Did you know that, while the effects of chemical pollution on human health are poorly defined, its contribution to the global burden of disease is almost certainly underestimated?
- Diseases caused by pollution were responsible for an estimated 9 million premature deaths in 2015—16% of all deaths worldwide, which is three times more deaths than from AIDS, tuberculosis and malaria combined, and 15 times more than from all wars and other forms of violence?
- Nearly 92% of pollution-related deaths occur in low-income and middle-income countries?
- The combustion of fossil fuels accounts for around 85% of air pollution impacts?
The report highlighted the rapid rate at which new chemicals and pesticides are being synthesised, and warned that some 5,000 have become so common that they “have become widely dispersed in the environment and are responsible for nearly universal human exposure”. Fewer than half of these high-production volume chemicals have undergone any testing for safety or toxicity.
Out of commission
As technology advances, the range of chemicals being released is widening: recent years have seen novel chemicals including, according to the report, “developmental neurotoxicants, endocrine disruptors, chemical herbicides, novel insecticides, pharmaceutical wastes, and nanomaterials” entering the environment; however, the pace of innovation is not being matched by the development of management controls, which are moving forward very slowly under regulations such as REACH.
The issue of pollution engages real questions of social and generational justice. In countries at every income level, disease caused by pollution is most prevalent among minorities and the marginalised. Children are at high risk of pollution-related disease and even extremely low-dose exposures to pollutants during windows of vulnerability in utero and in early infancy can result in disease, disability and death in childhood and across their lifespan. A graphic illustration of children’s vulnerability is provided in the figure below, taken from the report.
Expanding the use of eco-labels would help to empower consumers to help choose low-pollution products. The Cradle to Cradle Certified™ (‘C2C’) label includes a ‘Material Health’ category: the concentrations of potentially problematic chemicals it stipulates are below legal maximums, and lower than those allowed by many other labels. Assessments of applications for certification often use evidence from a wide range of sources – not just the EU’s REACH evidence base, but more far-sighted information such as that found in the databases of the Swedish Chemicals Agency.
Clean bill of health?
The Lancet Commission’s figures above strongly suggest that the health costs of pollutants, including opportunity costs, should also be influencing variables when calculating the impact of policies. Where improvements in air quality have been made, principally in richer countries, health benefits have been accompanied by economic gains. According to the report:
“In the USA, an estimated US$30 in benefits (range, $4–88) has been returned to the economy for every dollar invested in air pollution control since 1970, which is an aggregate benefit of $1·5 trillion against an investment of $65 billion.”
The Commission’s recommendations include increasing and focusing the meagre funding for pollution control, particularly from international agencies and donors, to middle and low income countries. It is important that pollution issues are factored into decisions regarding which projects to fund: so in the UK, for example, the Department for International Development needs to make use of cost and return calculations to assess the value of its international aid investments in permanently combatting pollution in recipient countries.
This isn’t simply a matter of altruism: at present we’re often effectively exporting the pollution associated with the products we consume to the countries where they are made, so again there is a question of justice. But there is also potential self-interest: taking steps that help improve health and consequent productivity of what are now middle and low income countries will help them grow their economies and become larger export markets for our goods and services.
For higher income countries, the commission’s findings imply a need to incentivise a major reduction in the emission of pollutants. A key means of doing this is environmental fiscal reform to shift far more of the tax burden away from labour (via income and payroll taxes) and onto atmospheric carbon and other pollutants. Taxing environmental and social ‘bads’, in recognition of the costs they impose, is a vital part of the ‘polluter pays’ principle that encourages the development of low-emission alternatives to current practices.
In the UK, the government is incrementally taking this approach. The 2017 Budget in November imposed additional taxes on diesel cars not meeting the latest highest standard, which will be used in a new Clean Air Fund. However, vans were excluded from these supplements, and duty on fuels including diesel was again frozen. It is interesting that the government bases the cost of air pollution abatement policies on research carried out into people’s ‘willingness to pay’ (contingent valuation) to avoid deaths and shortened lives (mortality) and the ‘disutility’ of a hospital stay. For morbidity (illnesses) the methodology uses the cost of a hospital stay and, optionally, the loss of earnings.
For transport, the damage costs are expressed per litre of fuel, as shown in the table from BEIS below.
Clearly, if the Treasury opted to add these damage costs to the current rate of fuel duty, diesel drivers would see quite a large tax increase!
However, even the damage costs would be greater if the scope of the UK Government’s air quality impact assessment methodology were wider. Under the current method, only a narrow range of pollution impacts are evaluated and everything that is not included is assumed to have zero impact. This is plainly absurd, as the Lancet Commission’s findings make clear. I think it should be expanded to take account of the much wider pollution impacts credibly reported by the Lancet Commission; and the wider economic benefits of pollution prevention – the US$30 per $1 invested quoted above.
We all want and need clean air (much as the Victorians wanted a clean River Thames after they’d experienced the ‘Great Stink’), not just compliance with legislation which allows compromised air, so we should follow the direction of travel more quickly and by and large do what it takes to get there as soon as possible. That would mean adopting more of a Scandinavian approach to environmental and health problems. Let’s hope the new Clean Air Strategy, to be published in 2018, will move towards this mindset.
The Lancet Commission report is a thick line in the sand. Society in the UK and globally should move forward with bold investment which will deliver step changes in health experience and reductions in the costs of maintaining modern industrial societies.