A journey to clean air - a roundtable discussion on air pollution

The last few months have seen a raft of new evidence which clearly shows how much of an impact air pollution has on public health.

The details are serious. It is estimated 2,500 deaths in Scotland each year are directly caused by breathing poor air.

Traditionally a problem for those with lung problems, the latest research shows both short and long-term exposure to pollutants is also damaging to the heart and blood vessels, increasing the likelihood of both heart disease and stroke.

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Research at the University of Edinburgh by Professor David Newby, Dr Mark Miller and others, supported by £7m investment by the British Heart Foundation (BHF), found that ultra-thin PM2.5 particles, such as those found in diesel fumes, have become associated with increasing the likelihood of heart attack by 13 per cent. 

The particles are so thin they bypass the lungs and directly enter the blood vessels. 

The link between poor air and mortality provided the backdrop to Holyrood’s recent roundtable event in association with the BHF, which brought together researchers with campaigners and third sector organisations to discuss how Scotland might be made aware of the severity of the issue.

The Clean Air Act of 1956, brought in to tackle industrial smog, was an environmental milestone but Newby pointed out it was also associated with a marked drop in ill-health. “So we know if you legislate to reduce air pollution it reduces death, it reduces adverse health effects,” he said, using the smoking ban in public places as another example.

Modern pollution, however, is different because the particles are so small. Using controlled exposure studies in Northern Sweden and Edinburgh, Newby and his team discovered blood vessels react differently to the particles, making blood clots more likely. “All of these things contribute to the belief this is causal, not just an association,” he said. 

With traffic pollution a major contributor, spikes in heavily congested traffic were recorded at up to four or five times higher inside the car than outside, although cyclists, who breathe more deeply, will also get an equivalent level of harmful particles. Pedestrians are also affected, particularly very young children at pushchair height.

Although Edinburgh benefits from being near the sea, and Glasgow from being rainy, Newby suggested, both factors which kept air pollution down, levels were still high enough to be of concern.
Campaigner Mic Starbuck, a facilitator for the Royal Society for the Arts in Glasgow wellbeing network, has felt the very real effects of these levels. Diagnosed with asthma as a child, he enrolled at Strathclyde University in 1969 and has watched the transition in air quality since.

“There was still the big old-fashioned smogs, as opposed to the modern smogs the professor has been describing. Survived those fine, no trouble at all. Coughed up the black stuff, got rid of it, no trouble. Played hockey for my district, trial for Scotland, fit as a fiddle.

“In recent years, though, I’ve started to show very considerable deterioration.”

He describes himself therefore as “an example” of how air pollution has changed, describing how he has developed cardiovascular disease which has affected his nervous system. He has become acutely sensitive to his environment as a “citizen scientist”, he said, suffering when exposed to central heating outlets on homes, fumes from fast-food takeaways and in train and bus stations when diesel engines are left running. 

Glasgow city centre, he said, could sometimes prove too much. “You can taste it, you can feel it in your eyes, you can’t breathe, you just have to grab a taxi or whatever you can and get the hell out of there,” he said.

James Cant, director of the BHF in Scotland, said the increased recognition of how people were being affected highlighted a need for a “strategic” approach from local and central government. The British Lung Foundation’s Scotland director Irene Johnstone agreed, and said air pollution needed to be prioritised across every government department. 

“It’s really important air pollution isn’t seen to be the problem of one department or of one single source. It should be addressed across every single government department in Scotland, be it health, housing, the environment and I think if they are going to reach their 2020 targets, one of the things we’ve asked for is evidence of what these different departments are going to do to look at it,” she said.

In fact, the Scottish Government’s record on the basics is patchy. It continues to break European legal clean air standards six years after the deadline. The 2020 targets, laid out in the latest ‘Cleaner air for Scotland’ strategy, seem a long way off. 

Emilia Hanna, campaigner with Friends of the Earth, who was unable to attend after a family emergency, told Holyrood: “Let’s hope that Humza Yousaf brings a new direction for transport which moves us away from a “car is king” approach to one where the Government makes it handier for us to walk, cycle, and use public transport.”

The focus on traffic was largely agreed around the table, but there were warnings about the blunt use of targets. “Often targets are set very nobly and for all the right reasons but whether or not they’re implemented or breached is usually a different thing. I think it’s for bodies like ourselves and the British Heart Foundation to keep that pressure on in that regard,” said Johnstone.

John Lauder, national director at Sustrans Scotland, which works to enable more journeys using bicycle or walking, or ‘active travel’, said one such target is to have ten per cent of functional trips to be made by bicycle by 2020. The current figure is only two per cent. Around 16 policies to encourage walking and cycling had not been translated into action, he said.

“The evidence from round the tables is that departments are not working across government. They’re just isolated in silos. For eighty years, you could argue, transport has revelled in being in its own silo,” he said.

Cycling campaigner Sally Hinchcliffe from Pedal on Parliament agreed. “We’ve never had a target to reduce car use, as far as I know. The target has been to increase walking and cycling, but that could be round the block,” she said.

According to Friends of the Earth, there are no new transport actions in ‘Cleaner Air for Scotland’ which would seriously cut pollution levels on streets.

Hinchcliffe questioned whether the orthodoxy of the economic benefit of private car use was a sound case. “In the current climate, to hear one of the Scottish Government stand up and say ‘we want to reduce the use of the private car’ – I can’t imagine that happening,” she said.

Both Lauder and Cant warned against scapegoating the motor car, especially within a culture so dependent on it. “In many cases, families’ prosperity is often defined by the car,” suggested Cant. “Similarly, the prosperity of the nation is very often defined by the car as well. Increasing car sales is indicative of good economic news, and we need to tackle that in a subtle but effective manner which makes people realise the use of the car and the purchase of a car carries implications and responsibility with it.”

Johnstone agreed the approach should be nuanced. “Focusing on one element like cars is always going to be provocative but I don’t think we should shy away from it. We didn’t shy away from reducing the amount people can drink before they drive a car because that was a danger to their health, and we didn’t shy away from smoking. 

“In all of that people said, ‘we’re very nervous about entering into that sphere’ because they thought it was to do with the nanny state, but there are ways you can position these arguments where it’s not about enforcing a change, enforcing car use, it’s about enforcing behavioural change,” she said.

Improving the cycling infrastructure was raised by Newby and Hinchcliffe. “Forty years ago the Dutch started to do this. They made all the mistakes, they fixed the problems and they’re still improving their network and the result is 25 per cent journeys by bike, 50 per cent in some cities, 60 per cent in some cities. It’s really clear,” said Hinchcliffe.

Getting buy-in from local authorities, especially when budgets are squeezed, can prove difficult, however. Starbuck pointed to how the road haulage industry had piled pressure on Glasgow council over the Commonwealth Games infrastructure. “Yes, we need to get goods in and out of our cities, we don’t want our shopping centres to collapse, but we need to solve that,” he said.

Lauder said he had experienced a varied response from local politicians, including one “very fickle” senior councillor. “For me, the best local authorities to work with are the ones with strong leadership. Good clear leadership from the top, he said. Of Scotland’s £2bn transport budget, one and a half per cent is spent on active travel, he pointed out. 

Fintan Hurley, scientific director at the Institute of Occupational Medicine, said he “strongly supported” moves to active travel, and suggested it should be backed up with a public transport system which provided people with options. “Exhorting on car use won’t work. There has to be infrastructure that allows people to shift,” he said. 

Miller pointed to how Lothian Buses had won awards for its use of low emissions vehicles. “I would believe it’s had some commercial success from those, from the advertising saying these are good,” he said.

“It’s worth speculating whether Edinburgh’s bus fleet is better and better driven because it’s publicly owned,” suggested Lauder, pointing out Scotland’s reputation as a bus manufacturer. 

Hurley said health policies need to be aligned with policies to tackle climate change, and vice versa, pointing to the example of how a push to use diesel vehicles has now been proven to harm public health. 

“Some of these things are win-wins, and some of them aren’t. Diesel was one that wasn’t. Good for climate change, bad for public health. Biomass is similar,” he said. Cant said the push toward the use of biomass energy was “a very loose definition of the term environmental” because of its environmental and physical impact.

Hurley added: “Checking the unintended effects are really important and I think these things have to be looked at holistically, with a real aim to get the win-wins. 

“I think when people are under financial pressure they sort of lose that breadth of vision. Sometimes, it is actually the way to achieve it, to dig in and find that breadth of vision and cooperate.”

Ruaraidh Dobson, of the Scottish Centre for Indoor Air at the University of Aberdeen, said a similar thing had happened with changes in ventilation in homes to drive up energy efficiency which had led to much poorer indoor energy quality.

For Starbuck, it is about arming people with information, allowing them to see the quality of the air they are breathing. This would be helped, he said, by replacing the current ‘traffic light’ approach, which bases itself on average readings and can be deceptive. “Do not believe the colours on any of these maps, be it European, Defra or our own that we’re paying a lot of money for. Kick it around and come up with a more sensible answer,” he suggested. 

Good work by local authorities could be celebrated as ‘fresh air champions’, suggested Cant. Planning would need to be involved, suggested Dobson: “In the south east of England, there’s been some success with new housing developers having to put in cycling infrastructure, but of course, a lot of the new housing developments have fantastic cycling lanes which end at the roundabout leading onto it.” 

Encouraging governments to take a joined-up approach could start with the formation of a cross-party group, it was suggested, which could look at investing more in active travel, green spaces and educating people about the dangers of poor air pollution, particularly to vulnerable people such as children and the elderly, and people who are already sufferers such as Mic Starbuck.
“If we’re taking them on a journey, we hope it’s one of active travel,” said Hurley.