Reductions in air pollution yielded fast and dramatic impacts on health-outcomes, as well as decreases in all-cause morbidity, according to findings in “Health Benefits of Air Pollution Reduction,” new research published in the American Thoracic Society’s journal, Annals of the American Thoracic Society.

The study by the Environmental Committee of the Forum of International Respiratory Societies (FIRS) reviewed interventions that have reduced air pollution at its source. It looked for outcomes and time to achieve those outcomes in several settings, finding that the improvements in health were striking. Starting at week one of a ban on smoking in Ireland, for example, there was a 13 percent drop in all-cause mortality, a 26 percent reduction in ischemic heart disease, a 32 percent reduction in stroke, and a 38 percent reduction in chronic obstructive pulmonary disease (COPD). Interestingly, the greatest benefits in that case occurred among non-smokers.

“We knew there were benefits from pollution control, but the magnitude and relatively short time duration to accomplish them were impressive.,” said lead author of the report, Dean Schraufnagel, MD, ATSF. “Our findings indicate almost immediate and substantial effects on health outcomes followed reduced exposure to air pollution. It’s critical that governments adopt and enforce WHO guidelines for air pollution immediately.” 

In the United States, a 13-month closure of a steel mill in Utah resulted in reducing hospitalisations for pneumonia, pleurisy, bronchitis and asthma by half. School absenteeism decreased by 40 percent, and daily mortality fell by 16 percent for every 100 µg/m³ PM₁₀ (a pollutant) decrease. Women who were pregnant during the mill closing were less likely to have premature births.

A 17-day “transportation strategy,” in Atlanta, Georgia during the 1996 Olympic Games involved closing parts of the city to help athletes make it to their events on time, but also greatly decreased air pollution. In the following four weeks, children’s visits for asthma to clinics dropped by more than 40 percent and trips to emergency departments by 11 percent. Hospitalisations for asthma decreased by 19 percent. Similarly, when China imposed factory and travel restrictions for the Beijing Olympics, lung function improved within two months, with fewer asthma-related physician visits and less cardiovascular mortality.

In addition to city-wide polices, reducing air pollution within the home also led to health benefits. In Nigeria, families who had clean cook stoves that reduced indoor air pollution during a nine-month pregnancy term saw higher birthweights, greater gestational age at delivery, and less perinatal mortality.

The report also examines the impact of environmental policies economically. It highlights that 25 years after enactment of the Clean Air Act, the U.S. EPA estimated that the health benefits exceeded the cost by 32:1, saving 2 trillion dollars, and has been heralded as one of the most effective public health policies of all time in the United States. Emissions of the major pollutants (particulate matter [PM], sulfur oxides, nitrogen oxides, carbon monoxide, volatile organic compounds, and lead) were reduced by 73 percent between 1990 and 2015 while the U.S. gross domestic product grew by more than 250 percent.

Given these findings, Dr. Schraufnagel has hope. “Air pollution is largely an avoidable health risk that affects everyone. Urban growth, expanding industrialization, global warming, and new knowledge of the harm of air pollution raise the degree of urgency for pollution control and stress the consequences of inaction,” he says. “Fortunately, reducing air pollution can result in prompt and substantial health gains. Sweeping policies affecting a whole country can reduce all-cause mortality within weeks. Local programs, such as reducing traffic, have also promptly improved many health measures.”

Download the full PDF of the study here.

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About the Forum of International Respiratory Societies (FIRS)
The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world's leading international respiratory societies working together to improve lung health globally: American College of Chest Physicians (CHEST), American Thoracic Society (ATS), Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

1 December 2019—The World Health Organization (WHO) has set a goal of ending the AIDS epidemic by 2030. To achieve that goal the Forum of International Respiratory Societies (FIRS)  is calling on governments, health advocates and non-government organisations on World AIDS Day to strengthen their response to AIDS and tuberculosis (TB).

TB is the leading cause of death among those with HIV/AIDS worldwide, accounting for about one in three deaths, according to the 2019 UNAIDS Global update.

“People with latent TB who are HIV positive need TB preventative therapy,” said James Beck, MD, ATSF, President of American Thoracic Society, a FIRS founding member “Studies show that this preventative therapy can reduce the chances of dying from TB and AIDS by around 40 percent.”

In the developing world, TB is often the first sign a person has HIV. Yet, about half of the people living with HIV and tuberculosis are unaware of their co-infection and therefore not receiving care that could prevent serious illness and death, according to WHO.

Shortly after AIDS emerged, it fuelled a global resurgence of TB that continues in many low- and middle-income countries. According to the Centers for Disease Control and Prevention, HIV infection is the strongest risk factor for progressing from latent to active TB.

HIV increases the risk of other infectious respiratory diseases, including pneumocystis jiroveci pneumonia (PCP) and bacterial pneumonia, both of which can be life threatening.         

Since the AIDS epidemic began, the WHO estimates that about 75 million people have become infected with HIV and 32 million people have died from AIDS-related illnesses. Today, in Africa alone more than 25 million people are living with HIV.

Education, prevention strategies and new medicines, particularly antiretroviral therapies, have reduced the number of AIDS deaths each year by more than half since their peak globally in 2004.

Still, UNAIDS estimates that in 2018 nearly 40 million people were living with AIDS and about 1.7 million people became newly infected.

FIRS believes a global response to HIV/AIDS can be strengthened by:

• Increasing awareness of the continuing global threat of HIV-related disease and its link to TB and other respiratory diseases.
• Improving the health outcomes of people living with HIV through patient care and research into improved treatments and treatment strategies for both HIV and TB.
• Reducing the incidence and severity of HIV-related disease by strengthening mother-to-child transmission prevention programs and increasing the early use of antiretroviral therapy.
• Improving HIV education in at-risk communities to reduce the incidence of new HIV infections.
• Reducing HIV-related health disparities and inequities.

“The good news is that antiretroviral therapies have turned HIV/AIDS from a death sentence into a chronic disease, and TB is preventable and curable,” Dr. Beck said. “These two facts, along with the millions of lives that we can save, should strengthen our resolve to make sure these medical advances are available to everyone.”

Download World AIDS Day fact sheet. 

About the Forum of International Respiratory Societies (FIRS)
The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world's leading international respiratory societies working together to improve lung health globally: American College of Chest Physicians (CHEST), American Thoracic Society (ATS), Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

A new report launched today calls policy-makers and political leaders to urgently implement cost-effective actions to achieve quick results for cleaner air.

Air pollution is a public health emergency, not only in Delhi, India but for 90 percent of us worldwide who live in areas of dangerous air pollution, which breach the World Health Organisation’s air quality guidelines. Measures to tackle air pollution deliver rapid results for health as well as co-benefits for the climate.

The report “Clean Air Now”, co-authored by the Forum of International Respiratory Societies (FIRS) and the NCD Alliance (NCDA), is released today to coincide with the United Nations Climate Change Conference (COP25) taking place in Madrid (Spain) from 2^nd-13^th December 2019.

The report includes examples from every continent of measures taken to rapidly reduce air pollution, including in Olympic host cities, and shows how quickly benefits are realised for health. After the introduction of clean air measures, significant health benefits can be observed within just a few weeks, for example in reduced hospital admissions. Over the longer term, benefits of clear air measures include significant increased life expectancy, fewer premature births, fewer heart attacks, strokes, respiratory diseases and early deaths.

“We knew that controlling air pollution would result in better health, but the promptness of major benefits was surprising,” said Dean Schraufnagel, Executive Director of FIRS and lead author of the paper.

Nina Renshaw, Director of Policy and Advocacy at NCD Alliance added: “Governments everywhere should roll out clean air policies urgently to tackle this global health emergency. Measures to tackle pollution pay for themselves many times over, in terms of lives saved and reduced costs for our health services, and are also measures to prevent climate breakdown and worsening health impacts of an overheating planet.”

Air pollution penetrates and affects nearly every organ in the body, as well as our mental health and wellbeing. It is a leading risk factor for non-communicable diseases (NCDs) such as stroke, heart disease, lung cancer and respiratory diseases. The World Health Organization (WHO) estimates that over seven million people die prematurely every year from exposure to polluted air. Most air pollution, and the associated health impacts and premature deaths, are preventable.

The report makes a series of recommendations, including:

• Adopt and strictly enforce emission standards for all pollutants in all relevant sectors, including industry, energy, transport, waste and agriculture.
• Include air quality measures in urban, rural and transport planning at city, regional and national level, including measures to encourage modal shift and active mobility, noting the additional benefits to health and wellbeing, the curbing of climate change, and the reduction of health inequalities.
• Rapidly phase our health-harmful subsidies for fossil fuels and polluting industries and introduce penalties for polluters and/or taxes on pollution.
• Redirect investment to health-promoting, accessible alternatives including clean transport and renewable energy, and towards the provision of universal health coverage.
• Improve housing conditions and ensure access to clean energy sources for indoor cooking, heating and lighting.

Download the report in English. 

Download the report in Spanish.

Read the "The Health Benefits of Air Pollution Reduction" study.

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About the Forum of International Respiratory Societies (FIRS)
The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world's leading international respiratory societies working together to improve lung health globally: American College of Chest Physicians (CHEST), American Thoracic Society (ATS), Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease that causes breathlessness, chronic sputum production and cough. There are 300 million current cases of COPD in the world. COPD is currently the third leading cause of death globally and is highly prevalent in low resource countries. Exposure to tobacco smoke and other inhaled toxic particles and gases are the main risk factors for COPD, although recent research has identified that suboptimal lung growth before and after birth can also increase the risk of COPD later in life.

World COPD Day is an annual global initiative run by the Global Initiative for Chronic Obstructive Lung Disease (GOLD), who are members of the Forum of International Respiratory Societies (FIRS).

The goal of World COPD Day is to raise awareness and present new knowledge and novel therapeutic strategies for COPD worldwide. This year, the 18th annual World COPD Day will take place on 20 November 2019. This year’s theme, “All Together to End COPD” emphasises the fact that many people are involved in the fight to end COPD. At every stage and at any age, there is an opportunity to prevent or treat COPD. From care providers, families and patients, to policy makers and employers - everyone can make an impact.

Initiatives to reduce the burden of COPD are taking place worldwide, including smoking-cessation programmes, fighting against both indoor and outdoor air pollution, as well as examining childhood disadvantage factors. Although there is no current cure for COPD, action can take place at any stage of the disease by a variety of individuals in many types of settings. Employers can strive for safe breathing environments, citizens can be good stewards of air cleanliness, and both patients and families can help advocate for more research and better access to care. Providers and policy makers can work together to improve access to spirometry, essential medications, and other treatments like pulmonary rehabilitation in addition to furthering research to improve patient outcomes.

FIRS invites everyone to participate in World COPD Day events on the 20 November 2019. Further information about World COPD Day can be found here.

About the Forum of International Respiratory Societies (FIRS)
The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world's leading international respiratory societies working together to improve lung health globally: American College of Chest Physicians (CHEST), American Thoracic Society (ATS), Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.