Mobilising the Health Community on Air Pollution�Dr Malcolm White & Larissa Lockwood�1/12/22

9-13 Kean Street, London, WC2B 4AY, Telephone 020 7420 4444

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Welcome!

• Larissa Lockwood – Director for Clean Air
• Dr Malcolm White – Clean Air Specialist

Agenda

• Welcome & Intro
• Health impacts of air pollution and UK context
• The National Primary Care Project
• Recommendations following the pilot(s)
• Discussion
• Summary and actions

The Lancet:

Air pollution causes upwards of 36,000 deaths each year in the UK

Air pollution causes over 6 million sick days a year in the UK

Air pollution has an estimated total social cost of £22.6 billion per year in the UK

Air pollution causes over 20,200 respiratory and cardiovascular hospital admissions a year in the UK

Sources of� Outdoor Air �Pollution

Pollution hotspots

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• Map example from Islington, London
• Main roads are common culprits

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Patient Groups

Talking to Patients about Air Pollution

• Ella Kissi-Debra and Future Prevention of Death Report.

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Royal Colleges Round Table Discussions:�

���The National Primary �Care Project���Our Clean Air� Champions!

www.actionforcleanair.org.uk/health

Topline Messages for Patients

�How to be a Clean Air Champion: 1

�How to be a Clean Air Champion: 2

Air Pollution Learning � --Needs included in standard pathways

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• GPs are always pressed for time. Therefore the topic should be included automatically as part of existing protocols and learning.

• “I think if we're having any training on asthma and COPD, air quality and air pollution should be included in that. So that then it just becomes a kind of standard education” GP_6

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• “If we really seriously are going to get this used, it has to be incorporated into protocols because clinicians are just so busy and we don't have time to do another thing. We just forget … GP_5

GP Clean Air Protocol

GP Clean Air Protocol

GP Clean Air Protocol

Outcomes

• Trained 43 Clean Air Champions, increasing their confidence for AP issues

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• 85% of survey respondents reported having spoken to colleagues about air pollution
• 75% of survey respondents reported having spoken to their patients about air pollution (7%)

Talking to Patients About AP

• “I was surprised actually as to how receptive people were about it to hear about [air pollution], and I think they found it helpful knowing what they could do to reduce their exposure” 

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• “..once people actually see that the facts and figures, people are astonished really that they haven't perhaps learned about it before and agree that it is something that they want to talk to people about”

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• “…it kind of felt like something she could actually do actively that could have a positive impact for her and help her feel better”

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• “..they were quite receptive to thinking about how even just things like, you know, trying to walk on different streets at different times and trying to just reduce their direct risk to air pollution. And, you know, they were interested in that”

GPs as Champions

• Primary Care Networks, GP registrar, nursing and pharmacist teaching, weekly practice meetings
• Articles published with British Geriatric Society, local and regional newsletters
• Resources Shared in WhatsApp and messaging groups

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• A GP sent a text message about air quality to ~23,000 patients

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Teaching the whole workforce

• “Quite difficult to engage patients with time restrictions etc on this in acute setting. But sharing with the nurses, who are doing end of year care reviews with patients, have more time to discuss trigger for their conditions including pollution. So good to get them involved as they have more time in these reviews”

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• “A patient with brittle asthma who, when I talked to her about the effect of air pollution, said that, yes, her consultant had also mentioned this to her.  I think the consistency of messaging across health care professionals has a reinforcing impact, greater than a single intervention” 

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Key Learning Points

• GPs keen to learn about air pollution
• Resources help spread the message
• Learning to communicate about air pollution takes time & practice
• GPs want training included systemically

Islington Primary Care Project

• 17 GPs, Nurses and Pharmacists taught.

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• Patients with pre-existing health conditions surveyed outside of practices, before and after the teaching. (186 and 134 respectively).

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• Concurrent communications campaign across the borough
• Wearable air pollution monitor video with Islington GPs
• Social Media
• Electronic banners/bus shelters
• Physical Banners
• Council building screens
• etc

Findings

• Similar improvements to confidence and knowledge among healthcare staff

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• Increased knowledge and understanding among patients

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• 52% of Patients that received advice took action
• Ventilating more while cooking and cleaning (24%), walking or cycling more (20%), using public transport more (16%) and using less polluted routes (15%)

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• Patients twice as likely to take action when they had received advice and seen the public health campaign

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Recommendations!

• Repeat a similar study on a larger scale, automatically including every healthcare professional across a PCN, trust or an ICS region

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• Widespread and deep public health campaign will support health professionals

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• Test independent use of the newly developed air pollution protocol 

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• Explore whether GP engagement leads to long-term patient behaviour change 

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• Embed air pollution learning within undergraduate and postgraduate curricula, including GAP resources

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• Greater NHS, Local Authority and governmental action and collaboration on AP
• Localised information and action on air pollution is received well by staff and patients

addresspollution.org

Thank you!

Global Action Plan

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