Doctors say 40,000 deaths a year linked to air pollution

A landmark report from the Royal College of Physicians (RCP) and the Royal College of Paediatrics and Child Health (RCPCH) has set out the dangerous impact air pollution is having on the UK's health – with around 40,000 deaths a year linked to air pollution. Every breath we take: the lifelong impact of air pollution presents that the harm from air pollution is not only linked to short-term episodes but is also a long-term problem with lifelong implications.

The report notes examples from right across an individual’s lifespan, from a baby’s first weeks in the womb through to the years of older age, including the adverse effects of air pollution on the development of the fetus, with emphasis on lung and kidney development, miscarriage, and increases in heart attacks and strokes for those in later life. Associated links to asthma, diabetes, dementia, obesity and cancer for the wider population are also included.

In relation to asthma, the report stresses the significant point that, after years of debate, there is now compelling evidence that air pollution is associated with both reduced lung growth in childhood and new onset asthma in children and in adults – whilst highlighting that air pollution increases the severity of asthma for those with the disease.

The dangers of outdoor air pollution have been well documented, however the report highlights the often overlooked section of our environment – indoor space. Factors such as kitchen products, faulty boilers, open fires, fly sprays and air fresheners, all of which can cause poor air quality in our homes, workspaces and schools. According to the report indoor air pollution may have caused or contributed to 99,000 deaths annually in Europe.

Although government and the World Health Organization (WHO) set ‘acceptable’ limits for various pollutants in our air, the report states that there is in fact no level of exposure that can be seen to be safe, with any exposure carrying an associated risk. As a result, the report offers a number of major reform proposals setting out what must be done if we are to tackle the problem of air pollution.

These include:

  • Put the onus on polluters – Polluters must be required to take responsibility for harming our health. Political leaders at a local, national and EU level must introduce tougher regulations, including reliable emissions testing for cars.
  • Local authorities need to act to protect public health when air pollution levels are high  When these limits are exceeded, local authorities must have the power to close or divert roads to reduce the volume of traffic, especially near schools.
  • Monitor air pollution effectively  Air pollution monitoring by central and local government must track exposure to harmful pollutants in major urban areas and near schools. These results should then be communicated proactively to the public in a clear way that everyone can understand.
  • Quantify the relationship between indoor air pollution and health – We must strengthen our understanding of the key risk factors and effects of poor air quality in our homes, schools and workplaces. A coordinated effort is required to develop and apply any necessary policy changes. 
  • Define the economic impact of air pollution  Air pollution damages not only our physical health, but also our economic wellbeing. We need further research into the economic benefits of well-designed policies to tackle it.
  • Lead by example within the NHS  The health service must no longer be a major polluter; it must lead by example and set the benchmark for clean air and safe workplaces.

The working party for the report was chaired by Professor Stephen Holgate. On the report, Professor Holgate said:

We now know that air pollution has a substantial impact on many chronic long-term conditions, increasing strokes and heart attacks in susceptible individuals. We know that air pollution adversely effects the development of the fetus, including lung development.

And now there is compelling evidence that air pollution is associated with new onset asthma in children and adults. When our patients are exposed to such a clear and avoidable cause of death, illness and disability, it is our duty to speak out

Dr Andrew Goddard, the Royal College of Physicians lead for the report, said:

Taking action to tackle air pollution in the UK will reduce the pain and suffering for many people with long-term chronic health conditions, not to mention lessening the long-term demands on our NHS. This is not just a job for government, local authorities or business – as individuals we can all do our part to reduce pollutant exposure.

Professor Jonathan Grigg, professor of paediatric respiratory and environmental medicine at Queen Mary University of London and the vice chair of the working party representing the Royal College of Paediatrics and Child Health, said:

There is clear evidence to suggest that long-term exposure to air pollution has a wide range of adverse effects in childhood, and exposure during early life can lead to the development of serious conditions such as asthma. As NHS costs continue to escalate due to poor public health asthma alone costs the NHS an estimated £1 billion a year it essential that policy makers consider the effects of long-term exposure on our children and the public purse.

We therefore call on government to monitor exposure to air pollution more effectively to help us identify those children and young people who are most at risk. We also ask the public to consider ways of reducing their own contribution to air pollution by taking simple measures such as using public transport, walking and cycling, and not choosing to drive high-polluting vehicles.

The report also emphasises how the public can do their part to reduce pollutant exposure, noting the impact collective action can have on future levels of air pollution in our communities. Suggestions include:

  • trying alternatives to car travel or preferably taking the active option: bus, train, walking and cycling
  • aiming for energy efficiency in our homes
  • keeping gas appliances and solid fuel burners in good repair
  • learning more about air quality and staying informed.

Other key points from the report:

  • The estimated cost of air pollution in the UK is £20 billion annually (in Europe €240 billion).
  • There is a need to develop new technologies to improve air pollution monitoring.
  • More research is required to determine how social and economic trends are affecting air quality and its twin threat, climate change.

Notes to editors

  • For more information or to arrange an interview with Professor Holgate or Professor Grigg, please contact Linda Cuthbertson, head of PR and public affairs, on +44 (0)20 3075 1254 or linda.cuthbertson@rcplondon.ac.uk.
  • For the report, the RCP and RCPCH assembled experts in medicine and environmental sciences to discuss the current evidence and draw up recommendations. The working party heard detailed evidence from experts and key organisations to inform their report and final recommendations.
  • A full list of evidence, scientific references and those consulted can be found on our website once the embargo has lifted.