The problem with pollution is, it is killing you softly from inside. It is almost impossible to escape air pollution as it is pervasive in cities, but also in the countryside where you do not expect it that much. This is the result of the study by Kuzma et al. (2024) published in “The Lancet Regional Health Europe”. Based on a data set of 8 million persons from Eastern Poland the effects of air pollution on myocardial infarction incidence was analysed. The use of the “European Union’s Earth Observation Programme” contributed data on air pollutants like PMs, BaP (benzo(a)pyrene), SO2 and NO2 concentrations. The multi-level data of 5 voivodeships, 101 counties, and 709 communities in Poland allows to differentiate the effects of damage to the heart tissue on cardiovascular disease. The other well-known factors are arterial hypertension, diabetes, obesity, chronic kidney disease, hyperlipidaemia, and smoking as most of us know already. The effects of BaP (benzo(a)pyrene) is shown for rural areas despite the lower observed traffic density in these areas. The killing occurs softly from within our bodies by just breathing in and out, and in and out continuously. The disease burden in these regions is observed with “recorded 63,154 hospitalizations and 5921 in-hospital deaths (9.4%) due to STEMI; and 76,543 hospitalizations and 4079 (5%) in-hospital deaths due to NSTEMI”. In short, the need to reduce air pollution further is an urgent demand that saves lives eventually.
(Image from public domain wikipedia or “do-it-yourself” here).
Silent Pandemic
There is a pandemic that is silently spreading across countries and continents. It only indirectly related to the Covid-19 pandemic. The medical journal “The Lancet Respiratory Health” (2024) has an editorial about the inequities of asthma as they develop over the life course. The development of asthma has pre-natal, genetic, environmental, life-style and socio-economic co-determinants. The study of respiratory disease, therefore, is a multi-factorial issue, which needs to disentangle the specific influences. Smoking as well as obesity have an impact on asthma, instantaneously or with delayed time effects of sometimes many years. Hence, it is important to take the whole life course into account, if we want to address the rising disease burden of asthma. Air pollution and heating-up of the planet are important drivers of the silent asthma pandemic across the globe. The social distribution of people working in “asthma- prone” work environments and/or living in highly polluted urban, suburban or rural areas near high frequency traffic is another latent factor causing huge costs to persons and society as a whole. Health inequity is growing over the life course. This is not easy to tackle as policy target as the onset of the disease has no single trigger, but rather a combination of influences that contribute in varying amounts to the evolution of respiratory diseases. (Image air pollution https://aqicn.org/map/germany/de/)
Air quality EU
On some days of the year there is a cumulative effect of bad influences on air quality in Europe. Cold winter temperatures increase emissions from heating. Outdated heating with coal, still important in Eastern Europe, causes high amounts of extra particles in the atmosphere. In January 2024 a train conductor strike in Germany irrespective of the good reasons for it, makes people take their cars. Road blockades by opponents to reducing diesel subsidies to agri-business add to the pollution situation on a specific day. Overall the population suffers and breathes additional amounts of cancerous particles. Particles settle as dust on crop producing soil, of which we all feed ourselves. This is a vicious circle, which we need to break in the interest of all of us, particularly for the more fragile people and children. The latter start to crowd the medical doctors with sometimes lacking the delivery of crucial medicines for this target group. Where do we go from here? Compromises are key, security of supply chain and allowing, not too much, time for transition periods.
Urban Living
Each time I pass by the closed airport in the middle of Berlin I am amazed by the crazy idea to have built this and maintained throughout the 20th century. Paris is desperately trying to re-naturalize small areas and roads, while in Berlin there is now still the huge park to enjoy for all. Sports activities benefit the most. What an amazing asset in the neighborhoods for so many in need to walk, run or cycle a bit to keep their exercise level up throughout their life course. It has still a huge potential to activate people. It just needs a bit more organizations and volunteers to embrace the opportunities. Only in comparison to other cities you realize what an asset this is now. It will remain a challenge to preserve this centrally located treasure for the benefit of all. In Paris the deconstruction of concrete is taking shape and 300 new sites have been identified for re-naturalization, as reported in LeMonde. In Zurich green spaces in the center have been saved and renovated with a lot of money to allow more people to enjoy the benefits of a green environment near the city center. The house and park by architect Le Corbusier is a fine example of this. Image below. The garden around the house is publicly accessible. As air pollution is threatening more and more and heating in cities is a serious health threat we would really like to welcome more preservation and re-naturalization in inner cities.
Car Energy
The car industry sells more electricity-driven than diesel-cars for the first time in July 2023 (ACEA, 2023). This is a turnaround, considering the large share of the most polluting cars in the EU. It is difficult to see this as good news as newly sold diesel-cars will be around and polluting for many years to come. Hybrid cars are an own category and full of heavy additional material that allows 2 types of mobility. Tax reductions to push hybrid cars into the EU-market were very expensive for tax-payers and increasing inequality through co-financing rather expensive cars. 36,3%, the largest share, are still petrol-driven cars, with little awareness for further CO2 reductions. This is the slow evolution of the energy consumption pattern of the automotive industry in Europe.
On the energy production side there have been substantial efforts to invest in clean energy, too (IEA, 2023). With the world burning at several places already it is, after all, good news that investment in solar energy production on a global level has reached the level of investment in fossil fuels. Major drivers of this evolution are 1. China, 2. Europe and 3. The U.S. A. (unadjusted for population size) according to this investment report. Grids and storage investments rise equally to new heights, reflecting new distributional aspects of power provision within and between countries. We are in the race against the burning of our planet due to our shameless use of fossil fuels, worst in form of flying small jet planes. Besides the large company and state investments we need the spending and investment power of the masses to speed up the end of the fossil fuel age of polluting dinosaurs. Please do not replace one dinosaur (coal, oil, gas) with another one (nuclear). Too big to fail is maybe an economic rationale, but it does not withstand natural disasters (Fukushima), human failure (Tschernobyl) or war activity (Saporischschja).
(Figure source: IEA, Power investment in billion US$, 2019-2023, IEA, Paris https://www.iea.org/data-and-statistics/charts/power-investment-2019-2023.
Air pollution
Only if we measure air pollution , we shall be able to be sure it is not getting worse or is improving. The European Environment Agency has developed an app that gives us fairly accurate measure of several important indicators of air pollution or air quality as they prefer to name the indicators. With the wild fires in Canada and the repercussions of this in U.S. cities we are certainly aware that air pollution by neighbours is just as important to know as air polllution originating in your own country.
In Europe this matters as well. Therefore the comparative view on air pollution is a necessary precondition to coordinate action within the EU. Specific meteological conditions yield SMOG in winter and too much heat facilitates SMOG in summer. Thousands of people die every year due to effects of air pollution. This is all well-known and documented.
In Science Advances (2023-6-9) new evidence is presented that fine particles (PM 2.5) in air transport influenza H1N1 viruses into the lower respiratory system and even other more distant organs like liver and kidneys. The conclusion is easy: Reduce air pollution much further, this saves lives and lots of costs in the health system as well. Well-being is advanced sometimes by doing less rather than more. Working more in the home office than in the inner city might reduce the peak of an influenza wave. New solutions to old problems are feasible with new technological advances and implementation like fibre-optic cables for fast internet service also in remote areas. Using the “Science Advances” should allow us to rethink our production and consumption model for the improvement of living and working conditions for all. Many extensions of our economic model shall be based on the “beyond growth” logic. We just need to dare to think and implement policies accordingly, rather than to continue to do the same mistakes over and over again. (Image: still building new Autobahn in Berlin 2022 in residential areas). 
Walking
Yes, walking again. It is so nice, if there are a few roads blocked for car and bus traffic in central cities. Walking the city becomes a marvellous experience. On Easter Sunday 2023 the Champs-Élysée is great because strolling down the avenue without paying attention to road traffic offers an even better view on the surroundings. Why don’t more cities dare to lock out cars to facilitate pedestrian circulation and reduce air pollution at the same time. No problem to reach more than the WHO recommended 10.000 steps/day on such a sunny day in Paris. Inside the Louvre, another chance to achieve new records in mileage by foot. 
