A new report from the Royal College of Physicians (RCP) has highlighted the growing evidence about the increased range of health impacts linked to toxic air even at low concentrations, urging government to act on air pollution as a serious and preventable public health threat.
The RCP has warned that air pollution affects almost every organ in the human body, estimated to contribute to the equivalent of 30,000 deaths in the UK in 2025 and cost more than £27 billion annually.
The new report from the RCP highlights studies in the last decade providing new knowledge about the significant health impacts of toxic air even at low concentrations, including on foetal development, cancer, heart disease, stroke, mental health conditions and dementia. As we spend more time in buildings, indoor air pollution also poses a growing concern. The report emphasises that poor ventilation, damp and mould, and emissions from domestic heating, gas cooking and household products all contribute significantly to poor health.
In A breath of fresh air: responding to the health challenges of modern air pollution, the RCP urges the UK government to recognise air pollution as a public health issue – rather than a solely environmental one – and take urgent and ambitious action to reduce preventable deaths and improve population health.
With impacts on both mortality and healthy life expectancy, the effects of toxic air on individuals, society, the economy and the NHS are huge. The RCP report estimates that:
-
In 2019 alone, costs for healthcare, productivity losses and reduced quality of life due to air pollution cost the UK upwards of £27 billion – and may be as much as £50 billion when wider impacts, such as dementia, are accounted for.
-
Annual costs could still be up to £30 billion per year in 2040, despite pollutant exposures being projected to fall in coming years under current government policies, including Net Zero policies.
-
Air pollution could still be linked to around 30,000 deaths in 2025, compared to government estimates of the equivalent of between 29,000 and 43,000 deaths in the UK in 2019.
There is no safe level of air pollution. Despite some progress in recent years, findings about the wide range of health impacts suggest the threat to public health remains significant and greater than previously understood.
A toxic burden on the most vulnerable people
Air pollution is harmful to everyone, but the most deprived communities – who typically contribute least to emissions – disproportionately experience its effects and suffer the worst health outcomes.
The RCP is calling for urgent action from the UK government, including:
-
Action to reduce pollution at source – including emissions from wood burning, agriculture, transport and indoor pollutants.
-
Identifying robust pathways towards the delivery of the World Health Organization’s 2021 Global Air Quality Guidelines on air pollution levels, with regular reviews of the most effective regulatory approach to continuously drive down pollution and improve health.
-
Targeted support to protect the most vulnerable and affected communities, who are often the groups and people least responsible for the problem.
-
A UK-wide public health campaign on air pollution, modelled on successful smoke free campaigns, that would provide accurate and trusted information about the health impacts of air pollution, the sources of indoor and outdoor air pollution and practical advice to reduce personal exposure.
-
A cross-departmental indoor air quality strategy to address exposures including damp and mould in homes, workplaces, transport, healthcare settings, and indoor public and retail spaces.
-
Integration of air quality into Net Zero policy development to ensure that the substantial air pollution benefits of decarbonisation can be realised.
A breath of fresh air, with a foreword from the Chief Medical Officer Chris Whitty, is the latest in a line of authoritative RCP reports shining a light on the biggest public health issues facing society. It was the 1962 RCP report, Smoking and health, that definitively stated the link between tobacco smoking and lung cancer.
Publishing this major new report on Clean Air Day, the RCP is calling on government to treat air pollution as a serious and preventable health risk.
Dr Mumtaz Patel, president of the Royal College of Physicians said:
‘Air pollution can no longer be seen as just an environmental issue – it’s a public health crisis. We are losing tens of thousands of lives every year to something that is mostly preventable. And the financial cost is a price we simply cannot afford to keep paying. There is no safe level of air pollution. The government must act now to protect our health.’
‘We wouldn’t accept 30,000 preventable deaths from any other cause. We need to treat clean air with the same seriousness we treat clean water or safe food. It is a basic human right – and a vital investment in our economic future.’
Professor Sir Stephen Holgate CBE, RCP special adviser on air quality, UKRI clean air champion and clinical professor of immunopharmacology, University of Southampton, and lead author of the report, said:
‘The science is now overwhelming; air pollution is a major driver of disease across the life course – from low birth weight and childhood asthma to heart attacks and dementia. It must be recognised and treated as a public health issue. The cost of inaction is measured not only in lives lost, but in people not being able to live healthily and in billions drained from our economy every year. We must act now – and we must act together.’
Dr Gary Fuller, UKRI clean air champion, associate professor in air pollution measurement at Imperial College London and joint editor of the report, said:
‘The UK is falling behind Europe in its legal protections on breathing polluted air. Europe’s ambition, as embodied in legislation, now is far greater than ours.
‘We have an opportunity to make the UK an international leader in creating clean air. This means working across society to identify a pathway towards the World Health Organization’s air quality guidelines. We are largely manging air pollution using the evidence from the 20th century rather than the evidence that we have gained in the last 25 years. We have a chance to mobilise this new knowledge to reviewing existing limits and policies to see if they doing enough to combat the many thousands of preventable deaths that we are seeing every year.'
Dr Suzanne Bartington, UKRI clean air champion, clinical associate professor in environmental health and honorary consultant in public health at the University of Birmingham and editor of the report, said:
‘Exposure to air pollution is not a momentary problem – the impact lasts the course of a whole lifetime. The scientific evidence is crystal clear that exposure to air pollution, even at low levels, in one part of our lives can go on to seriously affect our health in another. This preventable risk factor contributes to the onset and severity of a wide range of diseases, reducing quality of life and increasing demand for NHS and care services.
‘Higher concentrations of pollutants are often found in more socially disadvantaged areas, contributing to health inequalities. Through no fault of their own many people are destined to an increased likelihood of ill health, purely because of where they live. It is crucial that serious public health focus is given to the disproportionate impact of air pollution on certain groups of society, and the areas and populations with the greatest vulnerabilities.’