Tackling toxic air and climate change

The risk to non-smokers of developing lung cancer is rising significantly: in the UK 6000 people each year now die of lung cancer despite having never smoked, or having smoked a negligible number of cigarettes. This is thought to be as a result of increasing exposure to toxic air.

This makes lung cancer among non-smokers alone the eighth biggest cancer-related cause of death in the UK, ahead of leukaemia, lymphoma and head and neck cancer. However, as lung cancer remains strongly associated with smoking it has created stigma around the disease as self-inflicted, which has had an impact on the level of research into its other causes. Consequently, there is a need to raise awareness with clinicians and policy makers of the other risk factors – including indoor and outdoor air pollution.

While smoking is the single biggest lifestyle factor that affects lung cancer, accounting for around 86 per cent of cases, air pollution, fumes from coal fireplaces, and second-hand smoke are also linked to its development. Smoking history is often the first question clinicians will ask patients who come in with respiratory symptoms that could be an early warning cancer, but a history of not smoking could give false reassurance and send them down the wrong diagnostic path.

Even more worrying is the fact that worldwide nearly four million children develop asthma every year as a result of air pollution from cars and heavy vehicles, equivalent to 11 000 new cases a day. The key pollutant, nitrogen dioxide, is produced largely by diesel vehicles.

Childhood asthma has now reached global epidemic proportions: one in eight of all new cases is due to traffic pollution and evidence shows that existing WHO standards are not protective against childhood asthma. As a result of their high populations and significant pollution levels, the three countries with the greatest number of children developing asthma each year are China (760 000), India (350 000) and the USA (240 000). However, these data may underestimate the true levels in many poorer nations where asthma often goes undiagnosed and undertreated.

The risks to us all – and to all other species – from a combination of environmental pollution and climate change are plain to see: we cannot pretend to be unaware. Each and every one of us could and should modify our lifestyle, and encourage our friends, colleagues and patients to do likewise, by cutting back on air travel, reducing or cutting out the consumption of red meat and converting to a more plant-based diet.
What are your thoughts? How should we respond to the climate change emergency?

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