Professor Chris Whitty is Chief Medical Officer (CMO) for England, the UK government’s Chief Medical Adviser and head of the public health profession. He represents the UK on the Executive Board of the World Health Organization.
Air pollution affects us all. It is associated with impacts on lung development in children, heart disease, stroke, cancer, exacerbation of asthma and increased mortality, among other health effects. Except for air quality in our own homes, we have little control as individuals over the level of pollution that we and our families breathe – this must be seen as a societal problem to solve. Government has therefore had a central role in tackling air pollution in the UK going back at least to King Edward I in the 1280s, and does now. Many industries and sectors also have to be part of the solution.
Outdoor air quality in this country, and most high-income countries, has improved significantly since the 1980s. Some air pollutants such as sulphur dioxide from coal, and lead from petrol, are fractions of their previous levels.
As this report lays out, we can and should go further to reduce air pollution – and it is technically possible to do so. Improvements in engineering for transport and industry, modifications to agricultural practice and improvements in the built environment are examples that should, once a change is made, be self-sustaining and allow us to reap health benefits for the foreseeable future. Many of the changes to improve outdoor air pollution have significant co-benefits. For example, reducing the use of fossil fuels for energy reduces both air pollution and carbon emissions; improving active travel reduces air pollution emissions from vehicles and has direct health benefits to those who are walking, wheeling or cycling.
In particular, we need to concentrate on the places where people live, work and study; the same air
pollution concentration in a densely populated area will lead to greater accumulated health effects
than in a sparsely populated area as more people will be affected.
The path to better outdoor air quality is clear, and we now need to go down it. Indoor air pollution is becoming an increasing proportion of the problem as improvements in outdoor air pollution occur. Most of our days are spent indoors whether for work, study or leisure, yet indoor air quality has been studied much less than outdoors. While there are some spaces such as owner-occupied houses that are fully private, many indoor spaces are public, including health facilities, schools, other public buildings, and also shops and workplaces. As with outdoor spaces, people in public buildings are exposed to air pollution but can do little about it, so society needs to act. A better understanding of how we can prevent and reduce indoor air pollution should now be a priority.
This report is about air pollution and its solutions in England, but it is also an international problem. There is a lot we can learn from best international practice. Many air pollutants travel long distances, so emissions and air quality in continental Europe affect the UK and vice versa. It is important to acknowledge that the improvements in air quality we are seeing in high-income countries are yet to be felt in many middle-income countries, but many of the technologies and techniques will be transferable.
(Be warned, it’s a long one!)
