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Health effects of air pollution
Tanja from Guy’s and St Thomas’ NHS Foundation Trust explores how, through our partnership, we’ve been designing solutions to reduce air pollution.
Guy’s and St Thomas’ NHS Foundation Trust is one of the largest and busiest NHS trusts in the country. But most of its sites are in some of the most polluted areas of London. That’s a concern for the health of patients and staff, not to mention residents who breathe toxic air every day.
Air pollution is the single biggest environmental threat to people’s health. It contributes to up to 4,000 deaths per year in London and up to 43,000 per year in the UK.
Some people are particularly susceptible to the harmful health effects of air pollution, including children, older people, and people with health conditions. People from minoritised communities are disproportionately affected by poor air quality in cities such as London.
Many of these people either work at the Trust’s sites or will visit at some point, often when they are at their most vulnerable.
My role as Air Quality Manager at Guy’s and St Thomas’ NHS Foundation Trust is to reduce our contribution to local air pollution, and to work with staff and patients to better protect them from, and educate them about, air pollution and its harmful effects on health.
As an organisation that prioritises and promotes good health, it’s important that Guy’s & St Thomas’ NHS Foundation Trust acknowledges that it contributes to air pollution – whether by transporting patients, the deliveries it receives, or construction projects – and it’s even more important that the Trust takes steps to understand and reduce this contribution.
Through our partnership with Impact on Urban Health we’re designing solutions to lower our polluting emissions while communicating with staff and patients about poor air quality.
During the first 18 months of the partnership we identified how the Trust contributes to poor local air quality and how we could reduce air pollution at source. We also identified the data we would need to gather and asked ourselves how we can protect staff and patients from local air pollution and communicate about this issue.
Guy’s and St Thomas’ NHS Foundation Trust runs across five acute hospitals – where patients receive active care – and over 100 smaller sites where we provide local community services. This means there are complex and frequent transport operations that contribute to already high levels of local air pollution.
One way of reducing this transport footprint is to look at how our home-visiting colleagues move around our local communities. We have, for example, over 400 neighbourhood nurses across the Trust that have traditionally used cars to get to their patients’ homes.
As a test project, we gave two e-bikes to members of our neighbourhood nursing team at Mawbey Brough Health Centre. The bikes, which have excellent sustainability credentials, have large panniers that allow the nurses to transport all their equipment.
The introduction of e-bikes presented more challenges than we anticipated, from the training needs of our staff, to bike theft, and fire safety concerns around the charging of e-bike batteries.
Still, we believe in the significant potential of this project and not only from an air quality perspective. But also, its ability to improve operational efficiency with the nurses having reported mental and physical health benefits.
We now have a total of six outdoor air quality monitoring stations covering pedestrian entrances and loading bays: three around the St Thomas’ sites, one at Guy’s, and one at the Royal Brompton. We hope to be able to add another station at Harefield Hospital by summer 2023. Data from our air quality monitoring around pedestrian entrances are available here.
We’ve also finalised our first indoor air quality monitoring project, focussing on areas and wards where those most vulnerable to air pollution are present and/or where we might expect poor air quality. This includes accident and emergency, neonatal intensive care, the chest clinic, our kitchens, wards specialised for patients with lung conditions, and those looking after patients following heart or lung surgery. We monitored at these locations during summer and winter and are now analysing the results so we can address poor air quality where necessary.
Because of the severe effect air pollution has on children’s health, we have created a protective air pollution barrier between the Guy’s & St Thomas’ Day Nursery and the surrounding busy main roads. The screen, which is made of ivy, helps to block and filter pollutants while also reducing noise pollution, greening the area, and creating privacy.
We have also started a range of other initiatives, from creating leaflets about air pollution for our patients to creating a Clean Air Network for our Trust colleagues.
Following our exploratory work during the first 18 months of the project, we are pleased to have extended our partnership with Impact on Urban Health to June 2025. Key to the next phase of work is building on learning to date and embedding air quality considerations into all relevant areas at the Trust.
Jointly with our neighbouring Trust King’s College Hospital we have developed a Clean Air Plan 2023 – 2026, which describes our commitment to reducing our contribution to air pollution and to raising awareness of the issue to improve the health of our patients, staff, and local communities
We will, for example, develop air quality training for clinicians, extend our air quality monitoring work on our loading bays to help us reduce the local impact of deliveries and waste collections, and increase the number of e-bikes made available to staff members working in the community. We will also work with an external evaluation partner to help us estimate the impact of our work, understand learnings, and share these with our partners.
Local air pollution is not something any one organisation can solve on its own. We are looking forward to working with Impact on Urban Health, our staff, partners, visitors, suppliers, and members of the local community to implement the commitments and actions in our Clean Air Plan. Together, we can make the air around us cleaner and healthier for everyone.
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