To protect life

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Covid-19 has shown us that quick action on global health is possible, even if it does not solve the whole problem. Amy Hall asks if we can do the same with air pollution, another big killer.


A young boy with a gas mask during a fire in Kibera, the largest slum in Nairobi, Kenya. DONWILSON ODHIAMBO/Sopa Images/Lightrocket via Getty

A global health crisis can come in different forms. It can quickly spread across countries, stop economies and health services and kill far too many people. It can cause sudden job losses, closing of businesses, food supply problems and stop people moving in and out of whole countries. It can cause governments to promise hundreds of billions of dollars to support health services, people out of work and the homeless. It can see people in local communities helping each other.

Now, in May 2020, over 30,000 people around the world have died from Covid-19. The number of cases around the world is rising. It feels like society is falling apart and everything has changed. I’m scared for my family, my loved ones and my sanity. I’m scared for my friends with no homes, with no papers, and for people working in essential services who try to keep us all going. I’m scared about what we will have when this ends.

But not every health crisis comes so quickly, with so much noise. A health crisis could start with very few people seeing it, kill millions and destroy habitats, and it would be difficult to blame anything. It could be an emergency that puts us in hospital or kills us, but we don’t think it’s important – on the contrary, we think it makes our lives easier.

It can be a crisis that we just talk about, change things a little, and pass on the problem to poorer communities – across town, or across the world. And, mostly, to continue life as usual.

Air pollution is a crisis like that.

In a normal year on planet Earth more than seven million people die because of air pollution. Like Covid-19, the most vulnerable people are usually affected the worst, but nobody is immune. Humans have many differences, but we all need to breathe. But more than 90 per cent of us are breathing air that is unsafe and goes against WHO pollution guidelines.

Often, thinking it is bringing progress and comfort, we are filling our lives with poison – in our towns and cities, in the countryside, and inside our homes.

The UK Ministry of Health, after a long weekend of bad London smog (smoke and fog) in 1952 killed 12,000, was amazed that people did not know it was happening. Four thousand of these deaths were in official government figures at the time; the rest were added by experts later when they knew the effect of the smog.

In the UK (where I live), there were 1,649 more deaths because of smog in March and April 2014. I didn’t even notice.


Air pollution is damaging to almost every organ and cell in the human body. The effects can start before birth, with soot found on placentas.

Then it gets worse. Research shows that air pollution has effects on growth, intelligence, and development of the brain and co-ordination. Harming babies and children will have effects long into the future and can stop their lungs growing permanently. Dirty air can make asthma a lot worse.

It can be linked to heart disease, stroke, breathing problems, lung cancer, dementia and psychological problems. It’s not just the long-term health issues: there can also be short-term problems such as sneezing and coughing, eye irritation, headaches and dizziness.

Animals can have a lot of the same effects on health. This is in addition to the destruction of their habitats caused by acid rain, which pollutes soil, water and trees.

We cannot separate the air pollution crisis and the climate crisis. Many types of air pollution could be reduced at the same time as greenhouse gases, as they come from the same sources. Climate change causes heatwaves - and these make pollution worse. Diesel cars produce more pollution on hot days. Global air pollution from agricultural and forest fires (these are made worse by climate change) probably causes 339,000 early deaths each year.

So could we just clean the air and make it safer? More people are buying air purifiers – this market could be $30 billion per year by 2023. Alastair Lewis (a professor at the National Centre for Atmospheric Science in York, England) said that purifiers can make a difference inside a home. But outside, they are not so effective and use a lot of energy. Also, there is a problem with the waste. The chemicals from the air purifiers go to landfills and from there, go into our soil and water.


Smoke from a coal power plant. MICHAL KODYM/ALAMY


Humans definitely play a big role in making our air so toxic. But there are other things too. Geography, weather and all pollutants in the air all work together to create the effect.

But it is true that if we cut human polluting activity, that will help. Pollution makes other health issues worse. For example, experts have warned that Covid-19 could be worse in cities because of air pollution. If the air is dirtier, more people die from Covid-19, because the higher pollution is already affecting people with heart and lung problems.

A lot of pollution in cities comes from transport – eg. nitrogen oxides. Europe has a big problem with diesel and an estimate is that the health costs of air pollution from road transport are €67-€80 billion ($72-$86 billion) every year. Half of the countries in the world do not have controls on emissions from vehicles. There is a lot of pollution from air and sea transport too.

The main cause of air pollution is mining and burning fossil fuels eg. coal. Coal gives off lots of particles, sulphur dioxide, nitrogen oxides, carbon dioxide, mercury and arsenic. Coal is responsible for more than 800,000 premature deaths per year in the world – 670,000 only in China. More carbon dioxide emissions come from coal than any other human activity.

In houses, coal for cooking and light is the main indoor air pollution. A quarter of households in poorer cities rely on solid fuels for cooking. Those families can suffer from polluted air inside and outside the home. And women and girls suffer most.

Wood-burning ovens are now fashionable in many colder Western countries. But they are not good for people with asthma, or anyone who wants to breathe clean air. Burning wood produces more carbon dioxide than burning gas, oil and coal for the same amount of heat or electricity. A 2018 study in the UK found that wood burning added 24 to 31 per cent more particle pollution in the big cities of Birmingham and London.


We all need safe air to breathe, but it’s easier for some people to get this than others.

Poorer countries have more air pollution. Richer countries send their waste to other areas and get cheaper production by paying others to produce their goods. 22 per cent of air pollution-related deaths in the world are from goods and services produced in one region, for use by another region.

There is more inequality in health in poor areas, and pollution makes these worse. Poor communities often live near environmental hazards eg. big roads, power plants and waste disposal. The effects can be worse because of poor housing, poor quality of air in the home, the stress of living with little money, and limited access to healthy food and/or green space.

People with money can choose to move out of cities like Beijing, London and Delhi when pollution gets really bad, or stay in buildings with pure air if air quality is bad. People who have to live or work in the streets, or in factories or energy plants do not have this choice.

Air pollution is also an issue of racial justice. People living in Africa and other parts of the Global South more affected by air pollution, and black, brown and indigenous people in Western countries are also more affected. One study found that white people in the US breathed in 17 per cent less pollution than they create. This ‘pollution advantage’ is a big contrast to the disadvantage of black and Hispanic people – they experience 56 per cent and 63 per cent more pollution than they create.


Rosamund Kissi-Debrah outside the High Court in London, in2019, after judges agreed to a new inquest into the death of her daughter Ella from asthma. SAM TOBIN/PA ARCHIVE/PA


There is also inequality in getting information about air quality. There are more public stations to check air quality in Greater London than the whole continent of Africa. But many people are still pushing for improvements on air pollution in Africa – and access to information about air quality would really help.

Here are a some examples.

Rosamund Kissi-Debrah’s daughter Ella was a healthy, active child until she was seven. Two years later, in 2013, she died from a rare form of asthma. Ella grew up less than a mile away from London’s very busy South Circular Road.

The first inquest into Ella’s death didn’t mention air pollution, so Rosamund started a charity, the Ella Roberta Family Foundation, to support children with asthma in southeast London. Someone called her to tell her about the big rise in air pollution in the days around Ella’s death.

In 2018, a report by Professor Stephen Holgate (special adviser on air quality to the Royal College of Physicians) showed that Ella went to hospital at the same time as rises in air pollution levels around her home. The family got another inquest and are fighting to have air pollution as the cause of death on Ella’s death certificate.

Rosamund is working all the time to raise awareness about pollution.

Ella’s story inspired Jemima Hartshorn and other parents to form the campaign group Mums For Lungs.

Three years ago, Hartshorn was on maternity leave, living on a busy road in Brixton, London. She knew something was wrong with the air from all the traffic. So she started to find out more about air pollution. She got angry, then turned her anger into action. The first Mums For Lungs meeting had four people, the second six and now the group is active in three areas of London and working with other air-pollution campaigns. Now, local authorities in Hartshorn’s area are taking air pollution more seriously.

She thinks cars are the biggest problem. She says it’s OK to use a car if you have mobility problems or several young children. But driving is a habit for so many people and they think it is their right. With every drive, we pollute someone else.


Life for so many people has changed since COVID-19. The changes have brought anxiety, fear and heartbreak. But they have also shown how we could make radical changes. We made these changes because of the very big threat to human life.

As the virus has stopped our usual way of life, air pollution has fallen a lot. ‘This is a big experiment,’ said Paul Monks (professor of air pollution at the University of Leicester). ‘Is this how the future could be if we can move to a low-carbon economy? This might give us some hope from something terrible.’

We are ready to make much bigger changes for coronavirus than we would be ready to take to face climate change or atmospheric pollution.

Many places in the world have made big improvements to their air-pollution levels. We know that change is possible, but maybe it’s time to make the change quicker. We’ve had enough research for decades to show we need a lot of action. We need to see how important our air is for life, not just somewhere to put all our waste.