While the effects of chemical pollution on human health are poorly defined, its contribution to the global burden of disease is almost certainly underestimated? Diseases caused by pollution were responsible for an estimated 9 million premature deaths in 2015—16% of all deaths worldwide, which is three times more deaths than from AIDS, tuberculosis and malaria combined, and 15 times more than from all wars and other forms of violence. It is to be noted that nearly 92% of pollution-related deaths occur in low-income and middle-income countries and combustion of fossil fuels accounts for around 85% of air pollution impacts.
These were the conclusions of the Lancet Commission on Pollution and Health, comprised of 47 experts, which published a comprehensive report on its findings in October 2017. The report highlighted the rapid rate at which new chemicals and pesticides are being synthesised, and warned that some 5,000 have become so common that they “have become widely dispersed in the environment and are responsible for nearly universal human exposure”. Fewer than half of these high-production volume chemicals have undergone any testing for safety or toxicity.
Out of commission
As technology advances, the range of chemicals being released is widening: recent years have seen novel chemicals including, according to the report, “developmental neurotoxicants, endocrine disruptors, chemical herbicides, novel insecticides, pharmaceutical wastes, and nanomaterials” entering the environment; however, the pace of innovation is not being matched by the development of management controls, which are moving forward very slowly under regulations such as REACH.
The issue of pollution engages real questions of social and generational justice. In countries at every income level, disease caused by pollution is most prevalent among minorities and the marginalised. Children are at high risk of pollution-related disease and even extremely low-dose exposures to pollutants during windows of vulnerability in utero and in early infancy can result in disease, disability and death in childhood and across their lifespan.
Expanding the use of eco-labels would help to empower consumers to help choose low-pollution products. The Cradle to Cradle Certified™ (‘C2C’) label includes a ‘Material Health’ category: the concentrations of potentially problematic chemicals it stipulates are below legal maximums, and lower than those allowed by many other labels. Assessments of applications for certification often use evidence from a wide range of sources – not just the EU’s REACH evidence base, but more far-sighted information such as that found in the databases of the Swedish Chemicals Agency.
Clean bill of health?
The Lancet Commission’s figures above strongly suggest that the health costs of pollutants, including opportunity costs, should also be influencing variables when calculating the impact of policies. Where improvements in air quality have been made, principally in richer countries, health benefits have been accompanied by economic gains. According to the report:
“In the USA, an estimated US$30 in benefits (range, $4–88) has been returned to the economy for every dollar invested in air pollution control since 1970, which is an aggregate benefit of $1·5 trillion against an investment of $65 billion.”
The Commission’s recommendations include increasing and focusing the meagre funding for pollution control, particularly from international agencies and donors, to middle and low income countries. It is important that pollution issues are factored into decisions regarding which projects to fund: so in the UK, for example, the Department for International Development needs to make use of cost and return calculations to assess the value of its international aid investments in permanently combating pollution in recipient countries.
This isn’t simply a matter of altruism: at present we’re often effectively exporting the pollution associated with the products we consume to the countries where they are made, so again there is a question of justice. But there is also potential self-interest: taking steps that help improve health and consequent productivity of what are now middle and low income countries will help them grow their economies and become larger export markets for our goods and services.
For higher income countries, the commission’s findings imply a need to incentivise a major reduction in the emission of pollutants. A key means of doing this is environmental fiscal reform to shift far more of the tax burden away from labour (via income and payroll taxes) and onto atmospheric carbon and other pollutants. Taxing environmental and social ‘bads’, in recognition of the costs they impose, is a vital part of the ‘polluter pays’ principle that encourages the development of low-emission alternatives to current practices.
The Lancet Commission report is a thick line in the sand. Society in the UK and globally should move forward with bold investment which will deliver step changes in health experience and reductions in the costs of maintaining modern industrial societies.
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