Keeping car exhaust out of kids’ lungs

7 minute read

Transport emissions policy hasn’t changed, despite alarming costs to our health and to the public purse.

Thanks to expansive international research, a growing body of doctors are now recognising the harms of air pollution.

Like smoking, exposure to vehicle emissions places adults at higher risk of premature deaths, stroke, diabetes, heart, and lung disease. Children are at higher risk of being harmed by traffic pollution as it contributes to childhood asthma and recurrent lung infection.

There are now GPs and specialists who routinely assess patients on how much air pollution they are exposed to when they present with heart or lung problems such as asthma or recurrent respiratory infections, especially in children and the elderly. Questions may include, how close they live or commute on a busy road. Children are particularly prone to exposure to air pollution from idling cars at schools, shopping centres, and childcare centres.

Children experience higher exposure to toxic vehicle emissions due to their shorter height, they are closer to exhaust pipes, play more outdoors, and breathe more rapidly than adults whilst their lungs are still developing.

Motor vehicles account for most of the air pollution in urban areas in most cities and rural areas of Australia, and internationally especially industrial countries. While overall the level of air pollution is lower in Australia compared to other industrial countries, there are “hot spots” where air pollution from vehicle emissions is more concentrated such as living or working near major roads.

According to the latest information on the state of electric vehicles, electric vehicles (EVs) now represent 3.39% of all vehicle sales, with a significant 65% increase on 2021.

Drivers of these vehicles are no doubt motivated for various reasons, but what is usually overlooked in the debates about EVs is their contribution to public health. Tailpipe emissions from internal combustion engines are among the main sources of urban air pollution.

The recent vehicle pollution forum heard there is substantial evidence that vehicle emissions are much more harmful to human health than was previously thought.

Tailpipe emissions are a mix of pollutants, including carbon monoxide, volatile organic compounds, benzene, ground level ozone, oxides of nitrogen (nitrox) and particulate matter. Of greatest concern are fine particulates, because of their ability to penetrate the bloodstream via the lungs, and nitrogen dioxide (NO2), because of its high impact on lung function, particularly in children.

The forum also heard evidence from New Zealand which quantifies the harm it causes.

Extrapolating from the New Zealand study, the burden and costs to our health in Australia due to exposure to air pollutants PMs and NO2 are anticipated to be a staggering:

  • 11,105 premature deaths in adults per year;
  • 12,210 cardiovascular hospitalisations per year; 
  • 6,840 respiratory hospitalisations per year; 
  • 66,000 active asthma cases per year in the 0-18 age group. 

Most Australian estimates of health harms do not factor in NO2 gas emissions, and it is likely previous figures based on particulate matter exposure, significantly underestimate the real health impacts of vehicle emissions to help guide policy makers. According to a University of Melbourne report NO2 is the better indicator for health impacts from vehicle emissions.

The recently published Sydney Air Quality Study of the Greater Metropolitan Area assessed the health impacts based on results from a quantitative estimate of the levels of people’s exposure to air pollutants. The results found that most Sydney residents are exposed to significant levels of air pollution. These results were then used to determine the annual burden of mortality related to long-term exposure to PM2.5 concentrations. While the study found wood heater and industrial emissions were the largest sources of PM2.5 air pollutant exposure contributing respectively to 269 and 133 premature deaths annually, on-road motor vehicle emissions (cars and trucks) from exhaust and non-exhaust fumes contributed to a significant number of 110 premature deaths annually associated with significant health costs of $832 million (page 22, Table 8).

Australia’s emission reduction standards for motor vehicles are near the bottom of the developed world and there is no mandatory fuel efficiency standard. This is in stark contrast to California which leads the United States in vehicle emission standards. A recent study from the University of Southern California showed that a 2% increase in EVs led to a measurable drop in nitrogen dioxide (NO2) and a 3.2% decrease in asthma emergencies.

Other studies have also found the health of communities benefit with transition to EVs.

International policies that focus on protecting children from vehicle emissions have

demonstrated some success in reducing children’s exposure to vehicle emissions associated with measurable health improvements. These studies demonstrate that even a small reduction in vehicle emissions can have substantial health benefit.

The problem has been recognised in Australia for years, but action to address it is still lacking. In 2016 the then Department of Environment and Energy released a discussion paper which said, among other things:

“There are proven links between pollutants found in vehicle emissions and a range of human health problems (both short and long term). Air pollutants can have a significant impact on the cardio–-respiratory system. Individuals with pre-existing respiratory conditions, such as asthma and allergies, are especially vulnerable to air pollutants. The effects on human health can include reduced lung function, ischemic heart disease, stroke, respiratory illnesses, and lung cancer. The cost of premature deaths due to outdoor air pollution in Australia in 2010 has been estimated to be up to $7.8 billion and in OECD countries, it is suggested that road transport accounts for approximately half of the cost of these preventable deaths”.

Despite these alarming costs to our health and to the public purse, there has been no substantive change to transport emissions policy.  Significant public funds are rightly spent raising awareness for the accident road toll which killed 1,123 people in 2021 and 1187 in 2022, but traffic pollution causes ten times more premature deaths than road accidents.

The health benefits of reducing noxious emissions appear to have been downplayed by some. Australia still needs a strong national EV strategy to catch up to the rest of the world.

The Productivity Commission has cautioned against incentives for EVs on the basis that their uptake would happen without them. However, the US experience shows that incentives for EVs result in faster uptake.

Transport accounts for 18% of greenhouse gas emissions, and Australia’s target of 43% emissions reduction by 2030 will not be possible if transport policy remains in the slow lane. Improvements in public transport, incentives for active transport, energy efficiency and pollution standards, and EVs can all contribute to a healthier environment while lowering greenhouse gases.

Fear by the Australian Council of Social Security that EV policies will disadvantage lower income families is unfounded. Air pollution has been shown to impact the poorest communities most. These communities are often located near the most polluted areas. A more rapid uptake of EV cars, buses, and trucks benefits all. Reliable and low-cost public transport benefit all. Clean air is a basic human right.

Mitigation strategies for traffic related air pollution

  • Promote and improve active transport initiatives such as public transport
  • Introduce anti-idling legislation especially at school drop-off zones
  • Replacement of diesel school buses with electric buses
  • Create pollution barriers around schools e.g. plant more trees especially in open spaces and in buffer zones e.g. between people’s homes, schools and major roads
  • Create low emission zones “school streets”
  • Ban diesel vehicles and phase out all diesel vehicles
  • Consider air purifiers with HEPA filtration in buildings such as schools near major roads
  • Update vehicle and fuel standards to bring Australia into line with international markets by 2030

Raising awareness of the harms of traffic related air pollution is vital for cultural change to occur.

Simple public health messages

There are very clear steps to a low-emissions, healthier, transport environment:

  • Leave your car at home
  • Walk, cycle, scoot, and/or take public transport
  • Protect our kids – stop idling at school pickups
  • Electrify the bus fleet – perhaps the simplest, most effective child health measure governments can make
  • Lobby your local MP to clean up traffic pollution

We will all be healthier for it.

Associate Professor Vicki Kotsirilos AM is a practising GP and member of the Doctors for the Environment Australia.

Dr Graeme McLeay is a retired anaesthetist and is a member of Doctors for the Environment Australia.

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