Rob Yates
Ladies and gentlemen, welcome to Chatham House, on a rather grey horrible afternoon, and perhaps a bit grey – more grey and horrible than we’d really like because, you know, we’re here to discuss toxic air pollution, and a huge topic, affecting cities right across the world, and this is a topic that we picked as part of our discussions on London Global Cancer Week. We’ve been having discussions this afternoon about cancer control and universal health coverage. But we thought for a public meeting that we would have a discussion about a very topical issue that is affecting the lives of people in London, but also, countries across the world.
My name is Robert Yates, I am Head of the Centre of Global Health Security here at Chatham House, and we’re delighted to have these events that are thinking about health, not just in sort of a health system’s context, but involving other areas, such as environment, education, the legal determinants of health. And we’re delighted to have such a diverse audience and participants here this evening. I should explain that this meeting, even though we’re in the famous Chatham House, is on the record, so it’s being recorded, it’s being livestreamed and so, greetings to people across the world, but it therefore means that it is being recorded and so people should be aware of that.
Fire exits, we have one here, and otherwise, up the stairs. We’re not expecting any fire drills, so if you hear the alarms, please do head for the exits. So, the format of tonight’s event, we’re going to have our four eminent speakers, who are going to speak for about sort of five to six minutes each, on different aspects of this topic. But we very much want to encourage a dialogue with you, the audience, I mean, and I’m sure many of you – most of you, perhaps, are London residents yourselves and are concerned about this issue. We want – so, we want to hear your thoughts on how this is affecting you and really what collectively, we should be doing to tackle this problem.
So, if I can just introduce our speakers tonight, and to my immediate left I have Susannah Stanway, who is a Consultant in Medical Oncology at the Royal Marsden NHS Foundation Trust. Immediately to Susannah’s left we have Dr Benjamin Barratt, who’s a Senior Lecturer at King’s College London. Then we have Camilla Hodgson, who’s an Environmental Reporter for the Financial Times and has just done an excellent piece all about air pollution in the Underground. And then finally, Elliot Treharne, who’s Head of Air Quality at the Greater London Authority, and has very generously come to speak to us tonight. Of course, we’re in an election period and I’m sure people might have might some questions of a political nature, but Elliot is a Civil Servant and so, he’s going to be sort of constrained by purdah, as to how he can answer some of those questions. But please feel free to ask the panel what you like, basically. So, without further ado if I can hand over to Susannah, and I think you’re going to talk to us really about the medical implications of air pollution, and particularly thinking about cancer.
Dr Susannah Stanway
Yeah, thank you very much, and thank you very much for the invitation. So this is one of a series of meetings this week, which is part of London Global Cancer Week that five of us have put together, including other meetings that some of the Royal Colleges, the Royal Society of Medicine and the Economist ran a fantastic day yesterday and tomorrow, we’re at the Chatham House and the Royal College of Radiologists. And it’s a series of meetings where we’re trying to convene people to come together, so that we can educate people about cancer control in low and middle income countries and to raise awareness, to perhaps stimulate some more political will to invest in this area. So, I’m not an expert in air pollution, and I’m not going to pretend that I am. So, any questions particularly relating to that and policy, I shall direct to my learned colleagues on the left.
So, air pollution kills – is said to kill around 4.9 million people a year globally, and when I was doing my reading to prepare for today, I hadn’t really realised that in that 4.9 million people, includes people dying of cancer, I just assumed that it would be people dying of respiratory illness. And I was fascinated to learn this, because I think that this doesn’t really feature in the narrative around air pollution. Around 50% of cancer is said to be preventable and as Chris Wild, ex-Director of IARC said, “No country is going to have the resources to treat their way out of the cancer conundrum, so everything that we can do to prevent cancer is going to be imperative.”
And here we are, with a predominantly manmade situation, although air pollution, I appreciate is not all manmade, but it’s predominantly manmade, and this is potentially an excellent opportunity to prevent cases of cancer. It’s also got to be said that the majority of cancer cases in the world happen, or the majority of cancer deaths, should I say, happen in low and middle income countries, often where they don’t have the infrastructure to deal with cancer. And that 97% of people, living in cities over 100,000 to size, do not meet current WHO targets for air quality. So, air pollution leads to a range of adverse health outcomes, which I know Elliot, for sure, is going to touch upon at the end, but cancer is one of them. And in 2013, IARC made air pollution as a whole, and also particulate matter, they were defined as carcinogens by IARC.
There’s two other things that came out of my reading, which interested me and I hope they also interest you is, that there are some sociodemographic variances, with who air pollution hits, which I think is terrible and we need to stand up for the unheard and for people that are living in poverty, are uneducated and who are unemployed. So, if you look at the four top countries, where air pollution – or the cities, should I say, where air pollution is the worst: Beijing, Dakar, Delhi, and I’m going to forget the fourth, Mumbai, they are all in low and middle income countries. So it’s affecting – sort of between countries, it’s affecting some of the poorest countries, but also, within countries, there were two studies that I came upon in my reading, one was in St Louis in Missouri, along the Mississippi. And another was a study in China, which showed that the pockets where the air pollution was particularly bad, were the pockets where people that were living in poverty that had lower levels of education were, and this is terrible, from a human rights perspective.
So, coming to cancer, lung cancer is – I don’t need to tell anyone, a terrible cancer to get, many people present late, and our outcomes are not good, although it has to be said, improving. And again, 80% of the world’s billion smokers live in low and middle income countries, where they’re often not protected by the fiscal policies that smokers in high income countries or non-smokers in high income countries are protected by. And there are also interactions between smoking and air pollution, leading to adverse outcomes. So, there are a variety of epidemiological studies using many tools, prospective studies, retrospective studies, case control studies, cohort studies. And several of them are showing that there are – that there is an increased risk of cancer, when a variety of measures of air pollution are looked at, including particularly particulate matter, I think that’s probably where most of the evidence is for poor health and cancer outcome.
And also, it’s not just lung cancer that it’s increasing, and there were many studies that I came upon, which showed that there are increases in all kinds of cancers, for example, breast cancer, in a study looking at nurses in Canada. So, again, I just think that this narrative about cancer needs to get on the agenda. So, my five take home messages, from what I learnt in my reading, are that the public need to be made aware of the cancer side to the air pollution story. People need to be empowered to be able to make changes for themselves, when it comes to doing their bit to reduce air pollution. I can speak, having a husband that cycles to work every day or takes his moped, that has been knocked off, on multiple occasions, we need to have cities that are safe for cycling and for measures like that, which are potentially going to reduce air pollution to happen. I think that we need to learn more about the sociodemographics, affects how that is modified by air pollution, and I think that it is perhaps to get political leverage, if you look at a country like China, it’s said that it loses around 10% of its GDP because of poor health outcomes because of air pollution. And finally, I think that the smart cities of the future are going to have to think better about how we deliver clean air. Thank you.
Rob Yates
Alright, thank you. Thank you, Suzie. Right, so, Ben, you’ve done a lot of work – lots of work studying this all over the world, particularly in Asia and I think you’re going to help come up with the facts about, you know, just how bad air pollution is.
Dr Benjamin Barratt
Well, I thought I’d use my five minutes to address the sceptics in the room, and I’m not sure if there are any sceptics.
Rob Yates
You might want to reach out.
Dr Benjamin Barratt
No, quite the contrary, I want there to be sceptics because there are some issues around air pollution that leads to disbelief, to some degree. Suzie has quoted some fairly dramatic and very extremely worrying statistics and some people’s reaction is, “I simply don’t believe that.” So, at least if you’re not sceptical, some of this content might help you defend this against some that you come across that are. And from a very early age we’re taught about – to be very careful about what we put inside our body, don’t drink water from the pond, don’t kiss the dog, eat your greens. But we don’t really think about what we breathe, and later in life, this develops into some people making some really quite radical choices about how they put other things into their body: purified bottle water, go go berry diets, etc. So people think a huge amount about what they eat and what they drink, but they don’t think about what they breathe, and this is the first hurdle that we come across with sceptics, a lack of awareness and education, that Suzie alluded to, and there are parallels with smoking here
The profile of air pollution as a Public Health issue has risen, in recent years, there’s several reasons for that. But one of the main ones is the health impacts of air pollution have – the evidence has become stronger and more wide ranging, with lots of unexpected health outcomes affected, lung cancer and – being a relatively understandable one, but some of the other cancers are slightly more surprising, so the evidence there is much stronger. And there are challenges here around education, just as there are with other Public Health messages. But the health impacts of air pollution and the Public Health messaging are unique, and that is partly for the second two hurdles that I’ll highlight.
The second hurdle is one of disbelief, and a typical response might be, “I’ve never seen anyone die of air pollution, and anyway, it’s getting much better, we don’t have the smogs, like we did in the 50s.” And this is an understandable response, because people who are harmed by air pollution aren’t hit by a bus. There’s nothing visible about the harm of air pollution. It’s not only an invisible challenge, it’s also an invisible harm, but air pollution is a life course harm. We know that mothers living in more polluted areas have babies with lower birthweight. We know that those children growing up in more polluted areas have smaller lungs. So right from the start, right from day zero, those children are starting life with a challenge, and that means that their body is less able to counter other challenges that they come across later in life. So it may not be air pollution that causes that cancer, that respiratory disease, that cardiovascular disease, but it may be lung cancer that – it may be air pollution that let that disease in. Later on in life, air pollution can affect bodies already weakened by other disease, so it may shorten the lives of people who have disease, which may be because of air pollution or it may be because of some other health point – endpoint.
So it’s a life course disease that affects us all, and when someone says, “I’ve never seen anyone die from air pollution,” actually everyone, including everyone in this room, will have some harmful side effects of air pollution, it’s just most of us are fortunate enough to not recognise it. Other people say air pollution – air quality is improving, sure enough it is improving. It’s improving in London, it’s improving in the UK, many people, including myself, feel that it’s not improving fast enough, but it is. But one of the main reasons we’ve been able to improve our air quality, since the 1950s, is to export our polluting activities. So the low and middle income countries that Suzie mentioned are suffering because they are manufacturing the things that we need, so we’ve just offloaded this. So we have a duty, in our country and other developed countries, to these low and middle income countries to help them improve.
The hurdle – the third and final hurdle is one of visibility and personal control. The response that, “Well, there’s nothing I can do about it, it’s not my problem, and I’m going to stick my head in the sand.” And this is something that is – I particularly am interested in, is how do you make this issue personal, and how do you empower people, so that they feel that they do have some control over this issue, rather than it being someone else’s problem. By making it personal and so people can see how air pollution affects their own health and their own family’s health and exposure, then it becomes much more real. You can empower them to make choices, behavioural choices as to not only how much pollution they create, but also, some actions of how to avoid air pollution.
This isn’t always possible, and it’s not solving the problem, but by giving them that choice, giving that engagement, then they are more likely to support the kind of policies that Elliot will talk about, which may impinge on their lives and inconvenience them, but if they’re aware of those effects, they may be more accepting of them. So, while we strive for a cure for cancer, we must strive to remove the causes of cancer, more urgency with energy and purpose, and cleaner air will benefit the entire population across the whole planet. We can achieve lower rates of cancer, lower rates of respiratory disease, lower rates of cardiovascular disease, the list is long and the rewards are great. Are there still any sceptics in the room? Thank you.
Rob Yates
Thank you. Thank you very much indeed, Ben. And so now, if I can turn to Camilla, and, you know, you’ve actually been studying this just recently, and writing about it in the Financial Times, and particularly relevant to the Underground system. So, could you perhaps describe to us your findings, which were really quite alarming, I think.
Camilla Hodgson
Yes. Thank you for having me. I can’t remember actually, how this came about, but myself and my colleague, Leslie Hook, decided we wanted to study the air pollution on the Tube, particulate matter, specifically which, as we’ve heard, is one of these pollutants that is extremely damaging, particularly linked to lung cancer and a host of other diseases. And so, what I did was, I had two handheld monitors, which I took with me around the Tube, I went to 53 different Tube stations in Zone 1, all within the Circle Line and I took readings for every section of track between those stations, I did that a couple of times and then we had a look at our findings, crunched the numbers and what we found was that the very oldest lines, which are not as deep as the newer ones, they actually had relatively low levels of air pollution, and that’s for a number of reasons. It’s partly because they were actually originally built for steam engines, so they had lots of ventilation shafts placed in them, so that the smoke could escape, and they also have large sections of track that are outside, so there’s lots of space for the pollution to sort of dissipate. The worst lines that we found were predominantly the Central Line, which is very deep, it’s very old, it’s very busy, it doesn’t have very many ventilation shafts, and all of this combines to mean that the pollution, kind of, gets trapped down there, there’s not really anywhere for it to go. And the trains, because they’re so frequent, they kind of pull pollution along the network, without it really going anywhere.
And so, we put these findings to TfL to see what they had to say about it, and what they said, essentially was, they think currently with the information that they have, they think the air on the Tube is safe. And specifically it falls within the legal requirements set by the Health & Safety Executive, and that moderates things – all sorts of things, but including how much dust you can have in a workplace. And the rationale – that limit is much, much higher than the WHO limit, and the rationale, as I understand it, is essentially, I think that the people in a workplace are assumed to be relatively healthy, within a certain age bracket, not the very old, not the very young, you’re not expected to be there permanently. But having said that, it’s hundreds of times higher the HSE limit that the Tube is working to. Meanwhile, the WHO has said that it doesn’t think there is any safe standard for particulate matter, so it is quite a contrast. Having said all that, TfL did say, “Since Sadiq Khan has been Mayor, there’s been a much greater emphasis on tackling air pollution, looking at cleaning up the Tube, doing all sorts of cleaning pilots, thinking about different ways in which they can reduce the pollution that’s down there.” And there are some of those things ongoing, there are some studies that are kind of in the works, so it’s possible that that will change.
But it’s also notable that Sadiq Khan has said he wants London’s air to meet WHO guidelines by 2030 and he’s talking then about ambient air, which is the air that you find outside. And the conversation of the particulate matter found outside is different from what you find in the Tube, because in the Tube there’s – there are all these tiny little particles of metal, which come, for example, when the kind of the friction between the brakes and the wheels and the rails, all these tiny, tiny bits of metal that you can’t actually see, get into the air. And there’s also hair and dust and all sorts of other horrible stuff that’s accumulated down there over the last century and a little bit. So, it’s possible that, you know, Sadiq Khan could say, “I want to extend that kind of ambition of reaching WHO standards to the Tube.” I think part of the problem and maybe some of the reluctance to do that, apparently it’s just a difficult problem to solve, and TfL are trying quite hard, I think, to make changes and to clean – literally, they have cleaners who kind of scrub the tile walls, there are all these people who are trying to solve this problem, but it is difficult.
And I think another problem, which is an important point is that because the composition of the air in the Tube is quite different to what you find outside. There hasn’t been – there haven’t really been any health studies that definitively show the pollutant found in the Tube is terrible for your health, compared to, there have been lots of studies that show that particulate matter in general is very bad for your health. And so, there’s been a sort of strange assumption that because we don’t definitively know that it’s very bad for you, that maybe it’s not very bad for you, which is quite odd and not very precautionary. And crucially, also, the thing about outdoor air pollution, as I understand it at least, is that we don’t know what – particulate matter is made up of all these little particles, and we don’t know what, within that make-up, is the real driver of diseases. And so if you don’t know that, you can’t necessarily know that that – those individual elements and those components are not also in the Tube. So, I think that’s what we’re kind of hoping to find out more. I know that KCL are working quite – have worked quite extensively and are continuing to work with TFL to look into some of these issues, and they will see more in the future, but that’s kind of where we stand currently.
Rob Yates
Yeah, thank you, very interesting. That’s extraordinary. Just a very quick question, while it’s on my mind actually, I was just wondering, you know, so the people working in the Tube, particularly cleaning, you know, the Tube like this. Are the trades unions involved in these discussions, I mean, were they sort of – did you find there was any response from workers who are down there in the Tube all day, you know, who must be the most at risk, I suppose?
Camilla Hodgson
Yeah. They – I think they are involved in some health studies. I don’t know details of that because I tried to talk to them and they were very reluctant to talk to me, which might be because they’re in talks with TfL and they don’t want to – I don’t know.
Rob Yates
Interesting. Interesting. Elliot, so you’re working with the London Mayor and in tackling these problems, so can you perhaps outline what your response is, you know, has been?
Elliot Treharne
Yeah.
Rob Yates
Because I understand you’ve been a long time working with a number of Mayors in London.
Elliot Treharne
Yeah. So my first Mayor was actually Ken Livingstone, so I’ve done all three of the actual Mayors of London, working on air quality issues. Just to reiterate, and I’m sorry for being a bit dull about this one, but obviously, as we are in a pre-election period, I’m going to have to play this tonight with a very straight back, I’m going to be quite factual. But I promise you, normally, I’m much more fun, and you even look like you might believe me. And also, I was going to say, it’s funny ‘cause basically, someone’s done the equivalent of my job in London since the 13th century. So, air pollution has been a problem in this city for a very long time, and I was really struck about what Ben said about the great smogs and people, you know, often saying, “Oh, you know, air pollution’s not a problem like it used to be.” Well, my grandparents, when I told them that I was going to pursue a career in improving the air that we breathe, looked at me, they both grew up in London, and they both looked at me like I was absolutely crazy. And they looked outside and say, “You know, we were here in the great smogs, this was awful.” But I actually always take a great deal of inspiration from the great smogs. There was a huge policy response and the Clean Air Act was passed and as a policymaker, I take great encouragement from the fact that it is possible to address what often seem like very difficult and challenging issues, if people are bold enough and the leadership is in place to actually tackle them.
And I’m going to be talking about some of the interventions that have been taking place in London and also why air pollution is seen as such a priority. And I think that probably starts, exactly as Ben was saying, in terms of the health evidence that we’ve seen, but also, some of the analyses that we’ve done to try and understand that. So, we have a very strong partnership with King’s College London. They’ve done various bits of analyses for us, which have kind of demonstrated that thousands of premature deaths each year in London are caused by air pollution. We have also done a separate analysis to try and understand, if you look at schools, for example, the number of schools, which are located in areas, which exceed the legal limits that we’re supposed to be meeting. And there’s something like over 450 state schools are located in areas, which exceed the legally permitted level of air pollution. And to pick up the point around the socioeconomic impact of that, is when you look at those schools, around 80% of them are defined as being deprived, based on the proportion of children at those schools who have free school meals. So, air pollution is this massive issue, not just to health and not just to the environment, but also, an issue with social justice, and that means it’s a very exciting field in which to work, because the improvements you can deliver, deliver benefits, not just as Ben was explaining, for the entire population. But they also do a great deal to address some of the inequality, which is so widespread in the city in which we live.
In terms of the kind of main sources, I’m going to talk a lot about transport tonight. Roughly, when we look at nitrogen dioxide, and NOx emissions, around half of the sources of the emissions in London come from road transport. And that’s also where the Greater London Authority has the kind of the greatest influence to the powers that we have. So, we work very closely with Transport for London, which is the Mayor’s Transport Agency, and that gives us a lot of scope for putting in place, policies which actually tackle some of the big sources of air pollution. But we’ve been very clear that we want to go further and tackle other sources too, so from construction or from building emissions as well. But today, I’m going to mainly focus on the transport side. So, probably the kind of key thing to think about, when we put together a strategy around how we’re going to improve air quality in London was, before we actually looked at anything else, we were thinking about behaviour and the way that people travel in London. And what we really saw is absolutely vital to deliver benefits, not just from nitrogen dioxide, but also from particulate matter, which you’ve heard a little bit about tonight, was actually encouraging people to walk, cycle or use public transport.
And we’ve got a very big aim of increasing the number of people walk, cycle, using public transport from around 64% of trips today to 80% of trips by 2041, and that is an absolute transformation. That is, you know, trying to get Copenhagen levels of cycling in this city, and as you’ve probably seen a lot of investment in cycling infrastructure, segregated Cycleways, but also, Quietways, a whole range of different interventions to make it easier and safer for people to cycle, so that’s been absolutely integral. But we also recognise that in a city as big and as complicated as London, there’s always going to be a role for road vehicles, and what we wanted to do with them is trying to make sure they’re as clean as possible as quickly as possible. And probably the jewel in the crown of the interventions that we put in place, many of you might be aware that in April of this year, we launched the Ultra Low Emission Zone and that started in central London, but there’s plans to expand that up to the North South Circular in 2021. As well as to put in place, tighter standards for heavy vehicles, like buses, coaches and lorries, across London from next year as well. And in Central London now, if you drive a vehicle, which does not meet the – a diesel vehicle, which does not meet the Euro 6 standard, you have to pay £12.50 for entering or driving in Central London, and that’s been a very significant change and has driven a change in the types of vehicle seen in central London.
And if you look at from about February 2017, when people started preparing for what was the precursor to the EuLA, something we call the T-Charge or Toxicity Charge. What we’ve seen is a 36% reduction in nitrogen dioxide concentrations at roadside locations in central London. And that goes back to the point I was trying to make about the great smogs, if you’re willing to put in place bold policies, you can get really bold results as well. And that’s really exciting and is encouraging us that the next set of policies, the expansion that I was talking about, which will be taking place over the next couple of years, are going to have a similar big impact.
The Mayor also wanted to make sure that London was leading by example, and that TfL was leading by example. So one of the things that we’ve done a lot of work on is our bus fleets. Currently, 85% of the buses now meet the Euro 6 standard across the whole of London. By October next year, all of those buses are going to meet those standards, and that basically means that we’ve had around, or we will by October next year, have around a 90% reduction in emissions of NOx from the bus fleet since 2016. So again, it’s been a complete transformation of the bus fleet, and we want to go further. We currently have Europe’s largest selection of bus fleets, but we realise that what we want to get to is a bus fleet where all of those buses are zero emission.
And similarly with the taxi fleet, some of you might have seen the new electric taxi driving around, it’s a beautiful taxi made by the London Electric Vehicle Company, we now have around 2,600 of those taxis on the street. And that’s why you can start seeing them everywhere, because once you get to that kind of number, they have a kind of very high penetration rate and you can see them quite easily. We also recognise the huge value of making sure that schools and other sensitive locations, we are taking action to reduce exposure, and so that’s why we’ve developed a programme of school and nursery audits. We did 50 schools, and we’ve done 20 nurseries. We’re looking at the school, looking at the nursery, how we can reduce exposure as to children, travel to and from nursery, how we can address emissions in the area ar0und the school, how we can reduce emissions from the school estate. So we did that programme as a pilot and now the London boroughs are rolling that out to various different schools and nurseries in their areas as well.
And one of the other things that you might have seen that we’ve done is, we really think it’s important that Londoners know, as we’re implementing all of these measures and delivering improvements in air quality, that they know about the periods of worst air pollution. Obviously, we’ve talked a lot today about the impacts of long-term exposure to air pollution, there are also impacts from short-term exposure. So on the very worst pollution days, there’s a network of updates, which go out across TfL’s bus updates, bus countdown signs at Tube stations, to kind of make sure, and through social media. To make sure that Londoners are aware that it’s a high pollution day, to encourage drivers to switch off their engines and not engine idle, to make sure that we encourage people to walk and cycle, where it’s possible, to try and reduce the emissions in the city.
Rob Yates
Great, thank you very much, very impressive indeed. And I’ve just got a sort of couple of questions that I’d like to ask, perhaps before we put it to the audience, and it’s really struck me, it’s just amazing, the stats that you give, thousands of premature deaths per year in London alone and, you know, we were sort of talking about millions worldwide. And just the lack of concern and awareness of the population in this, I mean, if you think of say premature deaths, anything associated with, say, a terrorist outrage or even a significant transport collision, you know, say, were there a train crash and three people died, I mean, it would be 24 hour news. But yet, we’re talking thousands of people die, you know, therefore, you know, logically, tens every day, what it’s going to take, do you think, to sort of get the public really interested in this and demanding sort of faster change? And I was even sort of wondering that, you know, maybe linking this nebulous concept of premature deaths to the very fact that these are cancer deaths and, you know, that is something that does frighten people and worry people. Might we be sort of thinking about using tactics like this to, you know, sort of, get the population more engaged, or are there other tactics that other cities have maybe done to do this? And any of you sort of with thoughts on how we’re going to sort of raise this at the political agenda?
Dr Susannah Stanway
Anyone else want to go first? I mean, yeah, sounds like a very sensible idea to me. I mean, one obviously has to be careful about scaremongering, and I think that there’s perhaps some more data that needs to be collected, perhaps on other kinds of cancers other than lung cancers. And we need to study more about how it causes cancer, but yeah, I think some of the strategies you said might not be a bad idea, yeah.
Rob Yates
Any thoughts?
Dr Benjamin Barratt
I’d agree about, not so much scaremongering, but level of concern, and air pollution, unlike smoking is not something that you can choose to change entirely yourself. You cannot choose to stop breathing polluted air, short of entirely changing your life and moving somewhere much more pure. So, we’ve got to be careful that when we raise levels of awareness and education concern, we give people some root of empowerment to actually make a change. And that, to some extent, can be behavioural, choosing to cycle, choosing to walk, rather than drive, etc., but it also has to be political as well. So we’ve got to play this carefully. We mustn’t get to the point where people disengage, because they think they have no control over it and it’s just terrifying. Equally, we mustn’t get to the stage where parents stop allowing their children to go outside. We mustn’t get to the stage where people choose to stop cycling because they think it’s worse for their health, we’re in the polluted air. So there are public messaging challenges here. The people we really need to focus on are the Politicians, the policymakers and the people making those decisions.
Rob Yates
And Camilla, I just wondered what the response has been to your piece on the Tube, you know, has that created a lot of response in the Financial Times, you know, that?
Camilla Hodgson
Yes, I’ve had lots of individual people just emailing me saying, “I bought a,” what are they called? A kind of a dust mask thing, all sorts of individuals, things like that. I think, when I was talking to people, one of the suggestions, and obviously this is very Tube specific, was that there could just be more information around Tube stations that said, “If you’re – if you have severe asthma, if you’re predisposed to some sort of respiratory condition, you might want to consider taking the District Line. This alternative route is going to be better for you than going all the way through.” Like from Bond Street to Notting Hill Gate is – was the worst stretch that we found, and perhaps you don’t have to take that route, it might take you 20 minutes longer, but maybe that’s the better option for you.
Rob Yates
Gosh, yes, that’s fascinating. So, I’d like to – yes, we’ve got about 20 minutes, actually, so that gives us a good amount of time to engage the audience on this issue, and I’m going to be very equitable, from across the room. So, first hands go up and I think that the lady at the back, were you going to ask a question? Yeah, yeah. So, if you’d like to – and we’ve got roving microphones and if I may ask you to keep your questions quite short, please, or comments quite short, and I’ll maybe sort of take two or three at a time, so, yes, please.
Member
Hi, good evening, and thank you to the panel for the interesting presentations and thoughts that you shared. My question is on specific policies and interventions that have been tried and tested. So, for example, recently I know in Delhi that they have implemented the odd-even policy. But from a kind of high level scan of the landscape, it seems that there aren’t that many interventions and policies that have been trialled. So could you talk about some of the things that have been tested and where they’ve been successful?
Rob Yates
Thanks. Just hang onto that, then, and yes please, in the front here. And any on this side?
Duncan Bartlett
Thank you. My name’s Duncan Bartlett, I’m a member of Chatham House. I’m particularly interested in China actually, Dr Barratt, that’s your area of specialism. How important is it to the Chinese policymakers to tackle toxic air pollution in China?
Rob Yates
Thank you, and then, just one, for the time being here, then we’ll do another round in a second.
Member
Thanks. I also have a question from Dr Barratt about China and Chinese smoking culture, in general, because I think, and not just in the cities, but in rural areas, it’s one of the largest smoking nations and how much of an effect do you think that has on overall air quality and do you think you could ever reduce that?
Rob Yates
Right. So, Ben, quite a few for you there.
Dr Benjamin Barratt
I might defer on one of those. So, taking them in order, I’m sure Elliot wants to talk to the policy one as well. It’s a really important very astute question. I agree, there is not enough evaluation of the impact of interventions around the world, partly because it’s quite challenging, partly because policymakers don’t want to know whether it works or not just in case it doesn’t. So we’d rather not evaluate it because we might not get the answer we want. There does need to be more. London has the benefit of very rich data, whether that’s air quality data or transport data, or all sorts of data, so it’s a great city for evaluating policy impacts and there have been some fairly robust ones. If you go to somewhere like Delhi, evaluating the impact of that odd-even on using measurements would be extremely challenging. It’s easier to evaluate people’s behaviour and is there evidence that people are buying two cars, for example, and we know this happens in France. So, there are lots of different ways to evaluate policies, I agree, it’s very important and there isn’t enough of it going on, particularly when you get to health impacts. And this is something that will really help with your question, if there is strong evidence that if you improve air quality, you improve health, then people are more likely to take action. And that evidence is coming and there’s studies around the world now that actually showing improvements in health, due to policies.
China’s interesting. The Chinese government has three priorities: poverty eradication, financial growth and environmental improvement, is one of the three top priorities, why? Because it’s a very visible problem to the world and China does not want to be seen as having big visible problems. They want to be seen as having a problem and solving it, using their governance methods, so if they can show, we recognise this problem, we solved it, then that is an extremely good news story for the Chinese Government, so they’re making it very high profile. They are putting a huge amount of resources into it, which, for the first decade or so, had very little impact, because it wasn’t followed up properly. So people were behaving in the same way, they’d buy two cars, they were getting round the legislation, now they are having an impact. It’s going to start getting harder soon ‘cause the low hanging fruit are being been picked. So yes, it is very high on the agenda.
Smoking, so particularly in rural China, biomass burning is a big problem and a lot of households still use biomass, coke, coal within their homes to heat and cook, and the concentrations within those homes can make the Underground look like a meadow. They’re really horrendously high and the exposure, so the Underground, most of us only spend a small amount of our day in the Underground, a lot of people spend a lot of time at home. That is a very big concern, along with smoking, is obviously a big concern as well. I don’t see why China, as it develops, should not follow a similar pattern to other countries, that they develop and smoking levels drop. Others may have a different view on that, I’m not sure.
Rob Yates
And taxation being obviously a very effective way of dealing with that, isn’t it, yeah, yeah, yeah.
Elliot Treharne
I’m just going to jump in just also to say, I think again a very good question. In London it’s been a really important part of our approach is that we take a very evidence-based approach and evaluations are intrinsic to that. As Ben was saying, we’re quite lucky in London. We have a really well established air quality monitoring network. We introduced congestion charging, which gave us the camera network, which means that we know the types of vehicles that are driving in Central London. So that’s, for example, why I can say we know 77% of the vehicles driving in Central London meet the EuLA standards. The way I know that and we can compare them before and after is, because we had that camera network in place, since 2003. Likewise, in terms of the way I was able to give you those air quality improvement stats, a 36% reduction in energy roadside concentrations is again because we’ve got that monitoring network.
The good news is, in other cities is that we are part of a coalition of cities called C40, which actually has – is working with other cities around the world to actually identify very cost effective ways of putting in place, monitoring. We have been piloting something in London called Breathe London, which uses cheaper sensor networks to try and understand if they can replicate some of the benefits that we have from the really high quality, reference quality monitoring that we do and to see if they can be deployed in other cities, particularly. And we work very closely, for example, with Dar es Salaam in Tanzania, with other African cities as well. So, you know, it’s quite exciting about the opportunities technology is giving us to actually do better evaluation. But I agree, it’s really, really important, and something that’s not always done as well as it should be done.
Rob Yates
And just to pick up another thing that Ben said, you know, the tendency of people to gain the system, so you can set in place what you think’s a very logical policy and then the population go and think of a clever way of bypassing it. And there’s a classic example in Indonesia where they set up a three in one policy, that they – the fast highways going into town, that you needed three people in your car to avoid paying a big fine. And so that just immediately created overnight a big market of basically, women and babies standing by the road thumbing a lift, and then people would stop, pick up the women. So you’d have three people in the car and of course, you know, this was exposing women and babies to air pollution. I mean, this is what we have to deal with. So, yes, please, at the front here. Thank you.
Beatrice
Thank you. I’m Beatrice from Ghana. Thank you for the insight. It’s true, we know that air pollution carries a lot of illnesses, including cancers, but I agree with you that you are lucky in London. Let’s look at the low and middle income countries, and air pollution is the part that you don’t have boundaries, so how are government are made to enforce some laws? Or how do you put checks and balances, especially to the low and middle income countries, where people are thinking about bread and butter and not air pollution? Thank you.
Rob Yates
Thank you, and, yes, and just here. Yeah, here, that man over there, please.
Sven Harman
Hello, and thank you. My name is Sven Harman, I’m from the city of Copenhagen. I just want to ask you, the next challenge that we’re facing with air pollution in Copenhagen is from primarily cruise ships. We have a lot of cruise ships coming into port, and it’s increasing. And there is a lot of attention from policymakers to attract tourists to the city, however, these cruise ships, they burn off very, very heavy oils and they’re sitting idle in the port. So, currently, the policymakers in Copenhagen are trying to develop landlines for power, so that these cruise ships also have power, when they’re in port, but this is a very, very slow process. I was just wondering, what is the London’s take on this and are you also thinking about, like, the pollution from these very heavy oils.
Rob Yates
Yeah, at the back there, please.
John Mason
Thank you, sir, John Mason, Chatham House Member. Is there anything we can do to reduce the burden of the diesel fumes from black hackney carriages in London, thinking London, I mean, it seems to be an intractable political problem. It’s clear, Uber drivers have hybrids and then you have these 1950s technology, spewing 40 times as much diesel, heavy particulate matter. I was wondering with the cycling question that was sort of alluded to, isn’t it better maybe to be more transparent that it is actually dangerous for cyclists probably at the moment? They expose their lungs and greater input of breathing, and then, if there’s that pressure that would come from the need to have more cyclists, could finally push this, some progress with this issue. Thank you.
Rob Yates
Very interesting.
Elliot Treharne
I mean, I’m happy to start. I think there were some really interesting points in that. I think your commentary around the transboundary impacts is very, very important. Obviously, we’ve talked more from a London perspective, but you can get situations and days where up to 80% of the pollution seen in the city is actually coming from outside it. So, tackling transboundary pollution, having co-ordinated action is very, very important. Obviously, currently, we’re members of the European Union and within the European Union, there’s a directive called the National Emission Ceiling Directive, which puts in place caps on each country and what the amount of emissions they’re allowed to produce are. And that’s one way of tackling transboundary pollution. Obviously, I also talked about the way that cities co-operate quite a lot and so we work with other cities to try and make sure we reduce our emissions. So we’ve got a really strong partnership with Paris, for example, and there can be sometimes export of pollution between the two cities. To your question, which I also thought was really brilliant around cruise ships, you’re exactly right, in London the Port of London Authority, which has responsibility for most of the Thames, and activity on the Thames, they are putting in place an air quality strategy. They really recognise some of those impacts and as part of that, onshore power is going to be part of the answer.
Interestingly, I also had the pleasure of working in LA for a bit, and the Port of LA, you’ve got, you know, you’ve got the Port of LA and the Port of Long Beach, two ginormous ports next door to each other, which are basically, within the city and influence the kind of the whole kind of air pollution in the county of Los Angeles. And they’ve had a really successful track record in delivering onshore power, and of course, the reason they can do that is they’ve got standardised approaches and regulation – federal regulations around the big container ships. And it’s been those regulations, which have been absolutely critical, because you can install the infrastructure, but unless you have interoperability between the ships coming and the infrastructure you have, it actually is quite difficult to actually get those ships to use it. And cruise liners is definitely, I think, an area where there’s probably more effort needed to make sure that they are using the right consistency and approach to make sure they can always use onshore power, and to make sure there’s a joined up approach, not just in the UK, but across a wider set of cities around the world.
And finally, on taxis, again, very good point, I talked about the 2,600 zero emission capable taxis we now have in the fleet – we now have in London. And the reason for that is from 2018, we introduced a requirement that any new taxi that’s going to be newly licensed must be zero emission capable. Since 2018, we will no longer licence, for the first time, a diesel taxi and there’s been quite generous financial help available to help taxi drivers retire their old vehicles and then to get money to help them buy the new zero emission capable ones.
Rob Yates
Right, great. Oh, sorry, do you want to come in, we’ve got…
Dr Benjamin Barratt
I have something to say on the last point. The taxi issue, I think I’m probably right in saying the section of the population exposed to the highest level of diesel emissions in London are the black cab drivers or diesel taxis. And there’s various reasons for that, they’re sitting right in the pollution corridors, they are spending very long hours in those pollution corridors and the black cabs basically let in the vehicle in front exhaust and traps it within that box. We’re doing quite a large study with taxi drivers, van drivers, lorry drivers, within London, showing them the pollution levels that they’re exposed to. And they’re doing this – we’re doing this with the unions and with the operators as well, and educating them, “Look, not only are you affecting the air quality of London, you’re also exposing your workers and yourselves to very high levels of pollution, much higher than we experience elsewhere.”
Cyclists, we did a very neat little demonstration study looking at different forms of transport and exposure to pollution, and the cyclist had the quickest, lowest exposure to air pollution, compared to the other forms of transport. There’s a lovely video online. If you Google, Guardian and ClientEarth, you’ll probably find it on air pollution. So cyclists are actually exposed to lower levels of pollution, on average, than vehicle drivers and vehicle passengers because their air is ventilating constantly, and it’s not trapped in this little box. So, cycling, active forms of transport, better for your health, in terms of exercise, better for air quality, in terms of emissions, better for your health, in terms of lower air pollution exposure, and lower carbon emissions, so that’s climate change, obesity and air pollution all in one.
Rob Yates
Win-win, fantastic, yeah.
Member
So this is for Elliot, that this restriction on the black cabs, you know, all this transformation to electric, does that also apply to cabs or are you just talking about – when you mentioned taxis, do you mean London black taxis? That was my first question. The second thing is, I might just be getting old but, you know, I lived in London in the 80s and the 90s, I don’t remember it so congested as it is now. I mean, you can’t even travel around in a black cab, by the way, it’s just impossible during the day. Has it – sorry for my ignorance, but has there just been an increase in the amount of vehicles in London? And if there is, well, what is that cause, what type of vehicles is it, and why hasn’t the authorities been able to regulate it more?
Rob Yates
Here over this side. Yes, at the back, yeah.
Member
My question is – hi, and my question is about the using SUVs in London and whether those are being monitored? There’s been a recent article in The Times and The Guardian about the increase of SUVs cancelling out the benefits of electric cars. Is there anything that’s being done, from your work point of view, on convincing people not to buy an SUV, especially in the city of London where it’s not needed?
Rob Yates
And there was one, yes, just over here. You might have to be last.
Martina
I’m Martina, I’m a Public Health professional. I wanted to ask the question to Dr Susannah actually, about cycling in London. Isn’t it actually more harmful to cycle next to the cars on very busy roads in the morning? And the second question to Elliot about the contribution of pollution of public buses and what are the measures putting in place there? Thank you.
Elliot Treharne
Okay, so in terms of congestion in Central London, what I think you’ve seen is there’s been an increase, it’s really fascinating what’s actually happening at the moment. There has been quite a big change in behaviour around van use, for example, and those often are linked to deliveries and things like Amazon deliveries and Ocado deliveries, all those kind of delivery activity, which has seen actually – you’re seeing quite an increase in van activity, whereas, you probably have seen other modes remaining relatively static.
The other area which has increased quite considerably was private hire vehicles, and so, also in April, we brought in to place to a change where for the first time, private hire vehicles now, unless they’re especially adapted to accommodate people with disabilities, they actually now have to pay the Congestion Charge. And what was really interesting, in terms of the analysis that we’ve done, I talked about how we can do that, in terms of camera data, we’ve actually seen, since April, a reduction of between 3 and 8% in traffic volumes in Central London. So it does show you that, so those kind of interventions, and also, things like ULEZ, from a wider behavioural change perspective, can influence behaviour. And what was your – I’ve forgotten your other bit of your question.
Member
The other one was requiring the black cabs to transfer to electric, and great, but do you require the cab…?
Elliot Treharne
Do you mean private hire vehicles? So that’s coming in from – that’s being phased in over time. They’re a different industry, so obviously, a black cab is a – we very tightly regulate what types of vehicles they can have. You might know about the famous ‘turning circle’. And so, we’ve introduced those requirements for them from 2018, but from 2020, we’re phasing in the same requirements for private hire vehicles as well. Taxis currently have a 15 year age limit and that’s being tightened down to 12, private hire vehicles have a ten year age limit. So, basically, the way we’re introducing the policy, means that by 2033, all private hire vehicles, all taxis in London, will be zero emission capable ‘cause you’ll get that phased change over time. And just your – remind me of, one more time.
Martina
SUVs.
Elliot Treharne
SUVs, a very fascinating question, so one of the things that we do is, we recognise that there are still some issues, in terms of emissions in – from vehicles and different types of vehicles. So, in addition to having tools like the ULEZ, which obviously use the Euro Standards, we also provide other advice. So we partnered with the International Council on Clean Transportation, and what we’ve done with them is done a lot of analysis about vehicles and also, we’ve done testing basically, of their operation in the real world conditions. We’ve used that information, Paris has done something very similar as well, we’ve used that information to create a tool called the Cleaner Vehicle Checker, which includes current cars and second hand cars. And we encourage Londoners to use that as a tool when buying a vehicle, to know not only will they be ULEZ compliant, but they will know that they are buying the cleanest possible vehicle. So, it’s a point well made.
And finally on buses, I think I talked very quickly about the fact that we want all buses to meet the Euro 6 standard, so there’s a massive retrofit programme. We’re also buying new Euro 6 buses, so that by October next year, all 9,000 of our buses in London will meet the Euro 6 standard. That means we’re 90% lower – or their emissions will be 90% lower, as compared to 2016, so that’s a massive transformation of the fleet. But we want to go beyond that and we’re also now working towards the electrification of the London bus fleet as well.
Dr Susannah Stanway
And in answer to your question, I’m not sure I know the answers to that. I would think that it would require quite complex modelling to work out whether the benefits to one as an individual from the physical activity of cycling are negated by exposure to the many toxins in air pollution. I don’t know, Elliot, if you’ve got any take on it.
Elliot Treharne
So, I mean, you probably actually have more, Ben.
Dr Benjamin Barratt
Yeah. There have been a number of studies that have tried – attempted to disentangle those either in the UK or in other countries. It is very challenging indeed. My take is, look at the alternatives, and certainly if you cycle, the chances are you’re exposed to lower air pollution levels than if you’re in a bus, certainly if you’re in a taxi and definitely if you’re on the Tube. So what are the alternatives to travel from A to B?
Secondly, there are many, many health benefits from exercise. The more people that cycle the more extra people will cycle, it’s a knock on effect. And it also refers to the SUV and the taxi questions, that the more we educate people, the more choices they will make not to buy SUVs using the tools or otherwise, to catch the electric taxi and not the diesel taxi, as it drives past. So, awareness is important, certainly from everything I’ve seen – sorry, one more point, air quality in London actually isn’t that bad most of the time, it’s strongly affected by the weather. So, if you are concerned about exposure, you can pick which days you cycle on and which days you choose to walk, it will make quite a big difference. So if you’re particularly susceptible, use the tools Elliot’s talked about, use other websites and say, “Okay, tomorrow’s going to be a major pollution episode, I’m going to walk instead of cycle.” Every other day, please do cycle, it’s really important.
Rob Yates
And can I just ask one last question as the Chair that is there one city or – that’s really cracked this? I mean, we’re doing fantastic stuff in London here, but sort of looking at the world that – has there been a city that has been very, very polluted and through all these measures, maybe more, you would sort of hold up as the gold standard, or perhaps is there?
Elliot Treharne
So, I mean, in terms of transformation, I don’t think any city has cracked it and like, you know, what I think we have seen with air quality is the sheer amount of extra information, understanding we’re having around impacts and this invisibility point is quite critical. So, people say, “Oh, we’re not as bad as Beijing maybe is.” That’s missing the point, in terms of still the big challenges that we and other cities, which have made significant progress, still face. That said, there have been cities that have made significant progress. So, Mexico City, for example, used to be renowned for being one of the most polluted cities in the world. It’s still a very polluted city, but it’s been transformed, and they have put in place some pretty bold measures, in order to get there. Likewise, you know, LA have done some very ambitious things, London, I’m quite proud of what we’ve been able to achieve here but, you know, there’s no space for complacency. There is a long way to go and there’s a, you know, and as Ben was talking about, you know, there’s a lot more which needs to be delivered.
Rob Yates
Fantastic. Well, thank you very much indeed, and I trust that after tonight’s talks, that everyone’s going to be walking to work or cycling to work tomorrow, so don’t forget your helmet, and please join us upstairs. We’re having a reception upstairs, just at the top of the stairs in the room on – by the front door, and so, thank you very much, and a round of applause for my panel, please. Thank you [applause].
