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Health costs poor air quality

The Health Costs of Poor Air Quality

Poor air quality is a serious issue for Londoners’ health, leading to thousands of premature deaths each year. The UK is also now at risk of fines from the European Union for failure to comply with European limit values for pollutants. Initiatives to tackle the problem are underway, but more can be done. Local authorities are particularly well placed to ensure that new development and transport plans in their areas take air quality considerations into account and reduce levels of pollution.

London has some of the worst air pollution of any UK or European city, and air quality is a very significant issue for Londoners’ health. The Department for Environment, Food and Rural Affairs (Defra) estimates that current PM2.5 (Particulate Matter)(1) emission levels reduce average life expectancy of people in the UK by six months and cost the economy £15 billion each year; equivalent to the cost of obesity in urban areas.(2) The situation is particularly bad in London where 4,300 deaths each year are thought to be attributable to air pollution (the individuals dying, on average, 11 years prematurely).

Air quality is heavily influenced by weather patterns, and is usually worst when weather is warm and there is little wind to disperse pollution. These hot, still days are expected to become more frequent over the coming years as the impacts of climate change are felt.

Boroughs across London are involved in initiatives to reduce air pollution, but it is a challenging issue. Evidence demonstrates that though the public accept that tackling air pollution is everybody’s responsibility, people are often unwilling to change their own habits, particularly when it comes to travel. More can be done by all levels of government including the Mayor and boroughs, and of course, by the public. Local authorities have a key role in promoting air quality issues in their own areas through their air quality management plans and their planning powers. They are ideally positioned to ensure that work done to reduce the threat of future climate change can achieve a ‘double-win’ by also reducing air pollution.

Poor air quality in London is not just a recent problem, indeed concerns over pollution led to temporary bans on coal fires in London as early as the 14th century. The famous ‘pea-souper’ smogs of the 1950s caused thousands of deaths and were eventually tackled by the Clean Air Act of 1956, banning as it did the use of the most polluting domestic heating fuels.

The two types of air pollution that are of greatest concern to human health at present are:

Particulate Matter (PM): The majority comes from motor vehicle exhausts and from wear to brakes and tyres. Construction sites with high levels of dust and machinery emissions can also contribute. Some PM occurs naturally, from forest fires, particles blown in from the Saharan desert and from sea salt which is carried to London by air currents.(3)

Nitrogen dioxide (NO2): Road transport and heating systems are the most significant sources of nitrous oxides (NOx) in London, of which Nitrogen dioxide has the greatest impact on human health.

The problems that London now faces come largely from the use of motor vehicles, rather than domestic use of coal, and it is these same types of emissions that also contribute to the process of climate change. Interaction of different types of emissions in the atmosphere is complicated and can often make both problems worse. Fortunately, in many cases efforts to reduce the threat of climate change or air pollution can be mutually beneficial.

European legislation and the risk of fines

Most of the legislation governing air quality is based on guidelines provided by the World Health Organisation (WHO) and derived from research into the effects of air pollution on human health. These guidelines have led to the limit values set out in European legislation (Directive 2008/50/EC) which outlines a concentration value for each pollutant and a date by which the limit values should be achieved. In some cases these also allow a certain number of times in a year that a pollutant can exceed the limit value.

This European legislation has been translated into English law by the Air Quality Standards Regulations 2010, which set out the government’s objectives for key pollutants and how different sectors, such as transport and industry, can help meet them.(4) In London, the Mayor also has a responsibility to prepare an air quality strategy, which includes policies and proposals to ensure that the city meets national objectives.(5) London’s boroughs are required to review and assess the air quality in their areas. Where the level of a particular pollutant is too high in any area, the local authority must produce and implement an air quality management plan aimed at reducing the level of the pollutant. All local authorities in London have air quality management plans.

Progress towards meeting PM10 values has been gradual and now only a small number of roads in central London breach the EU limit values. In June 2011 the European Commission granted the UK government a time extension to meet these limit values. However, in the case of NO2, progress has not been as successful. The UK has consistently failed to meet the EU limit values for NO2, and in London, levels have been exceeded by some distance. As a result of this non-compliance the UK could potentially be at risk of European fines of up to £300 million for breaching air quality standards.(6)

The Localism Bill currently progressing through Parliament includes clauses that would allow the UK government to pass EU fines on to regional and local authorities. It is proposed that the proportion to be passed on would be relative to the degree to which each authority has power to tackle the problem. Both London Councils and the Greater London Authority (GLA) are working to ensure there is a transparent framework for passing on these types of fines and that London is not unfairly burdened by these fines if they are imposed.

Meeting the Challenge – the Clean Air Fund

As a result of the threat of EU fines for failing to meet PM limit values, Transport for London (TfL) has been awarded £5 million by the Department for Transport (DfT), which must be spent this financial year on initiatives to improve London’s air quality.

Three locations in particular have been identified as areas where meeting limit values could be challenging: the Marylebone Road, Victoria Embankment through to Tower Hill and Marble Arch to Hyde Park Corner. The majority of the funding will be spent on measures in these areas, and other locations where monitoring data shows air quality is a particular problem due to local circumstances.

TfL are working with borough officers to develop and implement Clean Air Fund measures such as:

  • A ‘no-idling’ campaign, including improving signage and information for drivers. TfL will be using a team of five marshals to encourage taxi drivers not to idle, and TfL has also introduced a system (via phone and website) for the public to notify them where idling is a problem.
  • Dust suppressants and deep cleaning which TfL recently trialled. The findings of the trial suggest that suppressants do work but are not a ‘cure-all’.
  • Installing green infrastructure such as green walls and trees.
  • Working with businesses to help them reduce their ‘air quality footprint’.

Examples of international air quality initiatives

Berlin: In 2008, Berlin introduced a Low Emission Zone (LEZ) in its inner city districts. Vehicles were given either no sticker or a red, yellow or green sticker to indicate the level of pollution they emit. Signs were erected at the entrance to the zone to indicate which colour sticker vehicles could enter. These standards were strengthened in 2010 and now only green stickered vehicles can drive into the LEZ. Any unauthorised drivers in the zone risk a €40 fine.

Beijing: Notorious for poor air quality, Beijing implemented over 200 programmes to improve pollution levels before and during the last Olympic Games. These focussed on energy consumption and efficiency (particularly in terms of coal usage), emissions from industry, construction sites and transport. New vehicle emission standards were introduced, public transport improved and only restricted access to the city allowed for private vehicles during the Games themselves.

Examples of current air quality initiatives in England

CareforAir: This is a partnership between four local authorities in South Yorkshire, funded by the South Yorkshire Local Transport Plan. It aims to raise awareness of air quality issues with local businesses, schools, organisations and individuals to encourage everyone to do their bit.

ECO Stars: ECO Stars (Efficient and Cleaner Operations) Fleet Recognition Scheme is a free, voluntary scheme designed to provide recognition, guidance and advice to operators of goods vehicles, buses and coaches across South Yorkshire.

BeAirAware: This is a partnership between the six local authorities in Tyne and Wear, Defra and Nexus (a passenger transport provider), which aims to raise awareness of air quality issues.

Healthy Air Campaign: Environmental Protection UK has launched a campaign to raise the profile of the health effects of poor air quality and to work with communities to develop plans to promote cleaner air.

Examples of current air quality initiatives in London

Biking boroughs: 13 outer London boroughs are working with TfL to encourage greater uptake of cycling. Funding has been made available to improve cycling infrastructure and parking, and on measures to improve cyclists’ safety.

Legible London: This is a TfL initiative involving boroughs, business improvement districts and other landowners to develop and implement a consistent and easy to understand system of maps and way-finding information to encourage more people to walk in London.

Source London: TfL and boroughs have been working in close partnership over the past year to develop the charging point infrastructure needed to support the uptake of electric vehicles in the capital.

CityAir: The City of London Corporation is working in partnership with the business community to generate support for reducing emissions associated with their activities in central London.

Low Emission Zone: London’s Low Emission Zone (LEZ) was introduced by the GLA in 2008. At present it does not apply to motorbikes or cars. Higher standards for other types of vehicles will be introduced from January 2012.

2012 Olympic Games: The Games are aiming to be the ‘greenest’ ever. All ticket recipients will be sent free TfL travelcards for the day of the event they have tickets for and limited on-site parking will only be provided for disabled spectators.

AirText: The system sends free air pollution alerts by text message, email or by recorded message to the home phones of people with cardiac or respiratory disease when air pollution levels are forecast to be moderate, high or very high. The messages provide information on the steps participants can take to minimise exposure to the pollution episode and better manage their symptoms, improving quality of life and hopefully reducing the need for visits to the doctor or hospital.


Despite the significant health problems and shocking mortality rates it causes, the intangible nature of air pollution makes it a very difficult problem to tackle. The single most effective measure that could be implemented, a policy to reduce the number of vehicle journeys made in the city, would be unpopular with many residents and politically very challenging to implement.

The Mayor’s air quality strategy, published in 2010, outlined a range of measures the Mayor will take to improve air quality, such as boosting the emission standards of bus and taxi fleets and by introducing a new oxides of nitrogen (NOx) standard for the London-wide LEZ. However the strategy is not as comprehensive as some boroughs had argued it should be. The delay to the implementation of the third phase of the LEZ (from autumn 2010 to January 2012) and the removal of the western extension to the congestion zone are both steps that delay efforts to improve the situation.(7)

Though London’s local authorities are actively taking part in many initiatives beneficial to improving air quality, they are to some extent limited in their ability to tackle air pollution. Many of the available measures, such as setting emission standards for new vehicles or influencing which vehicles can drive into London, sit within the remit of the EU, central government or the Mayor, and councils lack some of the tools they need.

For example, boroughs have raised concerns about some modern wood biomass boilers (used for heating homes and businesses). These have lower overall carbon emissions than conventional gas boilers, but some emit significantly higher levels of PM10 and NO2. The Clean Air Act (updated 1993) allows local authorities to declare a ‘smoke control area’ and prevent unauthorised fuels from being burnt. However this legislation is now out-of­date and can only be used to target appliances that emit smoke and sulphur dioxide, not the more modern problem of nitrogen dioxide and PM10 emissions. Updating the Clean Air Act to allow local authorities to target NOx and PM10 emissions would be a helpful step to support local authorities improve their own local air quality.

Raising awareness of air quality issues needs to be a joint priority for all levels of government in London, and the health implications of poor air quality should be highlighted more strongly. Boroughs, the GLA and TfL are jointly working on a number of programmes to boost levels of cycling and walking and to support the uptake of electric vehicles, all of which have positive implications for air quality.

However, the wider health benefits of these types of initiatives need to be articulated more clearly and health impacts should also be more explicitly accounted for in future cost/benefit assessments of proposed investments and mitigation measures to improve air quality.



1 PM refers to airborne particles and is categorised according to size in micrometers.

2 Air Pollution: Action in a Changing Climate, Defra (2010)

3 Particulate Matter is often described in terms of the size of particles emitted, for example PM2.5 refers to particles 2.5 micrometers in diameter. Particles of less than 10 micrometers in diameter (PM10) are a problem for human health because they can be inhaled and accumulate in the respiratory system.

4 Equivalent legislation exists in Scotland, Wales and Northern Ireland.

5 www.london.gov.uk/publication/mayors-air-quality-strategy

6 Defra published its draft air quality action plan in June 2011 for consultation. London Councils’ response is available

7 The congestion zone is a policy specifically focussed on tackling congestion rather than air pollution, but any reduction in private vehicle usage also helps to reduce harmful emissions