Research around Respiratory Problems and Pollution Data
What did we discover when we started looking at this area looking at the problem? so these numbers that you can see in front of you are really for Northern Ireland because this was a Northern Ireland focused project but you can put this into perspective if you remember that for example England has a population of around 30 times Northern Ireland. I don't have the numbers for England but you wouldn't be too far off if you take the numbers on the screen and you do the maths in your head and you multiply by 30.
In Northern Ireland there are over 2,000 people every year whose death is attributed to respiratory disease and some small areas in some wards in Northern Ireland that accounts for almost 70 percent of deaths that are linked to respiratory disease.
There's around 10,000 people admitted to critical care every year with respiratory problems and in fact research shows that 50 of them were admitted in the previous six months. People are coming back to hospital again and again.
One in every 10 times spent on prescription medicine is going on a respiratory medicine like salbutamol.
We also learned about the link between pollution and health, that link is not in dispute, the research literature that you can find has clearly established that connection and what is happening right now, in the cutting edge, is the detail of how these things are connected and the true detail of the kinds of conditions that can be impacted by pollution.
This particular study that you can see in front of you is a few stats a few pieces of information from a King's College London paper that was released in 2019 and it really personalises the pollution impact. They're saying that in Manchester if you cut air pollution by 20 you would have 20 fewer lung cancer cases every year, 284 fewer children with a lung function form every year. On higher days pollution in Manchester, every day of high pollution, you get six more cardiac arrests. Every day with high pollution in Manchester you get six more adults and eight more children being taken to hospital.
We also looked at the wider context to try and understand why our SBRI sponsors were interested in this particular challenge and it's really comes from this idea that was championed by a report on the Northern Ireland health service, from 2016, known as the Bengoa report. It's a very long report, it's 100 pages long so I crammed a lot into one slide here but the key thing to notice is that we cost the NHS the most as we get older. Very rapidly as we age into our cost to the NHS rises significantly so it's the healthy life that we can lead that impacts the NHS. The Bengoa report recognises this and in fact deprivation has a huge impact on health conditions and costs the NHS. With 14 years fewer of healthy life expectancy in deprived areas when compared to the most affluent the report suggests three key changes that the NHS should look to make over the next few years:
- Move away from a model based on achieved care to a model that's based on the needs of chronic patients, long-term patient care.
- Move away from a reactive model based on curing illness, of course that still has to happen, but to refocus on a proactive model designed to care for long-term health conditions.
- Move away from providing care to actively helping patients manage their own self-care.
So that's the context behind what has driven this particular SBRI and other initiatives like it around the uk.
What kind of pollution affects people in Northern Ireland and across the uk?
The most well-known perhaps is NO2 that you get from road traffic that's very common and we understood, especially the backlash recently about diesel cars for example, and the London mayor's introduction of charges to try and reduce that
There is a secondary source of particulate pollution that is mostly coming from home heating. There's also ammonia emissions from agriculture but what happens with ammonia emissions is they interact with the air which chemical reactions and they generate particulate pollution.
We're talking about NO2 and particulate pollution. NO2 is primarily a lung irritant, and that is not in any way to downplay its impact on people, it has huge impact on people dealing with with breathing conditions but particular pollution is strongly linked with causing respiratory conditions, causing lung cancer, triggering strokes, triggering cardiovascular disease and most recently is actually linked to causing dementia.