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Item type: Item , Ambient air pollution, urban green space and childhood overweight and obesity: a health impact assessment for Barcelona, Spain(2022) Rigau Sabadell, MarionaBackground: Recent studies have shown that high levels of air pollution and lack of urban green spaces (UGS) have an impact on childhood overweight/ obesity, but, to our knowledge, no study has evaluated the attributable burden of multiple air pollutants (PM2.5 (Particular matter 2.5 μm) and NO2 ) and urban green spaces (NDVI and % GA) on childhood overweight/obesity, and this is first study that includes both pollutants. The aim of this study is to estimate the attributable cases of childhood overweight/obesity due to ambient air pollution and UGS in the city of Barcelona, Spain. Methods: We applied a quantitative Health Impact Assessment (HIA) approach. We assessed exposure to air pollution particulate matter of 2.5 micrometres or less in diameter (PM2.5) and nitrogen dioxide (NO2) using a use regression model and two UGS proxies: the normalized difference vegetation index (NDVI), and the percentage of green area (%GA). Four ideal scenarios were evaluated: compliance 1) with the 2006 (10 μg/m3 annual mean PM2.5, 40 μg/m3 annual mean NO2) and 2) 2021 World Health Organization (WHO) guidelines (5 μg/m3 annual mean PM2.5, 10 μg/m3 annual mean NO2 (Nitrogen Dioxide); and 3) with 0.3111 NDVI; 3) with 25% GA, from which exposure-response functions were obtained. We estimated the relative risk and population attributable fraction (PAF) for each scenario and exposure, calculated the prevalence of childhood overweight and obesity and estimated the expected number of cases of childhood overweight/ obesity in Barcelona attributable to air pollution and UGS for each scenario. Results: If Barcelona's air quality policies were to meet the 2006 WHO AQGs (Air Quality Guidelines); for air pollution (scenario 1), we could prevent 736 (2.81%) annual cases of childhood obesity due to PM2.5 and 249 (0.34%) annual cases of childhood overweight/obesity due to NO2. However, complying 2021 WHO guidelines for PM2.5 and NO2 we could prevent 1,468 (5.60%) and 3,094 (4.32%) of annual cases of childhood obesity and childhood overweight/obesity, respectively. In addition, if Barcelona would increase the 25%GA and reach 0.31 units of NDVI, a total of 3,329 (4.65%) and 5,629 (7.86%) of annual cases of childhood overweight/obesity could be prevented, respectively. The attributable (and preventable) burden of childhood overweight/obesity by quintiles is higher in Q5 (most deprived) than in Q1 (least deprived). Discussion: The results indicate a large attributable burden of overweight/ obesity cases attributable to air pollution and a burden of almost twice as many cases attributed to lack of UGS (Urban Green Spaces)