Alistair Woodward

Publications of Alistair Woodward

• Indoor Air Pollution Levels Were Halved as a Result of a National Tobacco Ban in a New Zealand Prison.

  Authors: Simon Thornley, Kim N Dirks, Richard Edwards, Alistair Woodward, Roger Marshall

  Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 05/2012;

  INTRODUCTION: Few studies have measured the effect of tobacco bans on secondhand smoke (SHS) exposure in prisons. From June 1, 2011, the sale of tobacco was prohibited in New Zealand prisons. OneINTRODUCTION: Few studies have measured the effect of tobacco bans on secondhand smoke (SHS) exposure in prisons. From June 1, 2011, the sale of tobacco was prohibited in New Zealand prisons. One month later, the possession of tobacco was banned. We studied the indoor air quality before and after this policy was enforced. METHODS: We measured indoor-fine-particulate (PM(2.5)) concentrations using a TSI SidePak photometer. The instrument was placed in a staff base of a New Zealand maximum-security prison, adjacent to four 12-cell wings. Measurements were made before the sales restriction, during this period, and after the ban. Data were summarized using daily geometric means and generalized least squares regression. RESULTS: A total of 7,107 observations were recorded at 5-min intervals, on 14 days before and 15 days after implementation, between 24 May and 5 August. Before the policy was implemented, the geometric mean was 6.58 μg/m(3) (95% CI = 6.29-6.58), which declined to 5.17 μg/m(3) (95% CI = 4.93-5.41) during the sales ban, and fell to 2.44 μg/m(3) (95% CI = 2.37-2.52) after the smoking ban. Regression analyses revealed an average 57% (95% CI = 42-68) decline in PM(2.5) concentrations, comparing the before and after periods.Conclusions:Our study showed a rapid and substantial improvement in indoor air quality after tobacco was banned at a prison. We conclude that prisoners have reduced their smoking in line with the ban, and that a significant health hazard has been reduced for staff and prisoners alike.

• Temporal, seasonal and weather effects on cycle volume: an ecological study.

  Authors: Sandar Tin Tin, Alistair Woodward, Elizabeth Robinson, Shanthi Ameratunga

  Environmental health : a global access science source. 03/2012; 11(1):12.

  ABSTRACT: BACKGROUND: Cycling has the potential to provide health, environmental and economic benefits but the level of cycling is very low in New Zealand and many other countries. Adverse weather isABSTRACT: BACKGROUND: Cycling has the potential to provide health, environmental and economic benefits but the level of cycling is very low in New Zealand and many other countries. Adverse weather is often cited as a reason why people do not cycle. This study investigated temporal and seasonal variability in cycle volume and its association with weather in Auckland, New Zealand's largest city. METHODS: Two datasets were used: automated cycle count data collected on Tamaki Drive in Auckland by using ZELT Inductive Loop Eco-counters and weather data (gust speed, rain, temperature, sunshine duration) available online from the National Climate Database. Analyses were undertaken using data collected over one year (1 January to 31 December 2009). Normalised cycle volumes were used in correlation and regression analyses to accommodate differences by hour of the day and day of the week and holiday. RESULTS: In 2009, 220,043 bicycles were recorded at the site. There were significant differences in mean hourly cycle volumes by hour of the day, day type and month of the year (p < 0.0001). All weather variables significantly influenced hourly and daily cycle volumes (p < 0.0001). The cycle volume increased by 3.2% (hourly) and 2.6% (daily) for 1degreesC increase in temperature but decreased by 10.6% (hourly) and 1.5% (daily) for 1 mm increase in rainfall and by 1.4% (hourly) and 0.9% (daily) for 1 km/h increase in gust speed. The volume was 26.2% higher in an hour with sunshine compared with no sunshine, and increased by 2.5% for one hour increase in sunshine each day. CONCLUSIONS: There are temporal and seasonal variations in cycle volume in Auckland and weather significantly influences hour-to-hour and day-to-day variations in cycle volume. Our findings will help inform future cycling promotion activities in Auckland.

• Public health and the promise of free trade.

  Authors: Fergus Woodward, Alistair Woodward

  Australian and New Zealand journal of public health. 12/2011; 35(6):504-5.

• Regional variations in pedal cyclist injuries in New Zealand: safety in numbers or risk in scarcity?

  Authors: Sandar Tin Tin, Alistair Woodward, Simon Thornley, Shanthi Ameratunga

  Australian and New Zealand journal of public health. 08/2011; 35(4):357-63.

  To assess regional variations in rates of traffic injuries to pedal cyclists resulting in death or hospital inpatient treatment, in relation to time spent cycling and time spent travelling in aTo assess regional variations in rates of traffic injuries to pedal cyclists resulting in death or hospital inpatient treatment, in relation to time spent cycling and time spent travelling in a car. Cycling injuries were identified from the Mortality Collection and the National Minimum Dataset. Time spent cycling and time spent travelling as a driver or passenger in a car/van/ute/SUV were computed from National Household Travel Surveys. There are 16 census regions in New Zealand, some of which were combined for this analysis to ensure an adequate sample size, resulting in eight regional groups. Analyses were undertaken for 1996-99 and 2003-07. Injury rates, per million hours spent cycling, varied widely across regions (11 to 33 injuries during 1996-99 and 12 to 78 injuries during 2003-07). The injury rate increased with decreasing per capita time spent cycling. The rate also increased with increasing per capita time spent travelling in a car. There was an inverse association between the injury rate and the ratio of time spent cycling to time spent travelling in a car. The expected number of cycling injuries increased with increasing total time spent cycling but at a decreasing rate particularly after adjusting for total time spent travelling in a car. The findings indicate a 'risk in scarcity' effect for New Zealand cyclists such that risk profiles of cyclists are likely to deteriorate if fewer people use a bicycle and more use a car. Cooperative efforts to promote cycling and its safety and to restrict car use may reverse the risk in scarcity effect.

• Moving urban trips from cars to bicycles: impact on health and emissions.

  Authors: Graeme Lindsay, Alexandra Macmillan, Alistair Woodward

  Australian and New Zealand journal of public health. 02/2011; 35(1):54-60.

  To estimate the effects on health, air pollution and greenhouse gas emissions if short trips (≤7 km) were undertaken by bicycle rather than motor car. Existing data sources were used to modelTo estimate the effects on health, air pollution and greenhouse gas emissions if short trips (≤7 km) were undertaken by bicycle rather than motor car. Existing data sources were used to model effects, in the urban setting in New Zealand, of varying the proportion of vehicle kilometres travelled by bicycle instead of light motor vehicle. Shifting 5% of vehicle kilometres to cycling would reduce vehicle travel by approximately 223 million kilometres each year, save about 22 million litres of fuel and reduce transport-related greenhouse emissions by 0.4%. The health effects would include about 116 deaths avoided annually as a result of increased physical activity, six fewer deaths due to local air pollution from vehicle emissions, and an additional five cyclist fatalities from road crashes. In economic terms, including only fatalities and using the NZ Ministry of Transport Value of a Statistical Life, the health effects of a 5% shift represent net savings of about $200 million per year. The health benefits of moving from cars to bikes heavily outweigh the costs of injury from road crashes. Transport policies that encourage bicycle use will help to reduce air pollution and greenhouse emissions and improve public health.

• Estimating the global public health implications of electricity and coal consumption.

  Authors: Julia M Gohlke, Reuben Thomas, Alistair Woodward, Diarmid Campbell-Lendrum, Annette Prüss-Üstün, Simon Hales, Christopher J Portier

  Environmental health perspectives. 02/2011; 119(6):821-6.

  The growing health risks associated with greenhouse gas emissions highlight the need for new energy policies that emphasize efficiency and low-carbon energy intensity. We assessed the relationshipsThe growing health risks associated with greenhouse gas emissions highlight the need for new energy policies that emphasize efficiency and low-carbon energy intensity. We assessed the relationships among electricity use, coal consumption, and health outcomes. Using time-series data sets from 41 countries with varying development trajectories between 1965 and 2005, we developed an autoregressive model of life expectancy (LE) and infant mortality (IM) based on electricity consumption, coal consumption, and previous year's LE or IM. Prediction of health impacts from the Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) integrated air pollution emissions health impact model for coal-fired power plants was compared with the time-series model results. The time-series model predicted that increased electricity consumption was associated with reduced IM for countries that started with relatively high IM (> 100/1,000 live births) and low LE (< 57 years) in 1965, whereas LE was not significantly associated with electricity consumption regardless of IM and LE in 1965. Increasing coal consumption was associated with increased IM and reduced LE after accounting for electricity consumption. These results are consistent with results based on the GAINS model and previously published estimates of disease burdens attributable to energy-related environmental factors, including indoor and outdoor air pollution and water and sanitation. Increased electricity consumption in countries with IM < 100/1,000 live births does not lead to greater health benefits, whereas coal consumption has significant detrimental health impacts.

• Air pollution and mortality in New Zealand: cohort study.

  Authors: Simon Hales, Tony Blakely, Alistair Woodward

  Journal of epidemiology and community health. 10/2010;

  Background Few cohort studies of the health effects of urban air pollution have been published. There is evidence, most consistently in studies with individual measurement of social factors, thatBackground Few cohort studies of the health effects of urban air pollution have been published. There is evidence, most consistently in studies with individual measurement of social factors, that more deprived populations are particularly sensitive to air pollution effects. Methods Records from the 1996 New Zealand census were anonymously and probabilistically linked to mortality data, creating a cohort study of the New Zealand population followed up for 3 years. There were 1.06 million adults living in urban areas for which data were available on all covariates. Estimates of exposure to air pollution (measured as particulate matter with an aerodynamic diameter less than 10 μm, PM(10)) were available for census area units from a previous land use regression study. Logistic regression analyses were conducted to investigate associations between cause-specific mortality rates and average exposure to PM(10) in urban areas, with control for confounding by age, sex, ethnicity, social deprivation, income, education, smoking history and ambient temperature. Results The odds of all-cause mortality in adults (aged 30-74 years at census) increased by 7% per 10 μg/m(3) increase in average PM(10) exposure (95% CI 3% to 10%) and 20% per 10 μg/m(3) among Maori, but with wide CI (7% to 33%). Associations were stronger for respiratory and lung cancer deaths. Conclusions An association of PM(10) with mortality is reported in a country with relatively low levels of air pollution. The major limitation of the study is the probable misclassification of PM(10) exposure. On balance, this means the strength of association was probably underestimated. The apparently greater association among Maori might be due to different levels of co-morbidity.

• Injuries to pedal cyclists on New Zealand roads, 1988-2007.

  Authors: Sandar Tin Tin, Alistair Woodward, Shanthi Ameratunga

  BMC public health. 10/2010; 10:655.

  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 orThe 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. 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. 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. 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.

• If nobody smoked tobacco in New Zealand from 2020 onwards, what effect would this have on ethnic inequalities in life expectancy?

  Authors: Tony Blakely, Kristie Carter, Nick Wilson, Richard Edwards, Alistair Woodward, George Thomson, Diana Sarfati

  The New Zealand medical journal. 08/2010; 123(1320):26-36.

  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 inSmoking 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. 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%). 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). 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.

• Commentary on Sims et al. (2010): The decline in passive smoking.

  Authors: Alistair Woodward

  Addiction (Abingdon, England). 03/2010; 105(3):554-5.

• Copenhagen, climate change, revolutions and public health.

  Authors: Alistair Woodward

  Australian and New Zealand journal of public health. 12/2009; 33(6):505-6.

• Public health benefits of strategies to reduce greenhouse-gas emissions: urban land transport.

  Authors: James Woodcock, Phil Edwards, Cathryn Tonne, Ben G Armstrong, Olu Ashiru, David Banister, Sean Beevers, Zaid Chalabi, Zohir Chowdhury, Aaron Cohen, Oscar H Franco, Andy Haines, Robin Hickman, Graeme Lindsay, Ishaan Mittal, Dinesh Mohan, Geetam Tiwari, Alistair Woodward, Ian Roberts

  Lancet. 11/2009;

  We used Comparative Risk Assessment methods to estimate the health effects of alternative urban land transport scenarios for two settings-London, UK, and Delhi, India. For each setting, we compared aWe used Comparative Risk Assessment methods to estimate the health effects of alternative urban land transport scenarios for two settings-London, UK, and Delhi, India. For each setting, we compared a business-as-usual 2030 projection (without policies for reduction of greenhouse gases) with alternative scenarios-lower-carbon-emission motor vehicles, increased active travel, and a combination of the two. We developed separate models that linked transport scenarios with physical activity, air pollution, and risk of road traffic injury. In both cities, we noted that reduction in carbon dioxide emissions through an increase in active travel and less use of motor vehicles had larger health benefits per million population (7332 disability-adjusted life-years [DALYs] in London, and 12 516 in Delhi in 1 year) than from the increased use of lower-emission motor vehicles (160 DALYs in London, and 1696 in Delhi). However, combination of active travel and lower-emission motor vehicles would give the largest benefits (7439 DALYs in London, 12 995 in Delhi), notably from a reduction in the number of years of life lost from ischaemic heart disease (10-19% in London, 11-25% in Delhi). Although uncertainties remain, climate change mitigation in transport should benefit public health substantially. Policies to increase the acceptability, appeal, and safety of active urban travel, and discourage travel in private motor vehicles would provide larger health benefits than would policies that focus solely on lower-emission motor vehicles.

• Cyclists' attitudes toward policies encouraging bicycle travel: findings from the Taupo Bicycle Study in New Zealand.

  Authors: Sandar Tin Tin, Alistair Woodward, Simon Thornley, John Langley, Anthony Rodgers, Shanthi Ameratunga

  Health promotion international. 10/2009;

  Utility cycling provides substantial health, environmental and economic benefits. Despite a favourable trend in leisure-time cycling, cycling is infrequently used for everyday travel needs in NewUtility cycling provides substantial health, environmental and economic benefits. Despite a favourable trend in leisure-time cycling, cycling is infrequently used for everyday travel needs in New Zealand. This study investigated cyclists' attitudes toward environmental and policy measures that would encourage them to cycle more, particularly for a trip to work. A cross-sectional analysis was undertaken using baseline data obtained from the Taupo Bicycle Study, a web-based longitudinal study. The study population comprised 2469 cyclists, aged 16 years or over, who had enrolled in the 2006 Wattyl Lake Taupo Cycle Challenge. The majority (88%) reported the provision of bicycle lanes as an important factor that would encourage them to cycle more often, followed by bicycle paths (76%), better bicycle security (64%), reduced motor vehicle speed (55%) and bike friendly public transport (38%). Of those who reported travelling to work at least once a week (N = 2223), varying proportions reported shower facilities at work (61%), fewer difficult intersections (43%), rising fuel costs (41%), fewer car parks (27%), bike designed to commute (26%) and rising cost of car parking (25%) as important factors that would encourage them to cycle to work more often. There were important differences in these perceived influences defined by the participants' socio-demographic characteristics and current cycling habits.

• Cycling and walking to work in New Zealand, 1991-2006: regional and individual differences, and pointers to effective interventions.

  Authors: Sandar Tin Tin, Alistair Woodward, Simon Thornley, Shanthi Ameratunga

  The international journal of behavioral nutrition and physical activity. 09/2009; 6(1):64.

  ABSTRACT: BACKGROUND: Active commuting increases levels of physical activity and is more likely to be adopted and sustained than exercise programmes. Despite the potential health, environmental,ABSTRACT: BACKGROUND: Active commuting increases levels of physical activity and is more likely to be adopted and sustained than exercise programmes. Despite the potential health, environmental, social and economic benefits, cycling and walking are increasingly marginal modes of transport in many countries. This paper investigated regional and individual differences in cycling and walking to work in New Zealand over the 15-year period (1991-2006). METHODS: New Zealand Census data (collected every five years) were accessed to analyse self-reported information on the "main means of travel to work" from individuals aged 15 years and over who are usually resident and employed in New Zealand. This analysis investigated differences in patterns of active commuting to work stratified by region, age, gender and personal income. RESULTS: In 2006, over four-fifths of New Zealanders used a private vehicle, one in fourteen walked and one in forty cycled to work. Increased car use from 1991 to 2006 occurred at the expense of active means of travel as trends in public transport use remained unchanged during that period. Of the 16 regions defined at meshblock and area unit level, Auckland had the lowest prevalence of cycling and walking. In contrast to other regions, walking to work increased in Wellington and Nelson, two regions which have made substantial investments in local infrastructure to promote active transport. Nationally, cycling prevalence declined with age whereas a U-shaped trend was observed for walking. The numbers of younger people cycling to work and older people walking to work declined substantially from 1991 to 2006. Higher proportions of men compared with women cycled to work. The opposite was true for walking with an increasing trend observed in women aged under 30 years. Walking to work was less prevalent among people with higher income. CONCLUSIONS: We observed a steady decline in cycling and walking to work from 1991 to 2006, with two regional exceptions. This together with the important differences in travel patterns by age, gender and personal income highlights opportunities to target and modify transport policies in order to promote active commuting.

• Quantifying the Impact of Selection Bias Caused by Nonparticipation in a Case-Control Study of Mobile Phone Use.

  Authors: Martine Vrijheid, Lesley Richardson, Bruce K Armstrong, Anssi Auvinen, Gabriele Berg, Matthew Carroll, Angela Chetrit, Isabelle Deltour, Maria Feychting, Graham G Giles [......] Siegal Sadetzki, Tina Salminen, Marie Sanchez, Birgitte Schlehofer, Joachim Schüz, Jack Siemiatycki, Tore Tynes, Alistair Woodward, Naohito Yamaguchi, Elisabeth Cardis

  Annals of epidemiology. 02/2009; 19(1):33-41.e1.

  PURPOSE: To quantitatively assess the impact of selection bias caused by nonparticipation in a multinational case-control study of mobile phone use and brain tumor. METHODS: Non-responsePURPOSE: To quantitatively assess the impact of selection bias caused by nonparticipation in a multinational case-control study of mobile phone use and brain tumor. METHODS: Non-response questionnaires (NRQ) were completed by a sub-set of nonparticipants. Selection bias factors were calculated based on the prevalence of mobile phone use reported by nonparticipants with NRQ data, and on scenarios of hypothetical exposure prevalence for other nonparticipants. RESULTS: Regular mobile phone use was reported less frequently by controls and cases who completed the NRQ (controls, 56%; cases, 50%) than by those who completed the full interview (controls, 69%; cases, 66%). This relationship was consistent across study centers, sex, and age groups. Lower education and more recent start of mobile phone use were associated with refusal to participate. Bias factors varied between 0.87 and 0.92 in the most plausible scenarios. CONCLUSIONS: Refusal to participate in brain tumor case-control studies seems to be related to less prevalent use of mobile phones, and this could result in a downward bias of around 10% in odds ratios for regular mobile phone use. The use of simple selection bias estimation methods in case-control studies can give important insights into the extent of any bias, even when nonparticipant information is incomplete.

• Carbon pricing in New Zealand: implications for public health.

  Authors: Divya Dhar, Alexandra Macmillan, Graeme Lindsay, Alistair Woodward

  The New Zealand medical journal. 02/2009; 122(1290):105-15.

  The likely health effects of climate change make it one of the most pressing global public health issues of our time. Effects range from more intense and frequent cyclones, flooding, and heat wavesThe likely health effects of climate change make it one of the most pressing global public health issues of our time. Effects range from more intense and frequent cyclones, flooding, and heat waves through to changing infectious disease patterns, food and water insecurity, sea-level rise, and economic and social disruption. The governments of almost all developed nations are now focusing their attention on national policy responses to the threat of climate change. In New Zealand, it is currently unclear what path our current government will take to contribute to the global response and fulfil our Kyoto obligations. In this paper we discuss the main carbon pricing options currently under consideration, and their implications for health and health inequities in New Zealand. We summarise the literature about the likely health and equity implications of different kinds of carbon pricing policy. A health sector voice in these significant policy decisions is vital to ensuring a policy that both addresses the threats to wellbeing of climate change, and maximises the potential health and equity win-wins of an adequate and well-designed response.

• Why New Zealand must rapidly halve its greenhouse gas emissions.

  Authors: Scott Metcalfe, Alistair Woodward, Alexandra Macmillan, Michael Baker, Philippa Howden-Chapman, Graeme Lindsay, Simon Hales, David Sinclair, Richard Jaine, Liz Springford [......] Susan Wells, Jamie Hosking, Andrea Forde, Marie Bismark, Stephen Palmer, Gay Keating, Jenny Simpson, Rachel Highton, Divya Dhar, Penny Kane

  The New Zealand medical journal. 01/2009; 122(1304):72-95.

  New Zealand must commit to substantial decreases in its greenhouse gas emissions, to avoid the worst impacts of climate change on human health, both here and internationally. We have the fourthNew Zealand must commit to substantial decreases in its greenhouse gas emissions, to avoid the worst impacts of climate change on human health, both here and internationally. We have the fourth highest per capita greenhouse gas emissions in the developed world. Based on the need to limit warming to 2 degrees C by 2100, our cumulative emissions, and our capability to mitigate, New Zealand should at least halve its greenhouse gas emissions by 2020 (i.e. a target of at least 40% less than 1990 levels). This target has a strong scientific basis, and if anything may be too lenient; reducing the risk of catastrophic climate change may require deeper cuts. Short-term economic costs of mitigation have been widely overstated in public debate. They must also be balanced by the far greater costs caused by inertia and the substantial health and social benefits that can be achieved by a low emissions society. Large emissions reductions are achievable if we mobilise New Zealand society and let technology follow the signal of a responsible target.

• Explanations adequate for public health.

  Authors: Alistair Woodward

  Journal of public health (Oxford, England). 08/2008;

• The effect of eradicating poverty on childhood unintentional injury mortality in New Zealand: a cohort study with counterfactual modelling.

  Authors: Amanda J D'Souza, Tony Blakely, Alistair Woodward

  Journal of epidemiology and community health. 05/2008;

  ObjectiveTo examine the effect of household income on unintentional injury mortality in children and model the potential impact of eradicating income poverty as an injury prevention strategy.ObjectiveTo examine the effect of household income on unintentional injury mortality in children and model the potential impact of eradicating income poverty as an injury prevention strategy. DesignNational retrospective cohort study linking census to mortality records. Setting New Zealand during a three-year period following the 1991 census. Participants Children aged 0 to 14 years on census night. Main outcome measures Odds ratios for unintentional injury death by equivalised household income category and proportional reductions (population attributable risk) in unintentional injury mortality from modelled scenarios of nil poverty. Results One third of children lived in households earning less than 60% of the national median household income. Age-adjusted odds of death from unintentional injury were higher for children from any income category compared to the highest, and were most elevated for children from households earning less than 40% of the national median income (Odds ratio 2.81, 95% CI 1.73 to 4.55). Adjusting for ethnicity, household education, family status and labour force status halved the effect size (OR 1.83, 1.02 to 3.28). 30% of injury mortality was attributable to low or middle household income using the highest income category as reference. Altering the income distribution to eradicate poverty, defined by a threshold of 50% or 60% of the national median income, in this model reduced injury mortality by a magnitude of 3.3 to 6.6%. Conclusions Household income is related to a child's risk of death from unintentional injury independent of measured confounders. Most deaths attributable to low income occur amongst households that are not defined as 'in poverty'. The elimination of poverty may reduce childhood unintentional injury mortality by 3.3 to 6.6%.

• Should smoking in outside public spaces be banned? Yes.

  Authors: George Thomson, Nick Wilson, Richard Edwards, Alistair Woodward

  BMJ (Clinical research ed.). 02/2008; 337:a2806.