SOUTHAMPTON MEDICAL SOCIETY
President: Dr Alan Roberts FRCP
A meeting of the Southampton Medical Society was held on Zoom on the 6th March 2022.The President was in the chair.
The minutes of the last meeting were approved.
The President introduced the speaker Professor Sir Stephen Holgate who spoke to the title ‘Air Pollution - the greatest environmental health risk of our time’. Sir Stephen recalled the Great Smog of 1952 which was largely due to domestic coal burning. The number of deaths peaked at 4,200 resulting in the worst weekly total since the cholera outbreak of 1866. The next year there were 12,000 deaths. It resulted in The clean Air Act of 1956 with its emphasis on smokeless fuel. This produced a dramatic improvement. However there is a new crisis due to air pollution from liquid fuels - petroleum and gas burning. Factories and cars are producing CO, CO2, SO2, NO, NO2, hydrocarbons and suspended particles which the encouragement to use diesel fuel caused. The ‘Every Breath We Take’ report of 2016 estimated that 40,000 premature deaths were caused due to lung cancer, asthma, heart disease, and stroke. Successive governments have tried to hide the figures.
We are dealing with tiny particles 30 times as small as a human hair which are absorbed into the circulation through the lungs and damaging the organs. Research has shown it affects particularly vulnerable people - the elderly, pregnant mothers which result in low birth weights, and children who develop smaller lungs and have slower development. These are lifelong effects which start in utero. Research on the placenta has shown black carbon particles from car pollution are found on the fetal side of the placental circulation and also that the telomeres are shorter in these babies.
The average person in Britain spends 8% of their time outside and over 90% indoors. The exposure occurs at home, school and workplace. Asthma, which is normally thought of as an allergic disorder, is now thought to have its origins in air pollution.
Ella Adoo Kissi died in 2013 at the age of 9. For the inquest Sir Stephen was asked to help show that pollution had caused her death. Initial analysis suggested that air pollution was a cause of her asthma and a contributing cause of death. She lived beside a very busy road where air pollution was frequently at illegal levels. On going through her notes he found 27 admissions. They recorded devastating attacks of asthma with apnoea and even cardiac arrest. The episodes were fewer in spring and summer mainly occurring in autumn and winter. Virus infection and allergies were excluded as the cause. Post mortem showed there was no epithelium left in lungs and that the epithelial cells had been replaced by mucous producing cells with mucous plugs causing asphyxia. At the inquest he said that the UK government experts threw everything at the case to prove that pollution was not a cause of her death. The coroners finding that air pollution had caused her death was a first in legal history. The legally binding conclusion presented the case for dealing with London’s air pollution. As a result the Mayor of London called upon the health profession to inform patients of the risks and advise them how to protect themselves.
As we get down to lower levels of pollution we get disproportionate benefits. But toxins also come off the land from ammonium fertilisers and pesticides. We should remember too that wood burning stoves are as bad as cars. We need to reduce all these chemicals. The health professions have not yet got hold of these problems. We should keep the health message on the agenda and put over the benefits of clean air to the population who should demand it from the government.
The President thanked Sir Stephen for his excellent talk and said what a huge pleasure it was to have him speak to us.
There being no other business the meeting was closed.