Toxic air in the UK requires immediate action
Authors: None The Lancet Planetary Health
Journal: The Lancet Planetary Health (2017)

In the days before Christmas, 1952, adverse weather conditions and the burning of sulphurous coal led to the death of almost 12 000 people in London. Despite improvements in pollution prevention since the “Great Smog”, London continues to experience toxic air pollution linked to thousands of premature deaths every year. In 2017, however, the main cause of pollution is nitrogen dioxide emitted by diesel vehicles and not the widespread burning of coal. And this time it is invisible. According to European Union regulations, nitrogen dioxide levels ought to only surpass 200 μg/m3 of air during a 1 h period 18 times in a whole year, but by the beginning of January, London had already breached its annual air pollution limits. 15 other areas in the UK also breached legal limits for air pollution. Air pollution is linked to 40 000 deaths in UK each year, 9000 of which occur in London, costing the country almost £27·5 billion Most premature deaths from air pollution are caused by cardiovascular, cerebrovascular, and respiratory disease; however it has broader effects on health. The effects of air pollution can be very severe on children because of their developing organs and immune systems. And living near congested, dirty roads increases the risk of heart and lung disease in both adults and children, as well as development of dementia in older people. A recent collaboration between The Guardian and Greenpeace showed that 3000 schools and nurseries across England and Wales are within 150 m of roads with high levels of nitrogen dioxide, putting hundreds of thousands of children at risk. But despite this obvious problem, the Government doesn't seem to apply strict rules to tackle air pollution. Twice in the past—first in 2015 and then in November, 2016—plans to tackle air pollution were found to be illegal by the Supreme Court. To respond to the Court the Department for Transport must now present a new clean air plan by April 24. More than £2 billion has been committed since 2011 to cut emissions, but plans for clean air zones have only recently been set up and effective plans to tackle the emission of nitrogen dioxide are not yet in place, despite £290 million having been allocated to encourage use of electric vehicles, low emission vehicles, and alternative fuels. So what needs to be done? Most pollution in cities comes from road traffic and therefore from diesel vehicles that are responsible for most nitrogen dioxide emissions. Bringing the number of diesel cars in the centre of London down to 5% and increasing the number of cleaner alternatives should bring London into compliance with legal levels. “The solution in the next 5 years or so is to reduce the number of diesel vehicles”, Jonathan Grigg tells The Lancet Planetary Health. But to embrace such radical change, people will need a support system. Any plan will have to be ambitious and realistic at the same time, it will need generous scrappage schemes to persuade drivers to give up on their diesel cars and swap to cleaner alternatives. A key challenge will be to encourage drivers of both personal and commercial vehicles to transition to hybrid and ultra-low-emission vehicles. Low emission zones that penalise drivers of polluting vehicles have been used in the past and might be useful again. Sadiq Khan, the Mayor of London, has proposed a daily charge of £100 for non-complaint lorries and £12·50 for small complaint vehicles if they drive in the city. Urban planning will be vital. With a long term goal to meet air pollution limits set by the WHO and the European Union, public transportation will need to move towards sustainable solutions. Walking and cycling will need to be encouraged and, especially for the latter, safe. New roads tend to lead to new congestion and moreover reduce the available land for green spaces, which enhance air quality and should be a key part of urban development. Inevitably, exposure to air pollutants is beyond any one individual's control. Therefore, ministers need to tackle air pollution as a social as well as an environmental issue and public authorities need to act at regional, national, and international levels. Long-term policies and firm implementation of existing ones to reduce diesel use, encourage electric cars, and develop public transport systems, in tandem with better urban planning, will be crucial for an increasingly urbanised population. Such policies will require a continuous political support at both national and international levels, and policy makers should be held to account to ensure emission targets are met.