Every breath you take

Beauty Matters
by Natalie Evans-Harding
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Fancy cutting six months off your life? Breathe our deeply polluted air and you will, according to statistics predicting British city dwellers live six months less than in other parts of the world. Natalie Evans-Harding argues the time has come to take note of air pollution and its effects on our health. So why aren’t we?

In spring, interrupting a cursory Instagram scroll, I shot a post over to a Chinese friend. At dusk, Shanghai locals practising Tai chi in front of The Bund’s futuristic cityscape: “SO beautiful,” I’d captioned it. “Can’t wait!” This was the metropolis I wanted to visit: tradition and modernity silhouetted in front of a dusty pink sky; sun weighing heavy over the Huangpu River; rays piercing low-bobbing clouds so that the scene gleamed with an ethereal halo. “All I see in this photo,” she promptly replied, “is pollution. Pack a mask.”

Later in the year, slurping the end of a coffee on a friend’s balcony in Mexico City, he squinted to peer over my shoulder. One must look for the Ajusco volcano over breakfast, he told me, to determine whether it would be a “good day or a bad day”. This was no ancient Aztec superstition, but its visibility marked the level of air pollution and so informed his decision whether to cycle to the office. A bad day meant that fumes and exhausts had settled, blanketing the city, to bung up the Valley of Mexico so thickly you couldn’t see the surrounding mountain range. This is the capital, after all, where “birds suddenly fell down. They fell out of the sky and they were dead,” pollution researcher Gabriela Alarcon told Public Radio International last year.

And if these seem like localised issues to big pollution cities you’d be right; London, however, is certainly one of them. “Londoners are definitely not adequately aware of how polluted our city is,” stresses Dr Anant Patel, consultant respiratory physician at London’s Royal Free Hospital. “I remember the first time I saw visual evidence of it at an autopsy – the lungs of a 60-year-old gentleman who had lived here all of his life were completely black and he had never smoked. The pathologist said that this is what Londoners’ lungs look like; we breathe in soot and pollution constantly.”

Sunrise martial arts class by The Bund in Shanghai

London is currently the joint third worst offender for air pollution in Europe (tying with Berlin, behind Moscow and Rome) and it kills up to 9,000 people a year in the capital alone. British MPs call this level of air pollution “a national emergency” as 7.9 million Londoners (that’s almost 95 per cent of the capital’s population) live in an area that is more than 50 per cent above the legal limit for air pollution. The EU, which has already won three high court battles against the British government for flouting pollution regulations, labelled this state of affairs “life-threatening”and will now be taking the government to Europe’s highest court before imposing multimillion pound fines.

The statistics are undeniably terrifying, but how exactly does air pollution effect our health in real terms? “The problem is that continual exposure manifests not today or tomorrow but in decades’ time,” says Dr Patel, “so it’s a hidden killer.” In fact, air pollution is calculated to cut six months off British life expectancy because of its links to cardiovascular disease, strokes, diabetes, obesity and, in particular, lung disease and lung cancer. The young are especially at risk from air pollution because their organs are developing in polluted conditions. One in five Britons now suffer long-term respiratory issues, and ongoing research suggests air pollution is connected to low birth weight, stunted growth, autism, intelligence, coordination, and brain development and neurological health later in life (including dementia). Until those findings are conclusive, air pollution can currently be attributed to 40,000 deaths a year in the UK at a £20 billion cost to health services. “The science behind air pollution’s effect on health is so clear,” says Dr Patel. “We are simply not talking about this enough.”

Smoggy sunrise over Mexico City

And why not? Lung disease (which air pollution has been proven to trigger) is considered to be one of the UK’s big three killers alongside cancer and cardiovascular disease, but most lung conditions are still only diagnosed in A&E. While checking for cancer and maintaining good cardiovascular health has been drilled into public consciousness, resulting in earlier cancer detections and a big dip in heart disease, mortality rates from lung disease are roughly the same as those reported a decade ago. “Since most lung disease is found in smokers, people are less interested if they see an illness as self-inflicted,” Dr Patel believes. “Then it becomes more difficult to attract research funding or charities to raise awareness. But the fact is ten to 12 per cent of our lung cancer patients have never smoked. These people are put by the wayside through no fault of their own. It may be that a big proportion of them have been exposed to air pollution. That could be one of the biggest factors in the development of their disease.”

“Lung disease has an image problem,” Alison Cook, director of policy at The British Lung Foundation agrees. “It is not ‘the smoker’s illness’ as it is often described. The fact that a quarter of the population sees smoking as the only cause for lung disease shows a true lack of public awareness.”

The capital, perhaps surprisingly, isn’t actually the worst place to live in terms of air pollution in the UK (topping the list is Port Talbot in Wales, with Salford and Scunthorpe taking joint second place), but London’s scale of high-rise architecture combined with a dense road network allows air pollution to congregate, build up and settle, trapped between buildings with little breeze to disperse it. And while there’s no clear evidence to suggest that some boroughs are worse than others, there are air pollution hotspots. These vary depending on the weather and time of year, but are usually found around enclosed streets with a lot of diesel traffic.

“I’ve been campaigning for electric cars since 2010,” Dr Patel says. “The first thing you can do as an individual is to look at your method of transportation: less car use and more public transport, walking and cycling – that’s a big deal.” But until the UK bans petrol and diesel cars (expected in 2040), what can we do to protect ourselves? Should we all be making room for a pac-a-mask in our handbags? The jury is still out on the effectiveness of masks (certainly the surgeon-style mask is considered ineffective to deal with pollution), but supposed air pollution combatants such as personal air purifiers and pollution sensors have seen a spike in sales. Anti-pollution prestige skincare also grew by 30 per cent last year, making its market worth £3.1 million. This came after it was proven that pollution causes accelerated ageing and wrinkles. “Really, the only way to protect yourself and your family,” Patel says, “is avoidance of breathing in very polluted air, avoiding those pollution hotspots.”

View of pollution over London from St Paul's

And to do this doesn’t have to involve guesswork – there are air pollution monitors placed all around the city feeding back hourly readings. The government has its own air quality index, which the public can check, and there are third-party apps, such as London Air or CleanSpace, which will send tailored notifications to your phone and you can also use them to carry out searches on the move. Using this data to minimise your exposure to heavy air pollution is especially worth considering when exercising (be that a bike commute to work or an inner-city jog at lunchtime) when you inhale more quickly and deeply.

Unsettlingly though, indoors isn’t necessarily safer than outdoors. Indoor air pollution can be caused by everything from heating and cooking to paint fumes and scented products (yes, even candles), as well as stagnant traffic pollution that has seeped indoors. A study this year found that air pollution inside children’s schools was worse than outside, and the same will be true of inner-city office environments and those of us living near busy roads.

But while the effects of air pollution may seem insurmountable, measures can be taken to stop it in the first place. Unlike climate change, air pollution is absolutely reversible. As The Guardian points out, while London – depressingly – reached its annual legal limit for outdoor air pollution in less than a month into this year, that is considerably better than every previous reading taken over the last decade, when annual limits were reached in a matter of mere days. The mayor’s new fines imposed on older, dirtier cars and switching to low-emission buses on the capital’s most polluted routes were attributed to the improvement – and there’s still much further to go.

“Up until last year I wasn’t particularly positive,” states Dr Patel, “but we’re now just seeing the green shoots of our efforts.” The most important thing we can do as individuals, he stresses, is to cut out car use whenever and wherever possible, but also be a more informed consumer. “Air pollution that comes as a by-product of the agricultural process is enormous, and the meat and dairy industries are responsible for a big chunk of this,” he says. “People aren’t aware of the air pollution impact of buying a steak in a restaurant or supermarket, for example.” However, only real change can come from government policy, Dr Patel believes. “It has to come from the top level. You can use your democratic power – vote for parties listening to the scientific evidence, who will act on it with policies and legislation. And there’s a lot to be gained economically by having a cleaner environment from air pollution,” he shrewdly concludes, should there be any sceptics left out there. “Not only from better productivity of workers and less sick days, but from emerging technologies. There is no reason we can’t be at the forefront of a green revolution here in the UK.”