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ar efficiencies, treatment arms are rarely added to ongoing trials in practice. This paper demonstrates how this strategy is acceptable, feasible and beneficial to patients and the wider research community. ISRCTN Registry ISRCTN01844152 . Registered on August 08, 2014. ISRCTN Registry ISRCTN01844152 . Registered on August 08, 2014. Exposure to traffic-generated emissions is associated with the development and exacerbation of inflammatory lung disorders such as chronic obstructive pulmonary disorder (COPD) an