive to achieve net zero emissions, U.K. transport decarbonisation policies are predominantly focussed on measures to promote the uptake and use of electric vehicles (EVs). This is reflected in the COP26 Transport Declaration signed by 38 national governments, alongside city region governments, vehicle manufacturers and investors. However, emerging evidence suggests that EVs present multiple challenges for air quality, mobility and health, including risks from non-exhaust emissions (NEEs) and increasing reliance on vehicles for short trips. Understanding the interconnected links between electric mobility, human health and the environment, including synergies and trade-offs, requires a whole systems approach to transport policymaking. In the present paper, we describe the use of Participatory Systems Mapping (PSM) in which a diverse group of stakeholders collaboratively constructed a causal model of the U.K. surface transport system through a series of interactive online workshops. We present the map and its analysis, with our findings illustrating how unintended consequences of EV-focussed transport policies may have an impact on air quality, human health and important social functions of the transport system. We conclude by considering how online participatory causal modelling techniques could be effectively integrated with empirical metrics to facilitate effective policy design and appraisal in the transport sector.

Objectives The study aims to investigate the short-term associations between exposure to ambient air pollution (nitrogen dioxide (NO2), particulate matter pollution—particles with diameter