Interview — Addressing environmental risks to health

What are the most dangerous kinds of pollution and their health impacts affecting Europeans and their health impacts?

In Europe (meaning the 53 Member States of the WHO Regional Office for Europe — more than 900 million people), environmental risk factors still account for 1.4 million deaths per year and these deaths are to a large extent preventable. More than a third of these deaths are attributable to air pollution, which is the single most important environmental risk factor for our health. Another big proportion of pollution harm comes from hazardous chemicals. And, unfortunately, every day seven people, mostly children, die from diarrhoeal-related diseases so even water quality remains a problem. Even within the EU, in some rural areas, we have not yet achieved 100 % access to clean water and sanitation.

We still have a long way to go with environment and health but we can also be very clever in the way we join different agendas. For example, addressing air quality can mean addressing climate change emissions at the same time.

How did the effects of pollution on health change in Europe in the past decades?

In Europe, the situation has improved significantly. I was young at the time when the first legislations were brought into place to fight the acid rains and the eutrophication of lakes and seawater. We were perhaps the first in some industrial developments that were very problematic and we were also the first to be confronted with massive pollution and we had to deal with that. We have learned that you need common rules to deal with pollution because it knows no borders.

Of course, now we live in a globalised world and we have to acknowledge that pollution does not respect continental borders either. We have seen some issues moving from Europe to other regions where some dangerous industrial practices are still allowed, so we have a responsibility that goes beyond Europe, a responsibility for global health and that our policies support cleaner production.

Does air pollution influence the evolution of the COVID-19 pandemic?

There are still many unanswered questions regarding the relation between air quality and COVID-19 and it is a topic of current scientific investigation. However, there are some statements that we can already make. Improving air quality would never be wrong because we know that air pollution is an important risk factor for and cause of respiratory and cardiovascular diseases. People who have these underlying conditions have shown increased vulnerability to COVID-19 and are at a higher risk of reporting severe symptoms.

In the short term, we have seen an important reduction of air pollution across cities. This reduction is more prominent in the case of nitrogen oxides, a pollutant very much related to traffic, which is one of the activities most affected by the lockdown measures. There is a lot of research that is going on around this as we are speaking and from which we will learn and benefit in the future. COVID-19 is an unfolding tragedy but, at the same time, it has given us a glimpse at unprecedented data that could perhaps help us rethink the way to a ‘new normal’ that can deliver environmental and health benefits.

Can this crisis be a push towards a sustainable economy?

It is excellent that the European Commission has been working on the European Green Deal because it is a very strong commitment that can give a huge leverage to frame the recovery in a sustainable manner. There is an unprecedented opportunity for this ‘new normal’ to be a leap towards sustainable economic development and we are looking forward to working towards that in collaboration with the Commission.

What would be the easiest methods to decrease pollution?

If we focus on the example of air pollution, we need to address the sectors where it originates — the energy sector, transport, agriculture, waste management and many industries — working from local to global scales. A lot has been done over the past decades, but we still see that globally, 90 % of people are living in cities that do not meet WHO’s air quality guideline values. This means that we still have a significant way to go that requires working with the different sectors to see how we can promote cleaner and safer transportation systems, for example. For all sectors there are positive ways forward.

I think it is also important to acknowledge that the effects of pollution in general, and of air pollution in particular, are not equally distributed. People who live in more deprived areas, very often live close to contaminated sites or in areas where there is a very high flow of traffic. The differences can be large, not only between countries, but also within countries.

What is WHO Europe doing in the field of environment and pollution?

For more than 30 years, our core mission, as WHO, is to work with our Member States and within countries to support them in addressing their environment and health priorities. This came up very clearly at the last European Ministerial Conference on Environment and Health that took place in Ostrava in 2017. All 53 Member States came together and agreed to develop national portfolios for action on environment and health. We are at their side, supporting them in identifying the national priorities, and then supporting the work in that direction.

Also, we are continuing the normative work of the WHO: our Centre is coordinating the update of the WHO global air quality guidelines. Last year we launched the WHO environmental noise guidelines, providing public health-oriented recommendations to support legislation and policymaking for standards in our Member States and at the European level.

Do you expect the new WHO guidelines regarding noise and the forthcoming update on air pollution to be adopted by the EU as well?

I hope so. The WHO guidelines provide robust recommendations based on the most updated scientific evidence of what we know of the relationship between health and air pollution or environmental noise. From that point it is a political decision whether to refer to those guideline values when setting standards. We know that the European Commission refers frequently to WHO guidelines. For example, the EU Drinking Water Directive was revised based on the health-based recommendations and guideline values in the latest edition of the WHO guidelines for drinking-water quality. Environmental noise guidelines for the European region are considered in the revision of the Environmental Noise Directive. The debate remains open when it comes to the forthcoming update of the global air quality guidelines on how they will be reflected in European Union policies. We have to respect the political process and the deliberations of the EU and its Member States but we hope that those policies will promote and protect health, and we are here to support them.