Howthereportcameabout
• Greatstridesmadeontobaccocontrol,alcoholandobesity
• Airpollu<onremainsamajorpublichealthchallenge
• RCPandRCPCHconvenedworkingpartytodiscussevidenceanddrawuprecommenda<ons
WhytheRCPistacklingthisissue• Airpollu<ones<matedto
causearound40,000deathsperyearintheUK
• Es<matedcostofairpollu<onis£20bnannuallyintheUK
• Linkedtomajorhealthchallengesofourdaysuchasheartdisease,asthma,lungcanceranddemen<a
WhytheRCPistacklingthisissue• Natureandconsequencesofairpollu<onhavechangedconsiderablysincetheCleanAirAct1956
• Improvementsinairqualitystandardsandmanagementhasledtocomplacency
• Importantdifferencesinlocalexposuresandsuscep<bilityforindividualsandcommuni<es
• Loca<on,biology,depriva<on,behaviour,stress,andaccesstoenvironmentalresources
Airpollu;oninourchangingworld• Changesinthewaywelive
havechangedairwebreathe
• Totaldistancewalkedeachyeardecreasedby30%between1995and2013
• In2012,roadtrafficintheUKwas10xhigherthanin1949
• Notjustoutdoorenvironmentbutindooraswell
Protec;ngfuturegenera;ons• Firstreporttoexamine
healthimplica<onsofexposuretoairpollu<onoverlife<me
• Developingheart,lung,brain,hormonesystemsandimmunitycanallbeharmedbypollu<on
• Effectsgrowth,intelligence,asthmaanddevelopmentofthebrainandcoordina<on
Suscep;bility• Someindividualsandcommuni<esalsoface
mul<pleenvironmentalandsocialstressors• Thosepopula<onsmostexposedtoairpollu<onare
alsomorelikelytohaveotherstressorssuchaspoverty,poorhousing,loweduca<onalaZainment,obesity,long-termillnessesandhigherlevelsofsmoking
• Evidencethatotherfactors,closelyassociatedwithdepriva<on,suchasobesityandpre-exis<ngcardiovascularandrespiratorydiseases,increasessuscep<bility
Suscep;bility• Stress,atboththeindividualandthecommunity
levels,canweakenthebody’sdefencesagainstexternalinsultandinfluencetheinternaldoseoftoxicants
• Whilethehealthexperienceoftherela<velyaffluentiseffec<velyindependentofgeographicalregion,theMarmotReviewclearlyshowsthatgeographyhasamajorimpactonthehealtheffectsofdepriva<oninEngland
• Itisen<relyplausiblethatenvironmentalstressorssuchasairqualitycontributetothisinequity
Suscep;bility• Depriva<onhasbeeniden<fiedasincreasing
suscep<bilitytoPMinseveralstudies• Depriva<onappearstomodifytheimpactofPMon
pre-termbirthandrespiratorymortality• Obeseindividualsmaybeatgreaterriskfor
cardiovasculareventsduetoPM2.5exposure• AZenua<onofage-relatedlungfunc<ondeclineis
notobservedintheoverweightorobese• Recentresearchsuggeststhatobeseyoungchildren
maybemorelikelytodevelopasthmainassocia<onwithgreaterexposuretoPAHs
Suscep;bility• MaternalobesityexacerbatestheairbornePAHrisk
onreproduc<veoutcomesandsomeairpollutantsimplicatedinthedevelopmentofobesity
• Prenatalexposuretoendocrine-disrup<ngchemicalsmayincreasechildren’sobesityrisk
• Dietsrichinan<oxidantnutrientsmayhelptoprotectagainsttheharmfuleffectsofairpollu<on
• Airqualitycannotbeseeninisola<on-thereareotherfactorsthatincreaseexposureandeffect
• Someofthesolu<onswillbeoutsidethetradi<onalairqualitymanagementregimes
Conclusion
• Clearinequali<esinexposuresandaccesstoenvironmentalgoods
• Differencebetweenhazardandrisk-formerrequiresmonitoring,thelaZerinterven<ontopreventexposureorreducetoasafelevel
• Cleardifferencesinsuscep<bilitytoexposuresinindividualsandlocalcommuni<es
• Consequencesareseriousinpublichealthtermssomustbeconsideredinequi<es
• Requiresmorethanairqualitymanagement
Recommenda;onsforac;onandnextsteps• Educateprofessionalsandthepublic• Promotealterna<vestocarsfuelled
bypetrolanddiesel• Monitorairpollu<oneffec<vely• Protectthosemostatrisk• LeadbyexampleintheNHS• Studytheaffectsofairpollu<onon
health
Howyoucanhelp
• Championtheissueinparliament
• Highlightthesignificantadverseimpactthatairpollu<onhasonpeople’shealth
• Wewanttoworkwithyoutoprotectpeoplefromthedangersofairpollu<on
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