Dr. Colm Byrne:

I thank members for the opportunity to address the committee on this important issue. I am a consultant geriatrician and general physician working with the frailty intervention team in the Mater Misericordiae University Hospital. I am here today representing Irish Doctors for Environment. Irish Doctors for Environment is a non-governmental agency and registered charity comprising doctors, medical students and allied healthcare professionals in Ireland who aim to create awareness, interest, and implement action around environment health and the impact it has on our patients' health.

The climate crisis is a human health crisis and our future health as a species is inextricably linked to our planet's health. We need to choose the best solutions that reduce emissions and improve our quality of life. Electric cars and other vehicles are going to be an important part of the transition from internal combustion engines. In the short term, many trips will, by necessity, have to be done by car and EVs will be important for these. However, not every trip needs to be taken by car. Just as someone would not use a combine harvester to pick the kids up from school, driving 1 km to the shop for milk is not the best use of a car when one could walk or cycle. There are long-term health benefits to reducing greenhouse gas emissions through reductions in climate change effects, such as heatwaves, extreme weather, flooding and so on. There are other shorter-term simultaneous benefits to reducing greenhouse gases. The most obvious is a reduction in air pollution through a reduction in internal combustion engine vehicles. Research that I have conducted into air pollution and stroke incidence in Ireland has demonstrated a correlation between traffic-produced air pollution and stroke admissions in this country. Other researchers in Ireland have demonstrated similar effects on respiratory and cardiovascular diseases. These findings are in line with international studies that have demonstrated that there is no such thing as a safe level of air pollution. Recent changes to WHO guidelines have reflected this reality.

Cars have other effects on human health aside from just tailpipe emissions. All cars, including electric-propelled cars, produce particulate matter from other sources such as tyre wear, brake pads and through dust agitation, for example. Noise pollution is increasingly being recognised as a major health issue, with cardiovascular disease, stroke and dementia, among others, associated with it.Any noise above 55 dB can impact on human health, and all cars travelling at speed produce noise pollution through tyres rolling on roads. There is little difference between internal combustion engine vehicles and EVs at speeds above 50 km/h.

Another environmental health impact that is being increasingly recognised is the importance of green spaces, from impacts on activity and obesity to mental health benefits and stress reduction. Trees and green spaces also help us to adapt to the effects of climate change by reducing flooding during periods of heavy rain and urban temperatures during heatwaves. Car infrastructure obviously has a large impact on the available space in our cities and towns for green space. Again, the use of electric cars does not reducing this impact. Electric cars tend to be heavier than their equivalent internal combustion engine vehicles. This has implications when it comes to road safety. Heavier vehicles will have a greater impact in collisions, especially with vulnerable road users such as cyclists and pedestrians, and will lead to lower survival rates in accidents. Perhaps the largest impact of cars and other mechanically propelled vehicles is the impact on physical activity.A study recently published by The Lancet countdown on health and climate change calculated that by prioritising health in our climate plans, we have the opportunity to save 1.6 million lives due to cleaner air, and 2.1 million lives due to increased physical activity every year. That is why climate change is such a pressing issue.

Additionally, Ireland has an increasingly ageing population. As a geriatrician, I know that while this can be perceived as being associated with an increase in frailty and physical dependence, it is not necessarily an inevitability. Physical activity, in combination with a healthy diet, can help to reduce the likelihood of frailty and physical dependence in older age. The benefits start accruing at a young age and can persist throughout life. Therefore, the younger that people start being physically active, the better. We know that physical activity that is integrated into our daily lives is more sustainable and persistent than having to set time aside in the day for physical activity. With an ageing population, we will have a more robust population if we can integrate physical activity into our daily lives. However, for multiple reasons, we live in a world that is hostile to this.Many of us live in one-off homes with no footpaths or cycle lanes that are accessible to us. In our towns and cities, the car is king. Pedestrians and cyclists are afterthoughts in design, in contradiction to national design manuals and best practice. Cars are frequently parked on footpaths. Our footpaths are in a poor state of repair and are often a trip hazard. Many of our public benches have been removed, despite the fact that many older people need to stop regularly to rest. These multiple microaggressions create an environment that is unappealing to be in for pedestrians or cyclists, especially if they are disabled.

Cycling is great for our health. One study from Denmark demonstrated a 40% reduction in mortality over 12 years in people who commuted by bike, as opposed to those who commuted on public transport. Similarly, another Danish study has demonstrated an 8% increase in the concentration levels of children who cycle to school versus those that are driven. Sometimes electric bikes can be seen as cheating. However, studies have demonstrated that people will cycle further on e-bikes and often end up exerting themselves just as much as on a regular pedal bike, as they travel further and more frequently.

When we talk about EVs, we need to have a more open mind than electric cars, trucks or vans. We need not just to replace internal combustion engine vehicles with EVs, but to reduce the number of cars on the road overall. In 1990, there were 900,000 cars on the road; today there are 2.3 million. Indeed, 1 million EVs alone will not, by themselves, bring us in line with our 2030 transport emission targets. There needs to be a shift to alternative means of transport. Electric bikes, trikes and cargo bikes will have a big impact on our transition away from internal combustion engine vehicles. Electric bikes can extend the cycling range of people, reduce the effort required to get up hills or carry heavy loads and extend the range of people who can cycle. As a family, we have recently gone from a two- to one-car household.I was already cycling to Sallins station to get a train into Dublin for work. Therefore, we found that my car was sitting on the driveway for most of the week. We bought an electric cargo bike that has been revolutionary for our family. We now use it to cycle to most places in Naas, to visit my wife's family, to go to the supermarket, the playground and so on. My wife, who was not previously a regular cyclist, finds it easy to take out the bike and continues to cycle it, even though she is now in her third trimester with our second child. Electric bikes increase the ability of people to cycle. Additionally, in my work I have observed an increase in older patients who report cycling on e-bikes, even into their 80s. For those with reduced mobility, there are e-trikes and even e-cargo trikes that can improve people's mobility more than walking alone.

It is just a case of using the right tool for the job. Someone would not cycle from south Kerry to Dublin for work on just an e-bike. However, if he or she can combine cycling with bus or train transport, whole areas of the country become accessible without having to resort to driving. Safe cycling routes not just in our towns and cities, but in our rural villages and countryside, are essential to enabling this vision. Appropriate speed limits, quietways and greenways that link villages and towns are key infrastructure points. For instance, despite being a confident cyclist, I would be hesitant to cycle out to my parents' house in a rural part of county Kildare, with my son in tow.

Roads need to be made safer for cyclists and pedestrians to enable a move back away from car transport. There also needs to be safe, well-lit cycle parking at bus stops and train stations to ensure the infrastructure is both safe and seen to be safe to encourage people to use it.

Electric cars are part of the solution. However, we have an opportunity to build back better as we try to get ourselves out of the many issues our society faces. Climate change is an important issue that we face and addressing it can have co-benefits by reducing noise pollution, air pollution and physical inactivity, and can create a healthier and more resilient society. It would be a shame to miss the boat and continue to embed the harmful effects of driving on our society.