{"id":"https://openalex.org/W7204870603","doi":"https://doi.org/10.64898/2026.08.27.26361515","title":"The impact of London\u2019s Ultra Low Emission Zone on respiratory prescribing: a synthetic control study","display_name":"The impact of London\u2019s Ultra Low Emission Zone on respiratory prescribing: a synthetic control study","publication_year":2026,"publication_date":"2026-09-01","ids":{"openalex":"https://openalex.org/W7204870603","doi":"https://doi.org/10.64898/2026.08.27.26361515"},"language":"en","primary_location":{"id":"doi:10.64898/2026.08.27.26361515","doi":"https://doi.org/10.64898/2026.08.27.26361515","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.27.26361515","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/01/2026.08.27.26361515.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/01/2026.08.27.26361515.full.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5148883467","display_name":"George Huw Williams","orcid":"https://orcid.org/0009-0007-0337-0807","observed_orcids":["https://orcid.org/0009-0007-0337-0807"]},"institutions":[{"id":"https://openalex.org/I28407311","display_name":"University of Manchester","ror":"https://ror.org/027m9bs27","country_code":"GB","type":"education","lineage":["https://openalex.org/I28407311"]}],"countries":["GB"],"is_corresponding":true,"raw_author_name":"George Williams","raw_affiliation_strings":["Manchester Centre for Health Economics, University of Manchester 27th August 2026"],"raw_orcid":"https://orcid.org/0009-0007-0337-0807","affiliations":[{"raw_affiliation_string":"Manchester Centre for Health Economics, University of Manchester 27th August 2026","institution_ids":["https://openalex.org/I28407311"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5080133532","display_name":"Thomas Allen","orcid":"https://orcid.org/0000-0002-2972-7911","observed_orcids":["https://orcid.org/0000-0002-2972-7911"]},"institutions":[{"id":"https://openalex.org/I28407311","display_name":"University of Manchester","ror":"https://ror.org/027m9bs27","country_code":"GB","type":"education","lineage":["https://openalex.org/I28407311"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Thomas Allen","raw_affiliation_strings":["Manchester Centre for Health Economics, University of Manchester 27th August 2026"],"raw_orcid":"https://orcid.org/0000-0002-2972-7911","affiliations":[{"raw_affiliation_string":"Manchester Centre for Health Economics, University of Manchester 27th August 2026","institution_ids":["https://openalex.org/I28407311"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5148883467"],"corresponding_institution_ids":["https://openalex.org/I28407311"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10190","display_name":"Air Quality and Health Impacts","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T10190","display_name":"Air Quality and Health Impacts","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2307","display_name":"Health, Toxicology and Mutagenesis"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T10051","display_name":"Asthma and respiratory diseases","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13148","display_name":"Environmental and Air Quality Management","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2305","display_name":"Environmental Engineering"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/ultra-low-emission-zone","display_name":"Ultra Low Emission Zone","score":0.9919999837875366},{"id":"https://openalex.org/keywords/air-pollution","display_name":"air pollution","score":0.6610000133514404},{"id":"https://openalex.org/keywords/pm2-5","display_name":"PM2.5","score":0.9610000252723694},{"id":"https://openalex.org/keywords/bronchodilators","display_name":"bronchodilators","score":0.8859999775886536},{"id":"https://openalex.org/keywords/inhaled-corticosteroids","display_name":"inhaled corticosteroids","score":0.9940000176429749},{"id":"https://openalex.org/keywords/air-quality-policy","display_name":"air quality policy","score":0.9049999713897705},{"id":"https://openalex.org/keywords/spillover-effects","display_name":"spillover effects","score":0.8479999899864197},{"id":"https://openalex.org/keywords/general-practice","display_name":"general practice","score":0.43799999356269836},{"id":"https://openalex.org/keywords/respiratory-health","display_name":"respiratory health","score":0.597000002861023},{"id":"https://openalex.org/keywords/london","display_name":"London","score":0.5180000066757202}],"concepts":[{"id":"https://openalex.org/C2781018748","wikidata":"https://www.wikidata.org/wiki/Q927234","display_name":"Bronchodilator","level":3,"score":0.6288999915122986},{"id":"https://openalex.org/C559116025","wikidata":"https://www.wikidata.org/wiki/Q131123","display_name":"Air pollution","level":2,"score":0.60589998960495},{"id":"https://openalex.org/C126314574","wikidata":"https://www.wikidata.org/wiki/Q2364111","display_name":"Air quality index","level":2,"score":0.5494999885559082},{"id":"https://openalex.org/C55527203","wikidata":"https://www.wikidata.org/wiki/Q334194","display_name":"Spillover effect","level":2,"score":0.5435000061988831},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.5418999791145325},{"id":"https://openalex.org/C534529494","wikidata":"https://www.wikidata.org/wiki/Q7891","display_name":"Respiratory system","level":2,"score":0.531499981880188},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5259000062942505},{"id":"https://openalex.org/C197934379","wikidata":"https://www.wikidata.org/wiki/Q2047938","display_name":"Adverse effect","level":2,"score":0.47369998693466187},{"id":"https://openalex.org/C521259446","wikidata":"https://www.wikidata.org/wiki/Q58734","display_name":"Pollution","level":2,"score":0.4339999854564667},{"id":"https://openalex.org/C2776178081","wikidata":"https://www.wikidata.org/wiki/Q3286546","display_name":"Respiratory disease","level":3,"score":0.41940000653266907},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.41440001130104065},{"id":"https://openalex.org/C2426938","wikidata":"https://www.wikidata.org/wiki/Q3355478","display_name":"Medical prescription","level":2,"score":0.4016999900341034},{"id":"https://openalex.org/C2775924081","wikidata":"https://www.wikidata.org/wiki/Q55608371","display_name":"Control (management)","level":2,"score":0.3411000072956085},{"id":"https://openalex.org/C2987315675","wikidata":"https://www.wikidata.org/wiki/Q1773974","display_name":"Disease control","level":2,"score":0.29269999265670776},{"id":"https://openalex.org/C2993267355","wikidata":"https://www.wikidata.org/wiki/Q1519812","display_name":"Public health policy","level":4,"score":0.2921000123023987},{"id":"https://openalex.org/C2983914783","wikidata":"https://www.wikidata.org/wiki/Q3286546","display_name":"Lung disease","level":3,"score":0.2766000032424927},{"id":"https://openalex.org/C39432304","wikidata":"https://www.wikidata.org/wiki/Q188847","display_name":"Environmental science","level":0,"score":0.2734000086784363},{"id":"https://openalex.org/C111335779","wikidata":"https://www.wikidata.org/wiki/Q3454686","display_name":"Reduction (mathematics)","level":2,"score":0.27219998836517334},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.27079999446868896},{"id":"https://openalex.org/C2992779976","wikidata":"https://www.wikidata.org/wiki/Q3286546","display_name":"Pulmonary disease","level":2,"score":0.26829999685287476},{"id":"https://openalex.org/C2987853052","wikidata":"https://www.wikidata.org/wiki/Q131123","display_name":"Air pollutants","level":3,"score":0.2678999900817871},{"id":"https://openalex.org/C2993183539","wikidata":"https://www.wikidata.org/wiki/Q754447","display_name":"Respiratory infection","level":3,"score":0.2648000121116638},{"id":"https://openalex.org/C2781318095","wikidata":"https://www.wikidata.org/wiki/Q33127638","display_name":"General practice","level":2,"score":0.2635999917984009},{"id":"https://openalex.org/C2776804153","wikidata":"https://www.wikidata.org/wiki/Q210420","display_name":"Corticosteroid","level":2,"score":0.2605000138282776},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.2583000063896179}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.64898/2026.08.27.26361515","doi":"https://doi.org/10.64898/2026.08.27.26361515","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.27.26361515","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/01/2026.08.27.26361515.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},{"id":"pmh:oai:pure.atira.dk:openaire_cris_publications/f2e326d5-34a7-4b6d-876e-e652293ee7fd","doi":null,"is_oa":true,"landing_page_url":"https://research.manchester.ac.uk/en/publications/f2e326d5-34a7-4b6d-876e-e652293ee7fd","pdf_url":null,"source":{"id":"https://openalex.org/S4306400662","display_name":"Research Explorer (The University of Manchester)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I28407311","host_organization_name":"University of Manchester","host_organization_lineage":["https://openalex.org/I28407311"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Williams, G & Allen, T 2026 'The impact of London\u2019s Ultra Low Emission Zone on respiratory prescribing: a synthetic control study' medRxiv, pp. 1-32. https://doi.org/10.64898/2026.08.27.26361515","raw_type":"info:eu-repo/semantics/preprint"}],"best_oa_location":{"id":"doi:10.64898/2026.08.27.26361515","doi":"https://doi.org/10.64898/2026.08.27.26361515","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.27.26361515","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/09/01/2026.08.27.26361515.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.98580002784729,"id":"https://metadata.un.org/sdg/3"},{"display_name":"Sustainable cities and communities","score":0.875,"id":"https://metadata.un.org/sdg/11"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7204870603.pdf","grobid_xml":"https://content.openalex.org/works/W7204870603.grobid-xml"},"referenced_works_count":16,"referenced_works":["https://openalex.org/W1966750269","https://openalex.org/W2160721286","https://openalex.org/W2171656257","https://openalex.org/W2174495518","https://openalex.org/W2766301804","https://openalex.org/W2902960097","https://openalex.org/W3014460866","https://openalex.org/W3095498057","https://openalex.org/W3121705696","https://openalex.org/W3211751513","https://openalex.org/W4281807360","https://openalex.org/W4382932317","https://openalex.org/W4389154806","https://openalex.org/W4393221834","https://openalex.org/W4403936209","https://openalex.org/W4409487142"],"related_works":["https://openalex.org/W3211751513","https://openalex.org/W4415407464","https://openalex.org/W7113647874","https://openalex.org/W7214106984","https://openalex.org/W7056783152","https://openalex.org/W4289783287","https://openalex.org/W4390994127","https://openalex.org/W4416396876","https://openalex.org/W4405336774","https://openalex.org/W2900821204"],"abstract_inverted_index":{"Abstract":[0],"Urban":[1],"air":[2,32,51,184,206],"pollution":[3,207],"remains":[4],"a":[5,76,90,110,119,127,137,148,154],"significant":[6,92],"public":[7,236],"health":[8,16,211,237],"concern,":[9],"contributing":[10],"to":[11,30,81,233],"premature":[12],"deaths":[13],"and":[14,57,65,153,186,208,223],"adverse":[15],"outcomes.":[17],"However,":[18],"there":[19],"is":[20],"little":[21],"causal":[22,83],"research":[23],"evaluating":[24],"the":[25,37,165,177,199,214],"effectiveness":[26,200],"of":[27,39,43,139,201],"policies":[28,203],"designed":[29],"improve":[31],"quality.":[33],"This":[34],"study":[35],"assesses":[36],"impact":[38],"all":[40,190],"three":[41,191],"stages":[42],"London\u2019s":[44],"Ultra":[45],"Low":[46],"Emission":[47],"Zone":[48],"(ULEZ)":[49],"on":[50,182],"pollution,":[52],"via":[53,60],"PM":[54,98,115,150],"2.5":[55,99,116,151],"levels,":[56,100],"respiratory":[58,66,187],"health,":[59],"prescription":[61],"records":[62],"for":[63],"bronchodilator":[64,159],"corticosteroid":[67,124],"medications.":[68],"Analyses":[69],"are":[70,217],"at":[71],"general":[72],"practice":[73],"level,":[74],"using":[75],"generalised":[77],"synthetic":[78],"control":[79],"method":[80],"estimate":[82],"impacts.":[84],"Stage":[85,107,145],"1":[86],"was":[87],"associated":[88,210],"with":[89,101,226],"statistically":[91,169],"but":[93,126,171],"negligible":[94],"0.77%":[95],"reduction":[96,152],"in":[97,105,114,122,130,158,204],"no":[102],"corresponding":[103],"change":[104],"prescribing.":[106],"2":[108],"produced":[109],"paradoxical":[111],"2.69%":[112,149],"increase":[113,129],",":[117],"alongside":[118],"4.44%":[120],"decrease":[121,157],"inhaled":[123],"quantity":[125,133],"12.51%":[128],"average":[131],"daily":[132],"(ADQ)":[134],"usage,":[135],"suggesting":[136,213],"worsening":[138],"disease":[140],"severity":[141],"among":[142],"existing":[143],"patients.":[144],"3":[146],"yielded":[147],"modest":[155],"2.18%":[156],"ADQ":[160],"usage.":[161],"Spillover":[162],"effects":[163,181,216],"beyond":[164],"ULEZ":[166,178,202],"boundary":[167],"were":[168],"significant,":[170],"negligible.":[172],"We":[173],"find":[174],"overall":[175],"that":[176,224],"had":[179],"minimal":[180],"both":[183],"quality":[185],"prescribing":[188],"across":[189],"stages.":[192],"These":[193],"findings":[194],"provide":[195],"new":[196],"insights":[197],"into":[198],"reducing":[205],"its":[209],"impacts,":[212],"zone\u2019s":[215],"considerably":[218],"smaller":[219],"than":[220],"previously":[221],"reported,":[222],"integration":[225],"broader":[227],"policy":[228],"measures":[229],"may":[230],"be":[231],"necessary":[232],"achieve":[234],"meaningful":[235],"gains.":[238]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-09-02T00:00:00"}
