Breathe easy: Legislation to reduce air pollution appears to have worked. Getty
Everyone is freaking out about air pollution at the moment. Particulates, nitrogen oxide, sulphur dioxide, ammonia. Diesel fumes. Buses on Oxford Street. Schools in London apparently handing out backpacks that measure air pollution, like Geiger counters on recovery workers after a nuclear disaster. Is it giving you cancer, is it giving you cardiovascular problems, are women producing fewer eggs, is it making you lose your memory?
And it’s getting worse, apparently. The “death risk from London’s toxic air” – steady on, now – “sees ‘utterly horrifying’ rise for second year running”, shrieked the Evening Standard a week or two ago. According to the paper, the “rate of fatalities linked to breathing in killer particles went up from 6.4 per cent to 6.5 per cent in 2017”, having gone up from 5.6% to 6.4% in the previous year.
Which sounded very strange to me. Because, firstly, that figure seemed very high. If one person in every 15 died from air pollution, I think we’d know about it. Second, I thought that the air was, in general, getting cleaner.
Luckily for me, a new paper is out in the journal Environmental Research Letters which helps make sense of it all. I popped along to a briefing on it on this week.
The paper looked at the health impacts of air pollution with a snapshot every 10 years, starting in 1970 and ending in 2010. It found that for the main pollutants – sulphur dioxide (SO2), nitrogen dioxide (NO2), and particulate matter smaller than 2.5 micrometers (PM2.5) – things are a lot better.
Emissions have consistently dropped for SO2 and PM2.5, while emissions of NO2 rose slightly until 1990 and have dropped to well below 1970 levels since. Only about 55% of UK air pollution is directly linked to UK emissions (the rest is mainly from nearby countries), but still, the same pattern is visible. This pattern is not true for ozone, which got worse until 2000 and has declined a bit since, but that’s a smaller contributor.
And it has had an effect on public health. Using the same metric that the Evening Standard’s story used, the “percentage of fatalities linked to” PM2.5 in 1970 was about 12; in 2010 it was more like five. Similar drops are seen in deaths linked to NO2 and SO2.
The paper links this, convincingly in my mind, to air pollution control policies, in the UK, at European level, and internationally, such as the 1997 National Air Quality Strategy and the European vehicle manufacturing standards that were issued in the 1990s. Stephan Reis, one of the authors, pointed out that, in the 1970s, German manufacturers used to build cleaner cars to export to California, where the regulations were stricter, and sell more polluting ones in the domestic market.
Still, though, 5% of all deaths caused by particulate pollution alone sounds pretty bad, right? And that’s only one contributor, albeit the biggest. When you add in NO2 (about 3%) and ozone (about 2%) it gets even worse – 10% of all deaths caused by air pollution!
Except, of course, you can’t add them up like that. That’s not how it works. What they’re reporting is the ‘attributable fraction of mortality’, or AF. The AF is a statistical measure that describes “the proportional reduction in population disease or mortality that would occur if exposure to a risk factor were reduced to an alternative ideal exposure scenario”.
Insofar as I understand, it’s essentially relative risk, but in reverse – it’s saying, if you took this factor away, cleaned the air perfectly, how much would the annual mortality rate go down by? Which is an interesting question, but it’s not the same as “this causes 5% of all deaths”.
The risks overlap. So, if you added all the possible contributing factors of death together (smoking, ageing, obesity, diabetes, stress, car crashes, murder, meteorite strikes, Godzilla, whatever) it might add up to many thousands. It’s a very widely used and accepted metric, but I really don’t like it, because I think that when you give percentages, they should add up to 100. Otherwise people will hear “air pollution kills 6% of people”, which I’d say it definitely doesn’t. It contributes to 6% of deaths, but that’s not the same thing.
According to Sotiris Vardoulakis, one of the authors of the Environmental Research Letters paper, the effect of air pollution is roughly equivalent to, on average, a six-month reduction in the national average lifespan. Last year, a professor of respiratory medicine told BBC More or Less that in London, that figure is about nine months. Which is quite a big deal! And, of course, it won’t be evenly spread: some will see smaller effects, while some, especially those with preexisting lung conditions, are likely to suffer much worse.
But, for context, the AF caused by smoking in 2005 was 19% (27% among men). That’s not among the 25% of Britons who were smokers – that’s for the whole population. Obesity and alcohol are both significantly larger contributors as well. Vardoulakis pointed out that air pollution is the largest environmental factor, and it’s certainly not negligible, but “London’s toxic air” is getting a bit carried away. I’m concerned that over-fretting about it will stop people from doing things which definitely are good for you, like cycling, because they’re worried about particulates or nitrogen dioxide.
And there’s another point. This is a good news story! Legislation to reduce air pollution appears to have worked. People have had to bear some part of the burden of that regulation, either through increased costs or through bans on products, but it appears that we are all significantly healthier because of it. If we then all kick off and complain that our air is toxic and we’re all dying of the black lung – which we’re not; this is not the Great Smog of 1952 – then people might, understandably, feel that we’ve been wasting a lot of time and effort regulating all this stuff.
Air pollution is bad. That’s fine, we can all agree about that. And we all want a future world of electric cars powered by offshore wind, and London air that smells like primrose and freshly cut grass rather than piss and diesel. And maybe we’ll get it one day. But in the meantime, let’s have a little perspective: things are getting better, we’re all living longer, and it’s not going to kill you if you go outside and go for a run.
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SubscribeGreat article, agree with everything in it. The obsession with social media is a problem for many of the younger generation. I’m 67, live alone and enjoy my own company. This makes me wonder how the generation who lived during the war years coped with food rationing & no TV etc. Much more resilient than we are now.
But James, you’re making an assumption that everyone agrees the means justify the end, even though we cannot possibly know the end. You’re buying 100% the line that self-isolation (to protect the NHS in the short-term) is the best course of action and is therefore, without question, worth compromising liberty and economic prosperity. Your belief is that social isolation for an unspecified period is perfectly acceptable in these exceptional circumstances. Presumably you would feel the same way in a year’s time if this ‘lockdown’ continues and your government tells you it is morally your duty to forego your liberty to preserve lives, regardless of how many lives are ‘saved’. We all die eventually.
For you, it seems, thousands of premature deaths from respiratory problems caused by a virus that is only serious for a very small minority of the population should, without question, give a green light to our elected governors to compromise the liberty of the entire population and, arguably, risk the prosperity of future generations (while almost certainly hit less wealthy nations hardest). You are willing to cede your liberty for an indeterminate period to a few people in power, most of whom have very good jobs and secure pensions and priority access to healthcare. Is that right?
Why is it not possible to have a different belief? Could you not argue that letting nature take its course might mean short-term pain but long-term happiness? That herd immunity will get us through this crisis faster and at lower cost to the economy which funds advances in public health? Bodies piling up outside hospitals is an ugly prospect, of course, but we’ll deal with it; losing loved ones is an appalling prospect, but it’s inevitable. Maybe there is too much short-term emotion guiding policy ““ the fear of the unknown ““ and not enough hard-faced rationality. It’s impossible to know, of course, and we have an obligation to do what we are told, but we must allow free thought. Why is not possible for an individual to believe that social interaction is worth fighting for, above deaths which are inevitable? As a society we have to accept and tolerate anti-social behaviour. In fact, we should see it as a very healthy sign that state hasn’t entirely crushed individuality.
You, it would seem, are a natural conformist. Nothing wrong with that. Most people are. You are presumably happy if every time an unknown virus occurs in the future we should shut down and live in isolation, ceding authority to the state. To preserve the NHS, it’s, in your view, imperative. But what health service can prevent nature taking its course?
So there will be dissent and scepticism. But it has been very minimal, and over sensationalised in the media. I have witnessed no flouting of social distancing guidelines. I was out in Greenwich Park on Sunday and there were hundreds of people, most of whom kept their distance. Today, people are keeping their distance. It takes time to adjust to new rules. I haven’t witnessed anyone behaving recklessly. You can’t point the finger of shame at people doing what humans do: interacting, making mistakes. Also, can you prove to me that those people were risking the lives of others? Are you putting theoretical epidemiology ““ because everything is unknown right now ““ above personal liberty and tolerance? Are you prepared to lock up individuals who would argue that, for their mental health, they need contact with others? Are you saying that preventing pneumonia is more important than preventing the unknown but potentially far more damaging long-term consequences of prolonged de-socialisation? The risks cut both ways.
If this was a three-week social experiment, fine. Let’s go with the theory. Let’s give it a go. We might all benefit from a break. But one reduction in liberty easily leads to another. If you trust state to not wield power at the cost of freedom, that’s fine and dandy. I don’t. History tells us short periods of crisis lead to prolonged periods of authoritarianism. Lenin, Hitler, Stalin and Mao took advantages of such moments. In crisis, rationality and irrationality can easily become blurred. Let the state organise, not restrict.
Orban has done a lot of good in Hungary. There’s a lot of whining, from non-Hungarians about his policies – this article is in that group. His policies on illegals have kept most migrants out of Hungary. There are few knife attacks in Hungary, but they were a weekly occurrence in London. Now he is using his methods to keep infections down. There are 261 cases in Hungary, 9500 in the UK. UK population is 6x Hungary population. If the UK had Hungary-level cases, they would have 1400.
Hungary has had 1000 years of occupation. Orban is doing what Hungarians want him to do.
A thought provoking article Andrew-thankyou.
The trend you talk about of separating the body from the thanksgiving/celebration of the life has been growing for,I would say,around 25 years.
A distinction has to be made between the disposal of the body WITHOUT ceremony, and disposal WITH ceremony. The difference can be stark as illustrated by David Bowie’s decision to be cremated without ceremony and without anyone present. These ” direct cremations ” make up3%of disposals according to the Association of Funeral Directors recent statistics.
As a priest of the Church of England with 42 years experience ( retired) I am familiar with the disposal of the body WITH ceremony followed by a Thanksgiving Service, usually the same day. I cannot find any data but my experience is that this is a slowly growing trend.
Although the disposal has prayers and readings it is meant to be brief. The subsequent Thanksgiving service usually follows the basic pattern of a Funeral Service which in the case of the Church of England (contrary to some commentators) is very flexible with lots of options and opportunities for tributes,non-biblical readings,music etc. All of this is done within the context of Christian worship in which prayer and the Gospel of Hope in Jesus Christ in the face of death remains central.
The Church of England continues to conduct around 40% of funerals and they mostly follow the traditional pattern of funeral followed by disposal immediately afterwards.
Great article
“If you can’t count your blessings during a time like this, perhaps you don’t deserve those blessings at all.”
Indeed. I live in hope that most of us will come through fine and snowflakes of all ages will melt away while the rest of us remember our core Christian values.