Health, Air Pollution and Noise -
Colin Bannon MB CHB
1. INTRODUCTION
My name is Colin Bannon. I qualified in medicine in 1985 at Sheffield University, with a distinction in surgery, subsequently working on general medical wards in Chesterfield, and the surgical unit in Sheffield. I then spent two years as a junior paediatric doctor in Plymouth, and a year in obstetrics followed by spells in psychiatry and oncology. I am currently a GP in Plymouth and I am also employed by South West Devon Health.
I have developed a keen interest in public health and the environment, finding that collective actions, such as the present road based transport policy have as great an impact on health as our actions as individuals, with the former frequently contributing to the latter. Reading of research and experience during consultations with 4000 patients a year has encouraged my interest in the wider aspects of health.
Although not a transport “expert” I offer a view of the proposed Ring Road from the perspective of it’s impact on the population together with a critique of the quality of evidence placed before the inspector by Devon County Council.
2. Air Quality and Health.
The scale of modern global air pollution is unprecedented. Whether one examines the emissions per person, per car, our national emissions inventory, environmental performance has deteriorated over the last few decades. Since the Second World War we have emitted more pollutants into the air than the total time prior to that during which human beings have inhabited the earth. This should create a sense of caution when proposals are in offered which will further increase the total burden of emissions.
While there are considerable limits to research regarding the links between air pollution and human health, it is clear than there are important short term health consequences due to air pollution.
Long term health consequences are unknown but a cause of considerable concern. No generation to date has experienced the constant exposure to the range of pollutants experienced by people growing up in the UK at the moment. It would be naive to assume there will not be a health price to pay for chronic exposure to the common air pollutants described in the environmental statement.
While it is useful to await further research, the research available is sufficient to force calls for a new Clean Air Act, and for the Royal Commission on Environmental Pollution to express concern regarding current transport trends.
The Ring Road will increase the overall capacity of the road network allowing further increases in traffic, when the imperative from a number of standpoints is to prevent that happening.
3. The Environmental Statement.
The study is based on the Design Manual for Roads and Bridges Vol. 11 August 1994.
This provides a theoretical model for predicting the local levels of air pollutants for fixed local points given a certain set of traffic data, the road layout, vehicle speed and location of receptors.
The inaccuracies and assumptions inherent in such models are not stated, nor is the range of uncertainties surrounding the resultant predictions. The predictive power and historical performance of the model needs to be scrutinised at the inquiry.
Baseline data include a rural nitrogen dioxide monitor, whose results are not relevant to the proposed road, and “smoke” data from Plymouth, of little relevance to either Torbay. or road traffic There seems to be no realistic baseline data from the vicinity.
A further assumption is made regarding the link between health of the local population and monitoring guidelines recommended by the DMRB. However, adverse health effects are seen at levels lower than those recommended by the DMRB, and thus health effects will be seen locally. Indeed, for particulates pollution and carbon monoxide, there is no safe limit as adverse health effects are dose related.
The study has not been asked to examine the effect of current and predicted levels of pollution on specific groups at risk, i.e.: the young, those with specific diseases, the elderly, and other groups such as drivers, cyclists and pedestrians.
It is unfortunate the statement concludes that further, more detailed assessment are not required. However, given the methodology, no more studies would be possible, or indeed useful.
The conclusion:
“It is very unlikely that the emissions from the proposed road scheme will cause effect on human health.”
should actually read:
“The theoretical model we were asked to employ to examine the effects of air pollution for the proposed roads on health showed that future levels of pollution would not exceed current EC guidelines for individual pollutants” and,
The relevance of this to the health of the population in the immediate area and in the wider urban setting is unclear and clarification requires different methods and models of prediction.”
4. Air Pollutants - further evidence.
Further evidence is presented on the various pollutants which will be increased by the proposed road, particulates nitrogen dioxide, and carbon dioxide. However it should be noted that reductions in other emissions are dependant on increased speed, which may be neither feasible or desirable in the long term.
Particulates are increasingly seen as a major cause of concern. particularly in urban areas. I have detailed the reasons why and the research base for such statements.
Carbon dioxide emissions will increase with either of the new routes. This directly contradicts stated Government policy as it will make it difficult to achieve proposed reductions in emissions in the locality. There is no reason why Torbay should be exempt from efforts to stabilise emissions, and possibly atmospheric levels of CO2.
Ozone is a secondary pollutant with well documented adverse health effects. Local levels will be increased as the main producer of ozone, nitrogen dioxide will be increased to combine with volatile organic compounds. The temperate climate of Torbay will tend also to increase formation of photochemical smog.
Volatile organic compounds will probably be increased by the ring road, although not by evaporation from fuel tanks or inefficient combustion, but also bye escapes from petrol stations and during transportation of the increased quantities of fuel required.
5. Interpretation of monitoring data.
General and specific problems with monitoring are detailed. The relevance of monitoring to pronouncements on the public health is discussed.
It must be noted that in recent “poor air quality” episodes, traffic levels were not substantially higher than during other times when air quality was satisfactory. That is, the air quality, even in Torbay, will be poor unless the emissions from road traffic are dispersed. Monitoring simply reflects this reality.
The fact that biological effects may be masked by adequate treatment of airways inflammation by the medical services is a possibility given the increased provision of such services which has co-incided with recent increases in traffic growth.
More accurate methods of assessing impact of large roads is discussed, in particular the relevance of using proximity of main roads as a proxy for exposure to air pollution.
6. Further evidence on health impacts.
Asthma is a common name for wheezing, cough and difficulty breathing which has a number of different professional definitions. Its incidence is increasing, in line with exposure to traffic, and the cause and effect relationship between air pollution from vehicle exhausts and inflammation of the respiratory tract is biologically plausible.
Research has not firmly established a cause and effect relationship, but many of the difficulties faced by research have been discussed in chapter 7..
Levels of air pollution associated with “normal” monitoring results are associated with definite health effects.
Research from around the world demonstrated that there is a definite relationship between traffic exposure and subsequent illness. Relevant papers are presented detailing the magnitude of this effect.
Particulates increase hospital admissions from respiratory problems and have a significant impact on overall mortality.
Proximity to major roads seems to have a definite effect on respiratory health, although lifestyle variable make this difficult to study.
The Ring Road would increase traffic and increase exposure of the population to emissions. These effects have not been submitted to the inquiry elsewhere, and are included for completeness.
7. Local implications
The burden due to increased respiratory symptoms due to traffic exposure could be theoretically established for the local area by extrapolation from the study of childhood respiratory symptoms in Munich. While this would not be scientifically accurate, it would be a useful approximation.
Mortality for individual cities has been calculated from data relating levels of pollutants to death rates using methodology developed at the US Environmental Protection Agency. For Torbay, the rate is in between 30-40 deaths a year attributable to particulate pollution.
While the figures produced are of considerable interest, I would not pretend they represent scientific fact, simply the nearest we can approach it at this given time.
Such methodology certainly compares favourably with the theoretical calculations of air pollution recommended by the DMRB and used in the statement.
There are limitations to the production, completion and application of further research due to lack of co-ordination, standard methodologies and appropriate funding for more definitive work.
8. Other issues relevant to the Ring Road.
Carbon dioxide emissions are being incrementally increased locally and globally by changes in household and industrial consumption of energy. Transport serves these increases and forms an important area in which reduction of impact is essential in meeting Government targets. The ring road increases, directly through increased traffic use and indirectly through increased energy consumption, emissions of carbon dioxide. the health implications of this are discussed.
Oxygen consumption is rarely considered, and some information is presented outlining the possible reduction in the quantity in the atmosphere, together with consumption of different transport modes. If sustainability is moving towards balancing consumption with replenishment, the current oxygen use defines our distance from that aim.
Noise is a serious problem and has an impact on health which is hinted at in research through findings of increased risks for cardiovascular disease and poorer performance at primary school, and altered sleep.
9. The Royal Commission on Environmental Pollution.
This report is an important milestone in the debate regarding the future of transport. The proposed Ring Road will hinder progress towards meeting its targets, and contradicts many of its recommendations. While it does nor currently represent Government policy, its overall thrust is of great interest to all concerned with transport and health.
The gap between the proposed Ring Road and the recommendations of the Commission should be noted.
10. CONCLUSIONS
The evidence before the inquiry from DCC in the form of the environmental statement on air quality is methodologically weak and incomplete in terms of its assessment of the pollutants likely to damage health.
Its broad reassurance on the impact of air pollution from the Ring Road on health is inappropriate.
Evidence regarding the direct and indirect damage caused by increasing traffic supports then view that present levels of traffic are damaging to the health of the population.
There are many problems with present research in terms of it’s quantity and quality. Nevertheless peer reviewed evidence supporting the view that the impact of air pollution from traffic on the road and its contribution to the wider transport system is adverse is relatively robust.
The impact on air quality of construction of the road seems not be have been assessed.
The wider implications to health of carbon dioxide emissions, oxygen consumption, the need for a transport system to promote health as well as the difficulties caused by road based transport on access, social inequality, amenity nuisance and danger suggest that it is appropriate to divert such funding as that required by the Ring Road into mechanisms which increase the efficiency rather the volume of the transport system.
The Royal Commission of Environmental Pollution’s report on transport and the environment is summarised to point the way in which the impact of transport on health and the environment can be mitigated.
This document is a summary of Colin's proof of evidence. If you would like the whole document
please contact Sue Whitehead
