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|Topic title||Air quality and health (2019)|
|Topic owner||Health Protection Strategy Group|
|Topic author(s)||Richard Taylor (Environmental Health and Safer Housing Service, Community Protection)|
|Topic quality reviewed||March 2019|
|Topic approved by||Health Protection Strategy Group|
|Current version||June 2019|
|Linked JSNA topics|
Air pollution is the top environmental risk to human health. In the UK it is ranked as the fourth greatest threat to public health after cancer, heart disease and obesity, and is a contributory factor to heart disease and some types of cancer.
Human-made air pollution comes from a range of different sources including agriculture, industrial, commercial and domestic activities, and transport. Emissions from road traffic are one of the largest contributors to ambient air pollution in urban areas.
Long-term exposure to air pollution, at the levels experienced in many urban centres in the UK, including Nottingham, causes respiratory and cardiovascular disease and lung cancer. It has also has been linked to other cancers. In children, air pollution reduces lung development and function and can lead to the development of asthma.
Short-term exposure to elevated levels of air pollution leads to a worsening of symptoms for those with existing asthma, respiratory or cardiovascular diseases, and can trigger acute events such as asthma and heart attacks in vulnerable individuals.
In Nottingham in 2016, it is estimated that 181 adult deaths were brought forward due to the health impacts of air pollution (comprising PM10, PM2.5, NO2 and other pollutant species).
The impact of air pollution on health is modifiable, and there are cost-effective, achievable local collective and personal actions that reduce personal exposure to, and emissions of, air pollution, and improve health and air quality. These include active travel (walking and cycling), travelling using public transport and ultra-low emission vehicles, and increased energy efficiency (coupled with appropriate ventilation) in buildings and homes. These actions also produce benefits across local priorities, including increasing physical activity, achieving and maintaining healthy weight, reduction in hospital admissions due to excess cold, respiratory, cardiovascular and obesity problems, reduced CO2 emissions (a key driver of climate change), and reduce the generation of secondary pollutants that also effect health, and have other adverse impacts on the natural environment.
The national Public Health Outcomes Framework (PHOF) datasets show that in Nottingham in 2016 approximately 146 deaths (6.3%) of all adult mortality was attributable to long-term exposure to human-made particulate air pollution. It is estimated that in Nottingham in 2016 ambient concentrations of nitrogen dioxide (NO2) contributed to 35 additional deaths, i.e. 181 adult deaths were attributable to the combination of PM2.5, NO2 and other air pollutants.
It was predicted that by the end of 2019 concentrations of NO2 in Nottingham’s air will be below the annual mean National Air Quality Objectives (NAQOs), and EU limit value. However, despite meeting the NAQO for PM10, concentrations of particulate matter (PM10 and PM2.5) currently exceed, and are likely to continue to exceed, the World Health Organization’s guidelines. Furthermore, the WHO have advised there is no ‘safe’ concentration for particulate matter in ambient air.
There is increasing evidence that indoor air pollution significantly affects health, and contributes to the development of respiratory conditions that are then further exacerbated by ambient/outdoor air pollution and indoor air pollution e.g. asthma.
The government’s Clean Air Strategy 2019 considers both outdoor and indoor air pollution and how reducing emissions, pollutant concentrations and exposure, both outside and inside buildings and homes, can protect and improve health.
The National Institute for Clinical Excellence is preparing guidance (for publication late 2019) for local authorities and health organisations on how to improve citizen health by reducing outdoor and indoor air pollution, and exposure to it.
Resources/funding to sustain a co-ordinated holistic behavioural change programmes and multi-media messages.