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Dr Mike Holland• Mike Holland is a freelance consultant based in the UK, and an Honorary Fellow of Imperial College London
• BSc University of East Anglia, PhD University of Edinburgh• Clients include:
– National Governments (UK, France, Sweden…)– European Commission and its Agencies, World Bank, OECD, WHO– Industrial companies– Environment and health NGOs, including groundWork
• Memberships include:– UK Committee on the Medical Effects of Air Pollutants (COMEAP)– European Association of Environmental and Resource Economists– UK Chemicals Stakeholder Forum– UN/ECE Task Force on Integrated Assessment Modelling– RCP / RCPCH Task Force on Air Pollution
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The RCP report
• Produced by RCP and RCPCH
• Written by Royal College members and invited experts
• Released February 2016• Available at:
https://www.rcplondon.ac.uk/projects/outputs/every-breath-we-take-lifelong-impact-air-pollution
or google ‘every breath we take’
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Range of impacts linked to air pollution
• Most pollution work has focused on mortality and hospital admissions, which are concentrated in the elderly
• However, there are links to many other diseases including:– Cancer– Asthma– Stroke– Heart disease
• Throughout the full life course
– Diabetes– Obesity– Dementia
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Air quality limits and public protection
• Neither the concentration limits set by governments nor the World Health Organization’s air quality guidelines are fully protective of health
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Health burden of outdoor air pollution in the UK
• RCP report is focused on the UK and concludes that:– Each year, air pollution leads to the equivalent of 40,000 deaths in the UK from outdoor air pollution, valued at >£20 billion• PM2.5
• NO2• O3
– Much of that impact is from exposure below statutory limits in the UK
• However, the general findings of the report are relevant in other countries
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Role of the medical profession
• “When our patients are exposed to such a clear and avoidable cause of death, illness and disability, it is our duty as doctors to speak out.”– Medical profession is good at dealing with symptoms– Barriers on acting on causal factors likeair pollution
– You can use the report to get the medical profession to recognise the impact of air pollution on health
Selected recommendations for action by the health profession
• Act now, think long term• Educate professionals• Protect the public when air pollution levels are high• Tackle inequality, protecting those at most risk• Lead by example in the National Health Service– Major polluter!– Collaborate with local authorities?
• Messages are aimed mainly at health workers in the UK, but the same messagesapply everywhere
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Study on health impacts of coal burning in South Africa
• Funded by groundWork (FoE South Africa)• Objectives:– Inform the current debate on power generation in South Africa• Choice of power generation technologies• Consequences of not meeting emission limits
– Raise awareness of the harm to health caused by air pollution
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Impact pathway approach
• Tracks emissions through to impactsusing best available science
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EMISSIONS
e.g. tonnes of SO 2
DISPERSION
Increase in ambient concentrations e.g. local and regional ppb SO2
IMPACTUsing exposure-response curves, e.g. change in crop yield per ppb
together with geographical databases of receptors (e.g. people, crops, buildings)
COST
IMPACT
CONCENTRATION
Damage costs (e.g. market price)Willingness to Pay
Previous studies in South Africa• Vivid Economics
– Extrapolation of UK damage estimates per tonne emission• Energy system externalities in South Africa. Vivid Economics. http://www.vivideconomics.com/publications/energy-
system-externalities-south-africa
• Lauri Myllyvirta for Greenpeace International– More detailed dispersion modelling– Use of GBD response functions– Use of OECD methods for valuation
• Health impacts and social costs of Eskom’s proposed non-compliance with South Africa’s air emission standards. http://www.greenpeace.org/africa/Global/africa/publications/Health%20impacts%20of%20Eskom%20applications%202014%20_final.pdf.
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Starting point: emissions from the power stations
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Forecast annual average PM2.5 contribution from plant covered by Eskom’s application for emission limit
derogation, ug.m-3
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Map of population distribution
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Great London Smog, 1952• Provides a clear example of exposure response– First conclusive evidence of air pollution effects on health
– 4,000 excess deaths in London in 1 week
• Our work uses more recent research published since 1990– Mortality quantified using Global Burden of Disease Approach
– Illness quantified drawing on WHO-Europe recommendations
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Estimated annual impacts of coal fired generation in South Africa
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These estimates of impact do not include
• Several possible types of health impact identified in the RCP report– More studies need to be carried out to provide the dose-response relationships
• Impacts of emissions from mining, transport of coal
• Occupational health for miners• Contamination of water• …
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Graphs show the mortality effect of exposure to 1 ug/m3 PM2.5
18Poor health
Lower impact
High impact
Good healthPoor health
Russian men
Norwegian women
Conclusions• Coal fired power generation is a major source of air pollution in South Africa
• This pollution has a serious impact on health, equivalent to 2,200 attributable deaths per year, and associated ill health
• Analysis has not included all coal related emissions• The precise numbers are ‘uncertain’ to a degree. The science behind them is not.
• Total costs associated with these impacts exceed $2 billion annually
• These impacts are material and should be considered in future energy policy
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Additional slides
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UK response to poor air quality• Limited number of measures were implemented in the 1950s and 1960s– Ban on highly polluting fuels
– Industrial zoning
– New technologies
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The result – 30 year decline in emissions and pollution levels
UK Smoke & SO2: Annual Mean Concentrations at allNational Survey and Basic Urban Network sites
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Year
Concentration, ug m
-3
SO2 ug/m3
Smoke ug/m3Levels of SO2 are now negligible in UK cities, smoke concentrations also further reduced since 1997
UK emissions of PM10 and SO21970 - 2015
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0
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UKEm
issionPM
10,ton
nes/year
Coal Coke Gas Oil Other Peat Petcoke Waste Wood
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1,000
2,000
3,000
4,000
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6,000
7,000
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UKSO2
emissons,tonnes/year
Othersources
Domesticcombustion - coal
Coalpowerstations
Fuelcombustion (notinclcoalPS, domestic)
PM10
SO2
Emissions reduced by:• Fuel switching• Use of abatement technologies• Efficiency improvements
Further actions after 1997, largely in response to EU legislation
Does it need to take 60 years?
• NO!• We made some mistakes in the UK: South Africa can benefit from our experience and that of other countries
• New technologies are available that were not available 60 or even 10 years ago
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A final thought
• Air pollution harms thousands of people every year in South Africa, leading to higher levels of disease and early deaths– Bad news
• If you don’t act on the information– Good news
• We have identified a major burden on public health• We know what actions to take to reduce the burden
• We know what will worsen the problem• We need to take the opportunity 25
