Air pollution linked to seven million deaths globally
By Helen Briggs BBC News
Seven million people died as a result of air pollution in 2012, the World Health Organization estimates.
Its findings suggest a link between air pollution and heart disease, respiratory problems and cancer.
One in eight global deaths were linked with air pollution, making it “the world’s largest single environmental health risk”, the WHO said.
Nearly six million of the deaths had been in South East Asia and the WHO’s Western Pacific region, it found.
“The evidence signals the need for concerted action to clean up the air we all breathe.”
Dr Maria Neira WHO
The WHO said about 3.3 million people had died as a result of indoor air pollution and 2.6 million deaths were related to outdoor air pollution, mainly in low- and middle-income countries in those regions.
Over the years we have been running this charity, launched in 1995, we have come across many cases of people saying they were made ill from leaks of natural gas. We have also come across cases where the medics stated that some particular damage was not caused by Carbon Monoxide (CO). We have also come across cases where medics stated that symptoms suffered by victims were more akin to heavy metal poisoning than CO.
Roland Wessling, Cranfield university and CO victim
(CO+Savi (group of victims and victim groups) suggests that the following statement(s) is/are being used instead or at least in conjunction with any existing numbers in presentations, press releases, publications, etc.)
We suggest that this statement agreed by members of CO+Savi is used in press packs, press releases etc.
There is currently no conclusive and comprehensive way of accurately establishing the actual number of people harmed to whatever level by carbon monoxide and other toxins (CO+ for short). It is recognised that there are many sources of data collated over the years. However, this data is scientifically inconclusive at this point in time. We know that some people can suffer temporary illness, irreversible chronic ill health or death as a consequence of exposure to either low-level, chronic and high-level acute CO+ poisoning. Unfortunately, we do not know how many more are affected and we have no way of objectively and responsibly estimating the true figures.
Carbon Monoxide (CO) only
It is extraordinarily difficult even to obtain a test of appliances for CO. An investigation from an independent court expert (CORGI Services has such people) costs around £3,000. However, there is now a qualification called CMDDA1 which enables the engineer to test for CO and provide you with parts per million. In our opinion, this would not be good enough for a court case but it might be accepted by a patient’s medical advisers and might also be a first step before deciding to employ an independent court expert. Such a person, qualified under CMDDA1, should not change the appliance other than to turn it on and test it and measure for parts per million of CO. If you needed such a person you could try contacting the Gas Safe Register. However, their category ‘fumes investigation’ does not seem to necessarily mean that a firm has a person qualified under CMDDA1. We therefore suggest you contact the firm and ask them if they have someone qualified under CMDDA1, if they do to make sure they send that person and to make sure they do not change the appliance other than to turn it on, test for CO and give you parts per million of any CO found in writing. Ideally try to obtain this assurance in writing by email before the person attends.
Because it is very difficult to test appliances the consequence is that although people usually cannot prove they have suffered from CO poisoning (because a blood or breath test is often too late to produce a positive for CO), it is generally assumed that any illness or damage suffered, has been caused by CO, unless this is fought out in the courts by medical experts (which is very unusual because the majority of cases are abandoned or settled before court).
It is this background that made us wonder about the products of combustion generally many years ago. Research about CO in the laboratory has tended to be on rats exposed to quantities of CO released from cylinders of pure CO. However, in the household, workplace and real life situations, people are not exposed to pure CO but to the products of combustion. It is worthwhile considering the prevalence of this exposure (classified as just CO poisoning) and the evidence showing the other toxins that can be present in those products of combustion.
The Prevalence of Carbon Monoxide Poisoning
Research commissioned from University College London, published in a press release dated 02.10.06 by HSE, to inform its gas safety review highlights the dangers of CO poisoning in people’s homes, coupled with a lack of public awareness of the risks.
‘The early findings of the research include:-
- 23% of homes had one or more defective gas appliance;
- 8% of homes were judged to be at risk of dangerous levels of CO;
(Notes added by CO-Gas Safety. If there are 20,451,427 households with 2.36 people in each household there are therefore 48,265,367 people and 8% of them are 3,861,229, so 3.8 million people – be conservative and call it 2-3 million in the UK).
- 45% of homes had received no information on the dangers of CO; and
- A higher prevalence of problem appliances was found in the homes of vulnerable people (young, old, those in receipt of benefits).
Some years ago Stephanie Trotter was telephoned by Gareth Hughes who, along with his wife Carole, suspected they had been made very unwell by their oil fired appliance. Gareth had done everything correctly, it was his home and his appliance and nobody had touched it. So we sent Harry Rogers, expert court witness of R & T Engineering, to test his appliance. Harry found negligible CO but did inform Gareth that there were other products of combustion and aromatic hydrocarbons.
Gareth did some research on the Internet and came up with the following:- (these are from the internet but some seem to be difficult to download from those websites so we’ve downloaded them and if you can’t obtain them, let us know on email@example.com.)
1. Evidence from the Internet – Please note you may have to copy these references into Google rather than just click on them.
This is a DEFRA document (i.e. a British Government document) search for NoX, PM10s, Dioxins, Furans and PCBs and VOCs (Volatile Organic Compounds).
For natural gas see http://www.epa.gov/ttn/chief/ap42/ch01/final/c01s04.pdf and search for mercury, manganese, copper, arsenic, chromium, cadmium, barium, nickel etc. and see
For details of other toxins found in Domestic Heating Oil or fuel oil (Kerosene) combustion see http://www.epa.gov/ttn/chief/ap42/ch01/final/c01s03.pdf
This is from the United States Environmental Protection Agency.
This is an Australian document.
For wood see
We can supply further articles, a Danish article and an Australian one. Please email us on firstname.lastname@example.org
For mercury in oceans from deposits from power stations see http://www.ens-newswire.com/ens/may2009/2009-05-04-02.asp This document shows that mercury from coal fired power stations in China ends up in fish in the Pacific Ocean.
Just think what a blocked flue could do to a person in a confined space over weeks, months or years.
Gareth also managed to obtain a test of his appliance by an environmental air monitoring expert (this is expensive). This test found the other toxins. Gareth and Carole also had their blood and urine tested and raised levels were found.
You may also find the following of interest:-
22 March 2010
Environmental Audit Committee
EARLY DEATHS FROM AIR POLLUTION SHAME UK
NEW REPORT: Air Quality
Chair of the Committee available for interview / Contact: Nicholas 07917488141
Air pollution on UK streets is contributing to tens of thousands of early deaths each year and the Government is not doing enough to tackle the problem, according to a report published today by the cross-party Environmental Audit Committee. The MPs warn that Britain could face millions of pounds in fines if our cities continue to breach EU air quality targets supposed to protect public health.
Tim Yeo MP, Chair of the Environmental Audit Committee said:
“Air pollution probably causes more deaths than passive smoking, traffic accidents or obesity, yet it receives very little attention from Government or the media.”
“In the worst affected areas this invisible killer could be taking years off the lives of people most at risk, such as those with asthma.
“The large EU fines we face, if we don’t get to grips with this problem, should now focus Ministers’ minds.
“Much more needs to be done to save lives and reduce the enormous burden air pollution is placing on the NHS.”
According to evidence presented to the inquiry, air pollution could be contributing to as many as 50,000 deaths per year – as it makes asthma worse and exacerbates heart disease and respiratory illness. Averaged across the whole UK population it is estimated that poor air quality is shortening lives by 7-8 months. In pollution hotspots it could be cutting the most vulnerable people’s lives short by as much as 9 years. Despite these considerable impacts on public health very little effort is being put into reducing air pollution levels, compared with efforts to tackle smoking, alcohol misuse and obesity.
Air pollution from road vehicles causes the most damage to health. A dramatic shift in transport policy is required if air quality is to be improved. This means removing the most polluting vehicles from the road, cleaning up the vehicles that remain and encouraging smarter choices about transport. Many of the policies needed to reduce transport emissions have the added benefits of tackling climate change by reducing CO2 emissions.
See WHO guidelines for indoor air quality: selected pollutants 15.12.10
ISBN 978 92 890 0213 4
See page 70 second para from the bottom.
Walker (130) states that the incidence of chronic carbon monoxide exposure in Great Britain is officially 200 per year, while at the same time “250 000 gas appliances are condemned annually”. He speculates that if only 10% of these appliances give off significant amounts of carbon monoxide that reach the breathing space of residents, as many as 25,000 people every year may be exposed to carbon monoxide in their homes. The carbon monoxide support study (89) found that “only one case out of 77 was correctly identified (i.e. diagnosed) on the basis of symptoms alone” and that medical professionals were the least likely group to “discover” the fact of the carbon monoxide poisoning.
See also page 86
The 24-hour guideline
Chronic carbon monoxide exposure is different from acute exposure in several important respects, as noted above. Thus, a separate guideline is needed to address minimal exposure over 24 hours, rather than the 8-hour period used in the acute guidelines. The latest studies available to us in 2009, especially those epidemiological studies using very large databases and thus producing extremely high-resolution findings, suggest that the appropriate level for carbon monoxide in order to minimize health effects must be positioned below the 8-hour guideline of 10.5 mg/m3, possibly as low as 4.6–5.8 mg/m3. This is also essential since the minimal exposure time for this guideline is three times longer.
Note to explain these levels by CO-Gas Safety
10.5 mg/m3 = 8.9 Parts Per Million so call it 9 PPM
4.6 mg/m3 = about 4 PPM
However, some medics think that even these levels are too high and Harry Rogers, independent court expert witness says, ‘the only safe level of CO is zero’.
However, the only people to inhale only CO are rats or people in a laboratory who inhale cylinders of pure CO. Otherwise people are inhaling the products of combustion which have other toxins in them.
Please note the following matters, which are curious and supportive.
- The Reach Legislation, which basically requires all products to have to be proved to be safe, excludes fuels. See http://eurlex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2006:396:0001:0849:EN:PDF
- A test house has assured CO-Gas Safety that the toxins (such as mercury, manganese etc.) are in such tiny amounts that they cannot possibly cause a problem, yet state that they have done no research to prove this, nor can they quote any research done to prove this. All gas appliances are tested before sale for the CE Mark but they are tested with laboratory gasses, which are specially prepared to remove impurities, such as the other toxins.
- At the All Party Parliamentary Gas Safety Group (APPGSG) meetings, although the other toxins including the toxins were discussed, none of the energy companies present denied that they existed.
- Dr. Walker GP in the APPGSG stated that the other toxic compounds may well be responsible for some of the long-term consequences – see Page 19 of the report January 2009 see http://www.gassafetygroup.org.uk/lib/docs/allpartygassafetygroupreport_medicalawareness.pdf ‘Treatment for the long-term effects of CO exposure is, according to Dr Ed Walker is much more complicated. The picture is complicated by the fact that victims exposed to CO are often exposed to other toxic compounds at the same time, and it may be these that are responsible for some of the long-term consequences. However survivors of severe episodes of exposure often have extensive brain damage which can be demonstrated on MRI scans of the brain. This sort of damage is permanent and irreversible.’
- We have many other cases over the years in which toxicologists cannot explain damage suffered as resulting from CO, yet is consistent with damage as a result of the toxins.
- There is a case of a three year old, who died with a gas appliance in his bedroom, who had insufficient CO in his blood to kill him. However, Stephanie Trotter, OBE was told by the Coroner, that he had raised levels of toxins manganese, arsenic, barium and nickel (the manganese was apparently 15 times the higher levels – the levels of the other toxins were not given). This inquest decided the death was from natural causes and the high levels of manganese were explained by contamination and post mortem distribution, although we have been told that there is only research on post mortem distribution with regard to drugs, not heavy metals.
Please note that the APPGSG has refused to examine the other toxins confining their inquiry to CO only. However, as we submitted to the APPGSG, if poisons in water were being considered, and if toxins A,B,C and D were known to exist in water, surely it would be pointless and dangerous to consider only toxin A? Yet this in effect, is what the APPGSG, now interesting renamed as the All Party Parliamentary Carbon Monoxide Group (APPCOG) continues to do.
Please also note that it is extremely difficult for our victims to obtain the services of toxicologists to assist them in any meaningful way. The only toxicologists who have been at all helpful seem to have emigrated (e.g. Dr. Alison Jones who was head of Guys Toxicology unit) or retired or undertake research work only. We have tried very hard to obtain the name of a toxicologist to advise on the poisoning of foetuses, but it seems that there is nobody in the UK who can do this or if there is, they are unwilling to assist.
CO-Gas Safety wants research into:-
What is in gas before and after combustion (although this seems obvious from the documents on the Internet) and whether it is possible for significant amounts of toxins to be emitted into the atmosphere or far worse, blown back into or remaining in a dwelling when there is a partially blocked flue?
Would incomplete combustion affect this other than to increase CO?
What about flueless appliances such as cookers and some fires?
To undertake this research an independent body would have to be found to test the gas before combustion and after combustion using gas in pipes and burned in a boiler with a flue, a boiler with a partially blocked flue. This would also have to be done for a gas fire and also for a cooker in an average kitchen with average ventilation.
Also a flueless gas fire should be tested.
It is also possible that while the amounts of the toxins in fuels are small, these could build up in the body fat and possibly other organs and tissue etc. of the person concerned causing problems over a long period.
The same as above for oil, coal and wood.
We have been told by BRE that the cost of this research is about £10,000 in a laboratory and a further £40,000 for field tests. This is far more than we could afford but surely the gas and oil industry must have undertaken such research? If not, why not? British Gas/Centrica announced profits of £2.4 billion for 2010. Beconfused.com announced that BG had profits of £742 million in 2012 (see http://www.confused.com/gas-electricity/archive/centrica-profit-levels-rise-by-24-per-cent).Surely if fuel suppliers are selling their products to the public they should know what is in the fuel and whether if used correctly or incorrectly, there are any dangers to the public other than CO? Surely this cost is miniscule when balanced against impact on the health of the nation? We need this research to be of the highest quality and extremely independent. We have already asked Lord McKenzie (then Government Minister responsible for the Health and Safety Executive, which covers gas) in May 2009 to undertake this research, have written to Sam Laidlaw CEO of Centrica in 2009 and also drawn the attention of various Select Committees to this need. Please note that there is likely to be a risk to those inside from these toxins and toxins when the fumes are not exiting to outside air.
However, there is also a possible risk of planet poisoning rather than global warming but we suspect that it is those indoors, who are suffering the highest levels.
We suspect that many people whom GPs report as ‘TAT’ (Tired All the Time) are in fact suffering from poisoning caused by these toxins and/or Volatile Organic Compounds (VOCs). For blood tests for these toxins see http://http://co-gassafety.co.uk/about-co/prevention/ and click on ‘Blood tests’. These blood tests can be done weeks or months later, unlike tests for CO. It is also possible to have urine tests both before and after a provoker has been taken. However, it would still be necessary to prove on a balance of probabilities (for a civil claim) that these toxins, if found in the blood, came from the fuel and appliance concerned. However, if the research really has not been done by the fuel suppliers, surely urgent research on the other toxins emitted by appliances should be undertaken?
The All-Party Parliamentary Carbon Monoxide Group strongly supports the inclusion of carbon monoxide poisoning as a high risk. The All-Party Parliamentary Carbon Monoxide Group’s recent inquiry, ‘Preventing Carbon Monoxide Poisoning’, heard evidence that carbon monoxide poisoning causes 50 deaths a year (revised to 40 in the latest report by the Cross Government Group on Gas Safety and Carbon Monoxide Awareness), 200 serious injuries, and 4000 minor injuries – which costs the Department for Health in England and Wales approximately £178m a year in medical and care costs, as well as creating immeasurable human suffering.
Furthermore, it is thought that the number affected by CO poisoning is considerably higher– a recent study conducted by Liverpool John Moores University in 2011 measured CO levels in 109 homes over a number of weeks: it found that 24 homes had CO levels greater than 50 ppm (parts per million) – a level in which symptoms of poisoning, such as headaches, tiredness, and drowsiness can be experienced. A further 53 homes contained CO levels between 10 and 50 ppm.
CO-Gas Safety states:-
This then shows about 22% of homes with CO levels exceeding 50 ppm and 49% of homes with CO levels between 10-50 ppm. This equates very well with other research done over the last 10 years. If one was to extrapolate these figures across the whole of the UK, then we would arrive at a number close to 15 million UK citizens being poisoned by CO in levels greater than 50 ppm and around 34 million being poisoned by levels between 10 and 50 ppm. In total this is 49 million people in the UK being exposed to CO in levels greater than those recommended by the World Health Organisation and as a consequence significant numbers, running into millions will as a result of this exposure eventually suffer chronic ill health.
How do CO and other Toxins impact on the UK Population?
CO+Savi (group of victims and victim groups) suggests that the following statement(s) is/are being used instead or at least in conjunction with any existing numbers in presentations, press releases, publications, etc.
There is currently no conclusive and comprehensive way of accurately establishing the actual number of people harmed to whatever level by carbon monoxide and other toxins (CO+ for short). It is recognised that there are many sources of data collated over the years. However, this data is scientifically inconclusive at this point in time. We know that some people can suffer temporary illness, irreversible chronic ill health or death as a consequence of exposure to either low-level, chronic and high-level, acute CO+ poisoning. Unfortunately, we do not know how many more are affected and we have no way of objectively and responsibly estimating the true figures.
To prevent deaths and injuries from CO and other fuel toxins.
- All appliances powered by any fuel that burns should be serviced according to manufacturer’s instructions – usually once a year. Make sure that the person doing this work is properly qualified. Please check and remember it’s your money and your life. With gas the installer must be Gas Safe Registered. Also check with the Gas Safe Register http://www.gassaferegister.co.uk/that the individual who comes to install or service your appliance is qualified to do this. He or she should have an ID card with a number on it and you can check the website to see the individual concerned and what he or she is qualified to work on (e.g. boilers but not cookers).
- Make sure all chimneys and flues are regularly swept and checked.
- Ensure adequate ventilation and don’t block ventilation grilles.
- As an extra safeguard against CO, buy a CO alarm to European Standards to EN50291. This will cost around £15 from most good DIY stores and some supermarkets.
In an emergency, ring the Gas Emergency Service line on 0800111999 but they will only turn off your appliance or your gas. Seek immediate medical help and insist on a CO test and ask for the result in writing. Ordinary blood is adequate for this – there is NO NEED for arterial blood.
Further reading and resources
Read and updated 02.11.14.