APPG on Air Pollution February Newsletter

Risks of a Smoke-filled Brexit Kate Harrison

Diesel Filters Make Pollution Worse Greg Archer

Air Pollution News

Environment Bill Special

February 2020

The Public Health Challenge of Our Times Professor Stephen Holgate Chronic effects of Air Pollution

begin before Birth Dr Robin Russell-Jones

Published by Geraint Davies, MP Chair All Party Parliamentary Group on Air Pollution This is not an official publication of the House of Commons or the House of Lords. It has not been approved by either House or its committees. All-Party Groups are informal groups of Members of both Houses with a common interest in particular issues. The views expressed in this Report are those 1of the group.

The Environment Bill is our opportunity to clear the smoke Air Pollution APPG Chair Geraint Davies, MP Air Pollution is responsible for 64,000 early deaths a year in the UK and 8.8 million globally, even more than smoking which kills 7.2million people per year.

The Environment Bill is the opportunity to get provisions into law before we withdraw from the EU’s regime for air quality enforcement. Here we publish a series of articles to help inform debate.

In the first, Professor Stephen Holgate, of the Royal College of Physicians’ ‘Air Pollution: The Public Health Challenge of Our Times,’ maps out the impact on heart disease, lung disease, strokes, diabetes obesity and dementia. Professor Holgate believes the Environment Bill must also include indoor air quality as that’s where children spend 95 per-cent of their time amidst growing air-born risk from fumes and chemicals.

Then, environmental lawyer Kate Harrison, takes a look at the Environment Bill in ‘Risks of a Smoke-filled Brexit’ finding the Bill leaves the door ajar to a deterioration in UK public health.

In ‘Chronic effects of Air Pollution begin before birth,’ Dr Robin Russell-Jones underlines the urgency for action as harm begins from conception, through childhood and adulthood from low birth weight, to children’s IQ and mental health conditions.

Greg Archer’s ‘Diesel Filters make Pollution Worse,’ shows how diesel filters store up particulates, crush them into smaller, more dangerous particulates and belch them out every 300 miles. Motor manufacturers’ lobbying has meant that these belches are not included in the emissions testing regime. This revelation is hot

on the heels of the Diesel-gate scandal which exposed car manufacturers for cheating emission tests for nitrogen dioxide (NO2) and underlines the to update testing and to bring forward the ban on new diesel cars to 2030.

These findings underline the view that the Environment Bill must include indoor air quality; must require WHO limits for PM2.5 of 10 micrograms per cubic metre of air by 2030 staged as 12 µg/m3 by 2025 and 15 by 2021; must have an independent body to enforce these standards with fines to be paid to the NHS towards the health cost for Air Pollution and to local government for mitigation We urge MPs to join the APPG on Air Pollution and to support these measures by signing EDM #186 ‘Environment Bill: Air Quality Enforcement’ and EDM #187 ‘Indoor Air Quality in the Environment Bill’ (page 12). We urge others to write to their MPs asking them to sign these EDMs.

Kind Regards,

Geraint Davies, MP Chair of the Air Pollution APPG

Geraint Davies, MP for Swansea West House of Commons London SW1A 0AA 2

Tel: 02072197166 E-mail: Geraint.davies.mp@parliament.uk

Contents P.4 Air Pollution: The Public Health Challenge of our Time Professor Stephen Holgate

P.6 Risks of a Smoke-filled Brexit Kate Harrison

P.8 Chronic effects of air pollution begin before birth .

Dr Robin Russell-Jones

P.10 Diesel filters make pollution worse Greg Archer

P.12 Early Day Motions #186 and #187

3

P.14 References

Air Pollution: The Public Health Challenge of our Time Professor Stephen Holgate, Advisor to Royal College of Physicians.

W

e are constantly being told by Government Ministers that air quality in the UK is improving. While the closure of coal-fired power stations has improved air quality nationally in urban areas, where traffic is the major pollution source, better air quality has proven much more difficult to achieve.

At the same time evidence as to the harmful effects of air pollution has been rapidly increasing, particularly in relation to small particulates with a diameter of less than 2.5 microns, known as PM2.5. We also believe that ultrafine particles (PM0.1 or nanoparticles), are even more dangerous due to their enhanced ability to bypass the lung barrier, thereby accessing the blood stream and penetrating tissues, including the brain and the placenta. 1,2,3.

These particles are coated with metals, cancer-causing compounds such as benzo-a-pyrene, and other organic substances.

Once deposited in tissues they induce “oxidative stress” and inflammation, causing cells to die more quickly. Virtually every organ is susceptible to their damaging effects and it is for this reason that air pollution is the public health challenge of our time.

Negligence on this issue appears particularly callous given the most vulnerable members of 4

Figure 1. Overview of diseases, conditions, and biomarkers affected by outdoor air pollution. Conditions currently included in the Global Burden of Disease categories are shown in bold

our society often suffer the effects of air pollution disproportionately. It is generally agreed that NO2 aggravates asthma, and peak levels relate to increased hospital admissions .4,5.

“Virtually every organ is susceptible to the damaging effects of Air Pollution” In February 2013, Ella Kissi -Debrah, a nine year-old girl living close to the South Circular Road in London, suffered a fatal asthma attack after being admitted to hospital 27 times over a 3 year period.

I discovered a “striking association” between her admissions to hospital and pollution levels near her home, including NO2. In London and other major cities, up to eighty per cent of NO2 is derived from diesel vehicles. 38 out of 43 areas in the UK have been in breach of EU air quality standards for NO2 since 2010.

New vehicles with tighter emission standards have not produced the expected improvements in air quality due to gaming of the emissions tests by car manufacturers, and cheating in the case of the Volkswagen who fitted NO2 reduction technology that only operated under laboratory conditions. Under real driving conditions, these “cheat” devices turned off NO2 controls resulting in emissions from diesel vehicles that were 30 to 40 times

Ella Kissi-Debrah, a nine year old girl from Lewisham who suffered a fatal asthma attack in 2013.

higher than in the laboratory.

The case for taking action is clear and recent data paints an increasingly alarming picture regarding the effects of air pollution. In February 2016 I helped to produce a joint report by the Royal College of Physicians and the Royal College of Pediatrics which estimated 40,000 premature deaths annually in the UK are attributable to air pollution.

At the time we wrote the

RCP report, mortality data was strongest for heart disease, stroke, pulmonary diseases and lung cancer. A recent study in the European Heart Journal confirms this link and estimates an extra 790,000 deaths annually from ambient air pollution in Europe including 64,000 deaths in the UK.6 Forty per cent of deaths were from heart disease, 8% from strokes, 7% from pneumonia, 6% from asthma and

Figure 2.

Disease Buren from Ambient Air Pollution in Europe.

bronchitis, and another 32% from “other non-communicable diseases”.

Tightening legal limits for air pollution is the first step to averting the public health crisis we are in. Currently, UK legal limits for air pollution are set by the EU at the level of 25 microgrammes of PM2.5 per cubic metre of air (µg/m3). By contrast, WHO guidelines are much stricter at 10(µg/m3), a figure which is based on medical studies rather than being decided politically. Medicare data from the United States involving more than 60 million subjects demonstrate that there is no safe limit for PM2.5 making the need to adopt stricter standards ever clearer .7 The EU is expected to raise air quality standards to WHO limits and the UK should follow suite after Brexit. As we spend 90 per cent of our time indoors at growing risk from airborn chemicals and fumes interacting with out-door air pollution it is important that indoor air quality is also included in the Environment Bill, as underlined

by The Royal College of Paediatrics & Child Health’s Health effects of indoor air quality on children and young people.8 In 2016 the Health, DEFRA, Transport and Environmental Audit select committees collectively described air pollution in the UK as a “public health emergency.”9 The Government has a duty to protect our health and future generations: the Environment Bill is its opportunity to do so .

Professor Stephen Holgate is Special Advisor to the Royal College of Physicians on Air Quality.

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Risks of a Smoke-filled Brexit

Kate Harrison

The

EU (Withdrawal Agreement) Act maintains EU law and protection until the end of 2020.

After this point, EU laws governing air quality will become part of domestic regulation and ministers will be allowed to depart from EU interpretations of the law. Unfortunately, the government’s newly published Environment Bill 2019-20 will prove no substitute for our current level of protection when it comes to clean air.

In brief, the Bill outlines powers for new environmental targets, introduces a list of environmental principles, sets up the Office for Environmental Protection (“the OEP”) and includes 6

“ There is nothing in the Environment Bill that prevents Air Quality from deteriorating .” some additional measures in relation to Air Quality. The Environment Bill amends the local Air Quality management framework, providing that national AQ strategies are to be reviewed every five years with a Secretary of State duty to report to parliament every year on progress.1 While it is the duty of the Secretary of State to set long term targets and ensure that

-targets are met, the targets them-selves could be expressed in ways which are easy to meet and difficult to enforce.

The Secretary of State is allowed a 15-year time span for targets to be achieved: 2 this period of time is little comfort for those who believe there are only 10 years within which to act to save a habitable planet.3 The latest mortality estimate of 64,000 deaths annually from air pollution, for instance, means that 15 years at current levels of exposure would result in almost a million premature deaths in the UK alone.4 Worse still, there is nothing in the Bill that prevents Air Quality from deteriorating despite calls for a commitment to

non-regression. Although the Bill states that targets should improve the natural environment this aim is a cumulative test of all the targets together.

Technically speaking, the environment could be improved with targets that are weaker than those we have now because air quality is so often below the required standard .

In addition, Targets may be revoked or loosened if the Secretary of State is satisfied that meeting the target would ‘have no significant benefit’ or when, because of changes in circum-

“In the Environment Bill the power of environmental law will be weakened“ stances … the environmental, social, economic or other costs of meeting it would be disproportionate to the benefits.’5, 6 The government has claimed that for the first time it is enshrining Environmental Principles in law. But the environmental principles listed in the Bill (integration, prevention, precautionary principle, source principle, polluter pays principle) were already enshrined in (environmental) law through EU treaties. They bind all public authorities under EU environmental law and apply to administrative decisions.

By contrast in the Environment Bill what were legal principles become policy. In short, the power of environment law in the 7

UK will be weakened. The Bill includes measures to set up an Office of Environmental Protection through which members of the public can make complaints when environment standards are not met.

However, enforcement powers are limited to those connected with a ‘failure to comply’ with environmental law.6 The Secretary of State can remove any law from the definition of “environmental law” and ‘Failure to comply’ doesn’t mean straightforward non-compliance but ‘unlawfully failing to take proper account of environmental law when exercising … functions’.7 Rather than requiring public bodies to obey environment law; instead they must take account of the law during their decision making processes.

The Bill does not propose the immediate action necessary to address the urgent problem posed by emissions that risk human health and the environment. It may be that we should look to Human Rights Law as a means of holding the government and public authorities accountable when Air Quality limits are breached. In a recent case, the Netherlands Supreme Court has decided that where environmental hazards exist Articles 2 and 8 of the European Convention obliges the government to take urgent and suitable steps to protect its citizens’ health and the environment.8 The Environment Bill does not meet these criteria.

Kate Harrison is a solicitor at Harrison Grant, London.

Lets change the environment Bill to prevent thousands of deaths from Toxic Air Geraint Davies, MP The Environment Bill needs clear, enforceable targets by specific deadlines. Presently the Bill only includes a commitment to set a target for small particulates, PM2.5. In addition we need a timetable to achieve WHO guidelines with targets for PM2.5 of 10 µg/m3 by 2030 and 12 µg/m3 by 2025.

These must be enforced by an independent agency by levying fines when legal limits are broken. At the moment the proposed Office of Environmental Protection will have powers to make complaints when public authorities breach environmental standards, however the upper Tribunal to whom the cases are referred would lack the power to enforce fines. We need an agency able fine the government with fines paid towards the NHS costs of air pollution and to local authorities for mitigating air pollution. This would replace the Government paying EU fines through the courts for its failure to protect us with EU air quality standards. We need enforceable standards in the Environment Bill if we are to protect public health.

Geraint Davies, Chair of the Air Pollution APPG.

Chronic effects of Air Pollution Begin Before Birth

Dr Robin Russell-Jones MA FRCP FRCPath

A

ir Pollution is a global problem. 90% of the urban population worldwide are exposed to levels above the WHO guideline limit for small particulates (PM2.5) of 10 microgrammes per cubic metre of air (µg/m3). 1 Recent studies estimate that air pollution causes 8.8 million premature deaths globally, which represents 15.7% of all deaths.2 This makes ambient air pollution the greatest preventable cause of death globally, bigger even than smoking at 7.2 million deaths.

The new estimate for mortality in the UK is 64,000 premature deaths annually. UK citizens lose on average 2.2 years of life due to a health hazard that is beyond their control. These latest estimates are based on 41 studies from 16 different countries .3 Excess mortality is only a small part of the total picture. A joint Royal Colleges report from 2016, based on 40,000 deaths annually, estimated that air pollution in the UK costs the econo8

my £20 billion per annum, with mortality contributing only 8% of the total.4 The rest relates to morbidity - in other words the chronic effects of air pollution which begin before birth, and persist throughout life. This review will examine some of these other effects.

“Air Pollution costs the economy £20 billion per

annum, with mortality contributing only 8% of the total.”

Birth weight Birth-weight is a critical measure. An analysis of 32 studies linking pregnancy outcomes with the level of small particulates (PM2.5) concluded that each increase of 10 µg/m3 in PM2.5 lowers birth-weight by 16 grams.5 It is well known that smoking during pregnancy

also lowers birth weight, but mothers have the option of stopping, and most do. Living in urban areas does not give pregnant women this option. In Central London pregnant women are exposed to a level of small particulates that will lower the birth weight of their baby by around 24 grams. It is the equivalent of passive smoking twenty four hours a day for 9 months.6 Levels of PM2.5 in the capital are below the annual EU limit of 25 µg/m3, but the health effects of small particulates are without threshold. The EU commission are currently reviewing the Ambient Air Quality Directive and are likely to lower the annual limit. In the US, the legal limit is 12 µg/m3, and 8 µg/m3 in Australia.

During the Olympic Games in 2008, the Chinese Government made every effort to reduce pollution levels in Beijing, notably by restricting vehicle access, and birth weight increased.7 The maximum benefit (23 grams) was for women who were in the last trimester of their pregnancy during the Olympic Games -in other words the stage

of pregnancy associated with maximum foetal growth.

Exposure in utero Low birth weight is linked to a host of adverse outcomes in later life, including lower IQ. Evidence also exists for a direct impact of pollution during pregnancy. Polycyclic Aromatic Hydrocarbons (PAHs) are generated by any combustion process, so members of the public are exposed from activities such as smoking, cooking, domestic fires, and of course traffic, particularly diesel. Researchers in New York have reported that exposure to PAHs during pregnancy in non-smoking mothers is linked to developmental delay at 3 years;8 an IQ reduction of 4-5 points at 5 years;9 increased anxiety, depression and inattention at 6-7 years;10 reduced surface white matter in the brain at 8 years;11 and delayed self-regulatory behaviour that was most significant at 11 years.12 These observations have not yet been replicated in the UK. Even so the situation may be worse as diesel vehicles represent a much larger proportion of the UK car market than in the US. Since 2000 the proportion of new vehicles which run on diesel has increased from 14% of the new car market to almost 50%.

Levels of Benzo-a-pyrene, the only PAH monitored in the EU, have increased by 52% at traffic monitoring sites since 2000 .13

Effect on IQ These observations have profound implications for public health and educational attainment. UK children and teenagers are currently suffering a miniepidemic of mental health prob9

lems which the medical profession are struggling to explain.

Commentators have targeted social media, but the toxic impact of air pollution on developing brains is equally worthy of attention, and a vital area for further research.

Thus air pollution has also been linked with IQ deficits in teenagers and a recent Londonbased study showed higher rates of depression amongst teenagers exposed to higher levels of air pollution.14,15 It could be argued that these associations are not causal, but intervention studies are compelling and cannot be dismissed so easily. For instance, a recent US study demonstrated an increase in the cognitive performance of school children when air filters were fitted to schools in Los Angeles.16

Dementia There are also data showing that air pollution also impacts cognitive function in later life. A systematic review in 2016 identified 31 studies linking air pollution with cognitive decline: 15 in the Americas, 5 in Asia and 11 in Europe.17 In 2017 a study of 2.2 million older adults living in Ontario showed that their chances of developing dementia increased the closer they lived to a major highway, indicating a dose-response relationship for traffic-derived pollution and dementia.18 In 2018 a study of 75 GP practices in Greater London showed that the chances of developing dementia was linked to ambient levels of both PM2.5 and NO2.19 The authors concluded that 14% of dementia cases in the UK are attributable to air pollution.

Measures needed It is obvious that the UK Government should be doing more to mitigate these health effects.

HMG could increase the tax on diesel, introduce a diesel scrappage scheme, bring forward the phase-out date for fossil fuel vehicles from 2035 to 2030, and give councils the powers to identify and fine highly polluting vehicles at the roadside.20 They should also introduce WHO limits by 2030 at the latest with a mandatory air quality standard for PM2.5 of 10 Âľg/m3, and an intermediate target of 12 Âľg/m3 by 2025.

Instead, DEFRA has produced a Clean Air Strategy which conspicuously fails to address the problem posed by diesel.21 It contains a commitment to halve the number of people in the UK exposed to levels above the WHO limit for PM2.5 by 2025. This is not a standard. This is an aspiration that lacks any legal force.

It is for these reasons that the UK needs a Clean Air Bill and a National Clean Air Agency tasked with responsibility for both indoor and outdoor air quality.

Dr Robin Russell-Jones is Scientific Advisor to the APPG on Air Pollution. He was previously Chair of CLEAR, The Campaign for Lead Free Air.

Diesel Filters make Pollution Worse Greg Archer, UK Director Transport and Environment

C

armakers can no longer claim new diesels are clean.

Recent research published

by Transport and Environment has exposed that even the most modern diesel cars belch out huge numbers of hazardous fine particles. 1 For a decade new diesel cars and vans have been fitted with a diesel particle filter (DPF) to collect particles in the exhaust. The DPF was thought to have solved the diesel particle problem, but diesels produce so much soot the filters quickly clog and need regular cleaning typically every 300 miles.

This regeneration of the filter, which typically lasts around 25 minutes, releases huge numbers of the smallest, most hazardous particles.

T&E commissioned Ricardo Engineering to conduct the tests on the road and in the lab. We tested 2 cars a Vauxhall Astra and Nissan Qashqai but would have found very similar results on every diesel car, van and urban buses and delivery trucks too.

The tests measured a massive spike in the particle numbers during the time the filter was cleaned. The levels were so high the vehicles breached the particle num10

ber limit – by 32 to 115% but in standard testing the car is not considered illegal because tests are invalidated and redone when a regeneration occurs. In effect between 60 and 99% of all the particles emitted from the vehicle occur during the regeneration and are ignored.

“All diesel cars

should be banned from low emission zones, as Bristol has done .�

The legal limit for particle number is 6x10 11 . Most diesels in routine driving produce emissions substantially lower than this. The Nissan measured levels

above the legal limit during the regeneration on both occasions, 7.9 and 8.5 x10 11..

The Astra was much worse seeing 1.3x10 12 particles being released during the regeneration per km - around 5 times the legal limit.

The research shows diesels are an even more important source of particulates than previously thought and demonstrate that it is nonsense to suggest new diesel cars are clean. All diesel cars should be banned from low emission zones - as Bristol has done.

T&E also found that many of the particles released are too small to be measured during a standard road test. Only solid particles larger than 23nm in diameter are measured in the test, but T&E measured solid particles as small as 10nm and this increased the total number of particles by be-

tween 11% and 184% compared to when only regulated particles were measured. Nearly half the particles may be being missed in some tests. This omission is especially worrying because it is the smallest particles that have the greatest health concerns.

There are 7.5 million dirty diesel cars and vans on the UK’s roads fitted with DPFs. Given their typical mileage and the interval between filter cleaning

there will be around 230 million regenerations every year. Not all of these will occur in urban areas – but most will.

Even those occurring on highways will emit particles that once airborne will add to the background pollution levels. In addition diesel cars emit ammonia through the process of using urea to control NOx emissions. The ammonia is quickly converted in the air into secondary particles as

will the NOx emissions. So what should be done? Firstly, as part of the Environment Bill we must set an objective to achieve the WHO PM2.5 guideline value of 10um/m 3 by 2030.

Secondly, we need to rapidly phase out of new Internal Combustion Engine (ICE) cars and vans by 2030.

In doing so the UK will become a leader in Electric Vehicle (EV) sales attracting manufacturing of vehicles and cells into the UK. 2 We

Figure 1.Diagram showing particulate emission spikes of different cars tested during filter cleaning.

cannot achieve net zero emissions by 2050 unless we end sales of ICE cars as soon as possible. The budget must also ensure that grants for zero emission vehicles are retained as they are scheduled to end in March 2020.

These grants could be funded through reform of first year vehicle excise duty. 3 Thirdly, we need to improve the tests of particle number and limits should be met when a DPF regenera11

tion occurs. The EU is developing a new Euro Standard and we should follow their example to apply stricter rules. Until diesel vehicles are clean – and this work shows definitively they are not – they should be excluded from all low emission zones.

Finally, we need a new Clean Air Act. The toxic air we are daily forced to breathe must be cleaned up. The Environment Bill

will not tackle the main causes of air pollution hotspots, 95% of which are caused exclusively by traffic. The first Clean Air Act resolved the 1956 Smog – now we need a new Act focused on today's principal source of pollution: traffic.

Early Day Motions

Indoor Air Quality and Air Quality Enforcement Please find below Early Day Motions that MPs are free to sign. If you support their content then you can e-mail your local MP encouraging them to support the following EDMs.

EDM #186 Environment Bill: Air Quality Enforcement This House notes that, according to the Royal College of Physicians, air pollution accounts for 64,000 premature deaths at a cost of £20 billion each year; that enforceable EU air pollution targets will no longer apply after December 2020; that the Government has accepted World Health Organization (WHO) air pollution guidelines; calls on the Government to include in the Environment Bill the requirement that PM2.5 reaches the WHO guideline annual mean concentration of 10 (μg/m3) by 2030 with interim targets of 12 (μg/m3) by 2025 and 15 (μg/m3) by 2021; and urges that these limits are enforced by the proposed Office for Environmental Protection through fines that are then paid to the NHS towards the health costs of air pollution and to local authorities to reduce air pollution.

12

EDM #187 Indoor Air Quality in the Environment Bill This house notes that the Royal College of Paediatrics & Child Health report “The inside story: Health Effects of Indoor Air Quality on Children and Young People�; that children spend ninety five per cent of their time indoors; further notes that indoors they are exposed to indoor air pollution from construction materials emitting volatile organic compounds and formaldehyde, lack of ventilation, use of cleaning and cosmetic products, candles, cooking, showering, damp and mould; further notes that indoor air pollution causes respiratory ill-health in particular when combined with outdoor air pollution; calls upon the Government to include indoor air pollution within the Environment Bill, in particular in relation to schools, hospitals and public buildings, to provide for better ventilation and building regulations to ensure healthy air flow and to regulate in favour of public health in respect to known dangerous substances and to adopt a precautionary approach to new substances until there is evidence of their safety.

13

References Air Pollution: The Public Health Challenge of our Time (pp.4-5) 1.

Miller M et al. ‘Inhaled nanoparticles accumulate at sites of vascular disease.‘ ACS Nano (2017) DOI: 10.1021/ acsnano.6b08551.

2.

Liu N et al. ‘Do inhaled carbonaceous particles translocate from the lung to the placenta? ’ Abstract No PA 360 Occupational and environmental lung diseases: asthma and the airways, (2018).

3.

Cacciotollo et al. ‘Particulate air pollutants, APOE alleles and their contributions to cognitive impairment in older women and to amyloidogenesis in experimental models.’ Translational Psychiatry (2017); 7:1022-29

4.

Mills I. ‘Quantitative systematic review for the associations between short-term exposure to nitrogen dioxide and mortality and hospital admissions.’ BMJ Open (2015);5e006946.

5.

Collard P. ‘Short-term effects of nitrogen dioxide on hospital admissions for cardiovascular disease in Wallona, Belgium.’

International Journal of Cardiology; (2018) 255: 231-236.

6.

Lelieveld J et al. ‘Cardiovascular disease burden from ambient air pollution in Europe reassessed using novel hazard ratio functions.’ European Heart Journal (2019). ehz135,https://doi.org/10.1093/eurheartj/ehz135.

7.

Di Q et al. ‘Air Pollution and Mortality in the Medicare Population.’ New England Journal of Medicine (2017); 376: 25132322.

8.

Royal College of Physicians , ‘The inside story: Health effects of indoor air quality on children and young people.’ (2020) https://www.rcpch.ac.uk/resources/inside-story-health-effects-indoor-air-quality-children-young-people#what-did-wefind

9.

Environment, Food and Rural Affairs Committee, ‘Air Quality Fourth Report of Session 2015-16.’ (2016) p.3. https:// publications.parliament.uk/pa/cm201516/cmselect/cmenvfru/479/479.pdf

Risks of a Smoke Filled Brexit (pp.6-7) 1.

Her Majesty’s Government, ‘Environment Bill, 2019-20’ : https://publications.parliament.uk/pa/bills/cbill/5801/0009/20009.pdf.

2.

Ibid., p.5 (clause 7.3).

3.

Watts, Jonathan, ‘We have 12 years to limit Climate Change catastrophe, warns UN,’ (online: Guardian, 2018) : https:// www.theguardian.com/environment/2018/oct/08/global-warming-must-not-exceed-15c-warns-landmark-un-report

4.

Lelieveld J et al. ‘Cardiovascular disease burden from ambient air pollution in Europe reassessed using novel hazard ratio functions.’ European Heart Journal (2019). ehz135,https://doi.org/10.1093/eurheartj/ehz135.

5.

Her Majesty’s Government, ‘Environment Bill, 2019-20,’ p.2, (clause 3.3.a) : https://publications.parliament.uk/pa/bills/ cbill/58-01/0009/20009.pdf.

6.

Ibid., p.3, (clause 3.3.b).

7.

Ibid., p.18, (clause 30.7).

8.

Ibid., p.15, (clause 26.2.a).

9.

Akkermans J; Proper E, ‘Dutch Supreme Court Orders 25% Cut in CO2 starting in the New Year,’ Bloomberg (December 2019): https://www.bloomberg.com/news/articles/2019-12-20/dutch-supreme-court-upholds-landmark-greenhouseruling .

Chronic effects of Air Pollution begin before Birth and are Life Long (pp.8-9) 1.

Landrigan P et al. ‘The Lancet Commission on pollution and health.’ Lancet (2018); 391: 464-512

2.

Lelieveld et al. ‘Cardiovascular disease burden from ambient air pollution in Europe reassessed using novel hazard ratio functions.’ European Heart Journal, (May 2019); vol.40: 1590-96: https://doi.org/10.1093/eurheartj/ehz135.

3.

Burnett R et al. ‘Global estimates of mortality associated with long-term exposure to outdoor fine particulate matter.’

Proceedings of the National Academy of Sciences of the USA (2018); 115: 9592-9597

14

4.

Royal College of Physicians and the Royal College of Paediatrics and Child Health , ‘Every Breath We Take: The Lifelong Impact of Air Pollution’ (2016): https://www.rcplondon.ac.uk/projects/outputs/every-breath-we-take-lifelong-impactair-pollution .

5.

Sun X et al. ‘The association between birth weight and exposure to fine particulate matter (PM2.5) and its chemical constituents during pregnancy: a meta-analysis.’ Environ pollution (2015); 211: 38-47. https://doi.org/10.1016/ j.envpol.2015.12.022

6.

Smith R et al. ‘Impact of London’s road traffic air and noise pollution on birth weight: retrospective population based cohort study.’ BMJ (2017);359:j5299

7.

Rich D et al. ‘Differences in birth weight associated with the 2008 Beijing Olympics air pollution reduction: results from a natural experiment.‘ Environ Health Perspect (2015);123: 880-87

8.

Perera F et al. ‘Effect of prenatal exposure to airborne polycyclic aromatic hydrocarbons on neurodevelopment in the first 3 years of life among inner-city children.’ Environ Health Perspect (2006); 114: 1287-1293’

9.

Perera F et al. ‘Prenatal airborne polycyclic aromatic hydrocarbon exposure and child IQ at age 5 years.’ Pediatrics (2009); 124: 195-202

10.

Perera F et al. Prenatal polycyclic aromatic hydrocarbon (PAH) exposure and child behaviour at age 6-7 years. Environ Health Perspect (2012); 120: 921-926.

11.

Peterson B et al. ‘Effects of prenatal exposure to air pollutants (Polycyclic Aromatic Hydrocarbons) on the development of brain white matter, cognition, and behaviour in later childhood. ‘ JAMA Psychiatry (2015); 72: 531-40.

12.

Margolis A et al. ‘Longitudinal effects of prenatal exposure to air pollutants on self-regulatory capacities and social competence.‘ Journal of Child Psychology and Psychiatry (2016); 57: 851-60.

13.

European Environment Agency 2016 report. EEA report no 28/2016: https://www.eea.europa.eu/publications/airquality-in-europe-2016 .

14.

Wang P et al. ‘Socioeconomic disparities and sexual dimorphism in neurotoxic effects of ambient fine particles on youth IQ: A longitudinal analysis.’ PLOS ONE (2017); 12(12): e0188731. https://doi.org/10.1371/journal.pone.0188731

15.

Roberts S et al. ‘Exploration of NO2 and PM2.5 air pollution and mental health problems using high-resolution data in London-based children from a UK longitudinal cohort study.’ Psychiatric Research 2019; 272: 8-17.

16.

Gilraine M et al. ‘Air Filters, Pollution and Student Achievement.‘ EdWorking Paper No 20-188. (Jan 2020)

17.

Clifford A et al. Exposure to air pollution and cognitive functioning across the life course- A systematic literature review.

Environ Research (2016); 147: 383-398.

18.

Chen H et al. ‘Living near major roads and the incidence of dementia, Parkinson’s disease, and multiple sclerosis: a population-based cohort study.’ The Lancet (2017); 389:718-726.

19.

Carey I et al. ‘Are noise and air pollution related to the incidence of dementia? A cohort study in London England.’ BMJ Open (2018);8:e022404.doi:10.1136/bmjopen-2018-022404

20.

Russell-Jones R. ‘Air pollution in the UK: better ways to solve the problem.’ BMJ (2017); 357:j2713 doi: 10.1136? bmj.j2713.

21.

DEFRA. Clean Air Strategy Published Jan 14. 2019. Ref PB14554. GOV.UK : https://assets.publishing.service.gov.uk/ government/uploads/system/uploads/attachment_data/file/770715/clean-air-strategy-2019.pdf

Diesel Filters make Pollution Worse (pp.10-11) 1.

Transport & Environment, ‘New diesels, new problems,’ (2020): https://www.transportenvironment.org/publications/ new-diesels-new-problems .

2.

Archer G, ‘How to shift the UK from also ran to winner in the electric car race,’ Green Alliance Blog, (2019): https:// greenallianceblog.org.uk/2019/09/17/how-to-shift-the-uk-from-also-ran-to-winner-in-the-electric-car-race/ .

3.

Archer G, ’Funding purchase grants for zero emissions cars in a growing UK market,’ Transport & Environment, (2019): https://www.transportenvironment.org/publications/funding-purchase-grants-zero-emission-cars-growing-uk-market .

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Edited By Lily Russell-Jones

Secretariat Provided by Environmental

Industries Commission

Please contact Cameron McIntosh with any queries at cameron.mcintosh@eic-uk.co.uk

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