Air pollution has been a burning issue ever since humans discovered how to make fire. Today, nine out of 10 people around the globe are exposed to indoor and/or ambient air pollution that exceeds World Health Organization safety levels. So it might come as a surprise that the World Health Organization is having its first ever international conference on air pollution and health.

The conference takes place in the run-up to the next international climate event in Poland [COP24] which will respond to the latest scientific report that has warned we may have only 12 years to limit climate change catastrophe. Will such urgency be just what is needed to deliver large scale systems change in energy, transport and land use?

Air pollution is responsible for over 7 million premature deaths per year. Local and global air pollution is now top of the UN and WHO agenda with the health impacts of air pollution included in the UN Paris Agreement.

We know that we need to phase out fossil fuels for renewables, encourage active travel such as walking and cycling, and protect carbon stores in forests, soils and peatlands. So why the delay?

Climate change action has been dogged by a slowness to first accept the scientific evidence, then to embrace the mechanisms to deliver low carbon economies. This has been largely due to vested interests but also due to the sense that it may be hard to take meaningful action at an individual level.

One sector making a real impact though, is the health sector. On a daily basis, doctors, nurses, public health practitioners and allied healthcare professionals see the damage done by air pollution and climate change causing disease, disability and death. A quarter of deaths and disease from stroke and from ischaemic heart disease are due to outdoor air pollution; over one fourth of deaths and disease from lung cancer; and 43% of all deaths and disease from chronic obstructive pulmonary disease (COPD) are due to ambient air pollution.

Unmask My City, a global initiative that focuses on improving air quality in our cities has been working with health professionals to highlight the impact of fossil fuel use – coal, gas, diesel – on air quality and people’s respiratory, cardiovascular and cognitive health. One of the cities that joined this initiative is Sofia, Bulgaria. Here we are working with the Global Climate and Health Alliance (GCHA) to highlight poor air quality in Sofia and some of the larger cities in Bulgaria.

We are working closely with local health professionals, municipality officials, fellow NGO organisations (like WWF, ZaZemyata, Gorichka and umbrella patient organizations like NPO) to raise awareness and offer evidence based approaches to tackling this complex issue. A priority is establishing WHO safety levels for pollutants across EU territories, as it is obvious that non-medical reasons have been at play in establishing the current EU norms.

Air pollution levels must be brought in line with WHO safety standards in our cities. Our children and grandchildren deserve it.

Clean, renewable energy, better active and public transport infrastructure, electric vehicles, the elimination of fossil fuels subsidies, and smarter urban planning are but a few of the choices policy makers can deliver to avoid countless preventable deaths and drastically improve air quality for all.

Tackling climate change and air pollution is one of the WHO’s top five global priorities for the next four years. It’s great that WHO is having its first ever conference on air pollution. We’ll be checking in with the conference on 31 October, World Cities Day and beaming live real time air quality reports from Sofia. In sharing our local levels of air pollution we hope to get on the radars of decision makers at the conference to urgently remind them that everyone has a right to safe, clean air. With perhaps only 12 years to tackle climate change effectively, the clock starts ticking at this WHO conference. It’s time to help us and our planet breathe.

Burning wood or coal for cooking is associated with an increased risk of hospitalization or death from respiratory illness, according to a new study conducted in China and published online in the American Journal of Respiratory and Critical Care Medicine.

Researchers from the University of Oxford in the United Kingdom and the Chinese Academy of Medical Sciences report that hospitalizations or deaths of chronic and acute respiratory illnesses were 36% in those who used wood or coal for cooking, instead of those who used electricity or gas.

Researchers also report that the longer people use solid fuels, the greater the risk of hospitalization or death from respiratory disease than those who cooked with gas or electricity. Those who use wood or coal for 40 years or longer have a 54% higher risk of hospitalization or death from respiratory illnesses, while those switching from solid fuels to clean burning fuels reduce their risk to only 14% higher than those who have never been burned on wood or coal.

This past week was one of the most exciting for me in the last couple of years. I participated in two top notch global events. The Clobal Climate and Health Forum (GCHF) in San Francisco, and the European Respiratory Society Congress (ERS) in Paris - practically back to back.

Today in Paris was "no car day", which framed nicely, what I was anticipating to be an super exciting event @ ERS - the Symposium Air pollution and transplantation: near to one's heart and lungs! (catchy title) Co-chaired by Prof. Dr. Bart Vanaudenaerde (Leuven, Belgium) and Prof. Dr. Christophe Pison (Grenoble, France) two prominent researchers on lung transplant consequences. The presenting faculty were: Prof. Frank Kelly (Professor of Environmental Health @ Kings College London) who delivered a fantastic talk Linking ambient particulate matter pollution effects with oxidative biology and immune responses, Prof. Paul Cullinan (Professor in Occupational and Environmental Respiratory Disease at the National Heart and Lung Institute UK) elucidating Epidemiological evidence for air pollution being a risk factor for transplant failure and Prof. Valerie Siroux (La Tronche, France) sharing a brilliantly structured talk on Air pollution and Respiratory health: epidemiological evidences and clinical implications. Each talk in itself could have easily been a "raison d'être" for a action on air pollution, but each of the presentations ended in low-key "more data is required". This in front of an audience of less than 20 participants in a Congress with over 20 000 registered specialists with a self identified dedication to lung health?!?

The above sharply contrasted from the sentiment I had sensed @ CGHF, where over 250 environmental scientists, including urban planners and public health professionals were barely contained in the auditorium at UCSF sounding urgent and highly concerned (using many of the same sources of published and peer-reviewed literature).

This prompted my question and comments on how we are presenting the facts to the very people (pulmonologists) who should lead the public health debate around air-pollution - given the nature of their organ-related expertise and declared prophylactic foundation of the practice of medicine. Prof. Cullinan rebutted that this is a scientific meeting (not an activist gathering - I would presume as his unfinished comment), and Prof. Kelly added that in another situation he could be more insistent on the topic (obviously ERS was not perceived as the right place to sound an unequivocal expert warning of the health consequences of air-pollution). To add insult to injury, neither seemed eager to further discuss the topic or engage in a longer term professional dialogue on communicating the health risks to the wider professional audience of the ERS membership.

My hope, that experts of the global caliber of Prof. Kelly and Cullinan, with decades of highly scientific endeavors in the field of air quality and health, would embrace a proposal for effective communication, were dashed, with the undeclared innuendo that science is not about emotions.

I believe that we should not extract emotion from data to make it seem or sound more "scientific", we rather need to add all available data to our intrinsic passion to make it good science that effects meaningful change. Seven million reasons each year are hoping for this, while our colleagues are suffering from dwindling attention spans induced by information overload.

Politicians are polarizing most debates (driving a wedge in many topics including air-quality). Science and its communication is the only countermeasure available, though rarely used effectively as perceived by me above. Not bland data just short of the limit of discernible significance rather Science with the expressed passion for doing the right thing, for current and future generations.

Dr. Alex Simidchiev MD, MPH
Air4Health - Bulgaria

Sapienti sat!

A new Carnegie study found that the impact of fine particulate matter on the climate varies greatly depending on where it was released. The post is in Nature Communications.

The authors suggest a hypothesis that the impact on health may also be significantly dependent on where the source of the pollution is.



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