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Report lays bare need for significant improvements to air quality

The latest report from the Royal College of Physicians and the Royal College of Paediatrics and Child Health has laid bare the risks to health from air pollution, both outdoors and in domestic and work environments.

Every Breath We Take sets out the way pollution from a wide variety of sources – including diesel fumes, wood-burning stoves, pollen and even candles and air fresheners – creates a cumulative effect on the population’s health and gives rise to huge costs, yet is poorly regulated, monitored and understood, particuarlarly when it comes to indoor air quality (IAQ).

The report will be seized upon by the air conditioning and ventilation sector, which has already raised concerns about the lack of IAQ regulation, as an opportunity to improve standards and to emphasise the benefits of modern filtration technology in mechanical ventilation and AC systems.

It opens with a bleak summary of the cumulative effects of pollution: “Each year in the UK, around 40,000 deaths are attributable to exposure to outdoor air pollution, with more linked also to exposure to indoor pollutants. Air pollution plays a role in many of the major health challenges of our day, and has been linked to cancer, asthma, stroke and heart disease, diabetes, obesity, and changes linked to dementia.

”Neither the concentration limits set by government, nor the World Health Organization’s air quality guidelines, define levels of exposure that are entirely safe for the whole population. When our patients are exposed to such a clear and avoidable cause of death, illness and disability, it is our duty as doctors to speak out.”

Air pollution plays a role in many of the major health challenges of our day, and has been linked to cancer, asthma, stroke and heart disease, diabetes, obesity, and changes linked to dementia

On top of the direct health risks, the doctors pointed out that the costs of unmitigated pollution are also extremely high: ”The health problems resulting from exposure to air pollution also have a high cost to society and business, our health services and people who suffer from illness and premature death. In the UK, these costs add up to more than £20bn every year. Vulnerable people are prisoners of air pollution, having to stay indoors and limit their activity when pollution levels are high.

”This is not only unjust; it carries a cost to these individuals and the community from missed work and school, from more health problems due to lack of exercise and from social isolation. Taking action will reduce pain, suffering and demands on the NHS, while getting people back to work, learning and an active life. The value of these benefits far exceeds the cost of reducing emissions.”

While naturally a significant part of the report is concerned with the risks of outdoor pollution, among the report’s 14 recommendations for change are several that relate directly to IAQ improvements. These include:

  • Quantifying the relationship between indoor air pollution and health Understanding of the relationship between indoor air pollution and health must be strengthened, including the key risk factors and effects of poor air quality in homes, schools and workplaces. A coordinated effort among policymaking bodies will be required to develop and apply any necessary policy changes.
  • Determining how global trends are affecting air quality From increased energy production and consumption to global economic development and urbanisation, we need to improve our understanding of how major social and economic trends are affecting air quality and its twin threat, climate change.
  • Developing new technologies to improve air pollution monitoring Better, more accurate and wider-ranging monitoring programmes are needed so that we can track population-level exposure to air pollution. Adaptable monitoring techniques to measure must also be developed for emerging new pollutants and known pollutants that occur below current concentration limits. Practical technology – such as wearable ‘smart’ monitors – must be developed that empower individuals to check their exposure and take action to protect their health.

The report stressed that actions to decarbonise energy and heating sources and to improve kitchen extraction will have an overall beneficial effect, but noted that the increasing emphasis on insulation is reducing the benefits of ventilation.

But perhaps the most important recommendation from the report is that more work must be done on setting controls and guidelines at both a local and national level, and on strengthening existing instruments such as the Building Regulations to reduce indoor and outdoor pollution.


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