Urban Health Assessment Through a Planetary Health Perspective: Methods and First Results from the Rome NBFC Experiment

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This study offers a valuable multidisciplinary approach to urban health assessment under a Planetary Health framework, integrating atmospheric, biological, and vegetation data.  However, several issues remain and should be addressed before the manuscript can be accepted for publication.

1. The abstract is overly long. It would be better to reduce its length and present your key research methods and key findings in a more concise and precise manner.
2. There are too many keywords. Please reduce their number and ensure they are highly relevant to the core aspects of your study.
3. In this study, sampling and analysis were conducted in different locations. The authors should provide a detailed explanation of how the selected sampling sites were ensured to be representative.
4. The study integrates multiple disciplines and measurements, which is a strength, but the linkage between different datasets should be made more explicit to strengthen the overall narrative.
5. It may be helpful to consider incorporating relevant studies in the discussion section, such as titled: Environmental and health impacts of banning passenger cars with internal combustion engines: A case study of Leeds, UK; Evaluation of the public health impacts of traffic congestion: a health risk assessment
6. The conclusions could be made more explicit, highlighting the implications of the findings for urban health and planetary health approaches.

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

This study presents the methodology and initial findings of the Rome NBFC experiment, which applies a Planetary Health approach to evaluate urban health. The research combines atmospheric modelling, aerosol characterisation, human biomonitoring and vegetation analysis to investigate how traffic-related air pollution affects oxidative stress in people and plants. The initial results reveal seasonal pollution patterns, the role of urban vegetation in dispersing particles, and short-term biological responses to fine particulate matter. These insights support the adoption of biodiversity-based strategies to create healthier and more resilient cities.

This manuscript addresses a highly relevant and timely topic, providing a comprehensive, multidisciplinary investigation into the connections between air pollution, biodiversity and human health. The study is notable for its extensive dataset, which integrates four years of continuous environmental monitoring with multidisciplinary biological and modelling analyses.

Some limitations that are inherent to this type of study should be acknowledged. For example, certain participant subgroups, such as the IBD/IBS subset of 33 individuals, are too small to ensure broad representativeness. Integrating results from diverse methods and disciplines poses challenges and may lead to inconsistencies. Additionally, lifestyle, dietary habits and socio-economic factors may not have been fully controlled for in microbiota and biomarker analyses. From a methodological perspective, the PILS approach could underestimate ROS associated with small or hydrophobic particles. Finally, focusing on a limited number of sites within Rome restricts the generalisability of the study's findings to other urban environments. It is also hoped that the project results will be formulated more clearly by further research.

I recommend publication of the article, provided the text is revised to improve readability by simplifying overly complex sentences, and the noted methodological and interpretative limitations are addressed.

Remarks:

Abstract – The second half of the abstract is too cumbersome; it should be edited and shortened, as should the list of keywords.

Figure 1 – What indicates the separate elements on the bottom and the right and left sides of the figure? If they are not important, I would remove them to make the figure easier to understand.

Figure 3 – It looks like borders aren't needed here.

Lines 369-371 – How important is it for the paper to list the entire set of elements?  None of them were found in the analyses. The paper is so full of information that it would be better to omit superfluous details.

Line 624 – It should probably be 6 instead of 6.66.

3.1 Four-year wind patterns – If the wind rose is analysed, it should provide at least some general information about the location of the main local and regional sources of pollution.

Figure 4 –I don’t understand the scale. Is 6,6815 the maximum observed wind speed? This should be clarified in the text.

3.2.1 Four-year statistics …. – Some notes should be made regarding interannual variations.

Figure 5 – The numbers on scales are difficult to see. Also, it is unclear whether the simulations were performed for a specific date. It would be useful to have the option of viewing the modelling description (e.g. initial and boundary conditions) in the supplementary materials.

Line 721 – How will you determine short- and long-range aerosol transport from profiling?

Lane 727 —I believe the year should also be mentioned here and in any other similar episodes.

3.4.3 BC and UHI – Why was BC (and not PM, for instance) considered in relation to UHI?

Conclusions - The work aims to provide a holistic picture, but the numerous components of the study are difficult to piece together coherently. Perhaps a diagram should be created to illustrate the relationship between these diverse experimental and modelling studies.

Author Response

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Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

This manuscript focuses on taking the planetary health perspective as a framework and integrating multi-disciplinary approaches to evaluate the urban health of Rome. It particularly explores the associations between exposure to traffic-related air pollutants and oxidative stress in both humans and plants. Although this research report offers practical suggestions for optimizing interdisciplinary methods in urban health assessment and for analyzing the mechanisms underlying the associations between exposure to traffic-related air pollutants and ecological and human health, certain revisions are essential for the publication of this manuscript.

 

1. It is recommended to supplement data on long-term impacts. The health hazards of air pollution are mostly chronic cumulative effects, such as the association between long-term PM₅ exposure and cardiovascular diseases; thus, short-term data can hardly reflect the actual risks. The lack of long-term data will limit the guiding role of research in long-term urban health planning and reduce its policy relevance.

 

2. In the regulation of urban air pollutant exposure, while establishing a pollutant diffusion simulation system based on vegetation coverage and atmospheric dynamics is undoubtedly important, the application of high-performance, green, and non-polluting air filtration materials is equally crucial for ecology and human health. It is suggested that additional references such as Journal of Hazardous Materials, 2022, 432, 128735, ACS Sustainable Chemistry & Engineering, 2025, 13, 6209, Advanced Materials, 2020, 32, 2002361, etc.

 

3. It is recommended to analyze the synergistic effects of multiple pollutants. The current study mainly focuses on particulate matters such as PM₅ and black carbon, but has not systematically analyzed the combined toxicity mechanisms of gaseous pollutants and particulate matters. However, in the actual environment, the interaction of multiple pollutants may exacerbate oxidative stress effects.

 

4. In the references, some have incorrect formats. Please check carefully, for example, lines 1170, 1185, 1194, etc.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The authors have addressed my concerns, so I recommend the manuscript for acceptance.

Reviewer 2 Report

Comments and Suggestions for Authors

The authors took all the comments very seriously and did a great job finalising the article. I believe its quality has improved significantly, and it can be published in its current form.
There are only a couple of minor points that I think should be taken into account before publication.

1. Line 644 and Figure 4: the wind speed values are given with excessive precision, which exceeds the accuracy of the measurements. I would leave one decimal place, but no more than two.
2. Lines 661–668: This new paragraph is missing references.

Reviewer 3 Report

Comments and Suggestions for Authors

The author has revised the original manuscript based on the reviewers' suggestions and it is now ready for publication.