A study shows that the impact of air pollution on GP and A&E workloads may be greater than previously thought. Put another way, improving air quality could ease pressure on the NHS.
Researchers compared the timing of 114,930 GP and 9,878 A&E respiratory visits in Bradford with air pollution measured around the city. Polluted days were followed by increased health service use for breathing problems, with impacts persisting for more than 100 days.
A third of GP and half of A&E respiratory visits were attributed to nitrogen dioxide that was above World Health Organization (WHO) daily guidelines. This pollutant mainly comes from diesel vehicles and was estimated to cost the NHS in Bradford about £1.95m over the four-year study. There is also the hidden cost of time away from work and lost education, as well as the way that illness affects people’s lives.
Separate research in south London between 2009 and 2013 also found increases in GP visits and inhaler prescriptions in the days immediately after pollution peaks.
Prof Rosie McEachan, the director of the NHS Born in Bradford research programme and co-author of the new study, said: “There is no safe level of air pollution. We need more ambitious city-wide policies: clean air or low-emission zones, greater regulation of industrial pollution, cheaper and more reliable public transport, and infrastructure to enable people to use greener ways to get around.”
The size of the air pollution impact may be related to underlying health problems in the area. Long-term respiratory illness in Bradford is greater than the national average. Even before the cost-of-living crisis, 15% of homes were living in fuel poverty and 22% of children were below the poverty line.
A separate study of more than 300,000 people across the UK found that people on lower incomes were more vulnerable to breathing problems from air pollution.
McEachan added: “Like other deprived cities in the UK, Bradford has high levels of respiratory illness. This is likely due to air pollution as many deprived urban areas are also pollution hotspots. High pollution events make these problems worse, with clear impacts on health service use.”
The UK government’s air quality information service would classify most of these pollution events as low.
McEachan commented: “UK air quality information systems should reflect the more stringent levels recently endorsed by the WHO. It is really important that the public understand the impact that dirty air has on their health.”
New research from ISGlobal, the Barcelona Institute for Global Health, has quantified the impacts from different pollution sources to help local and national politicians to prioritise action. For Bradford nearly half the attributable deaths from nitrogen dioxide in 2015 were linked to traffic. Agriculture in the surrounding area is the top source for health impacts from particle pollution, but reducing pollution from transport, home heating and energy generation will help, too.
Prof Mark Nieuwenhuijsen of ISGlobal said: “In this day and age, no one should die of air pollution in Europe. Bolder measures are required to drastically reduce pollution and deaths associated with traffic. At the same time, we need to tackle other sources including industry and shipping, along with limiting home wood burning and emissions from farming.”
