We focus on four complex health issues more prevalent in urban areas
With the Social Progress Imperative, we've developed the first neighbourhood level, health-focused social progress index of its kind.
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Health effects of air pollution
Debates around air pollution have been sabotaged by misinformation and online abuse. So, what does the research say about how air pollution affects health?
You’ve probably noticed there’s been lots in the news about air pollution.
Media coverage has focused on the effects of lockdown on air quality, on the Ultra Low Emission Zone (and other clean air zones around the country), and ongoing debates about low traffic neighbourhoods.
Sadly, this coverage has been usurped by paid-for misinformation campaigns on social media, racist abuse, and aggressive trolling.
Among all this conflicting information, it’s difficult to know what’s accurate and what’s not.
In April, I wrote a thread summarising the research into the health effects of air pollution. I linked to research that has shocked me the most while learning about air pollution in the last three years.
It quickly became the most read tweet I’ve written. I think that’s because people are concerned about air pollution, but online misinformation and toxic messages make it intimidating to ask questions.
The research shows us that chemicals in the air are devastating our health. Most people across the UK, particularly those in urban areas, are breathing air that surpasses the World Health Organization’s guidelines.
Clean air is a human right. Air pollution, therefore, limits the freedom of most people on Earth, and some people more than others.
It’s bad. Worse than people may realise.
Globally, air pollution is estimated to contribute to one in five of all deaths. When factoring in deaths from indoor air pollution, estimates rise as high to ten million deaths per year.
In the UK, air pollution is estimated to contribute up to 43,000 deaths per year, 4,000 of those in London.
Air pollution reduces healthy lifespan. It cuts short the lives of billions of people by up to six years, making it a far greater killer than smoking, car crashes or HIV/Aids.
Some people on social media often refute the above information, often asking why – if the above research is true – air pollution isn’t attributed as an official cause of death. The reason is because air pollution causes health issues, which can be fatal. For example, air pollution contributes to cancer.
At Impact on Urban Health, we often say “air pollution is a social justice issue”. We also point out the links between air pollution and systemic racism.
People often question this, sharing their views on social media or in the below the line comments on news articles. “How can air pollution discriminate based on a person’s skin colour?” people ask.
The Lancet Commission on Pollution and Health summarises it well: “…in countries of every level of income, the health effects of air pollution are most frequent and more severe among the poor and the marginalized.”
The Lancet’s observation is evident in London, where we test interventions to improve air quality.
Research shows Black, Asian, and children from other minoritised communities, and children in areas of deprivation in London, all experience greater air pollution burden. Similarly, a recent report from the Greater London Authority found that Black people and people from other minoritised communities are more likely to be affected by air pollution.
This finding is reflected in major cities across the UK, where Black residents are being exposed to more levels of illegal air pollution than any other ethnic group.
Of course, air pollution itself can’t discriminate. But the effects aren’t equal.
It’s easy to understand that people in cities are disproportionately affected by air pollution. Within those cities, it’s children, older people, people with health conditions, people who live in areas of deprivation, and people from minoritised communities who are most affected.
The more air pollution a person breathes, the more likely it is they will develop cancer.
In fact, for every ten microgram per cubic meter (µg/m³) of increased exposure to fine particulate matter (PM2.5), the risk of dying from any cancer rises by 22%.
(For context, the UK Government announced in December 2022 that they have set a target of ten micrograms per cubic meter for PM2.5 by 2040. The average annual levels in London were over 13 micrograms per cubic metre in 2019.)
Another study finds that: “Each 10-µg/m3 elevation in fine particulate air pollution is associated with approximately a 4%, 6%, and 8% increased risk of all-cause, cardiopulmonary, and lung cancer mortality, respectively.”
Air pollution affects people throughout their entire lives. From before birth to death, air pollution increases the risk of stroke, dementia, cancer, multiple longer-term illness including respiratory and cardiovascular disease, and early death. The same research concludes that even low levels of air pollution are harmful to health.
Exposure to air pollution increases the risk of premature birth and significantly increases the risk of low birth weight in babies, leading to lifelong damage to health.
Air pollution is as harmful for pregnant women as smoking when it comes to rising the risk of miscarriage. Research has also found pollution particles in placentas.
Even if burning fossil fuels wasn’t causing the climate emergency, the loss of life caused by air pollution is enough justification to stop burning them.
Globally, it’s estimated that two degrees of global warming will lead to an extra 153 million deaths this century from the air pollution caused by burning fossil fuels.
There is good news. Air pollution can be fixed relatively quickly. Research shows most of the UK could fall within the World Health Organization’s (WHO) recommended guidelines by 2030. And the more a city cleans up its air, the longer its inhabitants live.
Across the UK, being within WHO’s guidelines would mean “longer and much healthier lives, including an average of 3,100 fewer new coronary heart disease cases, and 388,000 fewer reported asthma symptom days in children each year.”
The value of the total benefits gained would be over £380 billion, which would more than justify spending up to £3.3 billion per year on existing and new policies to address air pollution.
The online misinformation and use of malicious tactics – including racial abuse of people on social media – is a deliberate attempt to sabotage the narrative around one of the most urgent public health issues the UK has ever faced.
How should communicators work in this context of misinformation? When asked about the challenge of communicating about air pollution, David Fenton, named as “one of the 100 most influential PR people” by PR Week describes the climate crisis as “a blanket of pollution around the Earth that is trapping heat that used to go back out to space and that’s making the storms and the droughts stronger and is melting the ice and flooding our cities.”
Focusing on the consistent findings of research tells a clear story: Air pollution devastates the health of people and the planet.
We've supported the Clear The Air campaign from Asthma UK and the British Lung Foundation. See how air pollution unfairly affects some communities more than others and what can be done to level up.
In December 2022, the Chief Medical Officer for England – Professor Chris Whitty – published his annual report, and it focused on air pollution. Kate Langford, Programme Director of our Health effects of air pollution programme, and Professor Whitty explain why there is hope in the efforts to improve air quality.
Kings College's Dr Frank J Kelly discusses why we require better evidence around what works in order to solve the issue of air pollution.
Our insights into clean air solutions include an evidence review of interventions in inner cities as well as public perception research.
The more we know about air pollution in urban areas, the more we will be able to design effective solutions.