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Urgent Action Needed for Cleaner Air

Last time you went to you doctor, she probably asked you if you are a smoker or second-hand smoker. But did she ask you whether you’ve been having any environmental exposures such as air pollution? No, is most likely the answer, but she should, and this is one of more recommendations on how our societies should act very fast to make our air cleaner from the European Respiratory Society, an international organisation that brings together healthcare professionals, epidemiologists, patient representatives, scientists and other experts working in respiratory medicine.

“Air pollution is the major environmental stressor that affects all of us, daily, throughout lifetime. For long time we knew that air pollution affects adversely our lungs, increasing risk of asthma chronic obstructive lung disease, lung cancer, pneumonia and influenza. However, newest research showing that air pollution can travel via our blood stream to almost all organs in our body, and increase pur risk of heart disease, dementia, diabetes, and cancers other than lung, is alarming, calling for action now,” says Zorana Jovanovic Andersen, professor environmental epidemiology at the University of Copenhagen, Denmark.

She’s behind the statement ‘Clean air for healthy lungs – an urgent call to action: European Respiratory Society position on the launch of the WHO 2021 Air Quality Guidelines’ giving recommendations and it states that any improvements in air quality will result in health benefits, even at concentrations well below current or future limit values.

“Before we believed that air pollution at the levels we observed in Denmark, and other Nordic countries were safe for our health. Now we know, from the latest Danish studies, that air pollution at any level is harmful,” says professor Andersen.

Air pollution is a major risk factor to public health, contributing to morbidity and mortality from respiratory, cardiovascular and cerebrovascular disease, and lung cancer according to the statement, which underlines that every year, air pollution leads to 509 000 premature deaths in Europe and serious aggravations of lung and heart diseases that affect millions of children and adults.

Zorana Jovanovic Andersen. Photo: Branislav Nenin

Because of the links with multiple diseases and the ubiquitous nature of the exposure, air pollution is the fourth leading risk factor for morbidity and mortality in the Global Burden of Disease study, surpassed only by high blood pressure, tobacco use and poor diet, the statement underlines.

The Recommendations

According to the paper the organisation recommends following

  • Inclusion of environment-related health issues in the core medical training of future healthcare professionals
  • Inclusion of environment-related health issues in continuing medical education courses, provided, for example, by medical societies
  • Clinicians always to ask their patients about environmental exposures, in addition to questions about active and second-hand tobacco smoking
  • Development of evidence-based clinical guidelines for treatment and prevention of environment-related disease
  • Advocating for appropriate reimbursement policies by health insurance for guideline-recommended personal protection devices
  • Engagement with patient representatives for awareness raising, educating and advising patients, specifically the most susceptible and vulnerable patient groups
  • Raising their voices for clean air policies as advocates of their patients’ health

The statement highlights the main messages of the 2021 World Health Organization (WHO) Air Quality Guidelines and points out how the ambitious European Union (EU) Green Deal can provide solutions through a modern air quality legislation.

Air pollution poses a major burden to respiratory patients and legislation fails to protect them, according to the statement. Therefore, urgent action and alignment of air quality standards with WHO guidelines are needed to ensure healthier lungs and tackle the climate change crisis.

“Combating air pollution has to be priority for our societies, as it will improve our health immediately and prevent the substantial number of new diseases, as well as help mitigate unprecedented climate change crisis, driven by fossil fuel emissions, also main causes of air pollution,” says Zorana Andersen.

Get the full study

Photo: Branislav Nenin