“An estimated 127,000 children under the age of five die every year from ambient air pollution”

“No, really, this is fine”: pollution over Beijing. Image: Getty.

In cities across the world, children leave their homes and make the most important journey of the day – the one to school. Fast roads and stranger danger are the significant concerns for parents but one of the biggest threats, to children’s long term health and development, is air pollution.

he death of Ella Kissi-Debrah, a 9 year old Londoner who died of respiratory failure in 2013, has crystallised the brutal physical impact of air pollution on children. She suffered from severe unstable asthma for just three years, during which time she was hospitalised 27 times. All but one episode correlated with dangerously high spikes in the most noxious air pollutants.

A report, supporting Kissi-Debrah family’s campaign for air pollution to be recognised as Ella’s cause of death, described the “striking association”. Professor Stephen Holgate, its author, said there was a real prospect that, without unlawful levels of air pollution, Ella would not have died”.

The health effects of air pollution in children. 

In the UK, air pollution has never been officially attributed as a cause of death by a coroner, but evidence between exposure to air pollution and health is compelling. Dirty air has been linked to 40,000 premature deaths each year, including 9,400 in London. The majority of air pollution in the capital is caused by the 6m daily car journeys. Nearly 2m Londoners, including 400,000 children, live in areas that exceed the annual average nitrogen dioxide levels set by the World Health Organisation (WHO). Over 800 schools and educational institutions in the capital are within 150m of roads that breach legal air quality limits.

The majority of air quality related deaths, however, take place in urban regions of the developing world where the air quality is visibly poorer. An estimated 4.2m people die as a result of high levels of ambient air pollution – a figure that includes more than 127,000 children under the age of five, each year, many living in rapidly growing (and motorising) cities in Asia and Africa. 

The health impact of air pollution on children is profound, and long lasting. Children and infants draw between two and four time more pollutants into their lungs, compared to adults in the same environment. Children also tend to be exposed to greater levels of pollution than adults because they are smaller and are closer to the source of vehicle exhausts when travelling along roads.


Air pollution in different areas of London. 

The two main London pollutants are particulate matter (PM) and nitrogen dioxide (NO2). At high concentrations NO2 causes inflammation of the airways and long-term exposure affects lung function while PM aggravates respiratory and cardiovascular conditions and is linked to cancer in later life. There is even evidence that traffic pollution could even be affecting the learning capacity of millions of schoolchildren; some diesel vehicle emissions have been linked to learning disorders like ADHD.

The impact of air quality is not, however, equal, says Saul Billingsley, director of my employer, the FIA Foundation. “Across the globe dirty air disproportionally affects the poorest children, whose families are least likely to own vehicles and therefore contribute the least to poor air quality. It is perhaps the ultimate inequity: to have no choice but to breathe killer air.”  

A recent study showed that London schools with more deprived catchment areas tended to have the lowest air quality, and the pupils had the least resilience to the effects because of a range of interlinked factors including childhood obesity and lower physical activity.

What, then, can parents do to protect their children? A gut reaction of parents to avoid outdoor pollution is, counterproductively, to drive more.  Across the UK, one in five journeys on the road in the morning rush hour are taking children to school. While air pollution is harmful to children, walking and cycling can actually help reduce exposure to vehicle emissions as car occupants often breathe higher levels of air pollutants than those on the street.

Education about the impact of pollution, and how to avoid it, is a significant area of development. In London, proximity to the source of air pollution has a significant impact on exposure; in the city centre, exposure can be halved by taking quieter routes. In an international project including a Southwark school, air quality tests in and around the schools identified pollution hotspots, so parents and pupils could be taught how to avoid them. This type of information, says Ella’s mother, would have changed her daily 40 minute along the South Circular road.

Number of London primary schools affected by air pollution, categorised by deprivation ranking.

Not all parents are convinced, however: TfL research shows that 60 per cent of primary school parents would only be willing to take alternative routes to avoid pollution if it added less than five minutes to the journey.

“This is a man-made crisis,” adds Billingsley, “millions of unnecessary journeys are made in dirty vehicles, exposing passengers and other road users alike to dangerous emissions. The solutions rely on action from everyone: government investment in sustainable transport infrastructure, tighter enforcement of vehicle emissions and individuals choosing walking and cycling for their own health and everyone around them.”

London’s air quality crisis requires policy makers to be ambitious in delivering healthy streets. They must focus on identifying and dis-incentivising high polluting vehicles, and be prepared to create the conditions for significantly reducing the school run (through measures like traffic calming, low emissions zones, and non-motorised school areas), while having an honest dialogue with parents, motorists and the wider community about the environmental and health imperatives for action.

Ultimately, it is only by implementing a holistic programme prioritising health through transport, education and urban planning policies that we will be able to build a safer, cleaner, city for our children. 

Kate Turner is media & public affairs manager at the FIA Foundation, a charity which campaigns on road safety.


What's actually in the UK government’s bailout package for Transport for London?

Wood Green Underground station, north London. Image: Getty.

On 14 May, hours before London’s transport authority ran out of money, the British government agreed to a financial rescue package. Many details of that bailout – its size, the fact it was roughly two-thirds cash and one-third loan, many conditions attached – have been known about for weeks. 

But the information was filtered through spokespeople, because the exact terms of the deal had not been published. This was clearly a source of frustration for London’s mayor Sadiq Khan, who stood to take the political heat for some of the ensuing cuts (to free travel for the old or young, say), but had no way of backing up his contention that the British government made him do it.

That changed Tuesday when Transport for London published this month's board papers, which include a copy of the letter in which transport secretary Grant Shapps sets out the exact terms of the bailout deal. You can read the whole thing here, if you’re so minded, but here are the three big things revealed in the new disclosure.

Firstly, there’s some flexibility in the size of the deal. The bailout was reported to be worth £1.6 billion, significantly less than the £1.9 billion that TfL wanted. In his letter, Shapps spells it out: “To the extent that the actual funding shortfall is greater or lesser than £1.6bn then the amount of Extraordinary Grant and TfL borrowing will increase pro rata, up to a maximum of £1.9bn in aggregate or reduce pro rata accordingly”. 

To put that in English, London’s transport network will not be grinding to a halt because the government didn’t believe TfL about how much money it would need. Up to a point, the money will be available without further negotiations.

The second big takeaway from these board papers is that negotiations will be going on anyway. This bail out is meant to keep TfL rolling until 17 October; but because the agency gets around three-quarters of its revenues from fares, and because the pandemic means fares are likely to be depressed for the foreseeable future, it’s not clear what is meant to happen after that. Social distancing, the board papers note, means that the network will only be able to handle 13 to 20% of normal passenger numbers, even when every service is running.

Shapps’ letter doesn’t answer this question, but it does at least give a sense of when an answer may be forthcoming. It promises “an immediate and broad ranging government-led review of TfL’s future financial position and future financial structure”, which will publish detailed recommendations by the end of August. That will take in fares, operating efficiencies, capital expenditure, “the current fiscal devolution arrangements” – basically, everything. 

The third thing we leaned from that letter is that, to the first approximation, every change to London’s transport policy that is now being rushed through was an explicit condition of this deal. Segregated cycle lanes, pavement extensions and road closures? All in there. So are the suspension of free travel for people under 18, or free peak-hours travel for those over 60. So are increases in the level of the congestion charge.

Many of these changes may be unpopular, but we now know they are not being embraced by London’s mayor entirely on their own merit: They’re being pushed by the Department of Transport as a condition of receiving the bailout. No wonder Khan was miffed that the latter hadn’t been published.

Jonn Elledge was founding editor of CityMetric. He is on Twitter as @jonnelledge and on Facebook as JonnElledgeWrites.