Britain, under the Tories, is blighted by crises, from NHS underfunding to school cuts, but, as World Alzheimer's Month kicks off, it is the link between two of the most damaging issues facing the British people, the social care and air quality crises, that is worth urgent exploration.
Image credit: Nick Youngson.
Poor air quality in the UK is linked to 40,000 deaths every year; it's a public health crisis that runs up a bill of almost £30bn annually - paid for from the taxpayers' pocket.
The biggest source of the two main types of air pollutants in the UK is road transport, accounting for 31% of nitrogen oxides (NOx), 18% of PM10 and 19.5% of PM2.5 emissions - particles less than or equal to 10 micrometres and 2.5 micrometres in diameter, respectively. At urban monitoring sites, road traffic accounts for more than 64% of air pollution.
The headline figures are both stark and vital for illustrating the scale of an issue that has encouraged only apathy from a Conservative government whose latest air quality plan has been found wanting - again. But the big numbers obscure some of the lesser known impacts of the air pollution crisis.
Image credit: Ruben de Rijcke.
From children to the elderly, from those suffering with respiratory and heart diseases to the disproportionate effects on the poorest residents and those least responsible for contributing to the problem, the myriad ramifications of toxic air are often underreported - people prefer the simplicity of big numbers.
Hidden yet further beneath those marquee statistics, however, is a burgeoning area of air quality research exploring a possible link between air pollution and Alzheimer's disease.
Alzheimer's is a progressive brain disease that eventually strips sufferers of their ability to remember, communicate and live independently. It currently affects almost a million people in the UK and is the most common type of dementia. More than 200,000 people will develop Alzheimer's this year, that's one every three minutes.
The cost of dementia in the UK has risen to more than £25bn a year. People living with the disease and their families shoulder two-thirds of the burden while unpaid carers do the equivalent of £11bn worth of work every year.
Alzheimer's disease and dementia is the leading cause of death for women in England and the second biggest cause of death for men. There is no cure for Alzheimer's disease or any other type of dementia. However, delaying the onset of dementia by five years would halve the number of deaths from the condition and save 30,000 lives a year.
Image credit: Pixabay.
As a member of both the European Parliament's Public Health and Transport committees and vice chair of the European Alzheimer's Alliance, it is clear to me the exploration of any link between air pollution and Alzheimer's should be a priority for policymakers and researchers alike.
The latest research published earlier this year finds particulate pollution (PM2.5), the tiny 'dust' particles less than the width of a hair produced from vehicle breaking, grinding operations, and as a byproduct of combustion that penetrate deep into the human body, can nearly double the risk of women aged 65 to 79 years developing Alzheimer's. The research by academics at the University of Southern California is the first of its kind to demonstrate that air pollution interacts with a so-called 'Alzheimer's risk' gene - APOE4 - to accelerate brain ageing.
The University of Southern California research is not the first, however, to reveal a link between particulate air pollution, cognitive ageing and Alzheimer's.
Researchers at the University of Toronto, also earlier this year, reported in perhaps the most respected medical journal, The Lancet, that among the 6.6 million inhabitants of Ontario, those living within 50m of a major road were 12% more likely to develop dementia than those living more than 200m away - the difference in particulate pollution levels at these distances can be tenfold.
While, in 2017, academics and researchers are at the cutting edge, the origins of the field can be traced back to 2008 when a study in Mexico found a correlation between the neurodegeneration in dogs - and the presence of amyloid-β, a protein linked to Alzheimer's - and the levels of air pollution in Mexico City. The neuroscientist leading the study, Lilian Calderón-Garcidueñas, also found a similar pattern of neurodegeneration in children and young adults.
However, Calderón-Garcidueñas's studies didn't have rigorous controls or account for the fact that the presence of amyloid-β, although linked with the disease, doesn't necessarily signal Alzheimer's.
Image credit: Pixabay.
Another study conducted in Mexico and the UK last year found magnetite - a potentially toxic particulate byproduct of traffic pollution - in samples of brain tissue from 29 people from Mexico and eight from Manchester. The analysis suggested Magnetite may increase molecular level damage to brain cells, especially in the presence of the same key protein linked to Alzheimer's disease.
However, none of the people studied had Alzheimer's and only a handful had suffered from a neurodegenerative disease.
It is important to be clear that no study has yet established how particulate matter pollution might enter the brain or exactly how it causes mischief while there. Based on the research so far, scientists and healthcare professionals have been cautious not to make any conclusive proclamations about a causal link between air pollution and Alzheimer's.
But the studies, while not definitive, do provide an emerging picture of particulate pollution as a plausible risk factor in the development of Alzheimer's.
The EU precautionary principle mandates: action should be taken to mitigate plausible risks until they are proven not to be risks at all. By sticking to it, the UK Government could ease the parallel air quality and social care crises, for which they're responsible. Urgent and bold action on air pollution will, at best, help prevent thousands from developing Alzheimer's disease while reducing both the unnecessary premature deaths of 40,000 Britons and the associated public health bill. At worst, it will just help prevent tens of thousands of unnecessary deaths and save the British taxpayer almost £30bn a year. It's a win-win situation.
It begs the question then: why is the Government still displaying such a shocking disregard for the UK's legal and moral obligation to take action on air pollution?