Sarah at her job

Health effects of air pollution

Air pollution and people with heart and lung conditions

Urban air pollution and the health of people with heart and lung conditions

What we've learned

  • Short-term spikes of NO2 have been associated with increases in hospital admissions for asthma and short-term spikes in PM2.5 and NO2 have also been associated with COPD related hospital admissions.
  • Levels of PM2.5 across the whole of the boroughs is higher than the World Health Organisation (WHO) air quality recommended guidelines, and 5 out of 10 hospitals in Lambeth and Southwark are in an area with a level of PM2.5 50% higher than the WHO guidelines.
  • People with health conditions are more likely to be aware of the health effects of air pollution, but there are differences. For example, people with lung conditions are nearly 35% more likely to think air pollution is important to their health than people with heart conditions.

People with heart and lung conditions


of local respondents to our survey live with a lung condition


people with lung conditions are nearly 35% more likely to think air pollution is important to their health than people with heart conditions


These maps indicate prevalence of lung and heart conditions. Chronic obstructive pulmonary disease (COPD) is more common in the north of Southwark, while asthma is more common in the south of the boroughs. The distribution of these conditions is driven by many factors in addition to air pollution such as age and other risk factors.

Health conditions in Lambeth and Southwark

To understand exposure we need to understand where people spend their time and how polluted those environments are. While more work is needed, these dots mark places where people with heart and lung conditions spend some of their time: our local hospitals.

The entire footprint of our boroughs is above the guidelines set by WHO for air pollutants PM2.5 and PM10. Half of our local hospitals (5 out of 10) are in areas with PM2.5 levels that are 50% higher than the WHO guidelines recommend.


  • People with asthma are more sensitive to inhaled irritants including air pollution. Spikes of NO2have been associated with short-term increases in hospital admissions for asthma.
  • People with COPD (chronic obstructive pulmonary disease) have a diminished capacity to clear their lungs and as a result, can incur a higher than normal dose of air pollution. Short-term spikes in PM2.5 and NO2 have also been associated with COPD-related hospital admissions.
  • Long-term exposure can lead to the onset of heart and lung disease in healthy adults and has been linked to the exacerbation of lung and heart conditions, including heart attacks and hypertension.

Research has shown air pollution can worsen existing heart and circulatory conditions, such as symptoms of angina, heart failure, atrial fibrillation and others. Cleaner air isn’t just a nice thing to have – it is vital to help people live healthier and longer lives.

Jacob West Executive Director of Healthcare Innovation, British Heart Foundation


As part of the groundwork for our programme, we researched air pollution awareness among people living in our inner-city area. Together with partners including Global Action Plan, Opinium and BMG Research we did:

  • On-street interviews with 401 local residents
  • Focus groups, including one consisting of people who have a pre-existing health condition (all 65+)
  • A public perception survey of 1,033 local residents

This insight will help us develop more effective projects to address poor air quality and improve the health of local residents – particularly the vulnerable groups who are the focus of our programme.


Greater sense that air quality has dropped

When we asked our focus groups about the challenges of living in Southwark and Lambeth those with health conditions, or caring for someone with a health condition, were more likely to say the air quality has got worse.

Concern about air quality in Lambeth and Southwark also rises if individuals are aware of the problem or directly affected by it. The patient focus group, for example, ranked the importance of air pollution as a local issue higher than older people, families and businesses. For these latter focus groups, the most important issues are safety (young families and older people) and the cost of rent (businesses).

Stronger connection between pollution and health

The patient focus group felt the connection between air pollution and their health most strongly. This group were well informed about air pollution as many had been diagnosed with conditions associated with air pollution and had been informed by a health professional that air pollution could be contributing to their condition.

Take active steps to protect health

The patient group were also the exception to a general lack of awareness of how to protect yourself from air pollution; some are consciously taking steps to protect their health.

However, there were still misunderstandings common amongst the general public about what is effective: one participant mentioned buying a face mask to reduce their exposure.

Differing attitudes for different health conditions

People with lung conditions think air pollution is more important to their health than people with heart conditions. This suggests that people with lung conditions are more aware of the impact air pollution has on them.

The majority of people in Lambeth and Southwark understand that the main source of air pollution is traffic and, when asked for detail, were able to identify specific sources. However, in the focus groups, air pollution was often discussed in the same breath as other environmental issues, such as recycling and air miles. The exception was the patient focus group, for example the following comment about delivery vans.

Well, delivery vans in general. I moved in to where we are now 25 years ago. There was such a thing as getting things delivered by foot but now daily in the square at the back of our house between us and the river you can get 15 or 20 coming in there, Tesco, Iceland, yodel, Amazon, DHL, the post office, special deliveries, its constant!

Patient focus group participant

Both the patient and family focus groups suggested lowering the cost of public transport would help alleviate the problem of air pollution. The focus group of people with health conditions (all aged 65+) also mentioned the importance of the Freedom Pass for public transport.

I’ve never smoked in my life but I was diagnosed with COPD about four or five years ago. They did some tests and they came back and said I’ve got the lungs of an 84-year-old. I did drive around London for 23 years

Health conditions focus group participant