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Prev Med. 2013 Nov;57(5):573-9. doi: 10.1016/j.ypmed.2013.07.021. Epub 2013 Aug 9.

Health impact assessment of increasing public transport and cycling use in Barcelona: a morbidity and burden of disease approach.

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Centre for Research in Environmental Epidemiology (CREAL), C. Doctor Aiguader, 88, 08003 Barcelona, Spain; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Departament de Ciències Experimentals i de la Salut, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain. Electronic address:



Quantify the health impacts on morbidity of reduced car trips and increased public transport and cycling trips.


A health impact assessment study of morbidity outcomes related to replacing car trips in Barcelona metropolitan (3,231,458 inhabitants). Through 8 different transport scenarios, the number of cases of disease or injuries related to physical activity, particulate matter air pollution <2.5 μm (PM2.5) and traffic incidents in travelers was estimated. We also estimate PM2.5 exposure and cases of disease in the general population.


A 40% reduction in long-duration car trips substituted by public transport and cycling trips resulted in annual reductions of 127 cases of diabetes, 44 of cardiovascular diseases, 30 of dementia, 16 minor injuries, 0.14 major injuries, 11 of breast cancer and 3 of colon-cancer, amounting to a total reduction of 302 Disability Adjusted Life Years per year in travelers. The reduction in PM2.5 exposure in the general population resulted in annual reductions of 7 cases of low birth weight, 6 of preterm birth, 1 of cardiovascular disease and 1 of lower respiratory tract infection.


Transport policies to reduce car trips could produce important health benefits in terms of reduced morbidity, particularly for those who take up active transportation.


Air pollution; BAU; Bicycling; Business as usual; DALYs; Disability Adjusted Life Years; Fine particles (less than 2.5μm); HEI; HIA; Health Effects Institute; Health Impact Assessment; Health impact assessment; METs; MeSH; Medical Subject Headings; Metabolic Equivalent of Task; NO2; NOx; Nitrogen Dioxide; OECD; OR; Odds ratio; Organization for Economic Co-operation and Development; PM(10); PM(2.5); Particulate matter less than 10μm; Physical activity; Public transport; RR; Relative Risk; Traffic injuries; UFP; Ultra-fine Particles; WHO; World Health Organization; YLD; YLL; Years Lived with Disability; Years of Life Lost; nitrogen oxides

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