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Systematic Literature Review on the Health Effects of Long-term Exposure to Traffic-Related Air Pollution

The health effects of traffic-related air pollution continues to be of public health interest, with highest exposures in urban settings and residences in proximity to busy roadways.

Following its well-cited 2010 critical review, in 2018 the HEI Board of Directors appointed an expert HEI panel to review the scientific literature on traffic-related air pollution and health (see list of members below). Much new science has been published since the 2010 review.

The overall objective was to systematically evaluate the epidemiological evidence regarding the associations between long–term exposure to traffic-related air pollution and selected adverse health outcomes. The Panel drew conclusions about the confidence in the strength of the evidence, discussed strengths and limitations of the existing studies, and made recommendations for future research. Results were quantitatively combined to evaluate the strength of the evidence, where appropriate. In addition, the quantitative results of the review may be useful for future risk and health impact assessments of traffic-related air pollution.

The Panel formulated criteria for selection of health outcomes in the review, including policy and public health relevance. Selected health outcomes included all-cause and cause-specific mortality, respiratory effects, cardiovascular effects, diabetes, and birth outcomes.

The Panel used a systematic approach to search the literature, assess study quality, summarize results, and reach conclusions about the body of evidence. To this end, a review protocol (pdf) was published. The protocol has been registered in Prospero.

The review has been completed and is available here.

For more information please contact Hanna Boogaard at HEI.

HEI Panel on the Health Effects of Long-term Exposure to Traffic-Related Air Pollution*

 Traffic Panel


Front row, from left: Eleanne van Vliet, Jennifer Weuve, Sharon Sagiv, Evi Samoli, Jeff Brook, Danielle Vienneau, Audrey Smargiassi, and Allison Patton. Back row, from left: Francesco Forastiere, Hanna Boogaard, Barbara Hoffmann, Richard Atkinson, Gerard Hoek, Fred Lurmann, Adam Szpiro, Greg Wellenius, Meltem Kutlar Joss, and Rashid Shaikh.

Francesco Forastiere, PhD (cochair)  Visiting Professor, Environmental Research Group, School of Public Health, Faculty of Medicine, Imperial College, London, UK  

Frederick Lurmann, MS (cochair)  Manager of Exposure Assessment Studies, Sonoma Technology, Inc., Petaluma, California

Richard Atkinson, PhD  Professor of Epidemiology, Population Health Research Institute, St. George University of London, UK

Jeffrey Brook, PhD  Assistant Professor, Occupational and Environmental Health Division, Dalla Lana School of Public Health, University of Toronto, Canada; Member, HEI Research Committee

Howard Chang, PhD  Associate Professor, Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia

Gerard Hoek, PhD  Associate Professor, Institute for Risk Assessment Sciences, Environmental Epidemiology, Utrecht University, Netherlands

Barbara Hoffmann, MD, MPH Professor of Environmental Epidemiology, Institute of Occupational, Social, and Environmental Medicine, Heinrich Heine University of Düsseldorf, Germany; Member, HEI Research Committee

Sharon Sagiv, PhD  Assistant Adjunct Professor of Epidemiology, Center for Environmental Research and Children's Health, Division of Epidemiology, University of California Berkeley School of Public Health

Evangelia Samoli, Associate Professor of Epidemiology and Medical Statistics, Dept. of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

Audrey Smargiassi, PhD  Associate Professor, Department of Environmental and Occupational Health, School of Public Health, University of Montreal, Quebec, Canada

Adam Szpiro, PhD  Associate Professor of Biostatistics, Department of Biostatistics, University of Washington, Seattle

Danielle Vienneau, PhD  Assistant Professor (Habilitation), Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, University of Basel, Switzerland

Jennifer Weuve, MPH, ScD  Associate Professor, Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts


Consultants to the Panel

Julia Fussell, PhD, Senior Research Fellow, School of Public Health, Imperial College London, London, United Kingdom

Frank Kelly, Frank Kelly, PhD, Humphrey Battcock Chair of Environment and Health, School of Public Health, Imperial College London, London, United Kingdom, HEI Review Committee

Tim Nawrot, PhD Professor Environmental Epidemiology, Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium

Gregory Wellenius, ScD Professor, Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts


HEI Science Staff

Hanna Boogaard, Project leader, Consulting Principal Scientist

Allison Patton, Deputy project leader, Staff Scientist

Dan Crouse, Respiratory outcomes, Senior scientist

Eleanne van Vliet, Birth outcomes, Staff Scientist

Martha Ondras, Neurologic outcomes, Research Fellow

Eva Tanner, Report Review, Staff Scientist

Rashid Shaikh, Director of Science Emeritus

Annemoon van Erp, Deputy Director of Science


Contractor team

Meltem Kutlar Joss, Ron Kappeler, and students Lara Stucki, Zoe Roth, Elina Wüthrich supervised by Professor Nino Künzli, Swiss Literature Database, and Services on Health Effects of Ambient Air Pollution (LUDOK), Swiss Tropical and Public Health Institute, University of Basel, Switzerland as well as students Leonie Hoffmann and Pascale Haddad under the supervision of Prof. Barbara Hoffmann, University of Düsseldorf, Germany.