Alistair Woodward - Academia.edu (original) (raw)

Papers by Alistair Woodward

BMC Public Health, Oct 30, 2010

Background: The risk of injury is one of the major barriers to engaging in cycling. We investigat... more Background: The risk of injury is one of the major barriers to engaging in cycling. We investigated exposure-based rates and profiles of traffic injuries sustained by pedal cyclists that resulted in death or hospital inpatient treatment in New Zealand, one of the most car dependent countries. Methods: Pedal cyclist traffic injuries were identified from the Mortality Collection and the National Minimum Dataset. Total time spent cycling was used as the measure of exposure and computed from National Household Travel Surveys. Analyses were undertaken for the periods 1988-91, 1996-99 and 2003-07 in relation to other major road users and by age, gender and body region affected. A modified Barell matrix was used to characterise the profiles of pedal cyclist injuries by body region affected and nature of injury. Results: Cyclists had the second highest rate of traffic injuries compared to other major road user categories and the rate increased from 1996-99 to 2003-07. During 2003-07, 31 injuries occurred per million hours spent cycling. Non-collision crashes (40%) and collisions with a car, pick-up truck or van (26%) accounted for two thirds of the cycling injuries. Children and adolescents aged under 15 years were at the highest risk, particularly of non-collision crashes. The rate of traumatic brain injuries fell from 1988-91 to 1996-99; however, injuries to other body parts increased steadily. Traumatic brain injuries were most common in collision cases whereas upper extremity fractures were most common in other crashes. Conclusions: The burden of fatal and hospitalised injuries among pedal cyclists is considerable and has been increasing over the last decade. This underscores the development of road safety and injury prevention programmes for cyclists alongside the cycling promotion strategies.

Transportation Research Part D: Transport and Environment

PubMed, Aug 13, 2010

Background: Smoking contributes to the 7 to 8 year gap between Maori and non-Maori life expectanc... more Background: Smoking contributes to the 7 to 8 year gap between Maori and non-Maori life expectancy (2006 Census). To inform current discussions by policy-makers on tobacco control, we estimate life-expectancy in 2040 for Maori and non-Maori, never-smokers and current-smokers. If nobody smoked tobacco from 2020 onwards, then life expectancy in 2040 will be approximated by projected never-smoker life expectancy. Method: Life-tables by sex/ethnicity/smoking status for 1996-99 were estimated by merging official Statistics New Zealand life-tables, census data and linked census-mortality rate estimates. We specified six modelling scenarios, formed by combining two options for future per annum declines in mortality rates among never-smokers (1.5%/2.5% and 2.0%/3.5% for non-Maori/Maori; i.e. assuming a return to long-run trends of closing ethnic gaps as in pre-1980s decades), and three options for future per annum reductions in the mortality rate difference comparing current to never-smokers (0%, 1% and 2%). Results: In 1996-1999, current smokers had an estimated 3.9 to 7.4 years less of life expectancy relative to never-smokers. This smoking difference in life expectancy was less among Maori than among non-Maori. If the 2006 census smoking prevalence remains unchanged into the future, we estimate the difference in 2040 between Maori and non-Maori life expectancy will range from 1.8 to 6.1 years across the six scenarios and two sexes (average 3.8). If nobody smokes tobacco from 2020 onwards, we estimate additional gains in life expectancy for Maori ranging from 2.5 to 7.9 years (average 4.7) and for non-Maori ranging from 1.2 to 5.4 years (average 2.9). Going smokefree as a nation by 2020, compared to no change from the 2006 Census population smoking prevalence, will close ethnic inequalities in life expectancy by 0.3 to 4.6 years (average 1.8 years; consistently greater for females). Discussion: If smoking persists at current rates it will become an even greater constraint on life expectancy improvements for New Zealanders in the future. Continued increases in life expectancy, and closing of the Maori:non-Maori gaps in life expectancy, would be greatly assisted by the end of tobacco smoking in Aotearoa-New Zealand by 2020.

Indoor Air, Dec 1, 2008

Houses in New Zealand have inadequate space heating and a third of households use unflued gas hea... more Houses in New Zealand have inadequate space heating and a third of households use unflued gas heaters. As part of a large community intervention trial to improve space heating, we replaced ineffective heaters with more effective, non-polluting heaters. This paper assesses the contribution of heating and household factors to indoor NO2 in almost 350 homes and reports on the reduction in NO2 levels due to heater replacement. Homes using unflued gas heaters had more than three times the level of NO2 in living rooms [geometric mean ratio (GMR) = 3.35, 95% CI: 2.83-3.96, P < 0.001] than homes without unflued gas heaters, whereas homes using gas stove-tops had significantly elevated living room NO2 levels (GMR = 1.42, 95% CI: 1.05-1.93, P = 0.02). Homes with heat pumps, flued gas heating, or enclosed wood burners had significantly lower levels of NO2 in living areas and bedrooms. In homes that used unflued gas heaters as their main form of heating at baseline, the intervention was associated with a two-third (67%) reduction in NO2 levels in living rooms, when compared with homes that continued to use unflued gas heaters. Reducing the use of unflued gas heating would substantially lower NO2 exposure in New Zealand homes. Understanding the factors influencing indoor NO2 levels is critical for the assessment and control of indoor air pollution. This study found that homes that used unflued gas combustion appliances for heating and cooking had higher NO2 levels compared with homes where other fuels were used. These findings require institutional incentives to increase the use of more effective, less polluting fuels, particularly in the home environment.

BMC Public Health, Jan 21, 2015

Background: Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia, and the inc... more Background: Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia, and the incidence of AF is increased markedly among elite athletes. It is not clear how lesser levels of physical activity in the general population influence AF. We asked whether participation in the Taupo Cycle Challenge was associated with increased hospital admissions due to AF, and within the cohort, whether admissions for AF were related to frequency and intensity of cycling. Methods: Participants in the 2006 Lake Taupo Cycle Challenge, New Zealand's largest mass cycling event, were invited to complete an on-line questionnaire. Those who agreed (n = 2590, response rate = 43.1%) were followed up by record linkage via the National Minimum Health Database from December 1 2006 until June 30 2013, to identify admissions to hospital due to AF. Results: The age and gender standardized admission rate for AF was similar in the Taupo cohort (19.60 per 10,000 per year) and the national population over the same period (2006-2011) (19.45 per 10,000 per year). Within the study cohort (men only), for every additional hour spent cycling per week the risk changed by 0.90 (95% confidence interval 0.79-1.01). This result did not change appreciably after adjustment for age and height. Conclusions: Hospital admission due to AF was not increased above the national rate in this group of non-elite cyclists, and within the group the rate of AF did not increase with amount of cycling. The level of activity undertaken by this cohort of cyclists was, on average, not sufficient to increase the risk of hospitalization for AF.

ISEE Conference Abstracts

Associations between cellular telephone use and risk of brain tumors have been examined in a numb... more Associations between cellular telephone use and risk of brain tumors have been examined in a number of epidemiological studies including INTERPHONE. Although results revealed no positive associatio...

Journal of the Royal Society of New Zealand

European Journal of Epidemiology, 2022

This is a repository copy of Association of allergic diseases and epilepsy with risk of glioma, m... more This is a repository copy of Association of allergic diseases and epilepsy with risk of glioma, meningioma and acoustic neuroma: results from the INTERPHONE international case-control study.

This chapter positions the late Tony McMichael’s contributions in the social, political and ecolo... more This chapter positions the late Tony McMichael’s contributions in the social, political and ecological context in which he worked from the early 1970s to the present. We document how his research and writing were shaped by this milieu and explore some of the barriers, challenges and opportunities that shaped his career. McMichael’s work was distinguished in two respects. These are, first, the range of epidemiology subspecialties that he mastered (including occupational health, cancer, nutrition and environmental health), and second, the depth and lasting impact of his research. We provide examples of the work he and his colleagues carried out on lead, smoking, health inequalities and the links between diet and cancer. In recent decades, Tony was probably known best for his focus on the effects of adverse global ecological and environmental changes, and climate change in particular. He contributed to an improved understanding of causality within epidemiology, rejecting an exclusive f...

International Journal of Epidemiology, 2021

Background Exposure to high doses of ionizing radiation is among the few well-established brain t... more Background Exposure to high doses of ionizing radiation is among the few well-established brain tumour risk factors. We used data from the Interphone study to evaluate the effects of exposure to low-dose radiation from diagnostic radiological examinations on glioma, meningioma and acoustic neuroma risk. Methods Brain tumour cases (2644 gliomas, 2236 meningiomas, 1083 neuromas) diagnosed in 2000–02 were identified through hospitals in 13 countries, and 6068 controls (population-based controls in most centres) were included in the analysis. Participation across all centres was 64% for glioma cases, 78% for meningioma cases, 82% for acoustic neuroma cases and 53% for controls. Information on previous diagnostic radiological examinations was obtained by interviews, including the frequency, timing and indication for the examinations. Typical brain doses per type of examination were estimated based on the literature. Examinations within the 5 years before the index date were excluded from...

Environmental Health Perspectives, 2020

and Initiatives (award MRP-17-446315). J.W. has received funding to develop transport and health ... more and Initiatives (award MRP-17-446315). J.W. has received funding to develop transport and health models by the European Research Council (ERC) under the Horizon 2020 research and innovation program (grant agreement No. 817754). This material reflects only the author's views and the Commission is not liable for any use that may be made of the information contained therein. J.W. also receives funding to develop transport and health models from the UK MRC (METAHIT and JIBE projects) and from the UK DfT (PCT project). The other authors declare they have no actual or potential competing financial interests.

Scandinavian Journal of Work, Environment & Health, 2018

Conflicting results have been obtained about the association between exposure to occupational lou... more Conflicting results have been obtained about the association between exposure to occupational loud noise and risk of vestibular schwannomas (acoustic neuromas). In the largest case-control study conducted to date on this tumor, consistent associations have been observed with self-reported loud noise exposure.

Environmental pollution (Barking, Essex : 1987), 2018

To date, greenhouse gas (GHG) emissions, mitigation strategies and the accompanying health co-ben... more To date, greenhouse gas (GHG) emissions, mitigation strategies and the accompanying health co-benefits in different economic sectors have not been fully investigated. The purpose of this paper is to review comprehensively the evidence on GHG mitigation measures and the related health co-benefits, identify knowledge gaps, and provide recommendations to promote further development and implementation of climate change response policies. Evidence on GHG emissions, abatement measures and related health co-benefits has been observed at regional, national and global levels, involving both low- and high-income societies. GHG mitigation actions have mainly been taken in five sectors: energy generation, transport, food and agriculture, household and industry, consistent with the main sources of GHG emissions. GHGs and air pollutants to a large extent stem from the same sources and are inseparable in terms of their atmospheric evolution and effects on ecosystem; thus, GHG reductions are usuall...

The New Zealand medical journal, Jan 17, 2017

Reducing the exposure of children and young people to the marketing of unhealthy foods is a core ... more Reducing the exposure of children and young people to the marketing of unhealthy foods is a core strategy for reducing the high overweight and obesity prevalence in this population. The Advertising Standards Authority (ASA) has recently reviewed its self-regulatory codes and proposed a revised single code on advertising to children. This article evaluates the proposed code against eight criteria for an effective code, which were included in a submission to the ASA review process from over 70 New Zealand health professors. The evaluation found that the proposed code largely represents no change or uncertain change from the existing codes, and cannot be expected to provide substantial protection for children and young people from the marketing of unhealthy foods. Government regulations will be needed to achieve this important outcome.

American journal of epidemiology, 2016

When investigating the association between brain tumors and use of mobile telephones, accurate da... more When investigating the association between brain tumors and use of mobile telephones, accurate data on tumor position are essential, due to the highly localized absorption of energy in the human brain from the radio-frequency fields emitted. We used a point process model to investigate this association using information that included tumor localization data from the INTERPHONE Study (Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden, and the United Kingdom). Our main analysis included 792 regular mobile phone users diagnosed with a glioma between 2000 and 2004. Similar to earlier results, we found a statistically significant association between the intracranial distribution of gliomas and the self-reported location of the phone. When we accounted for the preferred side of the head not being exclusively used for all mobile phone calls, the results were similar. The association was independent of the cumulative call time and cumula...

The Science of the total environment, 2017

With rapid economic development, China has been plagued by choking air pollution in recent years,... more With rapid economic development, China has been plagued by choking air pollution in recent years, and the frequent occurrence of haze episodes has caused widespread public concern. The purpose of this study is to describe the sources and formation of haze, summarize the mitigation measures in force, review the relationship between haze pollution and public health, and to discuss the challenges, potential research directions and policy options. Haze pollution has both natural and man-made causes, though it is anthropogenic sources that are the major contributors. Accumulation of air pollutants, secondary formation of aerosols, stagnant meteorological conditions, and trans-boundary transportation of pollutants are the principal causes driving the formation and evolution of haze. In China, haze includes gaseous pollutants and fine particles, of which PM2.5 is the dominant component. Short and long-term exposure to haze pollution are associated with a range of negative health outcomes, ...

The Science of the total environment, Jan 28, 2016

Recent evidence suggests that there may be an interaction between air pollution and heat on morta... more Recent evidence suggests that there may be an interaction between air pollution and heat on mortality, which is pertinent in the context of global climate change. We sought to examine this interaction in Hefei, a hot and polluted Chinese city. We conducted time-series analyses using daily mortality, air pollutant concentration (including particulate matter with aerodynamic diameter <10μm (PM10), sulphur dioxide (SO2) and nitrogen dioxide (NO2)), and temperature data from 2008 to 2014. We applied quasi-Poisson regression models with natural cubic splines and examined the interactive effects using temperature-stratified models. Subgroup analyses were conducted by age, gender, and educational levels. We observed consistently stronger associations between air pollutants and mortality at high temperatures than at medium temperatures. These differences were statistically significant for the associations between PM10 and non-accidental mortality and between all pollutants studied and re...

The Science of the total environment, Jan 22, 2016

Temperature extremes and air pollution both pose significant threats to human health, but it rema... more Temperature extremes and air pollution both pose significant threats to human health, but it remains uncertain whether pollutants' effects on mortality are modified by temperature levels. In this review, we summarized epidemiologic evidence on the modification by temperature of the acute effects of air pollutants on non-accidental and cardiovascular mortality. The EMBASE, PubMed, ProQuest Dissertations and Theses, and Elsevier Science Direct databases were used to identify papers published up to 2nd December 2014. Studies with appropriate design, exposures and outcome indicators, quantitative estimates and high/intermediate quality were included. Twenty-one studies met the inclusion criteria, of which 12 reported the effects of PM10 on mortality modified by temperature, 10 studied O3, and the rest examined NO2, SO2, PM2.5, PM10-2.5, CO and black smoke. We divided temperature into low, medium, and high categories as defined in each study. In high temperature days, a 10μg/m(3) inc...