Clean Air (Human Rights) Bill [HL]

Baroness Bull Excerpts

2nd reading
Friday 8th July 2022 Lords Chamber

[Baroness Bull (CB)]

My Lords, it is a pleasure to speak in support of the Bill from the noble Baroness, Lady Jones of Moulsecoomb, and I congratulate her on her work in this area over so many years. We have already heard powerful arguments for the importance of this Bill. According to figures from the World Health Organization, almost the entire global population— 99% of us—live in places where air quality guidelines are not met. The populations of low to middle-income countries suffer the highest levels of exposure, but even here in London, one of the world’s wealthiest conurbations, legal levels for nitrogen dioxide were breached across the entire city in 2021. The city’s pollution hotspots recorded air pollution levels 50% higher than legal limits.

The evidence is clear that poor air quality poses one of the greatest environmental risks to health. An estimated 4.2 million deaths globally are linked to ambient air pollution, including from stroke, heart disease, lung cancer, chronic obstructive pulmonary disease as well as chronic and acute respiratory diseases like asthma. Air pollution is especially dangerous for children because of the juvenility of their brains and respiratory systems, their higher ratio of breathing rate to body size and the simple fact that they spend more time outdoors. I join others in remembering Ella Kissi-Debrah and paying tribute to her mother, who is doing so much to help ensure that no other children and their families have to suffer as Ella did.

The link between air quality and physical health is well established; it should, on its own, be reason enough to act. However, there is growing evidence to suggest that air pollution exposure can also adversely affect the brain and increase the risk of psychiatric disorders, and this is what I will focus on today. Studies published in 2019 by colleagues at King’s College London, in which I declare my interest as set out in the register, showed that exposure to air pollution at the age of 12 had a significant association with depression at age 18. The researchers reported that the most likely cause was

“pollutant particles small enough to cross the blood-brain barrier, causing inflammation in the brain, which is known to link to the development of depressive symptoms”.

Children living in the top 25% most polluted areas were three to four times more susceptible than those living in the 25% least polluted areas.

The researchers’ most recent study from 2021 showed that youth in the general population across England and Wales who were exposed to high levels of outdoor air pollution during adolescence were more likely to develop mental health problems as they transitioned to adulthood. Worryingly, the researchers found this across the spectrum of mental health problems: depression, anxiety, PTSD, ADHD, conduct disorder, eating disorders and psychosis. This suggests that exposure to polluted air at this critical stage of brain development is a non-specific risk factor for mental ill-health.

A further study last year among residents in south London demonstrated increased use of mental health services, both in-patient and out-patient, in people recently diagnosed with psychosis and mood disorders. The cost of this to the NHS, never mind the personal cost to the individual, is significant. A recent report from the Mental Health Foundation and the LSE put the annual cost to the UK of mental health problems at around £118 billion.

There are many good reasons to clean up the air that we breathe: reducing deaths from the physical harms caused by pollution and improving the health of the planet are high among them. But the growing evidence of causality between air pollution exposure and psychiatric disorders indicates that interventions to improve air quality, such as those that the Bill proposes, could also play a role in improving mental health prognoses and reducing associated healthcare costs. This suggests just one more reason why the noble Baroness’s Bill makes good sense, and I am happy to offer it my support.

Food Supply and Security

Baroness Bull Excerpts

Thursday 14th May 2020 Lords Chamber

[Baroness Bull (CB)]

My Lords, there are 1 million people on the Government’s clinically vulnerable list but nearly 14 million people living with disabilities. That is 21% of the UK population. They fall outside high-risk categories, yet need, and are entitled to, support in accessing the food that they require.

The current legal action of more than 300 people against major supermarket chains suggests that they are not receiving this, and that these problems are systemic, not a series of one-offs. Examples cited include difficulties in accessing delivery slots; visually impaired shoppers being refused support from sighted guides and wheelchair users being denied help; long queues excluding people with mobility issues or chronic pain conditions; and the impact of purchasing limits on people with autism, who often experience rigidity around foods. Doing without our usual brands might not be a problem for many of us, but for people with autism it can make the difference between eating and going hungry.

The collective action argues that supermarkets are obliged under the Equality Act to make reasonable adjustments for people with disabilities, but the British Retail Consortium has said that its primary aim is

“to ensure clinically shielded groups identified by Government could easily access food without added risks to their health.”

This excludes disabled people, contravening rights and leaving them unable to access the food that they require.

The kindness of neighbours and strangers may well define these times as we look back in years to come, but although home deliveries from government, charities, family and friends are welcome, people with disabilities have a right to independent living. I acknowledge the efforts of supermarkets and their staff to keep the nation fed during this pandemic, but can the Minister commit the Government to supportin them in ensuring that temporary procedures in place during this extraordinary period are fair and inclusive to all?

Children’s Health: Vehicle Emissions

Baroness Bull Excerpts

Tuesday 11th June 2019 Lords Chamber

[Baroness Bull (CB)]

My Lords, it is a pleasure to follow the noble Baroness, Lady Blackstone. I congratulate the noble Baroness, Lady Randerson, on securing this important debate.

It is estimated that poor air quality is the cause of up to 40,000 premature deaths in the UK every year, with air pollution reducing life expectancy in those affected by an average of 11 years. Nevertheless, there is scant awareness of the scale of the problem. Air is a vital source of life on our planet, but it is fast becoming the health crisis we failed to see. Air pollution is bad news for all of us, but is especially so for children because of the juvenility of their brains and respiratory systems. As we have heard, children have a higher breathing rate to body size ratio and spend more time outdoors, both of which put them at even greater risk from exposure to polluted air.

The link between air quality and physical health is well established, with air pollution associated with a range of conditions that include cardiovascular and respiratory disease. However, new research is now demonstrating a link between air pollution and mental health. It has been several decades since the higher rates of schizophrenia in the inner city, relative to the outskirts, were first documented. Research undertaken since then has found that urban upbringing is associated with a twofold risk of psychiatric disorder in adulthood. Most studies have focused on the social features that might contribute to this elevated risk, which leaves a key feature of the urban environment underresearched. I am talking, of course, about air pollution.

Air pollution is a major worldwide health issue in urban areas, with 91% of the world’s city-dwelling population exposed to particulate matter in concentrations that exceed the World Health Organization’s air quality guidelines. Closer to home, the WHO database for 2018 revealed than 49 UK towns and cities are failing standards for fine particle air pollution. This is not just in the massive conurbations that we might expect to have a problem: the list includes Eastbourne, Chepstow and Eccles. A data audit in February by Friends of the Earth revealed that an astonishing 1,758 sites across England, Wales and Northern Ireland breached the annual air quality objective for nitrogen dioxide. Here in London, figures published in April revealed that 2 million people are living with dangerously high levels of pollution. This figure includes 400,000 children, with 400 schools in areas with over-the-limit levels of nitrogen dioxide.

We know that the most significant cause of poor-quality air in urban areas is pollutants released in combustion. To date, research has focused largely on the physical impact of early exposure to poor-quality air, but two recent studies from King’s College London —of which I declare my interest as an employee—demonstrate for the first time its impact on mental health. Both studies took advantage of two data sources: detailed geographical air pollution data, collected at sites across London, and the well-established E-risk longitudinal twin study. This nationally representative sample of twins born between 1994 and 1995 includes 2,232 children, who were assessed first at age five and then regularly up to age 18. In the studies, residential addresses as well two additional addresses at which they spent their time—that is, their schools—were linked with air quality data to estimate the children’s exposure to pollutants across the year. The findings are frightening.

The first paper revealed that exposure to air pollution at age 12 had a significant association with depression at age 18, with children living in the top 25% of the most polluted areas three to four times more susceptible than those living in the top 25% of the least polluted areas. The most likely cause, the researchers say, was pollutant particles small enough to cross the blood-brain barrier, causing inflammation in the brain, which is known to link to the development of depressive symptoms.

The second study provided what is believed to be the first evidence of a link between air pollution and psychotic experiences in adolescence. The connection between growing up in a city and an increased risk of psychosis has long been accepted, but most of the efforts to understand the link have concentrated on social factors such as neighbourhood deprivation or crime. In focusing on air pollution—a key element of the urban environment—researchers found that psychotic experiences were significantly more common among young people with the highest annual exposure to nitrogen dioxide, nitrogen oxide and fine particle air pollution. These pollutants are all subject to legally binding limits—limits that we know are not being met in towns and cities across the UK. The findings indicate that even if they were being met, young people’s longer-term mental health would still be at risk. Even at exposure levels lower than international guidelines recommend, nitrogen dioxide was found to be significantly associated with adolescent psychotic experiences.

Researchers from King’s College London believe that if the recent trend of inaction continues, it will take 193 years to reach legal compliance on air quality. We cannot allow that to be the case. The Government’s clean air strategy commits to progressively cut public exposure to particulate matter so that the number of people living in locations above the WHO guideline level is reduced by 50% by 2025. Does the Minister agree that, given the public health crisis we are hearing about today, this rate of progress is just not ambitious enough? It is estimated that, by 2050, 70% of the world’s population will live in cities. Unless we take urgent action now to tackle emissions and improve air quality in the urban environment, generations of children into the future will be breathing air that will damage them for life.

Vehicle Pollution: Children’s Health

Baroness Bull Excerpts

Monday 18th February 2019 Lords Chamber

[Lord Gardiner of Kimble]

That is precisely why we require local authorities to come forward with plans. Nottingham, the first authority with an agreed plan, is retrofitting 171 buses to reduce emissions and replacing heavy, high-polluting vehicles such as bin lorries with electric vehicles, all under its current plan. Leeds is putting in a clean air zone, starting from 6 January next year. A number of immediate plans are taking place this year and next year, but in the meantime, this is obviously a continuum to reaching the point we want—zero emissions and many fewer pollutants.

[Baroness Bull (CB)]

My Lords, we are increasingly aware of the impacts of air pollution on physical health, but recently published evidence has shown a convincing link between air pollution and mental health. In particular, research has found that children exposed to air pollution at age 12 have an increased likelihood of depression and conduct disorder when they reach age 18. Can the Minister confirm that in assessing the impact of air pollution on health, we will take both mental and physical health into account?