9000 Londoners die each year from air pollution. What the health ?

''Every Londoner in the capital lives in an area exceeding World Health Organization guidelines for the most dangerous toxic particles," according to the government. Indeed, a report by King's College London (KCL)(2018) said there are thousands of premature deaths in London due to long-term exposure to particulate matters (PM 2.5 and PM 10) and Nitrogen Oxide (NO2).

To tackle this health problem, Sadiq Khan, the Mayor of London and Transport For London (TFL) implemented on 8 April new emission standards for cars in central London called the Ultra Low Emission Zone (ULEZ). But will these new emission standards really reduce air pollution ?

''It is encouraging that politicians begin to engage with it and take it seriously. I think it is an important step and it will help but that is not enough,'' said Beth Gardiner, a journalist and author of the book Choked : The Age of Air Pollution and the Fight for a Cleaner Future.

£157 million : the cost of air pollution in the UK

Air pollution has a huge economic impact. In 2017, the cost of air pollution linked to the NHS and social care in England was estimated at £157 million. A report from Public Health England in 2018 warned the bill could reach £18.6 million by 2035 if there is no viable plan to improve air quality. Air pollution has to be taken seriously by the national government and not only in one city. Some hot spots in London and Greater London won't be covered until 2025 by the ULEZ.

KCL published a report in November 2018 on the impact of London's low emission zone (introduced in 2006 and covering heavy vehicles) on air quality and children's respiratory health. The report's authors said : '' We found no evidence of a reduction in the proportion of children with small lungs over this period, despite small improvements in air quality in highly polluted urban areas during the implementation of London's LEZ.''

Also, 438 schools in London are located in areas which exceed legal air quality levels. This is partly why the Mayor of London is implementing these new standards : to improve air quality for children. Why children ? Because '' [They] are more vulnerable to breathing in polluted air than adults. For their size, they breathe more air each minute than an adult, '' according to an article by the British Lung Foundation.

Reducing 20% of NOx emissions by 2020 with the ULEZ, mission: impossible ?

Transport for London claims that there would be a 20% reduction in Nox emissions London-wide by 2020. On paper, this is a breakthrough. But actually, people who are registered for the Congestion Charge discount will profit from a sunset period. It means that they will benefit from a 100% discount on ULEZ daily charge until 24 October 2021. This discount will be applied to "give them more time to change their vehicle to meet the ULEZ standards," says TFL on its website category dedicated to ULEZ. If one can benefit from a 100% discount then, why would one buy a new car now ? So the goal of reducing Nitrogen Oxide emissions by 20% in one year seems ambitious.

To deal with air pollution effectively, people need to have financial support. This is what Maudie Spurrier, public affairs and campaigns officer for Client Earth, is suggesting : "We need to help and support people and businesses so they can switch to cleaner and healthier forms to transport with a scrappage scheme or vehicle taxation system." This suggestion is also shared by journalist and author Beth Gardiner.

" People were encouraged to buy diesel because it was perceived as better for the climate which did not turn out to be the case sadly. But there are lot of diesels now on the roads. It is true that it is not fair to them to pay the price so the government should help people to buy new cars to take diesel cars off the road, " she says

Microbusinesses and charities can benefit from £3.500 to £6.000 of funding from TFL to change their vehicles in Central London in order to comply with the new emission standards. But there is no such help for individual drivers, except for the discount on the daily charge.

Some organisations did not support the introduction of ULEZ in London. The Alliance of British Drivers (ABD), a libertarian organisation is one of them. Paul Biggs, ABD director, environmental spokesman who is in denial of climate change, wrote an article entitled 'Air pollution : a crisis created by politicians ?' It seems somewhat controversial when 28 000 to 36 000 people die prematurely each year from air pollution in the UK. But Paul Biggs seems to ignore this statistic. He argues that Sadiq Khan is introducing ULEZ to " solve budget problems " because the ABD "estimates income over five years as being £313.6 million rather than £55.3 million," which is the official figure.

"The problem is bigger than one city and the mayor doesn't have the power to take all the steps to really solve that. " said Beth Gardiner. She added : "We need action at a European level."

Indeed, exposure to particulate matters caused 422.000 early deaths in 2015 in Europe, says a

report by the European Environment Agency published in 2018. The EU started in the 2000s to set up air quality standards such as Nitrogen Dioxide levels and Particle Matters levels limits. If countries exceed these limits, nothing will happen just because the EU has issued directives. Unless, organisations decide to take countries to court.

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The smoky top 3 : the effects of air pollution on health

"What you quicky learn when you start reading about air pollution is that it's linked to enormous health problems," said Beth Gardiner. She added that if it was a case of knife crimes or bombs we would be thinking about it every day. Indeed, exposure to air pollution leads to 28.000 to 36.000 early deaths a year in the UK, says a report from Royal College of Physicians published in 2016. But what really are the main effects of air pollution on health ?

Asthma

People with asthma are more likely to feel the effects of air pollution. A survey by Asthma UK showed in 2018 that two thirds of people with asthma felt that when the air is dirtier, their asthma is worse. For example, there are symptoms when air pollution levels are higher : you are coughing more, you need to take your inhaler more often, your nose and throat feel scratchy... But can air pollution cause asthma ? The answer is, yes. For example, for pregnant women who are exposed to high levels of air pollution, their baby have more chances of developing asthma.

Cardiovascular disease (CVD)

Not only people who have asthma are affected by air pollution. Everyone can be. Long exposure to high levels of PM 2.5 and PM 10 (related to fuel combustion) can lead to immediate or longer term heart problems. Older people and those with heart disease are more prone to have strokes or heart attacks even with a short-term exposure to air pollution.

Lung problems

It is a big issue for children because if they have long term exposure to air pollution, it could affect the development of their lungs. The British Lung Foundation said in an article that there was good evidence that outdoor air pollution contributes to lung cancer. Indeed, the International Agency of Research on Cancer has classified Particle Matters and more generally air pollution as carcinogenic.