Photo: Humber Muck from David Wright Flickr Photostream

Air pollution is often in the news as pollution episodes are reported in major cities in China and India. In London too, it is in the sights of the new(ish) mayor, who is calling for extra charges on polluting vehicles in the city. Now the issue is getting drawn into the Brexit debate as the EU attempts to make the UK government live up to its legal responsibility to reduce pollution – and campaigners fight to retain environmental legislation in anticipated absence of EU law. We seem set for more political discussion – and arguments about the numbers of deaths caused by air pollution are prominent. But debates about mortality figures risk distracting from other aspects of the issue. Though the effort to capture public attention is laudable, death counts seem remote from our experience. What then can be done to improve understanding of air pollution as a collective problem, and frame deliberation about the right response?

Despite work in epidemiology, it is hard to put a figure on the burden of mortality or morbidity associated with air pollution at a population level – a standard move in making it into a public health issue. Last week David Spiegelhalter, Winton Professor for the Public Understanding of Risk at Cambridge, blogged on media claims that ‘air pollution cuts short 40,000 lives a year in the UK’ – claims derived from a report by the Royal College of Physicians. Because air pollution is never recorded as a cause of death, we are always in the realm of estimating the contribution it might make to chronic conditions or heart disease. The uncertainty is high: ‘the figure could actually be between 5,000 to 60,000’ – this uncertainty should be part of public understanding according to Spiegelhalter.

Another move is to replace statements about the numbers of deaths in the population with estimates of life years lost. Yet this seems even more abstract. A third suggestion by Spiegelhalter is to talk about risk for the individual – imagining the possible loss of life in personal terms, so that for any one of us exposure to air pollution might reduce our life expectancy in just the same way as watching an extra hour of TV, being another 3kg overweight or having an extra drink or an extra cigarette a day.

The problem here is that while we can perhaps relate to the idea of ‘time lost’ from a lifespan this approach seems to slot air pollution in with the usual suspects of ‘health behaviour’ (sedentary lifestyles, obesity, alcohol or smoking). In this context, air pollution is made at least partly matter of personal responsibility: hence the transport secretary asking us to think before buying a diesel car this week.

But even without the more subtle critiques of the health behaviour concept, air pollution is quite different. Though we can contribute to the problem and solution though our actions, the fact that the effects are shared surely means there is more scope for collective action.

Campaigners for clean air in the 1930s and 1940s understood this, though many of their campaigns now look rather quaint. Where modern day campaigns target vehicle emissions, in the 1930s the ‘enemies’ of the National Smoke Abatement Society were the domestic coal fire and poorly regulated industry. Like modern campaigners, they struggled to make a clear case for the health benefits of cleaner air – resorting to rather vague associations and links to other contemporary interests, for example in sunlight and slums.

‘[S]moke with the dirt, gloom and ill-health that it causes, is one of the most important factors in producing slum conditions’ [NSAS 1934 report, p14]

Another strategy for the smoke abatement people was to argue ‘smoke means waste’. Industrial coal smoke, they argued, was inefficient use of energy, a waste of coal. This could resonate in the 1930s recession and in the 1940s as coal became more clearly positioned as a limited national resource.

They also created positive themes that held out hope of a better future – asking that new housing developments were mindful of air pollution and presenting images of cleaner urban environments across the 1920s and 1930s.

Finally they tried to link to the question of women’s work. Dirty air meant dirty homes, they argued, and women were unfairly burdened by extra washing and extra cleaning. The appeal to women could even be made through an appeal to supposed female vanity. ‘You can’t wear a plastic bag on your head’ cried one campaign in 1938, calling women to resist dirty air as a threat to their hair and make-up with a fetching depiction of a smiling face wrapped in cellophane like a posh bouquet.The image looks odd today, and yet perhaps we can learn something from these efforts to sell clean air as more than a question of health – or death.

While ‘waste’ doesn’t work so well for the particulate emissions from the car, it continues to resonate with people, and is used to good effect in campaigns about the environmental cost of the ways we produce, sell and use food, as well as appearing as a driver of recycling even among people not otherwise identifying as ‘environmentalists.’

The idea of the clean and pleasant city is more positive, invoking a notion of public space and amenity that may be disappearing in these days of cuts in spending on parks and private developments of large chunks of our cities –  but is worth fighting for.

And you don’t need to be worrying about your hair to respond to the plastic bag image by thinking that this is a problem that can’t be fixed by the individual – and reflecting on air as a public good. Though there is a growing market in local or domestic air filtering, and personal air quality monitoring, why accept a commercial solution which is only likely to increase existing inequalities in access to clean air?

Can we ally clean air campaigns to the battle for public space and public goods? Spigelhalter does take the collective perspective at some points. He thinks ‘it can still be good to seek improvements in air quality, but only provided these are based on careful analysis of costs per life-year saved’. That ‘God-view’ is actually the perspective of the state as purseholder for the collective – the payer for health and social care if they survive as public services. But there are other values that could be brought into play even if the costs don’t add up from a health perspective. What about the need for sustainable travel (walking, cycling, taking the bus) to reduce the wasteful carbon emissions that threaten the global climate and our future? What about community – where more pleasant cities offer a ‘humane’ space (in Richard Sennett’s terms) for us to imagine ourselves as sharing more than just air? And finally what about claims for justice – redressing the unequal burden of air pollution and acting to stop ‘free riders’ in expensive cars which filter their drivers’ air while making life miserable for people on pavements and buses?