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CSJ THE CLINICAL SERVICES JOURNAL Editor
Louise Frampton
louiseframpton@stepcomms.com
Technical Editor Kate Woodhead
Journal Administration Katy Cockle
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Design Steven Dillon Publisher
Geoff King
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THE CLINICAL SERVICES JOURNAL is published in January, February, March, April, May, June, August, September, October and November by Step Communications Ltd, Step House, North Farm Road, Tunbridge Wells, Kent TN2 3DR, UK. Tel: +44 (0)1892 779999 Email:
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The Chief Medical Officer, Chris Whitty, has published his annual report and high on the agenda is air pollution. It is associated with impacts on lung development in children, heart disease, stroke, cancer, exacerbation of asthma and increased mortality, among other health effects. In fact, the statistics are alarming – the mortality burden of air pollution in England is estimated to be between 26,000 and 38,000 a year. While outdoor air quality in this country, and most high-income countries, has improved significantly since the 1980s, Chris Whitty believes we have an opportunity to go much further to reduce air pollution. Tackling the issue can relieve pressure on the health service, which is already under severe strain – reductions in air pollution in London have led to reduced childhood asthma hospital admissions, for example. However, further improvements could also lead to significant reductions in coronary heart disease, stroke and lung cancer, among others.
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The first chapters of the CMO report lay out the health problems of air pollution, but most of the report is about achievable solutions. The report also includes a chapter with case studies of three cities in England – Birmingham, Bradford and London. Each of these cities has had significant challenges around air pollution and has taken slightly different approaches to tackle it. These have included integrating actions including around transport, urban planning and design, reducing pollution around schools and monitoring at a city level. Chris Whitty comments that “air pollution
is everybody’s problem”, adding that it will continue to improve provided we are active in tackling the issue.
It is a problem that needs to be tackled on many fronts, but the health service also has a role to play. For example, Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH) and Global Action Plan launched the Clean Air Hospital Framework (CAHF) (
https://media.gosh.nhs.uk/documents/ Clean_Air_Hospital_Framework.pdf). The strategy aims to improve air quality in and around hospitals – in order to create a healthier environment for patients and their
JANUARY 2023
families, staff, and the local community. Since the introduction of the CAHF at Great Ormond Street Hospital, in 2019, action has been prompted in different areas – including trained patient transport drivers, new electric ambulances, and the incorporation of air quality in some tender criteria. A car-free Play Street Programme has been embedded, air pollution monitoring equipment installed to measure fine particulate matter (PM2.5) and nitrogen dioxide (NO2
), and there have been
education and creative sessions with Young People’s Forum members. Staff-wide engagement sessions have been delivered and there is an organisational commitment to treat both the patient and the broader environment.
The statistics are alarming – the mortality burden of air pollution in England is estimated to be between 26,000 and 38,000 a year.
Ultimately, a Clean Air Hospital improves air quality outside and inside the hospital by minimising sources of air pollution under its control, provides advice to help protect staff, patient and public health from air pollution, and champions the case for clean air locally and nationally.
Chris Whitty is now urging healthcare providers to use the CAHF to improve their own performance in becoming a Clean Air Hospital.
Louise Frampton l Editor
louiseframpton@stepcomms.com
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Clean air: everybody’s problem
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