Intended for healthcare professionals


Air pollution in the UK: better ways to solve the problem

BMJ 2017; 357 doi: (Published 14 June 2017) Cite this as: BMJ 2017;357:j2713
  1. Robin Russell-Jones, chair
  1. Help Rescue the Planet, Stoke Poges, UK
  1. info{at}

The major health effects of air pollution can be reduced by tougher action on motor vehicles, argues Robin Russell-Jones

In 1915, Herbert Asquith, prime minister of Britain, said that the motor car was a luxury that was rapidly turning into a nuisance. More than a century later, vehicles still rely on the internal combustion engine, fossil fuels are still the predominant energy source, transportation accounts for 15% of greenhouse gas emissions globally, and outdoor air pollution accounts for 3.7 million premature deaths a year worldwide.1 In some capital cities, such as Beijing and Delhi, pollution is so bad that schools have to be closed and people are warned to stay indoors. Air pollution is thought to contribute to 1.6 million deaths a year in China, accounting for around 17% of all deaths, compared with almost 10% in the UK 234

The UK government has resisted implementing the EU air quality standards for the past seven years, during which time a growing body of medical evidence has shown the harmful effects of air pollution in general and of diesel in particular.5 Patients with heart and lung disease are the most affected by air pollution, but exposure to small particulates has also been linked to stroke, diabetes, obesity, and dementia.

In response to the successful court case brought by Client Earth, a non-profit environmental law organisation, the UK government published a draft position paper on 5 May to achieve compliance by 2020 with the legal limits for nitrogen dioxide (NO2) contained in the 2008 EU Air Quality Directive.6 The document, published jointly by the Department of Environment, Food, and Rural Affairs (DEFRA) and the Department for Transport, has been widely criticised for dealing only with NO2 rather than being a comprehensive Clean Air Act that …

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