Intended for healthcare professionals


Air pollution may claim 36 000 lives a year in UK

BMJ 2018; 362 doi: (Published 23 August 2018) Cite this as: BMJ 2018;362:k3632
  1. Jacqui Wise
  1. London

Air pollution causes 28 000 to 36 000 deaths a year in the UK, estimates from the Committee on the Medical Effects of Air Pollutants have shown.1

The committee’s previous estimate, made in 2015, was an annual effect equivalent to nearly 29 000 deaths a year. The new figure was arrived at by combining the effects seen in studies of nitrogen dioxide (NO2) and fine particulate matter (PM2.5). The committee found it difficult to separate the effects of particulate air pollution from that of NO2 because of scientific uncertainty.

In May the European Commission announced that it was taking the UK, along with France and Germany, to the European Court of Justice for failing to meet EU limits on nitrogen dioxide.2

NO2 gets into the air from the burning of fuel from vehicles and power stations. Breathing air with a high NO2 concentration can cause or worsen respiratory problems, and children and older people have the highest risk.

The UK government asked the committee to quantify the health benefits of reducing NO2 in the UK and carried out a systematic review and meta-analysis. The report estimates that a reduction in all traffic related pollutants consistent with a sustained 1 microgram/m3 reduction in NO2 could save 1.6 million life years over the next 106 years and increase life expectancy at birth by around eight days.

And a 1 microgram/m3 reduction in NO2 without a corresponding reduction in concentrations of other pollutants could save around 420 000 to 903 000 life years over the next 106 years and increase life expectancy at birth by two to five days.

However, the committee said that it was difficult to separate the impact of NO2 from other pollutants such as fine particulate matter, which are often emitted from the same sources. It said that the mortality burden estimates were based on a degree of speculation as well as hard evidence and should be regarded as an approximation.

The committee also emphasised that not all of the report’s conclusions were unanimous. A majority of the committee concluded that evidence showed an association between long term concentrations of NO2 and an increase in all cause mortality. However, three members of the 17 strong committee believed that evidence was insufficient to infer a causal association between long term ambient concentrations of NO2 and the risk of death.

Frank Kelly, committee chair, said, “While the mortality burden estimates in our report are based on research into nitrogen dioxide and particulate air pollution, they will also include the effects of other pollutants which are often found with these two pollutants such as ultrafine particles, polycyclic aromatic hydrocarbons, and volatile organic compounds.”

Laurie Laybourn-Langton, director of the UK Health Alliance on Climate Change, commented, “The link between air pollution and disease is indisputable, and health professionals have been saying for many years that reducing air pollution from road transport will have significant positive impacts on health.

“Understanding how the levels and ratios of different pollutants impact on health will not only provide further evidence to support this but will also help us develop new ways of reducing the health impacts of air pollution. In addition, more is needed by government to reduce air pollution, including expanding clean air zones and targeted support to encourage cycling and walking.”

Stephen Holgate, the Royal College of Physicians’ special adviser on air quality, said, “The government has a clear responsibility to act on the dangerous levels of air pollution in the UK and must act urgently.”


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