Air pollution is a major environmental health risk (WHO 2018). Air quality in Ireland is generally good, however there are localised issues across the country with several air pollutants causing concern. The continued use of solid fuel burning for home heating remains the leading contributor to fine particulate matter (PM2.5) pollution across Ireland. This pollutant is the most health-impactful of those affecting Irish people today and is thus the largest problem from an air quality point of view.
The European Environment Agency estimates that there were 1,300 premature deaths in Ireland due to PM2.5 air pollution in 2017 alone, with a figure of 538,014 premature deaths across the wider EU. Polycyclic aromatic hydrocarbons (PAH) in ambient air as a result of the burning of solid fuel is also a large problem in our towns and villages and we are above the related EEA reference level for PAH. Nitrogen dioxide (NO2) levels in our urban areas due to the continued reliance on fossil-fuel powered transport, particularly diesel, is also a problem that must be tackled. We were in exceedance of the EU limit value for NO2 at one urban traffic monitoring station in Dublin in 2019 and with further monitoring across Ireland it is becoming increasingly obvious that the problems of emissions from transport are more extensive than previously understood.
Recent assessments of the effects of noise highlight the significance of noise as a health concern and not only an annoyance issue. The European Environment Agency (EEA) estimates that long-term exposure to environmental noise from road traffic, railways, aircraft and industry contributes to 48,000 new cases of heart disease and 12,000 premature deaths each year in Europe. The EEA also estimates that 22 million people suffer from chronic high levels of annoyance and 6.5 million people suffer from chronic high levels of sleep disturbance as a result of long-term noise exposure.
There is also evidence of social inequity in noise exposure and impact in European populations, with those in lower socioeconomic groups more likely to be exposed to noise nuisance.
Climate change is a well establish global problem and is perhaps the biggest environmental challenge which we currently face. Whilst efforts are ongoing to mitigate the causes of climate change, substantial efforts are also being invested in climate adaptation, to prepare society for living with the impacts of climate change and reduce the associated risks. There is a wide range of potential health impacts associated with climate change, including:
In addition to physical health impacts, climate change can have profound impacts on psychological wellbeing and mental health. These effects are particularly felt by those living in sensitive areas such as those prone to flooding. However, there is now also a recognised general rise in “eco-anxiety” amongst the general public brought about by a fear in relation to the changes that we can see around us as a result of climate change, and the scale of the threat which we face.
Our understanding of the impacts of chemicals on our health and wellbeing has increased significantly in recent years. Whilst chemicals play a critical role in supporting modern society, experience over the last 60+ years has demonstrated that chemicals are often used without assessing or understanding the unintentional effects which they can have on our environment and on human health, resulting in intractable and persistent environmental problems which will take many generations to resolve.
The World Health Organization (WHO) estimates that 1.6 million lives were lost globally in 2016 due to exposure to chemicals. This is based on exposure to a limited subset of chemicals for which the health impacts have been well quantified. At a European scale, it is estimated that annually there are around 0.4 deaths per thousand population attributable to chemical exposure (this specifically excludes the effects of ambient air pollution from combustion sources). This equates to around 2,000 attributable deaths in Ireland per annum.
Apart from premature deaths, chemical exposure can also negatively influence quality of life. For example, in Europe it is estimated that nearly 1.9 million babies are born annually with mercury levels above recommended values, resulting in lifelong effects on learning and brain development.
Although the hazards associated with many individual chemical substances are well established, there is increasing evidence that the adverse effects of combinations of substances is greater than the sum of individual effects. Consequently, the extent of the threats posed by hazardous substances remains largely unknown. This is of particular concern given the increasing trend in global chemical output, with the WHO estimating that chemical production will be four times higher in 2050 compared to 2010.
In Ireland there is now a high level of awareness and concern in relation to the presence of chemicals in everyday products. A 2020 Eurobarometer special report on ‘Attitudes of European citizens Towards the Environment’, identifies that 88% of Irish people are concerned about the impact of chemicals in everyday products on their health and 89% are concerned about the impact on the environment. 77% of Irish citizens also believe that the government is not doing enough to protect the environment, while 67% of citizens believe that citizens themselves are not doing enough to protect the environment.
Human health is very much reliant on services which are provided by our natural ecosystems, including clean water, clean air, shelter, food and fuels for heating. A 2019 report from the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) highlighted the increasing trends in biodiversity loss with around one million animal and plant species now threatened with extinction. The Chair of IPBES commented that ‘the health of ecosystems on which we and all other species depend is deteriorating more rapidly than ever. We are eroding the very foundations of our economies, livelihoods, food security, health and quality of life worldwide’.
Biodiversity loss can have many potential health impacts. For example, food production relies heavily on stable and healthy ecosystems, with 75% of food crops relying on animal pollination in order to produce sufficient quantities of healthy and nutritious foods. Many of our pharmaceutical products are derived or based on natural materials. Over 70% of cancer drugs are natural products or are synthesised to mimic natural products. Loss of biodiversity and species extinction may therefore impact on our access to medical products.
Biodiversity loss can also lead to imbalances in ecosystems and, for example, increase the spread of infectious diseases through increased populations of certain species.
These trends in biodiversity loss need to be addressed in order to protect our ecosystems on which we rely for health and wellbeing.
Access to clean and healthy green and blue spaces is associated with better health outcomes including improved mental and physical health and reduced obesity. Recent research in Ireland found that those living in urban areas with low amounts of green space had a higher risk of obesity than those with a medium amount of green space. Interestingly, this research also found that those with large amounts of green space were also at higher risk of obesity, with no clear reason identified for this risk. Potential factors in these findings could be related to the accessibility of these green spaces (e.g. lack of footpaths, security concerns, etc.), however further research is needed.
With increasing trends in urbanisation and more people than ever living in cities, access to good quality green space is important in supporting our health and wellbeing. Between now and 2050, Ireland is projected to have one of the highest rates of urbanisation of any EU Member State, with an annual growth rate of more than 5%. Provision of accessible and suitable high-quality green spaces in these urban areas will be important in delivering a healthy and sustainable lifestyle for these inhabitants. As part of the mental health benefits these spaces can also provide for an increased sense of community and connectedness, with this social cohesion delivering significant societal benefits.
Access to green spaces is also another area where social inequity is a significant issue, with those of lower socioeconomic status tending to have less access to green space in their locality.
People are becoming more aware of both the positive impacts which a clean environment can have on their health and wellbeing, and the influence that their own individual choices can have on their local environment. Choices such as the fuel we use, how we manage our waste, the chemicals we use in our homes and gardens, household ventilation, the noise we create, etc., demonstrate our values and attitudes to our environment, community, health and wellbeing.
The collaborative public information resource Live Green (www.livegreen.ie) gives advice and tips on how we can take action to make healthier and more sustainable choices. Developing sustainable behaviours and consumption patterns is one of the main ways in which we can create a healthy environment which will help to deliver improved health and wellbeing across the population.
Ireland’s national strategy for sustainability, ‘Our Sustainable Future’, sets out sustainability challenges and how we might address them in order to ensure that our quality of life and general wellbeing can be improved and sustained in the decades to come.
A vibrant, inclusive and engaged community yields better health and environmental outcomes for all the residents, businesses, schools, etc. Sustainability in local communities is a key objective of the Public Participation Networks (PPNs), which aim to enhance public engagement in decision making and policymaking. PPNs are now established in every county and city across Ireland, based on three “pillars”: environment, social inclusion, and community and voluntary.
In 2013, the Government also published the Healthy Ireland Framework, which aims to bring about changes to make Ireland a place where everyone has the opportunity to live a healthy life. This framework is currently being reviewed to ensure it is fit for purpose out to 2030.
The trend in social inequity with regard to exposure to environmental stressors is of particular concern and needs to be clearly considered as part of future policy measures. These issues also tend to be exacerbated by the fact that people of lower socioeconomic status can be less resilient to the effects of environmental pollution. For example, they tend to have less choices about where they live and less ability to move to a different area, while they may also have greater difficulty accessing healthcare (e.g. they may not have private health insurance). Other elements include potentially a lower willingness or ability to complain and/or to engage in local decision-making processes which could impact on their local environment.
These inequity issues have been recognised as part of the 2019 EU Green Deal, which highlights the need for a just transition to a more sustainable society, leaving no one behind and ensuring that protection is afforded to those most vulnerable in our population.