Memorandum submitted by Asthma UK (AQ 29)

 

As the voice of people with asthma, Asthma UK welcomes the opportunity to contribute to the Environmental Audit Committee's inquiry into Air Quality. Asthma UK is the charity dedicated to improving the health and well-being of the 5.4 million people in the UK whose lives are affected by asthma. We work together with people with asthma, healthcare professionals and researchers to develop and share expertise to help people increase their understanding and reduce the effect of asthma on their lives.

 

Approximately one in eleven of the UK's population of 61.4 million people is currently being treated for asthma, 5.4 million people.[1]

 

Air quality is of prime concern to people with asthma and in our annual National Asthma Panel surveys, 66% have told us that traffic fumes trigger their asthma symptoms and 71% feel that the Government isn't doing enough to reduce traffic fumes. Also, 29% say that a reduction in air pollution is the single thing that would make the most difference to their quality of life in relation to their asthma.[2]

 

Costs to the health services

 

In 2007/08, there were over 74,000 emergency admissions to hospital because of asthma.[3] Asthma UK believes that up to 75% of hospital admissions for asthma are avoidable. Hospital admissions are costly; the NHS's non-elective spell tariff was 612 for 2007/08. Emergency hospital admissions are estimated to cost the NHS over 61 million per year[4] and the NHS spends around 1 billion a year in total treating and caring for people with asthma.[5] Although the reasons for individuals' emergency hospital admissions will be varied, it is reasonable to assume that poor air quality is a factor in many admissions, as there is a large body of published scientific research showing a direct connection between poor air quality and asthma exacerbations. For example, studies have shown a link between living close to main roads and respiratory symptoms, particularly in children. Studies have shown that the worst traffic-related pollutants in terms of health impacts are from diesel-powered vehicles such as trucks, lorries and buses.

 

Caring for people who experience an asthma attack costs over 3.5 times more than for those whose asthma is well managed.[6] Children are particularly susceptible to poor air quality and the estimated annual cost of treating a child with asthma is higher than the cost for an adult. In 2007-08, 38% of emergency admissions for asthma were children aged under 15. Admissions per head of population were more than twice as high for children as for adults.

 

Costs to society

 

Avoidable asthma symptoms have a considerable economic effect outside the health services. Over 12.7 million working days are lost to asthma each year[7] and avoidable factors such as poor air quality affect local economic activities. For example, in our National Asthma Panel survey, 42% told us that traffic fumes discouraged them from walking or shopping in congested areas.

 

We estimate the annual cost of asthma to society is 2.3 billion[8], so there is a compelling economic argument to support initiatives to reduce the expenses incurred by avoidable hospital admissions and lost working days.

 

European legislation

 

In December last year, the European Union rejected the UK's bid for extra time to reach its air quality targets. Although the EU's statement did not mention penalties, it is possible that the UK could be fined; this is another avoidable cost of failure to reach air quality targets.

 

 

 

Government action

 

All of these factors make a compelling economic argument for sustained action to improve air quality. The Government should ensure that UK law is compliant with EU air quality legislation. Efforts to achieve emission targets should be monitored and the public should be informed of progress. There should be effective incentives and sanctions in place to ensure that air quality targets are met. Asthma UK supports effective local measures to reduce levels of airborne pollution such as, for example, Low Emission Zones in urban areas, incentives to encourage the use of low-emission vehicles and effective enforcement of industrial emissions regulations. National governments across the UK should be proactive in helping society work towards cleaner air. There will be clear savings in costs to the health services and to the general economy.

 



[1] Health Survey for England 2001. The Scottish Health Survey 2003. Welsh Health Survey 2005/2006. Northern Ireland Health and Wellbeing Survey 2005/2006. Population estimates from Office for National Statistics, General Register Office for Scotland, Northern Ireland Statistics & Research Agency

[2] Asthma UK. National Asthma Panel, 2006. The National Asthma Panel is a telephone-based survey, carried out on our behalf by Ipsos-MORI and typically questions over 1,000 people who are a representative sample of the UK population in terms of the balance of gender, age, socio-economic background and location.

[3] Hospital Episode Statistics, Department of Health; Scottish Morbidity Record, Information Services Division, NHS Scotland; Health Services Wales; Hospital Inpatients System, Department of Health, Social Services & Public Safety Northern Ireland

[4] Methodology: R. Gupta*, A. Sheikh, D. P. Strachan* and H. R. Anderson* 'Burden of allergic disease in the UK: secondary analyses of national databases' Clin Exp Allergy 2004; 34:520-526; Data: GP: Weekly Returns Service Annual Prevalence Report 2001, RCGP Birmingham Research Unit. http://www.rcgp.org.uk/bru
Unit Costs of Health and Social Care 2004, Lesley Curtis, Ann Netten, PSSRU, University of Kent

Prescribing: Source: Department of Health, Prescription Cost Analysis 2004 http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsStatistics/
Scottish Health Statistics 2004/05 http://www.isdscotland.org/isd/info3.jsp?pContentID=1041&p_applic=CCC&p_service=Content.show& Health of Wales Information Service 2004 http://www.wales.nhs.uk/page.cfm?orgid=1&pid=975
Central Services Agency, Northern Ireland 2004 http://www.centralservicesagency.com/display/statistics
Admisisons: DH reference costs 2004
http://www.dh.gov.uk/PolicyAndGuidance/OrganisationPolicy/FinanceAndPlanning/NHSReferenceCosts/fs/en

[5] Methodology: R. Gupta*, A. Sheikh, D. P. Strachan* and H. R. Anderson* 'Burden of allergic disease in the UK: secondary analyses of national databases' Clin Exp Allergy 2004; 34:520-526; Data: GP: Weekly Returns Service Annual Prevalence Report 2001, RCGP Birmingham Research Unit.http://www.rcgp.org.uk/bru

Unit Costs of Health and Social Care 2004, Lesley Curtis, Ann Netten, PSSRU, University of Kent

Prescribing: Source: Department of Health, Prescription Cost Analysis 2004 http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsStatistics/

Scottish Health Statistics 2004/05 http://www.isdscotland.org/isd/info3.jsp?pContentID=1041&p_applic=CCC&p_service=Content.show&

Health of Wales Information Service 2004 http://www.wales.nhs.uk/page.cfm?orgid=1&pid=975

Central Services Agency, Northern Ireland 2004 http://www.centralservicesagency.com/display/statistics

Admisisons: DH reference costs 2004

http://www.dh.gov.uk/PolicyAndGuidance/OrganisationPolicy/FinanceAndPlanning/NHSReferenceCosts/fs/en

[6] Calculated from estimated prevalence of treated asthma in National Asthma Campaign 2001 Out in the Open: a true picture of asthma in the United Kingdom today. Asthma J 6 (suppl), and unpublished data from Hoskins G, McCowan C, Neville RG et al 2000 Risk factors and costs associated with an asthma attack. Thorax 55:19-24

[7] 1% sample of claims to incapacity benefit. Department for Work & Pensions, Information & Analytics Department (April-2001 to March 2002, 12,701,000 IB days claimed; June 2002 - May 2003 12,639,000 IB days claimed)

[8] Office of Health Economics. Compendium of Health Statistics, 15th edition 2003-2004. Department for Work & Pensions, Information & Analysis Department (April 2004)

 

11 February 2010