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Summary

Background papers: Lifestyle and wider determinants :: Air Quality [Update in progress] :: Summary

The impact of air quality upon health is unquestionable, and indeed has been a major driver in national and international attempts to reduce levels of air pollution. Long and short term exposure to poor air quality can have health impacts ranging from premature death due to cardiovascular disease and lung cancer, aggravation of asthma and other allergic illnesses, and reduced quality of life. Recent research has also linked air pollution to low birthweight.[1]

Medway's position between London, Kent and continental Europe brings health challenges associated with its unique pollution profile. Medway's extensive transport network carries a disproportionate number of HGVs, with their associated carcinogenic diesel emissions. Easterly winds can bring pollution, from continental Europe, which affects the whole of Medway, raising levels of particulate matter and/or ozone. Winds from the opposite westerly direction can bring London's urban pollution plume drifting across the area.

The Kent and Medway Air Quality Partnership provides strategic direction and support across the county, and has a health subgroup which provides advice to the respective partners on the health implications of air pollution. Medway Council is currently producing an Air Quality Action Plan, updating the previous edition published in 2005.

Key issues and gaps

Medway's Air Quality Management Areas, i.e. where pollution levels are monitored because quality does not meet the objective set by the EU Directive and the UK's own Air Quality Strategy, are in some of its most deprived wards. This correlates with the literature, in which deprived communities are most likely to experience the worst air quality.[2]

The possibility of providing air quality text alerts for vulnerable groups (the young, elderly, pregnant women and those with existing COPD and respiratory conditions) could be explored, based upon existing services in Greater London, Surrey, Sussex and Southampton, and using existing data collected by Kent Air.

The majority of air quality monitoring in Medway is focussed on measuring NO2 across 23 automatic monitoring sites. However, the Public Health Outcomes Framework provides data on PM2.5 as the pollutant most harmful to health. Medway has two sites that currently do so, but equipment to monitor this is expensive. The introduction of more affordable black carbon monitoring equipment, the data from which can be used as a proxy for PM2.5, may add greater detail to Medway’s air monitoring. To have sufficient detail to assess the health impact of air pollution in Medway, and make the case for evidence based measures to be implemented, it is important that PM2.5 is modelled in a range of locations.

There is arguably insufficient awareness across Medway of the impact of air pollution on the public's health. A balance needs to be struck between educating and informing the public to achieve behaviour change and adaptive action by those most at risk, and unnecessarily causing concern to vulnerable groups. The role of GPs and environmental health officers in developing and delivering these strategies is important.

Recommendations for commissioning

Work with Kent to provide a Kent and Medway air quality text alert service based on existing services in London, Surrey and Sussex, using the data already collected by Kent Air. Provide information for GPs on air quality and its impact upon asthma and existing COPD conditions. An integrated approach that maximises active transport and minimises people's exposure to air pollution would multiple health benefits. Public health should work closely and collaboratively with environmental health, planning and transport to ensure that major developments and transport planning consider the impact upon air quality and by extension the public's health.


References

[1]   Pedersen et al. Ambient air pollution and low birthweight: a European cohort study (ESCAPE) Lancet Respiratory Medicine 2013; 1(9): 695-704.
[2]   Walker G, Fairburn J, Smith G, et al. Environmental Quality and Social Deprivation: Phase II: National Analysis of Flood Hazard, IPC Industries and Air Quality 2003; Environment Agency. http://www.geography.lancs.ac.uk/envjustice/downloads/pr2.pdf?version=1%29 .