Clearing the Air: Embracing Uncomfortable Conversations

When discussing air pollution, it’s essential to confront the uncomfortable truths. From smog hanging over our cities to smoke inside our homes, air pollution poses a significant threat to both our health and our climate. Shockingly, every year, approximately 7 million premature deaths occur due to air pollution – that’s around 800 people every hour or 13 people every minute. The pollutants of major public health concern include particulate matter, carbon monoxide, ozone, nitrogen dioxide, and sulphur dioxide.

Understanding Air Quality

Air quality is the term we use to describe how polluted the air we breathe is. Poor air quality can be hazardous, especially to those with lung or heart conditions. According to the World Health Organization (WHO), air pollution is the contamination of the indoor or outdoor environment by any chemical, physical, or biological agent that modifies the natural characteristics of the atmosphere.

Both outdoor and indoor air pollution cause respiratory and other diseases, leading to significant morbidity and mortality. It’s crucial to recognize that air pollution has short-term and long-term effects on health, raising concerns among various groups, including individuals with heart and lung conditions, parents, caregivers, healthcare professionals, and those curious about air pollution within the scientific community.

A Tragic Case and a Wake-Up Call

In 2020, the Coroner’s court used WHO evidence from 2005 in the inquest into the tragic death of Ella Adoo Kissi-Debrah. Her acute respiratory failure was attributed to severe asthma and air pollution exposure, primarily from traffic emissions. The ruling underscored a failure to reduce nitrogen dioxide and particulate matter levels locally at the time, with Ella’s mother lacking sufficient information about the health risks of air pollution from doctors and other health professionals.

The coroner, Philip Barlow, warned in his Prevention of Future Deaths report, that the adverse effects of air pollution on health were not being sufficiently communicated to patients and their carers by medical and nursing professionals, and called on medical staff to do more to inform families about the dangers of air pollution.

The Role of Healthcare Professionals

To address this issue, doctors must play a more active role in educating patients about the health risks of air pollution. Training healthcare professionals is essential for enabling positive doctor-patient conversations on reducing exposure to air pollution. Encouragingly, Great Ormond Street Hospital has initiated a pilot scheme that considers air pollution at patients’ home addresses, adding data on nitrogen dioxide and particulate matter to patient records, indicating where air pollution concentrations at a patient’s postcode are above World Health Organisation safe levels.

A Call for Action and Education

Clean air is a fundamental requirement for a healthy environment. Although air quality has improved in recent years, there’s room for further progress, as emphasized in Chris Whitty’s Annual Report on Air Pollution (2022). We must focus on areas where people live, work, and study, educating patients about the risks of air pollution.

It’s evident that more should be done to integrate air pollution discussions into medical practice. While moving might not be an option, adopting measures like using Defra’s pollution forecast tool for daily planning and modifying routes to avoid congested roads during commutes can reduce exposure. However, this necessitates additional training for medical professionals to understand the effects of air pollution better.

The Royal College of Physicians (RCP) acknowledges the need for a comprehensive understanding of the impacts of air pollution on health within the medical curriculum. There is also an acceptance that doctors, and all healthcare professionals, need to understand that they have a responsibility to talk to patients about air pollution and how to avoid it. The RCP is actively working on producing and promoting resources to facilitate conversations about air pollution between healthcare professionals and patients.

Urban Planning’s Vital Role

Finally, urban planning plays a crucial role in promoting active forms of transport, which can significantly reduce air pollution emissions. Reversing the decline in active travel since the 1950s would bring substantial health benefits. As we strive for a healthier environment, let us all commit to educating ourselves, spreading awareness, and advocating for cleaner air for the well-being of current and future generations.