Journal Information
Vol. 22. Issue S1.
Informe SESPAS 2008: Mejorando la efectividad de las intervenciones públicas sobre la salud
Pages 53-64 (April 2008)
Vol. 22. Issue S1.
Informe SESPAS 2008: Mejorando la efectividad de las intervenciones públicas sobre la salud
Pages 53-64 (April 2008)
Capítulo 2. Políticas de salud pública. Políticas Frente a los riesgos cotidianos
Open Access
Transporte, medio ambiente y salud. Informe SESPAS 2008
Transport, environment and health
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Ferran Ballestera,b,
Corresponding author
ballester_fer@gva.es

Correspondencia: Ferran Ballester. Escola Valenciana d’Estudis en Salut (EVES). Conselleria de Sanitat. Generalitat Valenciana.
, Rosanna Peirób,c
a Escola Valenciana d’Estudis en Salut (EVES), Conselleria de Sanitat, Generalitat Valenciana, Valencia, España
b Centro de, Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Ministerio de Sanidad, Madrid, España
c Centro de Salud Pública de Alzira, DGSP, Conselleria de Sanitat, Generalitat Valenciana, Valencia, España
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Resumen

El transporte a motor se ha incrementado de manera exponencial en los últimos años. La organización de la sociedad requiere en gran medida la movilidad como un elemento esencial, pero, hasta hace poco tiempo, no se habían considerado las implicaciones para la salud y el medio ambiente de las formas de desplazamiento elegidas. En este capítulo se revisa el impacto negativo en salud que el tipo de transporte actual tiene en términos de lesiones de tráfico, el cambio climático, la contaminación atmosférica, el ruido, y las interferencias para las actividades cotidianas y la actividad física, como la dificultad para andar o ir en bicicleta. Se proponen algunas intervenciones posibles relacionadas con los instrumentos disponibles en salud pública y otras áreas, y se destacan aspectos donde se necesita más investigación. Se describen algunos ejemplos en España y en otros países. Se hacen recomendaciones acerca de la necesidad de reducir el uso del coche privado, desarrollar vías segmentadas y espacios de tráfico tranquilo conectados en las ciudades y entre pueblos cercanos para promocionar el desplazamiento andando o en bicicleta. Se plantea que el desarrollo y el mantenimiento de un sistema de transporte público que sea más rápido, seguro, barato y menos contaminante que el transporte privado debería ser una meta importante en las políticas públicas actuales. Estas acciones ayudarán a conseguir un cambio en los modos de transporte de la sociedad y, consecuentemente, una población más sana y un ambiente más sostenible.

Palabras clave:
Salud
Medio ambiente
Transporte
Accidentes de tráfico
Contaminación atmosférica
Ruido
Cambio climático
Políticas públicas
Abstract

Motor road transport has increased exponentially in the last few years. To a large extent, mobility is an essential element in the organization of society, but, until recently, the implications of chosen forms of transport for health and the environment have not been considered.

In this chapter we review the negative impact of current forms of transport on health in terms of traffic injuries, climate change, atmospheric contamination, noise, and interference with daily activities and exercise, such as impediments to walking or cycling. Some possible interventions related to the instruments available in public health and other fields are proposed. Issues deserving further research are highlighted. Some examples in Spain and other countries are described. Recommendations are made on the need to reduce the use of private cars and to develop segmented routes and areas of quiet traffic connected in the cities and among nearby towns to promote walking are cycling. One major goal in current public policies should be to develop and maintain a public transport system that is safe, cheap and faster and less polluting than private transport. These interventions would help to achieve a change in current modes of transport and would lead to a healthier population and a more sustainable environment.

Key words:
Health
Environment
Transport
Traffic injuries
Air pollution
Noise
Climate change
Public policies
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Bibliografía
[1.]
Ministerio de Medio Ambiente. Perfil Ambiental de España 2005. Informe basado en indicadores [citado 12 May 2007]. Disponible en: http://www.mma.es/portal/secciones/calidad_contaminacion/indicadores_ambientales/perfil_ambiental_2005/index.htm
[2.]
The PEP (Transport, health and Environment Pan-European Programme).
Transport-related Health effects with a Particular Focus on Children.
Austrian Federeal Ministry of Agriculture, Forestry, Environment and Water Management, (2004),
[3.]
Centro de Investigaciones Sociológicas. Encuesta de Ecología y Medio Ambiente. Madrid: CIS; 2005.
[4.]
R. Peiró, M. Seguí-Gómez, C. Pérez, A. López, M. Miralles, F. García Benavides.
Lesiones por tráfico, de ocio y domésticas y laborales. Descripción de la situación en España. Informe SESPAS 2006.
Gac Sanit, 20 (2006), pp. 32-40
[5.]
Accidentes de circulación con víctimas. Estadísticas de tráfico. Dirección General de tráfico [citado 25 Abr 2007]. Disponible en: http://www.dgt.es/estadisticas/estadisticas03.htm
[6.]
Pérez C, Cirera E; Grupo de trabajo sobre la medida del impacto sobre la salud de los accidentes de tráfico en España. Estudio de la mortalidad a 30 días por accidentes de tráfico (EMAT-30). Madrid: Dirección General de Salud Pública. Ministerio de Sanidad y Consumo; 2004.
[7.]
Pont P. El impacto de las lesiones por accidente de tráfico. Un acercamiento desde el registro de lesiones del Instituto Medicina Legal de Valencia. Memoria beca EVES Ref. 070/2005.
[8.]
La Encuesta de Discapacidades, Deficiencias y Estado de Salud. Instituto Nacional de Estadística [citado 4 Ago 2007]. Disponible en: http://www.ine.es/inebmenu/menu3_soc.htm.
[9.]
W. Haddon.
Options for the prevention of motor vehicles crash injury.
Isr J Med Sci, 16 (1980), pp. 45-65
[10.]
World Report on Road Traffic Injury Prevention,
[11.]
F. Racciopi, L. Eriksson, C. Tingvall, A. Villaveces.
Preventing Road Traffic injury: a public health perspective for Europe. World Health Organization.
Regional Office for Europe, (2004),
[12.]
R. Peiró, C. Álvarez-Dardet, A. Plasència, C. Borrell, C. Colomer, C. Moya, et al.
Rapid apraisal methodology for «health for all» policy formulation analysis.
Health Policy, 62 (2002), pp. 309-328
[13.]
J. Ferrando, A. Plasència, M. Oros, C. Borrell, J.F. Cruz.
Impact of a helmet law on two wheel motor vehicle crash mortality in a southern European urban area.
Injury Prevention, 6 (2000), pp. 148-158
[14.]
J.R. Villalbí, C. Pérez.
Evaluación de políticas regulatorias: prevención de las lesiones por accidente de tráfico.
Gac sanit, 20 (2006), pp. 79-87
[15.]
B. O’Neil, D. Mohan.
Reducing motor vehicle crash deaths and injuries in newly motorising countries.
BMJ, 324 (2002), pp. 1142-1145
[16.]
Health Effects Institute (HEI).
Air pollution, the automobile and public health.
National Academic Press, (1998),
[17.]
Mage DT, Zali O, editors. Motor vehicle air pollution. Public Health impact and control measures. Geneva: WHO; 1992.
[18.]
Société Française de Santé Publique (SFSP). La pollution atmospérique d’origine automobile et la santé publique. Bilan de 15 ans de recherche internationale. Nancy: SFSP, collection santé et societé n.° 4; 1995.
[19.]
H. Peace, J. Maughan, B. Owen, D. Raper.
Identifying the contribution of different airport related sources to local urban air quality.
Environmental Modelling Software, 21 (2006), pp. 532-538
[20.]
J.J. Winebrake, J.J. Corbett, P.E. Meyer.
Energy use and emissions from marine vessels: a total fuel life cycle approach.
J Air Waste Manag Assoc, 57 (2007), pp. 102-110
[21.]
M. Keuken, E. Sanderson, R. van Aalst, J. Borken, J. Schneider.
Contribution of traffic to leveles of ambient air pollution in Europe.
Health effects of transport-related air pollution, pp. 53-84
[22.]
E. Sanderson, D. Briggs, M. Jantunen, B. Forsberg, M. Svartengren, R. Sram, et al.
Human exposure to transport-related air pollution.
Health effects of transport-related air pollution,
[23.]
F. Laden, L.M. Neas, D.W. Dockery, J. Schwartz.
Association of Fine Particulate Matter from Different Sources with Daily Mortality in Six US cities.
Environmental Health Perspectives, 108 (2000), pp. 941-947
[24.]
A. Le Tertre, S. Medina, E. Samoli, B. Forsberg, P. Michelozzi, A. Boumghar, et al.
Short-term effects of particulate air pollution on cardiovascular diseases in eight European cities.
J Epidemiol Community Health, 56 (2002), pp. 773-779
[25.]
W.J. Gauderman, G.F. Gilliland, H. Vora, E. Avol, D. Stram, R. Mc-Connell, et al.
Association between air pollution and lung function growth in southern California children: results from a second cohort.
Am J Respir Crit Care Med, 166 (2002), pp. 76-84
[26.]
J.J. Kim, S. Smorodinsky, M. Lipsett, B.C. Singer, A.T. Hodgson, B. Ostro.
Traffic-related air pollution near busy roads: The East Bay children's. Respiratory Health Study.
Am J Respir Crit Care Med, 170 (2004), pp. 520-526
[27.]
N.A. Janssen, B. Brunekreef, P. Van Vliet, F. Aarts, K. Meliefste, H. Harssema, P. Fischer.
The relationship between air pollution from heavy traffic and allergic sensitization, bronchial hyperresponsiveness, and respiratory symptoms in Dutch schoolchildren.
Environ Health Perspect, 111 (2003), pp. 1512-1518
[28.]
D. Zmirou, S. Gauvin, I. Pin, I. Momas, F. Sahraoui, J. Just, et al.
Traffic related air pollution and incidence of childhood asthma: results of the Vesta case-control study.
J Epidemiol Community Health, 58 (2004), pp. 18-23
[29.]
G. Hoek, B. Brunekreef, S. Goldbohm, P. Fischer, P.A. Van den Brandt.
Association between mortality and indicators of trafficrelated air pollution in the Netherlands: a cohort study.
Lancet, 360 (2002), pp. 1203-1209
[30.]
C.A. Pope, R.T. Burnett, M.J. Thun, E.E. Calle, D. Krewski, K. Ito, et al.
Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution.
JAMA, 287 (2002), pp. 1132-1141
[31.]
N. Kunzli, R. Kaiser, S. Medina, M. Studnicka, O. Chanel, P. Filliger, et al.
Public-health impact of outdoor and traffic-related air pollution: a European assessment.
[32.]
E. Boldo, S. Medina, A. LeTertre, F. Hurley, H.G. Mucke, F. Ballester, et al.
Apheis: health impact assessment of long-term exposure to PM(2.5) in 23 European cities.
Eur J Epidemiol, 21 (2006), pp. 449-458
[33.]
World Health Organization. Country profiles of environmental burden of disease. Geneva, junio 2007 [citado 15 Jul 2007]. Disponible en: http://www.who.int/quantifying_ehimpacts/national/countryprofile/en/index.html
[34.]
Intergovernmental Pannel on Climate Change (IPCC). Climate Change 2007: The Physical Science Basis. Summary for Policymakers Paris, release: 02/02/07. Disponible en: http://www. ipcc.ch/
[35.]
A.J. McMichael, D.H. Campbell-Lendrum, C.F. Corvalan, et al.
Climate change and human health. Risks and responses.
World Health Organization, (2003),
[36.]
F. Ballester, J. Díaz, J.M. Moreno.
Cambio climático y salud pública: escenarios después de la entrada en vigor del Protocolo de Kioto.
Gac Sanit, 20 (2006), pp. 160-174
[37.]
World Health Organisation. The World's Health Report 2002. Geneva: WHO; 2002.
[38.]
B.A.M. Staatsen, H.A. Nijland, E.M. Van Kempen, A.E.M. De Hollander, A.E.M. Franssen, I. Van Kamp.
Assessment of health impacts and policy options in relation to transport. telated noise exposures.
RIVM, UNECE-WHO, (2004),
[39.]
García Sanz B, Garrido FJ. La contaminación acústica en nuestras ciudades. Barcelona: Fundación La Caixa. Colección Estudios Sociales n.° 12 [citado 20 Abr 2007]. Disponible en: www.estudios.lacaixa.es
[40.]
World Health Organisation. Regional Office for Europe. Noise and health. Disponible en: http://www.euro.who.int/ noise
[41.]
C. Linares, J. Diaz, A. Tobias, J.M. De Miguel, A. Otero.
Impact of urban air pollutants and noise levels over daily hospital admissions in children in Madrid: a time series analysis.
Int Arch Occup Environ Health, 79 (2006), pp. 143-152
[42.]
C. Clark, R. Martin, E. Van Kempen, T. Alfred, J. Head, H.W. Davies, et al.
Exposure-effect relations between aircraft and road traffic noise exposure at school and reading comprehension: the RANCH project.
Am J Epidemiol, 163 (2006), pp. 27-37
[43.]
C. DiGuiseppi, I. Roberts, L. Li.
Influence of changing travel patterns on child death rates from injury: trend analysis.
BMJ, 314 (1997), pp. 710
[44.]
B. Sonkin, P. Edwards, I. Roberts, J. Green.
Walking, cycling and transport safety: an analysis of child road deaths.
J R Soc Med, 8 (2006), pp. 402-405
[45.]
C. Dora, M. Phillips.
Transport, environment and health. WHO Regional Publications, European Series, n° 89.
World Health Organization, (2000),
[46.]
S.I. De Vries, I. Bakker, W. Van Mechelen, M. Hopman-Rock.
Determinants of activity-friendly neighborhoods for children: results from the SPACE study.
Am J Health Promot, 1 (2007), pp. 312-316
[47.]
A. Mowen, E. Orsega-Smith, L. Payne, B. Ainsworth, G. Godbey.
The role of park proximity and social support in shaping park visitation, physical activity, and perceived health among older adults.
J Phys Act Health, 4 (2007), pp. 167-179
[48.]
A. McManus, J. Smith, J. McManus, E. MacDonald, M. Williams.
Evaluation of an alternative transport initiative in Perth, Western Australia, 2000-04.
Health Promot J Austr, 3 (2005), pp. 184-188
[49.]
C.E. Matthews, A.L. Jurj, X.O. Shu, H.L. Li, G. Yang, Q. Li, Y.T. Gao, W. Zheng.
Influence of exercise, walking, cycling, and overall nonexercise physical activity on mortality in Chinese women.
Am J Epidemiol, 12 (2007), pp. 1343-1350
[50.]
J.L. Gutiérrez-Fisac, M.A. Royo-Bordonada, M.A. Rodríguez-Artalejo.
Riesgos asociados a la dieta occidental y al sedentarismo: la epidemia de la obesidad.
Gac Sanit, 40 (2006), pp. 48-54
[51.]
Encuesta de movilidad de las personas residentes en España (MOVILIA) 2000 [citado 4 May 2007]. Disponible en: http://www.fomento.es/mfom/lang_castellano/informacion_mfom/informacion_estadistica/publicaciones/movilia_2000/.
[52.]
D. Campbell-Lendrum, C. Corvalán.
Climate change and developing- country cities: implications for environmental health and equity.
J Urban Health, 84 (2007), pp. 109-117
[53.]
T. Kjellstrom, S. Friel, J. Dixon, C. Corvalan, E. Rehfuess, D. Campbell-Lendrum, et al.
Urban environmental health hazards and health equity.
J Urban Health, 84 (2007), pp. 86-97
[54.]
A. Coote.
What health services could do about climate change.
BMJ, 3321 (2006), pp. 343-344
[55.]
J. Subirats.
El análisis de las políticas públicas.
Gac Sanit, 15 (2001), pp. 259-264
[56.]
R.A. Lyons, S.J. Jones, R.G. Newcombe, S.R. Palmer.
The influence of local politicians on pedestrian safety.
Inj Prev, 12 (2006), pp. 312-315
[57.]
F. Bunn, T. Collier, C. Frost, K. Ker, I. Roberts, R. Wentz.
Traffic calming for the prevention of road traffic injuries: systematic review and meta-analysis.
Inj Prev, 9 (2003), pp. 200-204
[58.]
D.S. Morrison, M. Petticrew, H. Thomson.
What are the most effective ways of improving population health through transport interventions? Evidence from systematic reviews.
J Epidemiol Community Health, 57 (2003), pp. 327-333
[59.]
R. Elvik.
Area-wide urban traffic calming schemes: a metaanalysis of safety effects.
Accid Anal Prev, 33 (2001), pp. 327-336
[60.]
P. Nicolopoulou-Stamati, L. Hens, P. Lammar, C.V. Howard.
Effects of mobility on health: an overview.
Environmental health impacts of transport and mobility, pp. 277-307
[61.]
J. Pucher, L. Dijkstra.
Promoting safe walking and cycling to improve public health: lessons from The Netherlands and Germany.
Am J Public Health, 93 (2003), pp. 1509-1516
[62.]
J. Hill, E. Nelson, D. Tilman, S. Polasky, D. Tiffany.
Environmental, economic, and energetic costs and benefits of biodiesel and ethanol biofuels.
Proc Natl Acad Sci USA, 103 (2006), pp. 11206-11210
[63.]
K.J. Swanson, M.C. Madden, A.J. Ghio.
Biodiesel exhaust: the need for health effects research.
Environ Health Perspect, 115 (2007), pp. 496-499
[64.]
Plan tipo de seguridad vial urbana. Guía de apoyo para la actuación local. Observatorio de Nacional de Seguridad Vial. DGT [citado 4 Ago 2007]. Disponible en: http://www.dgt.es/dgt_informa/investigaciones/Plan_Tipo_de_Seguridad_Vial_Urban_2007.pdf
[65.]
R. Peiró, P. López, J. Marrodan, C. Fernández, C. Ramírez.
Actividades Intersectoriales en la prevención de accidentes de tráfico.
Gac Sanit, 17 (2003), pp. 332-334
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