Christopher Snowdon

Do we need to worry about air quality in Britain?

Do we need to worry about air quality in Britain?
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Is polluted air still a problem in Britain? When it comes to smog and pollution, most of us think about rapidly-industrialising city likes Shanghai and Delhi rather than London. Yet the research tells a different story: the Royal College of Physicians estimates that 40,000 deaths a year can be attributed to air pollution, and that the wider health problems resulting from toxic air – which include asthma, cancer, and stroke and heart disease – could cost the UK economy more than £20 billion every year. They’re staggering numbers – so why don’t we hear more about the problem?

On 17 June 2019, The Spectator gathered a group of politicians, academics and other experts together for a lunch to discuss this issue and establish what actions need to be taken. A few days earlier, the Evening Standard had reported an ‘utterly horrifying’ rise in the ‘death risk from London toxic air’. Public Health England also says the numbers are rising. The broadcaster Alastair Stewart, who chaired the lunch, kicked off proceedings by asking, how reliable are these statistics? Is the problem really getting worse? How bad is it and how worried should we really be?

The nature of air pollution has changed and there is still much we don’t know. Smokestacks and belching factories have made way for diesel exhaust fumes and fine particulate matter (PM2.5). Despite a ban on coal-burning in big cities, the problem of air pollution is worsening in many local areas, particularly outside schools, mainly because of motor vehicles. Professor Jonathan Grigg (Professor of Paediatric Respiratory and Environmental Medicine at Queen Mary & Member of the UK Committee on the Medical Effects of Air Pollution) said that the evidence of harm done by vehicle pollution has only become overwhelming quite recently. Air pollution particles have got smaller. This makes them less visible but no less dangerous. On the contrary, he said, ‘these very small particles are coated with all sorts of horrible toxins and are getting into places where they are not being handled.’

Richard Black (Director of the Energy & Climate Intelligence Unit and former BBC Environment columnist) added that fine particulate matter can travel deep into the lungs and may be able to cross the blood-brain barrier. He acknowledged that we still do not have a coherent view of all the impacts and that there is a danger of scaremongering. Nevertheless, air pollution particularly affects vulnerable, older people whose death is being hastened, and children with developing physiological systems, whose long term health and life expectancy is affected.

Yet research shows adverse impacts from air pollution on the health of people at all stages of the life cycle. Sarah Wollaston MP (Chair of the Health Select Committee) said that it is important to talk about the impact on healthy life expectancy and quality of life in order to get an overall picture of how air quality affects us. Professor Stephen Holgate (Chair of the RCP/RCPCH working party on air pollution) is concerned that ‘air pollution isn’t recognised by the medical profession as a whole as being a major cause of these illnesses’ and that it is time for doctors to take ownership of the issue.

The increasing use of diesel vehicles and the resulting rise in nitrogen oxide (NOx) emissions is the most obvious example of the UK going backwards in recent years. As Geraint Davies MP (Chair of the All Party Parliamentary Group on Air Pollution) pointed out, until recently 50 per cent of new cars were diesel thanks to perverse government incentives. As a result, air pollution has increased in many cities, especially London. ‘Now we’re in a situation where there has been a huge escalation of particulates and NOx,’ he said. ‘The government claims overall that air pollution is down looking at levels over a long period of time, and a lot of that is down to the closure of coal mines and the export of manufacturing industry to China and elsewhere, but in the last couple of years we’ve seen it go up.’ Instead of individual factories pumping out smoke, we have ‘an invisible factory of thousands of vehicles pumping out NOx and particulates to small children and pregnant women.’

Mr. Davies said that if parents knew how bad the air was outside their children’s school they would be up in arms. Part of the task therefore lies in educating the public; to ‘make the invisible visible’, as Professor Holgate put it. To that end, Clean Air Day is held on 20 June, organised by Global Action Plan. Chris Large (Senior Partner, Global Action Plan) suggested introducing a government funded information campaign about air pollution on the scale of anti-smoking and drink-driving campaigns. Nick Martin (Head of Environment and Sustainability, Great Ormond Street Hospital) said the NHS had an important role to play in improving air quality and communicating the benefits of a healthy environment to the public. Great Ormond Street Hospital has partnered with Global Action Plan to develop the first ever Clean Air Hospital Framework, which sets out actions NHS trusts can take to create a healthier environment for patients, staff and surrounding communities.

Education alone will not solve the problem. The government intends to include a section on air pollution in the much anticipated second part of its draft Environment Bill. Those who attended the Spectator lunch had no lack of suggestions for what should be in it. Dr. Wollaston said local authorities need greater powers to implement action to reduce air pollution and prioritise sustainable active travel. ‘You have to give local areas real powers,’ she said. ‘In my constituency there is one particular road in Totnes which is very, very heavily polluted and I’d like to see the local authorities do much more accurate monitoring in areas where there’s a problem and then have the muscle to say ‘we are going to deal with this and this is how we’re going to do it’. So it is about local and national policy.’

Professor Eloise Scotford (Professor of Environmental Law, Faculty of Laws, University College London) agreed that more effective coordination between national and local action on air quality was required. In her view, this coordination effort should go further. All government departments and agencies with some control over sources of air pollution (including control over behaviour that generates pollution) should share legal responsibility for keeping air pollution at safe levels. Better data is also important. Professor Scotford’s research shows that there are ‘gaming practices around current air quality standards and measurement requirements that distort data’. Professor Holgate argued that any forthcoming clean air legislation must have ‘a compulsion to have local air quality monitoring around places where people live and not have this global average model data which everybody has been deceived by.’

The idea of creating a legal right to breathe clean air met with agreement from around the table, as did Richard Black’s suggestion that responsibility for dealing with air pollution should be explicitly transferred to the Department of Health. ‘Everything about this conversation suggests it is a health issue,’ he said, ‘and not an environmental issue.’

On the policy specifics, Mr Davies urged the government to provide the kind of fiscal incentives that Norway has successfully used to switch 70 per cent of motorists to electric cars. One obstacle to uptake of electric vehicles is ‘range anxiety’ – fear of driving too far from a charge point – and so a huge number of electric charge points will need to be installed to kick start change, said Dr Wollaston, along with incentives for people on low incomes, such as a diesel scrappage scheme.

Some of these policies will be familiar to those who attended the Spectator Energy Summit. There is significant overlap between plans to tackle climate change and plans to tackle air pollution. Decarbonising transport will result in a huge cut in exhaust emissions, but whilst action on greenhouse gases often means action on pollution, Chris Large cited wood-burning stoves and cleaning products as examples of pollutants that will not be affected by carbon targets. Market forces should be enough to convert people to electric cars, said Richard Black, ‘but if you are talking about cleaning products or paints that contain high levels of DOCs [Discrete Organic Chemicals] then straightforward regulation may be the best way to do. History shows that industry innovates when sensible regulation comes in.’

So much of the public conversation is about outdoor air, but people spend 90 per cent of their time indoors. Most of our exposure to air pollution occurs in our homes and workplaces, whether from outdoor pollution coming indoors or from indoor sources such as stoves, frying pans, toasters and candles. ‘That’s a big issue,’ said Professor Holgate, ‘because nobody has really measured things carefully in that context. They’ve always assumed that it’s while you are walking up and down the streets that you get oral exposure but it’s not: people breathe air in homes, air comes into houses.’

This is where businesses like Philips come in. Elizabeth Littlewood (Head of Brand and Integrated Communications, Philips) said that air pollution was about to have its ‘plastics moment’. Philips makes World Health Organisation grade air purification technology. Home use has been driven by those suffering from allergies, asthma and hay fever or other respiratory issues and – increasingly – health conscious audiences who view purifying the air in their homes as a natural daily, healthy habit. With the public increasingly seeing clean air as a fundamental right, such equipment will become increasingly desirable – perhaps essential – in many commercial, domestic and public buildings.

For Mark Leftwich (Market Leader, Philips Healthcare), prevention starts in the home. Domestic air purification systems can help the NHS by stopping people going into hospital in the first place. ‘Strategically making a connection between our changing environment and the impact on our health galvanises the whole population of Philips. People really see this as the future and we have to address it. We have technology today which can make an immediate impact on people’s lives. We are totally passionate about it.’

The problem of air pollution in Britain’s towns and cities is real and we have a long way to go before we fix it, but the solutions are out there. Surveys show that most people think that air pollution should be a priority and that politicians should be doing more. There is work to be done to fully assess the risks and we need to measure local pollution more accurately. We all have a part to play in protecting ourselves and others, but everybody at the lunch agreed that leadership is needed from the government, starting with some immediate targets and plans in the forthcoming Environment Bill.

‘I think we’re at a tipping point now,’ said Dr Wollaston, ‘I think people are starting to get it because these are big changes for the public, but you can do it. It requires that combination of bringing the public along, making the case, producing the evidence and then you need the legislation to ensure it happens.’