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Increased car use has affected pollution emissions; it has also changed our air pollution exposure patterns, with more transport time spent in cars in polluted road environments. The charity Sustrans suggests that bias in favour of investment in road building and motorised transport has led to a 'windscreen perspective', ie viewing transport issues from the driver's perspective only. The Royal Commission on Environmental Pollution 6 pointed to the dominance of road traffic in many urban areas being linked to a web of environmental and social causes, with outcomes including air pollution, urban severance for those without car access, a decline in walking, and closure of local shops. The types of traffic on our roads have changed; freight transport has seen massive growth, especially with respect to light goods traffic and vans, which have grown in number by over 60% since the turn of the century. Road traffic growth has slowed in recent years. The distance driven on UK roads grew by 50% during the 1980s, by 14% during the 1990s and then by 6% between 2000 and 2009. Road miles peaked in 2007, followed by three consecutive years of decrease: the first consecutive annual falls since traffic records began. 7 However, transport planners dismiss the notion that we might have achieved peak car use; the current hiatus in road traffic growth is expected to be temporary. Traffic is expected to grow by a further 19–55% between 2010 and 2040, and is being reinforced by the rapid growth of small packet road transport. 8 Growth in traffic since the 1950s does not necessarily mean a proportionate growth in air pollution. For over 20 years, ever-tightening standards for exhaust emissions have been applied to new vehicles sold across Europe, although concerns are being expressed about how suitable such testing is under realistic driving conditions (http://theicct.org/nox-control-technologies-euro-6-diesel-passenger-cars/). There also remains concern about emissions when starting from cold; however, overall the abatement of air pollution from petrol vehicles has been very effective – a new petrol car emits less than one-twentieth of 1 Air pollution in our changing world Fig 1. Annual distance travelled by road in the UK 7 0 100 200 300 400 500 600 Annual vehicle distance (billion km) 1949 1954 1959 1964 1969 1974 1979 1984 1989 1994 1999 2004 2009 2014 Buses and coaches Motorcycles Goods vehicles Light vans Cars and taxis © Royal College of Physicians 2016 5

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