Making the Case for Air Quality Interventions

31st May 2018

The National Institute for Health and Care Excellence (NICE) has a remit to improve public health through evidence-based guidance. When NICE wanted to develop draft guidance aimed at helping local authorities to improve air quality across England, it turned to us to provide the evidence.

NICE knew that there were many possible interventions that local authorities might make to tackle air pollution from road transport. Working in partnership with the University of West England (UWE), we researched both the effectiveness and cost effectiveness of these interventions to provide NICE with the data it needed to choose between them and make recommendations to local authorities. UWE conducted an initial literature review to bring together all the available evidence, which we then synthesised in an economic model. Using the tools of Cost Benefit Analysis and Cost Utility Analysis, we were able to measure cost effectiveness against the potential benefits, including improvements to life expectancy.

Our analysis with UWE suggests that the benefits may be much higher than the costs for some air quality interventions under certain circumstances. With these results, NICE was able to produce draft guidance safe in the knowledge that it was recommending interventions for which the benefits justified the costs. The measures studied included off-road cycle paths, street washing and sweeping, motorway speed restrictions, bypass construction, motorway barriers, road closures, Low Emission Zones (LEZ) and vehicle idling.

Professor Mark Baker, Director for the Centre of Clinical Practice at NICE said:

“The battle against air pollution has to be one we are all fully committed to. This draft guidance from NICE seeks to redesign how we work and live in cities. When finalised, its recommendations will ensure that everyone who has the power to make the changes required can be confident in the action they are taking.”

Our Project Director Dominic Hogg added:

“Air pollution is an invisible killer. Local authorities, through their transport plans and the way in which they shape mobility, the options they offer their residents, and the infrastructure they develop, can do much to reduce the extent of the problem. What’s more, interventions in air pollution will also generate co-benefits in the field of climate change.”

Following a consultation on the draft guidance, NICE published the final version of the guidance, titled Air pollution: outdoor air quality and health, in June 2017.

Photo by Nicolò Lazzati (CC-BY-S.A 2.0), via