Abstract

In January the UK Government announced its Clean Air Strategy 2019, which outlines plans for improving air quality in the UK, especially in England. The strategy aims to collect better data for air quality and assess the impact of future policies; protect the nation's health and environment; secure growth in the economy while tackling air pollution; reduce emissions from transport, homes, farming, and industry; and address the problem of air pollution at all levels of leadership, including at the local level. The report notes that the UK's previous priority has been to tackle the biggest individual sources of pollution, which has led to reductions in emissions since the 1970s; however, these reductions are slowing, and the document states that action is needed on the contribution of smaller and more diffuse sources of air pollution such as smaller industry, product use, open fires, and spreading manure. The importance of air pollution to public health should not be underestimated. The Lancet Commission on pollution and health estimated that 4·2 million deaths globally were caused by ambient particulate matter (PM) in 2015, with a projected increase to 6·6 million deaths by 2050 if no new pollution controls are put in place. WHO also estimated that in 2016, 91% of the world's population was living in places where its own air quality guideline levels were not met. Air pollution contributes to a myriad of diseases including stroke, heart disease, lung cancer, and chronic and acute respiratory diseases, and the effects of air pollution vary by age. A recent study noted that PM2.5 concentrations and respiratory emergency department visits were strongly associated among children, whereas the association between ozone and respiratory emergency department visits was higher in magnitude among adults than children. If and when the UK leaves the EU, it will no longer be bound by EU directives setting ambient air quality standards, including international targets to reduce emissions of five of the most damaging air pollutants. The UK is already failing to meet the legal limit of nitrogen oxide concentrations, with particularly high concentrations being recorded at roadsides. In the foreword of the report, however, Michael Gove, the Secretary of State for Environment, Food and Rural Affairs, said he hoped the UK would “use the opportunity presented by leaving the EU to become a world leader in environmental excellence”. The strategy document adds new goals for air pollution, such as reducing the number of people living in places with PM2.5 concentrations above 10 μg/m3 (the WHO recommended limit) by 50% by 2025. But it's not clear to what extent any new UK legislation will hold ministers to account on these targets. Despite its commendable aims, the strategy document has received criticism from multiple sources. ClientEarth, an environmental law organisation that has already taken the current UK Government to court on several occasions over air quality compliance, claims the strategy does not sufficiently address pollution from road transport, and wrote in a statement on its website that the government's current plans for road transport are “in total disarray.” Jonathan Grigg, a leading UK paediatrician in the effects of air pollution, wrote in a letter to the Editor of The Times that the plan to halve the number of people exposed to air pollution above WHO recommendations by 2025 is “far too little too late”. But perhaps most troubling is that the strategy has been criticised by those with a responsibility for carrying it out—the local authorities. UK100, a network of local government leaders, highlighted in October last year that the £220 million Clean Air Fund was inadequate to address the public health crisis. Although the current document highlights additional funds for its strategy, it falls short of the £1·75 billion that was called for. Polly Billington, Director of UK100, indicated in an article in the Local Government Chronicle that the Clean Air Strategy fails to provide adequate powers or funding. The Clean Air Strategy 2019 has some important omissions on the specifics of how some of the plans would be enacted. For example, the report notes that new powers would be given to local authorities to take action in areas of high pollution, but there is little detail on what these powers are, or when they would be implemented. Specific policies, adequate funding, legally binding limits, and more ambitious targets are required to tackle air pollution. Although the Clean Air Strategy 2019 is a step in the right direction, more needs to be done.

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