ASPIRE

1. There has been a national air quality banding system informing the public of daily levels of pollution and implications for their health since the early 1990s. The system classifies air pollution levels into bands according to their effects on health, currently labelled low, moderate, high or very high, according to whether any one of 5 pollutants exceeds specified levels. The national system is available for the public to consult (uk-air.defra.gov.uk/air-pollution/daqi) but there are also now a number of systems that proactively contact members of the public that sign up to receive alerts e.g. by text message or email.
2. airAlert is one such information service that provides messages to registered members of the public, alerting them when the daily air quality index is forecast to be moderate, high or very high (www.airalert.info ). It has been in operation since 2006, originally covering the county of Sussex but now also covering Surrey and Southampton.
3. This research was commissioned by the Sussex Air Quality Partnership (Sussex-air) to determine the potential health benefits if the service in Sussex was expanded to a larger population within Sussex and to examine the feasibility of an intervention study to determine directly whether the service leads to actions that are effective in practice. The project concentrates on hospital admissions for respiratory endpoints, including asthma and COPD, as a more severe outcome with available concentration-response relationships and routine statistics. The original rationale for the air quality banding system was based on respiratory effects, given the opportunity for patients to adjust their medication in response to exacerbation of symptoms. For the period studied, the relevant pollutants were ozone (O3), nitrogen dioxide (NO2) and PM10.