ProfessorPatrickSaunders

Everybreathwetake:thelifelongimpactofairpollu<on

Howthereportcameabout

•  Greatstridesmadeontobaccocontrol,alcoholandobesity

•  Airpollu<onremainsamajorpublichealthchallenge

•  RCPandRCPCHconvenedworkingpartytodiscussevidenceanddrawuprecommenda<ons

WhytheRCPistacklingthisissue•  Airpollu<ones<matedto

causearound40,000deathsperyearintheUK

•  Es<matedcostofairpollu<onis£20bnannuallyintheUK

•  Linkedtomajorhealthchallengesofourdaysuchasheartdisease,asthma,lungcanceranddemen<a

WhytheRCPistacklingthisissue•  Natureandconsequencesofairpollu<onhavechangedconsiderablysincetheCleanAirAct1956

•  Improvementsinairqualitystandardsandmanagementhasledtocomplacency

•  Importantdifferencesinlocalexposuresandsuscep<bilityforindividualsandcommuni<es

•  Loca<on,biology,depriva<on,behaviour,stress,andaccesstoenvironmentalresources

Airpollu;oninourchangingworld•  Changesinthewaywelive

havechangedairwebreathe

•  Totaldistancewalkedeachyeardecreasedby30%between1995and2013

•  In2012,roadtrafficintheUKwas10xhigherthanin1949

•  Notjustoutdoorenvironmentbutindooraswell

Protec;ngfuturegenera;ons•  Firstreporttoexamine

healthimplica<onsofexposuretoairpollu<onoverlife<me

•  Developingheart,lung,brain,hormonesystemsandimmunitycanallbeharmedbypollu<on

•  Effectsgrowth,intelligence,asthmaanddevelopmentofthebrainandcoordina<on

Healtheffectsofairpollu;onoverourlife;me

Suscep;bility•  Someindividualsandcommuni<esalsoface

mul<pleenvironmentalandsocialstressors•  Thosepopula<onsmostexposedtoairpollu<onare

alsomorelikelytohaveotherstressorssuchaspoverty,poorhousing,loweduca<onalaZainment,obesity,long-termillnessesandhigherlevelsofsmoking

•  Evidencethatotherfactors,closelyassociatedwithdepriva<on,suchasobesityandpre-exis<ngcardiovascularandrespiratorydiseases,increasessuscep<bility

Suscep;bility•  Stress,atboththeindividualandthecommunity

levels,canweakenthebody’sdefencesagainstexternalinsultandinfluencetheinternaldoseoftoxicants

•  Whilethehealthexperienceoftherela<velyaffluentiseffec<velyindependentofgeographicalregion,theMarmotReviewclearlyshowsthatgeographyhasamajorimpactonthehealtheffectsofdepriva<oninEngland

•  Itisen<relyplausiblethatenvironmentalstressorssuchasairqualitycontributetothisinequity

Suscep;bility

Suscep;bility•  Depriva<onhasbeeniden<fiedasincreasing

suscep<bilitytoPMinseveralstudies•  Depriva<onappearstomodifytheimpactofPMon

pre-termbirthandrespiratorymortality•  Obeseindividualsmaybeatgreaterriskfor

cardiovasculareventsduetoPM2.5exposure•  AZenua<onofage-relatedlungfunc<ondeclineis

notobservedintheoverweightorobese•  Recentresearchsuggeststhatobeseyoungchildren

maybemorelikelytodevelopasthmainassocia<onwithgreaterexposuretoPAHs

Suscep;bility•  MaternalobesityexacerbatestheairbornePAHrisk

onreproduc<veoutcomesandsomeairpollutantsimplicatedinthedevelopmentofobesity

•  Prenatalexposuretoendocrine-disrup<ngchemicalsmayincreasechildren’sobesityrisk

•  Dietsrichinan<oxidantnutrientsmayhelptoprotectagainsttheharmfuleffectsofairpollu<on

•  Airqualitycannotbeseeninisola<on-thereareotherfactorsthatincreaseexposureandeffect

•  Someofthesolu<onswillbeoutsidethetradi<onalairqualitymanagementregimes

Conclusion

•  Clearinequali<esinexposuresandaccesstoenvironmentalgoods

•  Differencebetweenhazardandrisk-formerrequiresmonitoring,thelaZerinterven<ontopreventexposureorreducetoasafelevel

•  Cleardifferencesinsuscep<bilitytoexposuresinindividualsandlocalcommuni<es

•  Consequencesareseriousinpublichealthtermssomustbeconsideredinequi<es

•  Requiresmorethanairqualitymanagement

Recommenda;onsforac;onandnextsteps•  Educateprofessionalsandthepublic•  Promotealterna<vestocarsfuelled

bypetrolanddiesel•  Monitorairpollu<oneffec<vely•  Protectthosemostatrisk•  LeadbyexampleintheNHS•  Studytheaffectsofairpollu<onon

health

Howyoucanhelp

•  Championtheissueinparliament

•  Highlightthesignificantadverseimpactthatairpollu<onhasonpeople’shealth

•  Wewanttoworkwithyoutoprotectpeoplefromthedangersofairpollu<on

Ques;ons?