Co-developing strategies to reduce exposure to fine particulate matter (PM2.5) in Scotland

Abstract

Air pollution is the world’s greatest environmental health threat, and exposure to air pollution is responsible for 7 million premature deaths every year, attributed to illnesses such as ischaemic heart disease, stroke and lung cancer. Fine particulate matter is a significant pollutant from a health perspective since it can penetrate the thoracic region. While policies and legislation to improve ambient air quality are vital, these are slow to implement and take effect. It has been argued that for more immediate health benefits, and for people to have greater control over the quality of the air they breathe, air quality-related policies must be supplemented with individual-level behavioural changes aimed at reducing personal exposure to air pollution. Personal exposures, the pollutant concentrations experienced by an individual as they move through space and time, are influenced by the environments people spend time in and the activities they partake in. Thus, personal exposures can be modified by behavioural changes. Air quality-related behaviours and behavioural changes are influenced by complex and interlinked factors, such as information provision and awareness. These need to be considered in public engagement programmes aimed at promoting behavioural change. This interdisciplinary thesis aimed to co-develop strategies, separately with people with asthma (as a group susceptible to the effects of air pollution) and with members of rural communities (often overlooked in air quality monitoring) in Scotland, to promote awareness of air pollution and support exposure-minimising behaviour changes, using methods from environmental science, social science and health behaviour psychology. Interviews conducted with people with asthma found that past experiences, misconceptions, and their sense of control, play a fundamental role in shaping air quality-related behaviours. Exploring the theoretical steps linking air quality information provision to behaviour change suggested that strategies to engage individuals with air quality data for behaviour change require a combined approach which simultaneously increases the relevance of data provided and increases participation. Applying and empirically testing this strategy to different degrees with people with asthma and rural communities, proved that it can enhance engagement and, significantly, demonstrated its ability to alter individuals’ misconceptions about their personal exposure or local air quality. However, its ability to support air quality-related behaviour change was more limited, with a more personalised strategy required to achieve this. For exposure-minimising behaviour change and subsequent public health benefit, a personalised approach to monitoring with a more supported behaviour change co-development strategy is therefore recommended. Current air quality information can be improved to better support and empower behaviour change.