We focus on four complex health issues more prevalent in urban areas
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Health effects of air pollution
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We can solve the issue of air pollution. Dr Frank Kelly, Professor of Environmental Health at King’s College London, discusses the requirement for more funding for interventions to build the evidence base around suitable solutions.
Breathing is one of those things that we take for granted. I remember learning to swim and being ‘winded’ (several times!) on the rugby field as two experiences that prompted me to appreciate how indispensable this function is. It is only when we are deprived of precious air that we are reminded that it is a prerequisite for life.
It is not merely the process of moving air into our body and removing waste gases that is important. What is in the air that we breathe is also crucial. Breathing polluted air, especially in urban areas, impacts our health in many ways and is one of the greatest environmental challenges we face.
Air pollution has a very significant impact on the public’s health. In England, 5% of adult deaths in 2015 were attributable to outdoor air pollution. This was due to an increased risk of cardiovascular and respiratory illness as well as lung cancer.
Even short-term (day-to-day) exposure can worsen respiratory and cardiovascular conditions, trigger asthma attacks and bring about premature deaths. Vulnerable segments of the population, such as children and the elderly, are more susceptible to the effects of air pollution.
Given the clear evidence for the effects that air pollution has on our health, we need interventions to improve air quality. These can vary to fit the need. For example, interventions can reduce emissions of air pollution at source, lower concentrations of air pollutants once emitted, or lessen peoples’ exposure to air pollution.
Although we spend most of our time indoors, poor indoor air quality can significantly contribute to total exposure to air pollution and the consequent health burden.
As pollutants emitted in populated areas, or areas with a high proportion of vulnerable segments of the population, are especially harmful to public health they should be prioritised in intervention efforts.
There is a dearth of evidence about the effectiveness of interventions on air quality and public health. Few of the attempted interventions include an assessment of their impact on air quality. Even fewer consider the impact on public health.
King’s recent research of air quality interventions in inner-city London found the strongest evidence is for solutions which reduce emissions at source. Many of these solutions need action on a large scale and political support.
We also saw that not all interventions reduce both particulate matter (PM) and nitrogen dioxide (NO2). Some may reduce one but increase the other. Each solution is likely to only have a small impact so many interventions are required at once to have an impact.
“ Breathing polluted air, especially in urban areas, impacts our health in many ways and is one of the greatest environmental challenges we face. Dr Frank Kelly Professor of Environmental Health at King’s College London
Breathing polluted air, especially in urban areas, impacts our health in many ways and is one of the greatest environmental challenges we face.
The extra work needed in this area requires funding that is in addition to that required for the intervention itself and often this support is not available.
This is where the cavalry comes in. Impact on Urban Health has decided to commit considerable resource and time to address the problems outlined above. It is launching a new ten-year programme addressing the health effects of air pollution.
With an appreciation that in inner-city areas everyone is exposed to air pollution, they will focus their efforts on groups that are particularly susceptible to the health effects of poor air quality.
Appreciating that interventions (of all types) are needed to solve this challenge, Impact on Urban Health will provide funding for interventions. Proving that public health has been improved is complicated and costly. This is the only way to guarantee that an intervention has been effective and is worthy of implementation.
To track, assess and enact an effective air quality intervention in a specific area, a localised understanding of emission sources, atmospheric distribution of pollutants, and exposure hotspots is essential.
The largest positive outcome in reducing the health burden of air pollution will be achieved by lowering the exposure of vulnerable segments of the population. To this end, Impact on Urban Health is encouraging interventions that target emission sources around vulnerable people centres, such as schools, hospitals and nurseries.
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