Along with denting its share price and reputation, Volkswagen may have inadvertently helped address one of the most neglected and insidious public health problems of our time.
Where public health and government bodies have struggled, it has managed to put air pollution, and diesel emissions, right on the front page.
Even in Australia, with our clear blue skies, outdoor air pollution accounts for more than 2 per cent of deaths.
Outdoor air pollution is a silent killer, accounting for an estimated 3.2 million premature deaths around the world each year. It may come as a surprise, but even in Australia, with our clear blue skies, it accounts for more than 2 per cent of deaths, more than are caused by motor vehicle accidents. In Sydney alone, the costs have been calculated at about $4.5 billion annually.
We don’t notice it because it is mostly invisible and ubiquitous, and we don’t really register it because it does not appear on medical or death certificates.
Air pollution consists of noxious gasses and tiny suspended particles that are a fraction of the width of a human hair, and it is these fine particles (PM2.5) that are responsible for most of the health effects. That is because they are small enough to evade our respiratory defences and penetrate deep into our lungs and even into our blood stream.
Long-term exposure, even at very low levels, increases heart disease, asthma and is now recognised as a cause of lung cancer, just like cigarette smoking. While greater exposure increases risks, there are some in society, such as children, the elderly and those with pre-existing heart and lung diseases who are much more sensitive. These groups suffer disproportionate health effects from air pollution.
Diesel engines are much worse than their petrol counterparts in this regard, producing up to four times the amount of nitrogen oxide and up to 100 times the particulate emissions. It is an intrinsic property of diesel engines and why they depend on devices to remove particulate and gaseous pollutants from the exhaust to comply with air quality standards.
And this begs the question; if a well-resourced, high-tech company like Volkswagen cheated on these emissions controls, how well are other car manufacturers doing? It seems more than likely that many more cars and their technologies will be found out.
The problem is now a vexed one indeed. Not only do we have a large number of vehicles creating hazardous emissions but this saga has highlighted the fact that urban air pollution from motor vehicles more generally is already resulting in serious illness in our urban populations.
It remains to be seen how our governments, with their duty to protect the health of its citizens, will respond to this.
The good news is we know from overseas experience that reducing air pollution has almost immediate and cumulative health benefits.
The US Environmental Protection Authority has studied the effects of the 1970 Clean Air Act and in 2011 concluded that for every dollar spent on improving air quality, about $30 was being saved. There aren’t many investments with that sort of return.
And if that wasn’t enough to prompt action, studies are predicting worsening health outcomes in coming decades. This is because our cities are growing, exposing more people to pollution: populations are ageing, meaning more vulnerable elderly people, and our cities are getting hotter due to both climate change and the urban heat island effect, which also worsens air pollution.
In the 19th century, living in a big city carried an “urban penalty” of worse health. This was successfully resolved with the introduction of regulations and infrastructure and use of technology, ensuring clean water, sanitation and safe food.
Current public health effects from air pollution can also be solved; by building more mass transit systems, giving incentives for electric vehicles, promoting cycling and walking in city centres, and reducing urban heat through better design and by increasing green spaces and tree canopy. We could even do as the French are proposing and phase out diesel vehicles altogether by 2020.
Dr George Crisp is the West Australian chairman of Doctors for the Environment Australia.
First published in the Sydney Morning Herald on 5 October 2015.