Forum topic: Poor Air Quality

The PGC site promoted a “Meet the Expert Evening” at the Royal College of Physicians as part of a wider Healthy Lungs for Life Campaign. The seminar was a side issue to a reported 20,000 lung-specialising (world / European?) scientist convention taking place in London.

Much (traffic related) Air Quality material has already been highlighted on the site and local press, but some new facts (to me at least) may prove enlightening:

Smoking: caused an estimated 100 million deaths worldwide in the twentieth century. The equivalent figure forecast for the twenty-first century is a staggering 1 billion. Not surprisingly the advice is to do all you can to give up (and not to start). Vaping was seen as better than smoking but far from risk free, ideally used as one possible route from smoking to complete abstinence. There is no long term research on vaping’s health impacts and doubts expressed over the quality control in place during manufacturing. Just what are you vaping? Formaldehyde for one it seems.

All speakers highlighted the (very) long term and cumulative impacts of poor air quality. A strong current concern was for the unborn and young children who may be experiencing (frequently traffic related) pollution incidents with longer term life impacts. Data is still emerging about the effects of the 1952 Great Smog, including a huge spike in new asthma cases at that time.

It was explained that in the 80’a and 90’s some indications that poor air quality may be a health issue were emerging but it has only been during the last decade with focused research that the sheer extent of the problem has started to be understood. Highlighted was a real communication challenge to make the public (and politicians) aware. The scientists are not entirely clear the best way of achieving this, acknowledging there is often public pushback against experts.

The most effective short term move was said to be the removal of diesel form the UK fleet and some real exasperation that there was no political move on this front. With this particularisation of the car fleet we are now apparently seeing “the development of a new disease”.

Specific research was underway with London kids. This chart, showing black carbon inhalation in one case over 24 hours really highlights the morning school run peak. However, the Professor explained that at this stage they simply do not know if the spike is any worse than the lower level but constant level of pollution to our health, only that both are detrimental. That research is ongoing



The joint report from the Royal Colleges of Physicians and Paediatrics and Child Care was released earlier this year (available on line). In it they said it was their duty to speak out when faced with such a clear and avoidable cause of death, illness and disability as Air Pollution.

Their call was for urgent, community wide action to protect the health, wellbeing and economic sustainability of present and future generations, where everyone accepts personal responsibility and makes concerted efforts to change behaviours. Central to this was a request to move away from petrol and diesel cars towards public transport, walking and cycling.

I guess we have been warned.

The report that Karl refers to is written by health professionals and is very long and thorough. Lay readers will find it tough going, but you only need to skim through it to get a very clear message and to become extremely worried, especially about what we are doing to our children and grandchildren - and that includes what we are doing to them while they are still in the womb.

Click on the link below to download the report:

Report by Royal College of Physicians: Every Breath We Take

This report should be compulsory reading for all MPs and local councillors.

There are some very effective graphics used - below is just one.

Check the infographic under Basil’s posting showing air pollution as a cause of smaller heads in babies. (This recent research was led by Jonathan Grigg, professor of paediatric respiratory medicine at Queen Mary University of London.) Now contemplate that alongside just reported research under Professor Ian Deary of Edinburgh University which concluded, to quote directly from one major newspaper, “The size of babies heads at birth is strongly linked to their future success with larger head circumferences and brain volume associated with higher intelligence, scientists have found.”

Feed that one through the repeatedly stated (non-polluting) “cycle lanes are only for a tiny minority” filter and hold head (of whatever size) in your hands. If 2 plus 2 does indeed equal 4 then the UK needs serious action, and fast.

This morning the BBC Radio 4 'Today' programme carried an item on air quality based on a consultation currently being undertaken by NICE (National Institute for Health and Care Excellence). It can be heard via the programme's website at about 2hrs 40mins through the broadcast.

In essence NICE's representative talked gaily about removing 'speed bumps' and lower speed limits, and the local government representative in the discussion mentioned walking and cycling, and how cash-strapped councils are at present. Clearly the NICE representative had no grasp of the complex issues surrounding streets issues.

Apparently - I haven't read much of it yet - the consultation doesn't deal with issues such as driving petrol vehicles rather than diesel (though it does suggest that public bodies should take care when choosing vehicles), which the local government representative was quick to point out.

At an uniformed guess I'd say NICE is very welcome because it has clout whether or not it understands all the streets issues, and because it supports the pressure for change locally.

The consultation document can be found here: https://www.nice.org.uk/guidance/GID-PHG92/documents/draft-guideline

Parents in London were advised to “take care” when taking their baby outside because of toxic air pollution levels - babies at risk from the very air we breathe in the world’s greatest city seems crazy but it has been some week in the world of air pollution.

A new air pollution warning system went live this week registering “high” all too quickly. The deputy mayor for environment and energy then urged the government to tackle “this diabolical situation”, calling our common air “London’s illegal and filthy polluted air”.

NICE (the body who run the cost / benefit equations to approve, or otherwise, drugs for use by the NHS) have focused on Air Quality, calling it the public health issue of our time. Their draft report is out for consultation and adds further weight to the list of air pollution horrors.

We also learnt that not only does polluted air irritate asthma but that traffic pollution is indeed responsible for turning healthy children into asthmatics. Data from 41 different epidemiological studies from several countries was used by researchers at Leeds University to confirm what many had long suspected. Asthma affects 1.1m children in the UK, killing several thousand UK citizens each year.

There was no comment on the equivalent effect on adults but I suspect adult lungs are not so far removed from the form of children’s so as to be without some impact. We will need to wait and see the definitive conclusion on that one.
Presumably based on such appalling data and concern for their citizens, four world class cities announced their intention to ban diesel vehicles by 2025: Paris. Madrid, Athens and Mexico City.

And last evening attendees at Bowes Ward Forum heard that Enfield Council is supportive of extending the Ultra Low Emission Zone (ULEZ) to the northern edge of the borough, ie close to the M25. A fleet operator, supporting the move, explained that the existing control infrastructure for the Clean Air Zone could be used at little extra cost. The Mayor is currently consulting on extending it as far as but not including the North Circular. It was explained how the likely effect of this would be for nearby areas such as Palmers Green and Bowes to have increased levels of dirty air, hence the wish to go all the way.

Wow. As I have commented before, this is a relatively new area of research and scientists are only at the early stages of identifying the health risks and issues. That means even more to come. 40,000 attributable early UK deaths pa, 10,000 of those for London. Imagine the reaction were that due to train crashes or terrorism. The Government sitting on their hands? I think not.

Very good feature about this on the Sunday Politics.

Although air quality is many times better than 40 years, it still presents a public health problem.

But, there is no air quality crisis and the response to the problem should be proportionate.

The statistics picked up in the media in the past year originate from one US study in which estimates where extrapolated for the UK and London.

The conclusions of the study have been grossly exaggerated, by environmentalists, notably Greenpeace, seeking to cause alarm.

You can watch again here. Available until 17 Jan 2017.

http://www.bbc.co.uk/iplayer/episode/b084jbfw/sunday-politics-18122016

The feature starts about 30 minutes into the program

Everything needs to be tackled proportionately but when HMG loses two cases in the Supreme Court for being insufficiently focused on the issue of Air Quality; the Royal Colleges produce comprehensive reports indicating c40k attributable deaths (down from the previous 50k as they deduped the effects of NOX and particulates previously aggregated); WHO highlighting more worldwide deaths due to air pollution than RTA’s; the British lung Foundation recently a report highlighting lung disease (causing 1 in 5 UK deaths) and recommending that to help reduce the impact air pollution has on the UK’s lung health requires “urgent cross-departmental government action”; and on and on from world leading UK medics and researchers in this space, does tend to suggest that underplaying the 2nd largest public health killer in the UK (after smoking, and confidently expected to rise in academic spheres) may risk looking a tad complacent whatever Andrew Neill / Greenpeace have to personally grandstand about.

The Guardian newspaper on the 9th of January carried an article by George Monbiot which imagined that you could buy canisters containing a toxic gas, and that some people walked the streets squirting the gas into the faces of children. He further he imagined that this behaviour became a craze such that the children couldn't walk a metre without receiving a faceful, and that whilst a single dose would not cause significant harm, repeated doses damaged hearts, lungs, and brains affecting health, intelligence and life chances. Of course such behaviour would be treated as a national emergency, with the canisters banned, the police mobilized and new legislation rushed through parliament.

Readers of the article know instantly where this article is going: we, and children especially, are being damaged, often very seriously, by poor air quality mainly caused by diesel engines. George Monbiot called it mass poisoning, worldwide killing more than three times as many as Aids, tuberculosis and malaria combined.

The article discusses many complexities of the situation; including the fact that worldwide neither governments or purchasers are taking serious action and why that is. But I'm going to sign off from this subject by saying that this is among the bigger issues of our time, and we should be happy and grateful that we have a local council which is doing what it can to encourage walking, cycling and public transport.