The Scandal of London’s Air

(Bloomberg Businessweek) -- A year ago, my wife, Leslie, and I embarked on an adventure, moving with our two sons from Seattle to London. We put the boys’ playhouse on the street, hugged our cedar tree goodbye and, seemingly in an eyeblink, landed at Heathrow, where the kind crew of the British Airways 747 brought our sons, then 7 and 5, into the cockpit. They perched on seats covered in furry sheepskin while the captain, strangely, confided his disappointment in his daughter’s new career as a veterinarian.

It was a kind of homecoming. I’d lived in London in my 20s, during the heyday of Oasis and Tony Blair—Cool Britannia—and was excited to return as a seasoned journalist. We moved into a semidetached house in Crouch End, near cricket pitches and tennis courts, across from a stop for the W7 bus that took me to the Tube and on to Bloomberg’s offices in the City. It was Instagrammable stuff, except for the pungent chlorine-like smell of exhaust from the diesel-powered cars, buses, and taxis crowding London’s hip streets. Even Fortnum & Mason smelled like a petrol station.

No city’s perfect. We entered bad smells in the deficit column of our move and tried to settle in. By last fall, two months after we’d arrived, I noticed that a raspy feeling in the back of my throat never really went away. My voice had a new resonant depth, like a smoker’s. My chest felt tight. My asthma, a routine condition I’d managed without a problem in Seattle, was flaring up in London.

I went to my local National Health Service clinic, entered an exam room, and blew into a spirometer. My lung capacity was 5% less than normal; nothing unusual to the doctor, who handed me a peak flow meter and a spacer, a plastic holding chamber for an inhaler—the kind my mother uses in her nursing home—and told me to come in if I noticed any big changes. At the pharmacy I picked up inhalers, powders, and pills in a square white bag, folded over at the top like Chinese takeout.

Anyone who’s seen The Crown knows about the Great Smog of 1952, when thousands died from coal pollution during a cold snap and London was, in Cyril Connolly’s famous phrase, the “largest, saddest, and dirtiest of great cities.” Before that were the pea souper fogs (also coal smoke) of Victorian days. I’d read about recent concerns over emissions of particulates and nitrogen dioxide (NO2), tied largely to the massive adoption of diesel vehicles: 12.4 million in the U.K. today, up from 1.6 million when I left in 1998; and across Europe, more than 50 million. But I’d assumed, like many in the West, that pollution was a Third World problem and that stringent-seeming European Union regulations were gradually cleaning the air.

Now, my own lungs burning, I began noticing things I’d looked past in the pell-mell of everyday life: One London friend’s strapping teenage son had asthma; another’s daughter suffered from unexplained breathing problems. I spotted a twentysomething taking a squirt from his inhaler before watching a National Theatre production of Antony & Cleopatra. The city’s mayor, Sadiq Khan, has adult-onset asthma. British people tended to shrug when we asked them about the air. “It’s not as bad as India’s, is it?” they’d say.

I discovered an undercurrent of agonizing stories from pollution émigrés: the bicyclist terrified by an asthma attack; the doctoral candidate from a rural town who gave up her dream to flee the London air. I was feeling trapped and worried for our own children. Was it all just confirmation bias? Was there any hard evidence to prove what I felt in my chest? Whatever happens with Brexit, this much is certain: For decades, Europe will be united by filthy air and a slowly unfolding public-health crisis caused by its embrace of diesel—something that was supposed to heal the environment.
 
 
King’s College London operates the world’s most extensive network of air-monitoring stations, 117 of them in almost all of London’s 32 boroughs. Their instruments generate a pollution map marked red for the highest levels and green for the lowest. The result is something like a bloodshot eye: red in the city’s center and down the arteries of major roads. It’s a visual representation of what makes this era of traffic-borne pollution so insidious. Conditions are worst exactly where the most people live. Nitrogen oxides produced by the combustion of diesel engines react with air to form NO2, a toxic gas that inflames the lung, heart, and brain and has been linked to cancer and dementia in addition to respiratory illnesses. Diesel tailpipes also produce tiny particles known as PM2.5s. A secondary pollutant, ozone, forms when the pollutants react with sunlight—and those levels, too, have worsened with climate change.

London has exceeded EU limits for NO2 since 2010, and levels are also high in Munich, Paris, and other cities that embraced diesel. Some days in London, the average level is higher than in Beijing, more than doubling the legal maximum.

I visited Frank Kelly, head of the Environmental Research Group at King’s College, in his office not far from the teeming traffic of Waterloo Bridge. His early research focused on how to give premature babies the right amount of oxygen to save them without hurting them; in recent years he’s overseen efforts to determine safe levels for pollutants. He hasn’t found them. And he gets especially frustrated by the fatalist streak of people who say the air could be worse. “You’ve got to bring this home,” he tells me. “It’s you, your children if you live in London. As an educated society, we shouldn’t do this to people.”

In study after study, the college has shown evidence of dramatic health effects. One found that pollutants on traffic-clogged Oxford Street wiped out the respiratory benefits of a walk there for people over 60. Another found teenagers living in dirtier air had 70% greater odds of developing psychosis. A third followed 2,500 schoolchildren in east London over seven years. By the end, those who’d breathed the most NO2 had lungs as much as 8% smaller. Kelly calls that “a clinically important” decrease. Lungs only grow until age 18, and their capacity starts dropping at 30. If the organ starts out smaller, people are more likely to have worse outcomes: twitchy, reactive lungs that develop asthma or other respiratory diseases. “It’s a really strong marker for later problems in life,” he says. Dutch researchers estimate 33% of new childhood asthma cases in Europe are caused by air pollution.

What’s all the more frustrating is that diesel engines were supposed to be a climate savior. Their fuel economy is generally better than that of gasoline engines, and policymakers believed in the late 1990s that they produced fewer emissions of carbon dioxide (a claim questioned by later studies). Diesel buyers in Britain, France, and Germany got tax incentives from their governments, who’d been lobbied by car manufacturers who convinced them the technology was cleaner. And, of course, policymakers believed lab tests were a genuine guide to real-world performance—a lie dramatically exposed in 2015 when Volkswagen AG admitted it had used software to ratchet down emissions during the standard testing protocol. On the road, VWs spewed pollutants at a rate as much as 40 times higher than in the lab. Other carmakers also showed huge gaps: for nitrogen oxides, an average of as much as 700 to 800 milligrams per kilometer on the street vs. 80mg in the lab, according to a June 2019 statement from the European Commission.

Volkswagen has paid $33 billion in fines and settlements, but the real price is measured in lives. The Royal College of Physicians estimated in 2016 that as many as 40,000 deaths a year in the U.K. are caused by exposure to outdoor air pollutants, updating a 2010 assessment of 29,000—in large part because of higher concentrations of NO2.

London has committed hundreds of millions of pounds to replace diesel buses with hybrid electric models and requires a £56,000 ($69,000) electric model for any new black cabs, famously dirty and foul-smelling. Most controversial, Khan is rolling out Ultra Low Emission Zones, charging £12.50 a day for vehicles that aren’t compliant with the latest standards. By 2021, the zones may stretch all the way to the North and South Circular roads that ring London. But tests that measure performance accurately continue to bedevil policymakers.

At the Real World Emissions conference, in March in a Long Beach, Calif., hotel—the same annual gathering of academics and car manufacturing officials where West Virginia University researchers five years ago unveiled the tests that tripped up VW—a procession of independent analyses showed how far vehicles under the demands of cold weather and city driving still diverge from the latest “Euro 6” emission standards. One paper by Andreas Gruber of the Vienna University of Technology estimated that even a plug-in hybrid emits twice the maximum Euro 6 limit for particulates. “So, next step, I hope we can work together to build a better future for us and our children,” he concluded, to slight titters from the crowd of industry professionals.
 
 
The death of a 9-year-old named Ella Adoo-Kissi-Debrah has the potential to galvanize an air pollution movement in the capital. She grew up in Lewisham, a borough of 300,000 in southeast London, joined a Little Kickers soccer team for Millwall FC at age 2, and loved playing drums, piano, and guitar. Around Christmas of 2010, just before she turned 7, she had a severe asthma attack and went into the hospital, the first of 28 visits over a three-year period. After she died in February 2013, the pathologist called it one of the worst cases of asthma ever recorded in the U.K. The inquest determined her triggers were airborne, and Ella’s mother, Rosamund Adoo-Kissi-Debrah, speculated to the Evening Standard that pollution was a factor. The family lives 25 meters from the South Circular road.

Stephen Holgate, a University of Southampton professor and one of the country’s foremost asthma experts, spotted the article. He contacted Ella’s mother and put together a paper correlating the child’s hospital visits with spikes in air pollution. It was the backbone for a legal assault orchestrated by Jocelyn Cockburn, a human-rights lawyer bothered enough by the air to move to the coast (a luxury, as she points out, that isn’t available to people of less means). In May the U.K. High Court granted her request for a new inquest, likely next year, on the grounds that air pollution should be cited as a cause of death—the first time in any official proceeding. If pollution is confirmed as a cause, it would usher in a wave of litigation to force authorities to clean up illegal pollution and open the door to holding polluters directly responsible. “Banning diesel would be a great start,” Adoo-Kissi-Debrah says. She shared a stage at a Vienna conference in May with former California Governor Arnold Schwarzenegger, who mused that climate campaigners might have it wrong by focusing so much on long-term risks rather than the here and now. “We have to let people know that pollution will kill you,” he said.

It isn’t just asthmatics who are affected by bad air; we are, in fact, more like canaries in the coal mine. One study of heart tissue from 63 young people who’d died in road accidents in Mexico City found billions of pollutant particles per gram associated with early and significant cardiac damage. Asthma expert Holgate says doctors have to educate patients about the dangers of air pollution in the same way they did about smoking.

Europe’s struggles are only one part of a pollution reckoning around the world, where 90% of people breathe dirty air, costing 7 million lives a year by World Health Organization estimates. Climate change is causing more intense and frequent wildfires that sometimes blanket parts of the U.S. West Coast, including my hometown of Seattle, in hazy smoke. In part, it’s a downside of the urbanization world leaders have encouraged as the best way to address poverty. Residents are packed closer together, increasing pollution. Now people everywhere—from Ulaanbaatar, Mongolia, which banned the burning of raw coal, to Beijing, which is in the midst of the world’s most ambitious ramp-up of electric cars—are starting to recognize the trade-off. Those benefits only go so far. Lung-penetrating particles are also generated by road dust and worn tires—solely traffic-dependent.

In December, Leslie and I gave up on London and returned to Seattle with our boys. The Ham & High newspaper in our London neighborhood recently reported that the “lollipop lady” (crossing guard) at the local primary school started wearing a gas mask. In Seattle, there was a whiff of wildfire smoke this August, but the wind shifted, and it went away.
 
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To contact the editor responsible for this story: Howard Chua-Eoan at hchuaeoan@bloomberg.net

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