In a month that has seen air pollution identified as the leading environmental health risk in Europe, shown to be absorbed into the placentas of pregnant women, and linked to increased risk of developing dementia, it is worth reflecting on some of the known health impacts of this persistent problem.
Across the world, in both developed and developing countries, air pollution remains a leading contributor to the incidence of non-communicable disease (NCDs).
In a recent statement ahead of the 68th session of the World Health Organization (WHO) Regional Committee for Europe, the European Public Health Association (EUPHA) and its partners affirmed that public health is at the heart of sustainable development. They noted the estimated 8.2 million deaths globally per year from NCDs caused by environmental factors such as air pollution and hazardous chemicals, of which about 7 million are attributed to air pollution alone.
Meanwhile, The Lancet Global Health released a study conclusively linking high exposure to outdoor and indoor air pollution in India’s northern states to the high burden of chronic obstructive lung disease. Polluted air also raises the risk of heart disease, stroke, diabetes and cancers, according to this first-ever multi-centric public-private study of five NCDs across India.
This all comes a year on from a landmark WHO report, Preventing Noncommunicable Diseases by Reducing Environmental Risk Factors, which determined that 12.6 million NCD deaths per year are linked with environmental causes, including 6 million from air pollution.
“Air pollution is the leading environmental health risk humans now face,” according to the Climate and Clean Air Coalition. Worldwide, almost one third of the cardiovascular disease burden is attributable to indoor and outdoor air pollution (17% and 13% respectively), second-hand tobacco smoke (3%) and exposure to lead (2%). Globally 29% of chronic obstructive pulmonary disease (COPD) deaths are attributable to indoor air pollution, 8% to outdoor air pollution and 11% in workplaces.”
This means that strategies to limit pollution, such as limiting industrial emissions, moving to clean energy sources, and clean and efficient transport, are key health interventions as well as improving sustainability and environmental resilience. The WHO also recommends reducing exposure to ionizing and ultra-violet radiation, and chemicals like solvents, pesticides, asbestos and formaldehyde, to prevent lung and other cancers.
According to research published on 22 August in the journal Environmental Science & Technology Letters, just one particularly prevalent type of air pollution is itself responsible for reducing global life expectancy by about a year – with the worst effects concentrated in less-developed countries.
“Simply reducing global PM2.5 air pollution to levels recommended by the World Health Organization would be the equivalent of globally eradicating breast and lung cancer in terms of life spans,” the report concluded.
Currently, about 95% of the world’s population is exposed to levels of pollution in excess of the WHO’s recommended level.
Heavy metal pollution is another significant risk. According to The BMJ, low doses of toxic metal contaminants such as arsenic, copper, lead, cadmium and mercury in the environment, water or foods can lead to coronary heart disease and cardiovascular disease.
“Worldwide, those at greatest exposure of arsenic, lead, cadmium and copper were around 30% to 80% more likely to develop cardiovascular disease than those at lowest exposure.”
This exposure is more likely to happen in low- and middle-income countries, though it may still affect those in higher income countries. The solutions for this particular problem are cheap, scalable technologies such as environmentally friendly water filters or behavioural interventions like rinsing rice and vegetables before cooking them.
The problem for many of these pollution based problems isn’t that there are not solutions that are innovative, easy or cheap. It is the lack of commitment to pursue them.
The United Nations High-Level Meetings on Noncommunicable Diseases (UN HLM on NCDs) and the Political Declaration, which were meant to be milestones in the international response, have included the recognition that air pollution are significant risk factors and that social, economic and environmental determinants, as well as commercial and market factors, affect the risk factors for NCDs – a strong step forward. But governments, private partners and civil society organisations need to come together with specific objectives and plans to ensure that we avoid a global health epidemic that could lead to millions of preventable illnesses and deaths.