Asthma and traffic pollution

It is common knowledge that the prevalence of asthma has increased significantly in densely built-up areas such as the Grand Harbour area, Sliema and Pembroke where traffic congestion is high. Yet, a special report on asthma (May 11) barely mentioned traffic pollution in the context of this increase in asthma. Could this be because the report was largely based on information from “official” sources?

A suspicion that the explosive increase in asthma might be attributable to pollution from road traffic arose in the early 1990s. Subsequent surveys yielded strong evidence of an association between the development of asthma in children and the degree of traffic-related pollution. A connection was also seen between living on or near roads with heavy traffic flow and childhood asthma and admissions to hospital.

The usual suspects as pollen, household pets, climatic conditions, dust mites – and even exercise – were cited as causative factors in the report but, inexplicably, the role of traffic pollution was either downplayed or ignored. Too much “staying indoors” was blamed this time – only to be contradicted on page 4 by the bleak advice that children should stay behind closed windows indoors “on hot days” (which is equivalent to staying in for about four months of every year) to avoid asthma.

Apart from a brief mention of the strategy for prevention of non-communicable diseases and a draft legal notice on such improbable items as fireplaces and industrial ovens, the question of traffic pollution was barely mentioned. This notwithstanding the fact that traffic pollution is accepted as a major factor accounting for huge increases in asthma.

Exposure to traffic pollution has another long-term adverse implication. Impaired lung function is commonly seen in children who grow up in polluted areas. The pollutants which appeared to be most closely associated with lung function deficits were nitrogen oxides and, especially, sooty particles as emitted by diesel engines.

In spite of strong evidence, our health and environmental authorities have been staring down the barrel of a smoking gun and doing nothing about it. The threat from smoke-emitting buses had been tolerated by our government for decades and the black smoke emitted by those old diesel buses has almost certainly already inflicted irreparable harm. The largely ineffective SMS system ended up a feeble joke after it was discovered that reports submitted by the unsuspecting public were being ignored.

Though the old buses have been replaced, many diesel-driven large vehicles, private buses and private cars continue to emit smoke laden with toxic particles. Yet, the government remains in denial and continues to tolerate this.

The proliferation of apartment blocks continues as though Malta is teeming with homeless people and unnecessary urban development has gone beyond environmental sustainability. In most places it has resulted in further encroachment of remaining open spaces and traffic congestion in a suffocating urban jungle. Property overdevelopment ignores the fact that our environment starts on our doorstep and healthy mobility starts there. But our residential roads have become drab and robbed of their social function by traffic. Such roads do not invite people to walk in them and speeding traffic renders them unsafe so children are often not allowed to go out alone. So, yes, children do stay at home.

To make matters worse, healthy mobility is not being encouraged. Walking or using a bicycle for short trips, now commonplace in European towns, continues to be regarded as eccentricity in Malta. Roads continue to be widened and more car parks created, further encouraging urban car use. At the same time, the government’s Mussolini-like obsession with high visibility projects such as sportsfields, recreation parks and the like continues, these being a good excuse for much ribbon-cutting and photo opportunities. Such projects are all very well but they are not the answer because people mostly have to drive to them, adding to the pollution.

The public is also part of the problem. Such is our attachment to our beloved cars that, unlike air or sea accidents, the health impact and premature deaths associated with pollution from road transport are accepted with equanimity. We continue using our cars even for the most trivial of distances and still indulge in the traditional toxic “Sunday drive”.

So, as the article proclaims, “asthma is just marching on”. It will continue to do so as long as we continue to pollute in such a prodigal way.