Vehicle-related pollution may cause more than 11,000 deaths a year

Anastasia Tsirtsakis

16/03/2023 4:47:27 PM

A GP expert says new research on the impacts of vehicle emissions on the health of Australians means it should be a consideration in general practice.

Cars lining up on a freeway.
People who live near major roads, unborn babies and children are particularly vulnerable to the health effects of vehicle-related air pollution.

Emissions from cars and other vehicles are a major source of air pollution around the world with significant health impacts. In 2018, more than 3200 deaths and 1.3% of the total burden of disease in Australia was attributed to air pollution.
But new estimates indicate the impacts are likely far worse than previously thought.
The research, conducted by Melbourne Climate Futures (MCF), shows that annually vehicle emissions in Australia may cause:

  • 11,105 premature adult deaths
  • 12,210 cardiovascular hospitalisations
  • 6840 respiratory hospitalisations
  • 66,000 active asthma cases.
For context, road accidents across Australia in 2021 resulted in 1123 premature deaths – that is 10 times less than the number of deaths resulting from air pollution.
MCF Academy Fellows Clare Walter and Dr Kelvin Say presented the figures from their latest research at the Vehicle Pollution Forum last month.
To establish these figures, they scaled the New Zealand HAPINZ 3.0 study – the most recent research on New Zealand vehicle emission impacts – to the Australian population.
But why the significant disparity between previous estimates?
According to the research, the health effects of air pollution are caused by a mix of pollutants including fine particulate matter (PM2.5) – tiny solid particles that can be inhaled and enter the bloodstream – and nitrogen dioxide (NO2). However, up until now, estimates have not factored in NO2 gas emissions, grossly underestimating the real picture.
In response to the findings, MCF has released a position statement calling for urgent action, which has been endorsed by a number of organisations, including Asthma Australia, the Climate and Health Alliance, Doctors for the Environment Australia (DEA) and the Australian Chronic Disease Prevention Alliance.
GP Associate Professor Vicki Kotsirilos, who attended the Vehicle Pollution Forum on behalf of the RACGP’s Specific Interests Climate and Environmental Medicine and as a DEA spokesperson, was a consultant on the position statement.
She told newsGP she was ‘quite shocked’ by the latest estimates. She says the evidence on air pollution harms is so ‘compelling’ that it needs to be on GPs’ radar. 
‘As GPs, we need to now consider transport-related air pollution and how it impacts the health of our patients,’ Associate Professor Kotsirilos said.
‘For example, if children are presenting with regular asthma attacks and/or persistent chronic asthma, and we’re increasing the need of asthma medications, we should now not only think about risk factors such as exposure to household smoking, gas or wood fire smoke, but also exposure risk to traffic-related air pollution.’
The health-related consequences of air pollution are far reaching, with unborn babies and children particularly vulnerable to the effects, as are the elderly, those with underlying chronic diseases, such as heart and lung diseases, disadvantaged populations – particularly those who live near major roads, and Aboriginal and Torres Strait Islander peoples.
Associate Professor Kotsirilos says children are most at risk due to their smaller stature and greater lung surface, which results in them having a higher respiratory rate than most adults.
‘So, they’re actually taking more rapid breaths and are therefore inhaling more air pollutants,’ she said.
‘And what we know is that those finer particulate matters and NO2 not only affect the lungs, but they can actually enter the bloodstream and affect any organ in the body … increasing the risk of stroke in adults and possibly intellectual disorders in children.’
The Melbourne-based GP suggests doctors consider asking their patients the following questions:
  • Do they live on or near a major road?
  • Have they noticed triggers for asthma at car parks situated at shopping centers or schools where there is a concentration of vehicles?
‘Often the cars at two-minute drop off centers are idling and that creates a greater concentration of air pollution,’ Associate Professor Kotsirilos explains. ‘These areas are what we call “hotspots”.’
So, what can be done?
Associate Professor Kotsirilos says the first step is raising awareness among the community about the harms of air pollution, with a national campaign akin to that of anti-smoking in the 1980s. But she says GPs can also do their part in their daily practice to help patients start to think about their own actions.
‘So, for example, leaving their car at home and considering walking to the shops, catching public transport or riding a bike,’ she said.
‘That way there will be less vehicles on the road and therefore less pollution on the roads – and they get the health benefits of exercising.’
Associate Professor Vicki Kotsirilos is calling for urgent action on addressing Australia’s vehicle carbon dioxide standards.

For people living on major roads and near freeways who are not in a position to move, the GP recommends avoiding opening windows that are in direct exposure to air pollution, such as those facing roads, and planting trees on the property, where possible.
‘The research shows that the more trees we have, the better for our health,’ Associate Professor Kotsirilos said. ‘They also filter air pollutants, so they can actually act as a barrier, particularly when the trees are quite leafy and dense.’
In addition to personal behavioural changes, however, air pollution experts are also calling for action at a government level.
Associate Professor Kotsirilos says this could include everything from anti-idling legislation to educate drivers to turn off their car engines when at a drop-off point, to ensuring educational facilities are built away from major roads to help mitigate exposure.
Meanwhile, addressing Australia’s vehicle carbon dioxide standards should also be on the agenda, she says, and that high-emitting vehicles such as buses and trucks, especially those that are diesel dependent, should be replaced with electric alternatives.
‘This is happening overseas already,’ Associate Professor Kotsirilos said.
‘The next vehicle that we may want to purchase, if we can afford it – and there are cheaper ones now – is an electric vehicle and particularly if it’s using green energy,’ she said.
‘The Federal Government is unlikely to subsidise it but putting extra taxes like the state government has done in Victoria is not good. What the Federal Government could consider, which is something I raised at the forum, is actually taxing the heavily polluting vehicles to discourage the purchase of those – just like cigarettes are heavily taxed.
‘So, it’s actually working on all levels simultaneously and acknowledging that there’s robust evidence now from international studies that pollution is harmful to human health.’
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