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Air_pollution_main report_WEB

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Preface For us all, life on Earth depends upon the air we breathe and our ability to extract oxygen from it for energy creation. During a lifetime, a person breathes about 250 million litres of air, weighing about 300,000 kg. However, unknown by many, the air we breathe contains more than natural gases, as amply demonstrated on 5–9 December 1952, when London was engulfed by a dense fog in which air pollution from the burning of coal causing a massive increase in severe lung disease and death. As pointed out in the first RCP report on air pollution and health in 1972, 1 the recognition of how serious a public health issue this was led to the Clean Air Acts of 1956 2 and 1968, 3 in which measures were introduced to dramatically reduce industrial and domestic fossil fuel emissions with great effect. Following this, everyone thought that the problem of air pollution was over. But how wrong we all were. Over the next half century a different, more insidious form of air pollution appeared, linked to the emissions from the ever-increasing number of motor vehicles and other forms of transport on our roads, rail and seas that are dependent upon combustion of petrol and diesel fuels. Added to this chemical onslaught is the effect of indoor air pollution from workplaces and the fittings, furnishings, heating and cooking in our homes. Contemporary ambient air pollution in the UK largely comprises small and ultra-fine particles, oxides of nitrogen and ozone, and is largely invisible apart from episodes when particles and oxides of nitrogen cause a brown haze which, in other regions of the world such as China and South-East Asia, is becoming a regular feature. However, although pollution often cannot be seen or smelled, its effects are insidious and dangerous. Population-based studies as well as modern biological science have revealed highly potent toxic effects of chronic exposure to 'modern-day pollutants', not only on the lungs but also on the heart and broader cardiovascular system. We are further recognising that the systemic effects of pollutants extend beyond the cardiopulmonary system to affect many other organs, increasing the risk of disease that begins from conception and persists across the lifecourse. Added to this are the multiplying effects of urbanisation and climate change, both of which are driving air pollution in the wrong direction. 4 The Clean Air Acts of the last century, as well as recent tobacco smoking legislation, put the onus on the polluter to reduce emissions for the greater good of those around them. In the case of modern air pollution, it is currently the public at large that has to take responsibility for avoiding exposure, irrespective of their role in generating pollution, in contrast to the recently introduced tobacco smoking in public places legislation. The evidence base summarised in this report emphasises that the time has now arrived to take air pollution, as currently encountered in the UK, much more seriously than has been the case. It should be considered a major public health problem deserving of multiple measures to drive down exposure in as many ways as possible. It is our view that this requires urgent, determined and multidisciplinary action that is long overdue. Indeed, if we do not act now, our children and generations to follow will be those who suffer from our failure to act. Professor Stephen Holgate Chair of the RCP/RCPCH working party on air pollution © Royal College of Physicians 2016 vii 1 www.rcplondon.ac.uk/projects/outputs/air-pollution-and-health-1972 2 www.legislation.gov.uk/ukpga/1956/52/pdfs/ukpga_19560052_en.pdf 3 www.legislation.gov.uk/ukpga/1968/62/pdfs/ukpga_19680062_en.pdf 4 www.eea.europa.eu/publications/air-quality-in-europe-2015

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