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APPENDIX B
ATMOSPHERIC POLLUTION AND HEALTH
A SURVEY IN LONDON
Introduction
Smoke has long been a matter of concern in this country ; Royal Proclamations of
both King Edward I and Queen Elizabeth I prohibited the burning of coal in London
during such times as Parliament was in session. As a local authority function general
smoke abatement appears to date from the Town Improvement Clauses Act, 1847,
and more generally from the Sanitary Act, 1866, and in consolidated legislation from
the Public Health Act, 1875 [in London from the Smoke Nuisance Abatement
(Metropolis) Act, 1853 (enforceable by the police), and the Public Health (London)
Act, 1891]. These powers in London are exercised by the City Corporation and
Metropolitan Borough Councils. Under the acts private dwellings are exempt from
action although the City took special powers to create a smokeless zone in 1955 and
Woolwich Borough Council has introduced a smokeless housing estate by making
tenancy agreements conditional upon the use of smokeless fuels. The Alkali Works
Regulation Act of 1906 also governs the production of noxious or offensive gases in
certain chemical processes ; the control of such gases outside the scheduled processes
resides in general public health legislation.
It took a catastrophe of the magnitude of the London fog of 1952 [see Appendix A
of my annual report for 1952 and Ministry of Health report, 1954, for a full description]
to focus public attention on the seriousness of the effect of atmospheric pollution on
health. The Report of the Committee on Air Pollution, 1954 (the Beaver Committee),
led to the Clean Air Act, 1956, upon which great hopes are set for an improvement in
the state of the atmosphere of the industrial cities of Great Britain.
Medical literature, especially since 1952, abounds with references to the effect of
atmospheric pollution on health, Pemberton and Goldberg (1954) have shown how
the death rate from bronchitis increases with the degree of urbanisation and that there
is some correlation between deaths from bronchitis and the amount of pollution in the
atmosphere; Joules (1956) has referred to the differential death rate from bronchitis in
middle-aged men between industrial cities and seaside resorts, although he reminds us
of the importance of differences in social class in this context.
The invaliding effect of fog as seen by a clinician has been described by Leese (1956)
and Lawther (1956). The Standing Advisory Committee to the Medical Research
Council in Social and Environmental Health has a sub-committee on atmospheric
pollution with working parties engaged on various aspects, e.g. chronic bronchitis in
relation to atmospheric pollution, the constituents of atmospheric pollution and means
of prevention, mortality and morbidity statistics, etc.
Atmospheric
pollution
The situation in London
The main sources of pollution of the London air are the numerous domestic and industrial
chimneys which emit smoke, grit and gases. Except in busy streets, contamination
from vehicle exhausts does not contribute a large proportion of the total of impurities,
and pollution from other sources such as chemical processes is generally small. Fuel
can be burnt in more and in less satisfactory ways ; since the less satisfactory are prevalent
the air contains respiratory irritants, and these have health effects which may range
from a minor risk to a major disaster. Within this large built-up area, pollution shows
no respect for administrative boundaries and the state of the atmosphere in any locality
is affected by distant as well as by local sources. One of the most important controlling
factors is the prevailing weather, in particular the degree of turbulence of the atmosphere.
There are seasonal and short period fluctuations in the incidence of pollution,
and a reliable comparison of the conditions can only be made through a long term
survey.