On a fine day, when London basks beneath blue skies, it can be difficult to imagine air pollution remains a significant problem. It is not as though the capital is still swathed in thick smog. But as Dr Gary Fuller, an air pollution scientist at Imperial College London, explained when we first met in January 2020, despite the capital’s clear horizons, its air remains dirty. And although that pollution might be invisible, that doesn’t make it any less deadly.
That is why we launched The Air We Breathe, a year-long project reporting on air pollution in London, the people it affects and those looking for solutions to the problem. Thanks to the pandemic — which made its own impact on air pollution and the way we travel in the city — our project was extended by a few months. But now we can consider what we’ve discovered along this journey, and what lessons we can learn from it.
The extent of the problem quickly became clear. In a normal year, 5.8 million car journeys are made every day in the capital, making it one of the most polluted places in the UK. More than two million Londoners live in areas that exceed air pollution limits, with exposure to poor air quality associated with ill-health and premature death.
The pollutants we breathe are particulate matter or gases such as nitrogen dioxide, released by diesel exhausts, and sulphur dioxide, released from burning coal and oil, and ozone, which when formed at ground level can be very harmful.
Particulate matter (PM) is tiny bits of solid or liquid suspended in the air. These particles are 30 times smaller than the average human hair; particles smaller than 2.5 micrometres are called PM2.5 — they can settle in the airway and get into the bloodstream, and are the most dangerous to human health.
“Globally, breathing PM2.5 is one of the largest risk factors for an early death,” Dr Fuller said. “Around four million people die early from breathing PM2.5 across the globe — around 400,000 in Europe, and nearly 4,000 in London.”
For those with asthma and other lung conditions, air pollution can be a particular concern. Helen Faliveno told the project that after she moved from rural Essex into central London, she had a terrible asthma attack. “I passed out and was in hospital for a week. It was really scary,” she said.
We also talked to Wilfred Emmanuel-Jones, a businessman, farmer and founder of “The Black Farmer” food range, who has a serious auto-immune condition that affects his lungs. After buying an air purifier, he was shocked when he saw what it caught. “I was devastated to see it all because it made the air pollution really real for me.”
But while breathing dirty air is bad for your lungs, the damage dirty air can cause to our health as a whole is only beginning to be fully understood. According to a global review published in 2019, almost every cell in the human body can be affected.
In that study, scientists from the Forum of International Respiratory Societies concluded that air pollution could be linked to heart disease, diabetes, dementia, liver problems, brittle bones and damaged skin. It can also affect fertility, foetuses and children. The British Heart Foundation says there are around 11,000 heart and circulatory deaths every year in the UK that are attributable to air pollution.
A separate study by University College London, also published in 2019, found that people living with air pollution have higher rates of depression and suicide.
Some Londoners are more affected than others. In February, I spoke to Rosamund Kissi-Debrah, whose nine-year-old daughter Ella Roberta died in 2013 after experiencing a severe asthma attack. Air pollution was recently confirmed as being a contributing factor to her death.
The family’s home is 25 metres from South Circular Road in Lewisham, where levels of nitrogen dioxide air pollution from traffic constantly exceeded the annual legal limit of 40µg/m3 between 2006 and 2010. Kissi-Debrah says it’s vital that we talk more about air pollution and inequality.
The statistics paint a stark picture. Nearly half of London’s most deprived neighbourhoods exceeded EU nitrogen dioxide (NO2) limits in 2017 compared with two per cent of its wealthiest areas, according to a 2019 data-mining analysis from the European Environment Agency.
A recent study found that Londoners from Black, Asian and Minority Ethnic (BAME) communities are exposed to the highest levels of air pollution.
Kissi-Debrah said: “When it comes to air pollution, we can’t get away from the inequality. We need to confront it rather than deny it. It’s easy to shy away from but I think it is best to address it so that we can come up with a solution.”
Children are particularly vulnerable to breathing polluted air. The mayor of London recently drew attention to the fact more than 400,000 children are living in areas which exceed legal limits for air pollution.
The impact on young lungs can be dramatic. Dr Ian Mudway, a senior lecturer in the School of Public Health at Imperial College London, talked to me about his groundbreaking six-year study which focused on eight and nine-year-old children in Tower Hamlets and Hackney.
That study, published in 2018, found that dirty air was stunting the growth of children’s lungs by about 80 to 100 millimetres. “People find it difficult to visualise the volume, but we worked out it was about the size of two large eggs that these children were losing in lung capacity,” explained Mudway.
The impact of that reduced lung development is significant — it places children at risk of lung disease, severe asthma attacks and early death.
Shazia Ali Webber launched I Like Clean Air, a campaign for parents and children, in 2015 when pregnant with her third child. She began to hand out flyers to parents with information and maps of quieter, less-polluted routes they could take to school.
“I just felt like air pollution was hitting the headlines but the detail of how it affects children wasn’t really coming through,” she told me.
The School Streets Initiative has also taken off over the past few years. Aimed at reducing pollution in the morning and afternoon, and encouraging walking, cycling or scootering to school, the idea is a simple one: roads surrounding schools are closed to traffic at drop-off and pick-up times, with exemptions for blue-badge holders. It’s been a success at Albemarle Primary School, where headteacher Theresa Moses told me: “So many now scoot or cycle that we don’t have room in our cycle racks and they now line the length of the school gates.”
There is also an increasing focus on how air pollution impacts pregnancy. “In the last five years there has been an explosion of work into birth outcomes and these are currently being reviewed by advisory bodies,” Jonathan Grigg, a professor of paediatric respiratory and environmental medicine at Queen Mary University of London said. “What we don’t know yet is the direct link between the changes we see in the placenta and negative effects on the foetus. But the evidence supports a causal link.”
We launched The Air We Breathe a few months before coronavirus first stopped the city, and early reports suggested that this resulted in cleaner air.
But there is also growing evidence linking exposure to polluted air to increased cases of coronavirus as well as deaths from it. The communities most negatively affected by air pollution are also those most likely to become seriously ill or die from coronavirus.
Some studies in the United States, Northern Italy and the Netherlands have suggested that long-term exposure to air pollution before the pandemic is associated with severe symptoms from Covid-19 and a greater risk of death. So what can be done about such a complex problem? The Government’s long-awaited Environment Bill is crucial when it comes to policy. Campaigners are lobbying for much stronger laws. Zak Bond, policy officer at Asthma UK and the British Lung Foundation, said the charities are campaigning for the Government to commit to WHO limits, particularly on PM2.5. “We’re currently meeting our legal limits for these tiny particles but that’s because the [limits] are incredibly lax and they are double what the WHO says is the bare minimum for what you should be aiming for,” he noted.
In October London’s Ulez scheme — where vehicles that do not meet emissions standards must pay a daily charge to travel within the zone — is set to be dramatically expanded up to but not including the North and South Circular Roads. The new Ulez area will be 18 times the size of the original and cover a significant portion of the capital.
Whether the expansion goes ahead depends upon who is elected as Mayor of London in May. Sadiq Khan, the current mayor, is the plan’s architect but his Conservative opponent Shaun Bailey is against the idea.
The expansion is important, argues Oliver Lord, head of policy and campaigns at the charity Environmental Defense Fund Europe, as London has been breaching legal limits for air quality for more than a decade.
“We’ve still got a big issue with diesel in the capital and anything that can be done to speed up the replacement of older vehicles will have a massive impact,” he said.
But as individuals, we can also make a difference. Consumers can reduce the impact of home deliveries on air quality, for example, by choosing suppliers who offer low or no tailpipe emission delivery options. It’s also worth consolidating deliveries and choosing slower shipping times.
Choosing to maintain lockdown activities such as walking and cycling rather than hopping in the car also helps — 60 per cent of car journeys in London are under 2.5 miles, according to TfL — and the health benefits of active travel outweigh any harm caused by breathing polluted air, according to a 2016 study.
Audrey de Nazelle, senior lecturer in air pollution management at Imperial College London, worked on research that concluded that London is one of the better cities in the world in which to cycle and walk. “We do increase air pollution inhalation when we walk or bike, there’s no doubt about that, but the physical activity benefits always outweigh the risks,” she said. There are also different ways to get children to school. David Smith, founder of the Little Ninja air pollution campaign, invested in an electric cargo bike for his family, which he says has revolutionised the school run.
“It can be actually faster to get places than by car. I hope when the Ulez expansion comes in people will consider [a cargo bike] as an alternative to just going and buying a more modern car because even the most environmentally [friendly] cars still cause air pollution.”
But it’s not just decisions we make outside the home that can make a difference. Indoor air pollution is a growing area of interest among scientists who are concerned by the increase in chemicals, such as cleaning products, being used in our homes. Meanwhile woodburning stoves can have a negative impact both on the health of those enjoying their warmth, and those breathing in the smoke outside.
We need a public health review of the main roads in our city, putting people’s lungs and our climate first
Almost two-fifths (38 per cent) of PM2.5 in the UK comes from domestic wood-burners and open fires, according to research from the Department for Environment, Food and Rural Affairs. And while increasingly strict measures mean particle pollution from traffic and industry is expected to decrease, wood-burning could offset any improvements.
Right now everyone’s attention is focused on the pandemic but now is not the time to look away from the problem of air pollution, especially given the potential link between the two issues.
Lord argues that “we can’t skirt around the edges” when it comes to air pollution and health inequalities. “We need a public health review of the main roads in our city, putting people’s lungs and our climate first,” he said.
Everyone has to play their part. Almost three quarters of walkable trips are currently made by car in London. “The more we walk and cycle in our local neighbourhoods,” Lord said. “The better our health, our climate and our economy.”