Blog by Professor Kevin Fenton, London Regional Director of Public Health, Office for Health Improvement and Disparities (OHID)
Air pollution is the largest environmental health risk we face today. Both short-term and long-term exposure to air pollution impacts health and affects people across the lifecourse from birth to old age, with heart disease and lung cancers in adults to asthma and chest infections in children. London has the highest percentage of deaths attributable to particulate air pollution of all English regions (7.1 per cent) with an estimated 4,000 deaths caused by air pollution each year. While air pollution affects everyone who lives and works in London the impacts are disproportionately spread, affecting the most vulnerable and the poorest the hardest. There are stark inequalities in who is most at risk of poor air quality across the city. Poor quality housing, proximity to high emissions areas make a marked difference in potential exposure to air pollution with certain groups more vulnerable to the impacts, such as those with pre-existing health conditions and young children.
Despite a range of efforts by London’s public sector partners, 99 per cent of Londoners live in an area where air pollution exceeds the latest recommendations from the World Health Organisation (WHO) for particulate matter PM2.5., (one of the air pollutants thought to have the greatest impact on human health). While there is no clear evidence of a safe level of exposure (below which no adverse health outcomes occur/risk is lower), actions to improve air quality improve life and health. If London met the WHO guideline for PM2.5 by 2030, the population in London would gain a 20 per cent increase in life years saved over the next 20 years.
On 16 December 2020, air pollution was recorded as a medical cause of death for the first time, following the second inquest into the death of nine-year-old London school girl, Ella Adoo-Kissi-Debrah. The inquest brought into sharp focus that air pollution was and remains a real risk to life; and the need for ambition and further action to reduce pollution. In response, a Clean Air and Health Summit was convened by the Mayor of London in February 2022. The Summit was attended by leaders from national and local government and health experts. It inspired unprecedented engagement and generated commitments to action that will help reduce air pollution, risks and health inequalities across London.
There is strong commitment and a wide range of actions being taken by London health and care partners, local boroughs, London Councils and the Greater London Authority to improve air quality.* Currently, local authorities are being consulted on proposals to tackle poor air quality; including increased engagement between local authorities and local communities on air quality and health and stronger requirements for cross-sectoral collaboration on local Air Quality Action Plans. But this will not be enough. The call for accelerated action is clear, not only across health and care sectors, but across agencies and together with local communities. The solutions are within our reach - as air pollution harms our health, things we do to stay healthy like walking or cycling to work, are good for the air too.
Everyone has a role to play. Action on reducing London’s air pollution cannot wait. It will continue to harm Londoners’ health and is likely to have devastating consequences if not tackled with the level of urgency and ambition it demands, particularly for younger people and future generations. By working together to act on air pollution, we can achieve better air for better health for ALL.
* This commitment and action has been reinforced through the London Vision commitment on air quality, the NHS London Sustainability Network integrating air quality initiatives into ICS Green Plans and a range of initiatives fronted by the GLA, local boroughs and London Councils. Additionally, there are examples where the Global Action Plan ‘Clean Air Hospital Framework’ has been adopted, adapted, and implemented.
Professor Kevin Fenton