The Washington PostDemocracy Dies in Darkness

The air we breathe may be slowly killing us

Sunrise illuminates a haze over the London skyline this week. In Britain, air pollution kills more people than car accidents.
Sunrise illuminates a haze over the London skyline this week. In Britain, air pollution kills more people than car accidents. (Hannah Mckay/Reuters)

Florence Williams is the author of “The Nature Fix: Why Nature Makes Us Happier, Healthier, and More Creative.”

Spring is a deceptive season. It tricks you into thinking you’ve emerged from the dull gloom of winter into a bright festival of light, green, health and freshness. You want to go outside, but if you are an anxious and decently informed person, you may have a nagging sense of the lurking hazards, both personal and global: the tick-borne diseases, the melting polar caps, the insect apocalypse. To this lengthening list you may now add another: air pollution. Counterintuitively, it is worse in the spring, often invisible and odorless, determined to reach deep into your lungs and your brain.

Two new books are here to paint a stark and alarming picture. Air pollution may not be a charismatic menace. Understanding it requires a passing knowledge of chemistry and epidemiology (which both books ably provide). But understand it we must. Decades of research now suggest that the poisons and particles of bad air shorten lives, impair learning and increase our risk for dementia, with more bad news mounting. A study published this spring followed children in Britain for 18 years and found significant associations between air pollutants and psychotic episodes during adolescence.

Furthermore, air pollution is not just an urban problem or an industrial problem; as both books point out, pollution molecules are spread everywhere across the globe. “In 2016,” Gary Fuller writes in “The Invisible Killer: The Rising Global Threat of Air Pollution — and How We Can Fight Back,” “95 percent of humanity breathed air that did not meet WHO guidelines and the situation was getting worse, especially since the turn of the century.” More than 40 percent of Americans breathe unhealthy air. In Britain, air pollution kills more people than car accidents and is second only to cigarette smoking as a public health threat. Globally, air pollution is believed to be responsible for 7 million deaths per year, according to the World Health Organization.

If we are shockingly under-acquainted with the causes and the effects of air pollution on our health, longevity and cognition, we are not alone. Fuller, who helped develop the London Air Quality Network at Kings College, is a scientist with an iconoclast’s infectious enthusiasm for history. We learn about early researchers, their clever instruments and their blind spots. Charles Dickens and Sir Arthur Conan Doyle wrote evocatively of London’s famous pea-soup fogs; everyone knew that the city’s yellow, oppressive air was caused by burning wood and coal, but, shockingly, eminent health experts believed the smog was harmless, even salubrious, because it kept miasmic vapors at bay.

“In Victorian times,” Fuller writes, “breathing the ozone was thought to be part of the health-giving properties of a visit to the British seaside.” Scientists were beginning to understand how to measure ozone but not that it was a powerful oxidant (with an unstable three oxygen atoms), a molecule prone to break apart and react with other substances, including our lungs.

Air pollution kills quickly, and it kills slowly. Tiny, noxious molecules land on your lungs’ alveoli and then pass into your bloodstream. During and shortly after acute bad-air events, people die from constricted lungs (suffocation) and constricted arteries (heart attacks and strokes). Chronic, lower levels of air pollution damage lung tissue by triggering an immune response that inflames the lungs, leading to asthma, emphysema and other respiratory diseases.

We are not very good at recognizing the effects of pollution. It barely registers, for instance, that bad air causes premature deaths for an estimated 9,000 Londoners every year. But sometimes the devastation is hard to miss. Fuller recounts the dramatic smog event of 1930 in Belgium’s narrow Meuse Valley, when a dense fog trapped smoke, causing painful, wracking deaths for several hundred people. That was nothing compared with December 1952, when a coal-fueled smogapocalypse in London killed 12,000.

Fuller makes a brisk and readable case for why bad air is a problem, explaining the dangers of tiny particulates, car and plane exhaust, acid rain, and indoor cooking smoke, responsible for millions of deaths and countless illnesses each year. And back to the problem with springtime air: The bump in seasonal pollution comes from agriculture, namely ammonia-based fertilizers. The ammonia reacts with sulfur dioxides and nitrogen oxides, forming nettlesome particles.

While the focus of “The Invisible Killer” is largely European and a bit theoretical, American journalist Beth Gardiner sets out across the world to find the people whose lives are most affected by black carbon, exhaust and ozone. And there are plenty. In one particularly moving section of her book “Choked: Life and Breath in the Age of Air Pollution,” she visits a 17-year-old girl in a small village in northern India. Renu, like 800 million other people in her country, rises each day at dawn, while her brothers are still sleeping. After gathering water from a well, she squats over a smoky wood-and-dung fire to prepare tea and bake bread for the family. She repeats this process throughout the day. “Renu says her face is often covered with soot when she finishes cooking,” Gardiner writes. “Her eyes water constantly, and blowing to kindle the flames sets off fits of coughing. The headache never goes away.” Renu’s family can’t afford gas or a gas stove.

Astonishingly, the global death toll from household air pollution is nearly 10 times that of malaria. By putting a human face on a problem of environmental chemistry, Gardiner shows us the devastation up close, creating a sense of dismay but also urgency to improve lives.

As a mother living in London, Gardiner deftly describes her anxiety over the location of her daughter’s urban school. As a reporter on the road, she braves “toxic snow” in China, admires a groundbreaking Chinese pollution reporter who mysteriously disappeared and reacts with frustrated disbelief over the “dieselgate” scandal, in which automakers were caught flagrantly cheating the software on emissions tests.

If there is a lesson in the history and current state of air pollution science and policy, it is that we constantly underestimate and under-regulate this public health menace. Beyond that, managing air pollution is a cosmic game of whack-a-mole. When we make significant strides in one arena, unexpected problems surface elsewhere.

Although burning natural gas is far cleaner than burning coal, the practice of fracking releases high levels of particulates as well as ozone from methane, resulting in a projected extra 200 to 800 deaths in Appalachia alone by 2020. And in households across Europe and the United States, people are glad not to be burning coal in stoves, but they miss the hearth effect and have been gradually building and using more wood stoves and fireplaces. By 2010, extra particle pollution from wood-burning in London was six times greater than the amount saved by enforcing new vehicle exhaust standards. Electric cars will help solve the exhaust problem but not the particulate matter that comes from degrading roads, tires and brakes, and of course the electricity may be generated from unclean sources.

The solution is not to throw up our hands and stay inside in the air conditioning (which, ahem, contributes to carbon emissions). One Barcelona team weighed the benefits of urban cycling against the downsides of breathing roadway pollution, and found an impressive gain in overall health from the outdoor exertion.

Changing behavior through regulation works. When indoor cigarette smoking was banned in 12 U.S. states, 10 countries and 15 cities around the world, heart attack rates dropped an average of 12 percent, and strokes and children’s asthma declined. When Britain required ultraclean, low-sulfur diesel, particulate pollution in central London dropped 60 percent. The city of Dublin prohibited the sale of dirty coal for home heating, and black smoke decreased 70 percent while deaths from respiratory problems dropped 16 percent.

Fortunately, these books offer some clear actions we can take, personally and collectively. For those of us who walk or exercise outside, it makes sense to avoid busy roadways, where our lungs take in 20 million particles with every breath, compared with 2 million in city parks. We should all argue that schools not be placed near major roads or freeways, that diesel fleet vehicles (like school buses) phase into cleaner fuels, that our cities build safer bike lanes and plant more trees, and that our governments strengthen and reauthorize laws to protect our health.

By 2050, 2.5 billion more people will be moving into cities around the world. But our century of the city will fail us unless we learn how to make these human habitats clean and green. Such cities are healthier and more humane for a wide variety of reasons. Now we have another one.

By Gary Fuller

Melville House. 304 pp. $26.99

By Beth Gardiner

Chicago. 290 pp. $27.50