Air pollution and mental health
Josephine Cock argues that psychologists should be more concerned about air pollution.
24 January 2022
Most of us enjoy the glow of a cosy winter fire and the aroma of food cooking on a summer barbeque. But it's well known now that they give off tiny particles and gases that can harm our health.1-4 In fact, wood smoke may be even more damaging than cigarettes.5 As this is a behavioural as well as a medical issue, why are psychologists not more concerned?6 Why do some of us shrug and say 'Well, yes, air pollution is truly terrible in some cities abroad, but there's no need to worry about it here, is there?' Well, actually, there is. There is no safe level.7,8 It's only a question of degree.9
According to a whole range of recent papers on cardiovascular health10-12, infant development13-16, cognitive decline,17-20 dementia and Parkinson's disease,21-24 depression and suicide,25-28 neurology,29-32 and toxicology,33,34it would appear, that chronic exposure to fumes, whether from fires, farmyards, traffic, or artificially scented products, does us no good at all.35-40 So, why isn't there more fuss? I haven't seen any posters at my GP clinic telling me not to use artificially fragranced items or not to get a wood stove if my children or relatives have asthma, have you?41,42 And when there is a high air pollution episode, our government just tells us to stay indoors if we are 'vulnerable'. We are not advised to stop making more pollution.43-46 My cardiorespiratory specialist always asks if I have biological allergies (no) and if I've smoked cigarettes (never) but not about the environment where I live or have lived.47
I know our government has recently placed restrictions on the sale of so-called wet wood and coal for fires and log burners, and has encouraged families to replace dirtier older stoves with new low-pollution Ecodesign wood stoves, but if the stoves are that bad, why not ban them altogether?48-52 I think it is because there would be outrage. People do not like having anything they cherish taken away from them. It's been the same with diesel cars.53 When they first came on the market, they were called environmentally friendly as well as economic. When they were not.54 I suspect it is the same with the wood stoves and some of the so-called 'natural' lotions and potions we use in our bathrooms and kitchens.55-57 Who bothers to check out the ingredients? I do.
Perhaps what we need is a more noticeable national awareness campaign, so that we can feel we are genuinely doing something to clean up the air we breathe?58-60 We know about the Low Emissions Zones for traffic in our cities, but they seem to be getting mixed responses.61-63 Same with electric cars.64 The Mums for Lungs group in London are trying to wean us of the wood stoves, which I wholeheartedly agree with.65,66 But what about those families in rural areas who have no other real option for warmth in winter? They would argue that fuel poverty prevents them from purchasing expensive heat pumps and solar panels.67,68 And more insulation is costly too.
Before we can cut back on air pollution, and find new ways to live, do we need to educate ourselves, and our children, on the sources and nature of that pollution? I doubt it is on the school agenda, but I could be wrong.69,70 After all, children are learning about the importance of preserving our environment. That's one 'good' thing coming out of the climate crisis – it has alerted us to the other problems that need fixing, whether through social change or new technology.71-73
So, what role can psychologists play in raising awareness on the harm air pollution does?74,75 If you are a counsellor or therapist, and someone comes to you with depression or stress, do you ask if they are living or working in a place where the air quality might be making them ill?76,77 I did an internet search and came up with a long list of references to scientific studies saying that air pollution can damage mental health and cognition.78-86 It may even be involved in dementia.87 It has been shown to stunt the growth of young lungs and damage babies' hearts, so why not their brains too?88-93 It is known that particulates can cross the blood-brain barrier.94-98
If we do not know the risks, or if we choose to ignore them, we cannot deal with the fallout.98-100 And who pays the costs? We know we do, if we end up wheezing and tottering our way through a tiring and possibly demented old age, or if we see our precious children being urgently rushed to A&E with a pollution related life-threatening asthma attack.101-103 And what about the cost to the NHS and the number of useful years of life lost to painful illnesses, caused, or exacerbated, by air pollution?104-108 Would it be appropriate for The Psychologist to run a new survey on what its readers think, and what they want to do, about air pollution, in all its many guises.109,110
Professor Sir Stephen Holgate at Southampton University and Dr Gary Fuller at Imperial College have suggested we should have a new Royal Commission on Air Quality.111,112 In 2018, the Rt. Honr. Michael Gove (then Secretary of State for Environment, Food and Rural Affairs) said, '(it is) our goal that by 2025, we will halve the number of people living in locations where concentrations of particulate matter are above the WHO guideline limit of 10 ug/m3'.113 But can this be achieved? Dirty old diesels are still permitted on our roads, even though it is true that the NO2 level in UK has dropped, and we should celebrate that fact at least. But what about fumes from construction sites and dockyards?114,115 And fine particulates from domestic combustion and farming?116,117
In 2018, Mr Gove also told us, 'The importance of raising awareness of the dangers of air pollution is evident in a research report, also published today, which shows just 1 in 5 respondents felt they knew a lot about its effects. The report also showed a lack of awareness of the wide range of sources of air pollution with most naming transport as the main cause. But transport emissions are only one part of the problem. From farming to cleaning solvents there are a large range of other day to day practices, processes and products that produce harmful emissions. Of particular concern is burning wood and coal to heat a home which contributes 38% of UK emissions of damaging particulate matter. Cleaner fuels and stoves produce less smoke, less soot and more heat. In future only the cleanest domestic fuels will be available for sale.' Indeed, the reduction in domestic coal burning has greatly reduced the overall level of PM2.5 here in the UK, which is to be commended, and 'wet' wood is (very largely) no longer for sale at shops and garages. However, at the national level, PM2.5 pollution from domestic wood burning continues and the percentage contribution from that source has gone steeply up not down in recent years.118-122 And not many know that.
Dirty old(er) stoves are set to puff away indefinitely as they have not been banned and the new, less-polluting stoves will deteriorate over time. Even a highly efficient, extra-hot burning, stove can be turned into a serious polluter if tainted wood or rubbish is burnt in it.123,124 So, yes, it is cosy to sit by the fire on a cold night but at what cost?125Even if I can't smell, or taste, the unhealthy smoke, perhaps my neighbours can? And is it harming their health as well as ours?126-128
I don't want to be a spoilsport or a scaremonger, but perhaps I should ask my GP, or therapist, if smoke is truly harmful? And are electric cars, heat pumps, solar panels, biomass pellets, and non-scented, non-plastic, organic products the right way forward? And shouldn't there be an air quality meter at every school and hospital across the land by now? If we really want to know how bad - or how good - our air is, shouldn't we be measuring it more widely and checking the levels daily? Or would that make us all neurotic?
Perhaps, by discussing air pollution sources and their effects on the brain, biology and behaviour, psychologists can help reach the wider community, and push for more collective action.129-136 The air we breathe matters enormously, and scientific evidence on brain injury from air pollution is coming in fast.137-145
Josephine Cock, PhD CPsychol AFBPsS (retired)
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