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The Lancet and Air Pollution

April 14, 2017

By Paul Homewood




We’ve pretty much covered the topic of air pollution and premature deaths already this week.

But this latest study has just been published by The Lancet.

No doubt, it will be used to press for more, wonderful renewable energy, and less fossil fuels.

These are the findings, (my bold):



Ambient PM2·5 was the fifth-ranking mortality risk factor in 2015. Exposure to PM2·5 caused 4·2 million (95% uncertainty interval [UI] 3·7 million to 4·8 million) deaths and 103·1 million (90·8 million 115·1 million) disability-adjusted life-years (DALYs) in 2015, representing 7·6% of total global deaths and 4·2% of global DALYs, 59% of these in east and south Asia. Deaths attributable to ambient PM2·5 increased from 3·5 million (95% UI 3·0 million to 4·0 million) in 1990 to 4·2 million (3·7 million to 4·8 million) in 2015. Exposure to ozone caused an additional 254 000 (95% UI 97 000–422 000) deaths and a loss of 4·1 million (1·6 million to 6·8 million) DALYs from chronic obstructive pulmonary disease in 2015.


The study seems to share the same methodology as previous studies, and is based around statistical models. The paper describes its methods:

Attributing deaths and disability-adjusted life-years (DALYs) to ambient air pollution requires spatially and temporally resolved estimates of population-weighted exposure, specification of a theoretical minimum risk exposure level (TMREL), estimation of relative risks across the exposure distribution, and estimates of the deaths and DALYs for diseases linked causally to air pollution. We combined estimates of exposure and relative risk to estimate the population-attributable fraction (PAF), the proportion of deaths and DALYs attributable to exposure above the TMREL. The numbers of deaths and DALYs for specific diseases were multiplied by the PAF to estimate the burden attributable to exposure.

In short, they have to guess the exposure to PMs in different regions across the world since 1990, guess the “safe exposure level”, guess the relative risks for various exposures, and guess the number of deaths that might have arisen from all of this.

In other words, the results depend on the assumptions you feed the model. Change these, and you could easily get ten times the number of deaths, or a tenth.


There are some parts of the study that are worth noting though.

First the geographic distribution. The table below lists the data for the ten most populous countries:




We find that the the Asian countries (excl Japan and Russia) listed account for 2.5 million of the world total of 4.2 million.

At the other end of the scale, death rates in the US and Japan are way below rest. Clearly this is a problem for the developing world, and much less so for the US and Europe.

It is of course no secret that air pollution is a very real problem in much of Asia, and part of this arises from household fuels.



The second thing to note is the role that population ageing plays:





In the US, for instance, there has been less exposure to pollution since 1990, and consequently less deaths as a result.

However, this has been partly offset by an ageing population. As I commented the other day, we all have to die of something sooner or later. An, sadly, when we get to 80, we are much more likely to succumb to respiratory disease. Particularly when we may have been exposed to polluted air for many decades previously.

Indeed, this ageing factor is apparent across every country except Nigeria.

In reality, the increase in deaths estimated by the study since 1990 simply reflects the fact that people have not died from other causes first.

Increased population also accounts for more deaths.


Taking this issue of age into account, the study reckons that deaths from air pollution in the UK has nearly halved since 1990, from 44.0 to 22.8 deaths per 100,000.

How many of these are due to exposure in the past is open to question.






It does not take a genius to work out that countries like China desperately need the sort of air pollution controls that the we in the west have had for decades.

They also badly need access to reliable, cheap energy so they don’t have to rely on burning wood and coal at home.

Provision of modern, clean power stations will achieve all of this in a way that renewable energy never will.


As for us in the west, we must not be afraid to acknowledge just how much things have improved in the last few decades. Without doubt death rates will continue to plummet.

But we must be very careful we don’t throw the baby out with the bath water.

  1. Ben Vorlich permalink
    April 14, 2017 10:01 pm

    As far as I’m aware it is still legal to have a wood fire to heat your home in Paris. I think that an attempted ban in 2014 by local government failed. Since then the blame has moved to diesel cars, which I’m sure contribute a lot, but in winter wood smoke must be a major contributor to poor air quality, not to mention the dust from ash which has to get into the air inside the house most days the fire is cleaned.

    • A C Osborn permalink
      April 15, 2017 10:19 am

      Ben, no diesel cars do not contribute “a lot”.

  2. Paddy permalink
    April 15, 2017 6:17 am

    Poor air quality is the new CO2. Very odd how clean all the buildings look in comparison with the ’50s.

    • Russ Wood permalink
      April 15, 2017 9:46 am

      Yes – as a child in Liverpool, I was quite used to the black civic buildings. I was somwhat amazed when the grime of centuries was cleaned off, displaying the pale limestone!

  3. Nigel S permalink
    April 15, 2017 8:23 am

    Is there a real problem with PM2.5? JunkScience says not. Plenty of references to check.

  4. April 15, 2017 10:17 am

    Treatments have/will improved also
    eg antibiotics for TB

  5. April 15, 2017 10:33 am

    Searching Twitter : Lancet air
    Shows 3 people tweeted Paul’s article here
    About 30 tweet form of Lancet article.. Half with alarmist graphic.

    Feb 19 Indian media carried “Lancet says air kills 2 Indians per minute” but none tweeted any original Lancet article.

  6. April 15, 2017 10:41 am

    The problem with all these types of report is that they depend on a pyramid of algorithms (calculations in old money) all of which depend themselves on definitions, data, assumptions and perceived current science; all of which, again, could be suspect.
    For instance Newton’s P = M*A, Assumed M was constant, however Einstein proved otherwise.
    Multiply this up as in the above report and the result can only be vague and inconclusive. However sadly in this day and age we all appear to accept the perceived wisdom of the computer above that of our own brains.

    As we all know, the answer to everything in the the universe is 42. Do we not?

    To me, what appears missing in this report is the genetic factor, where I suspect it is ignored in most of the data collected but must inevitably be a major contribution to premature death.
    Indeed I have anecdotal evidence of this in my family and colleagues.

    Overall however, air pollution is a major factor as a trigger for those whose immune system is suspect, as the report indicates.

    UIs (uncertainty levels) of 95% running through this report indicate the level of credence to be given to the conclusions.

  7. Tim Hammond permalink
    April 15, 2017 10:45 am

    These are nothing more than statistical deaths, generated by models and that use such low relative risks (at least in the West) as to be no risk at all. You can generate scary sounding numbers of deaths even with tiny relative risks, but it doesn’t mean they are real.

    As importantly, the researchers cannot show that the people they say have died have actually been exposed to the thing they say killed them, so the conclusions are literally nonsense.

  8. April 15, 2017 12:48 pm

    What does it say on the death certificate? All else is speculation.

    As I commented elsewhere earlier today, the attempts to make CO2 the bogeyman are failing; we need to find something else. It has to be invisible so that the sheeple can’t actually see it; it has to be chemical because then the experts (like “scientists” and “Doctors against Diesel”) can pontificate to the heart’s content and it has be taxable so that government can make money while they control it.

    There are times when I wonder how the human race has managed to survive this long! If it wasn’t our susceptibility to just about everything in our environment it should have been our susceptibility to being lied to and conned stupid by “experts”.

  9. nigel permalink
    April 15, 2017 1:26 pm

    “What does it say on the death certificate?”

    It says something like “Myocardial Infarction” or”Congestive Pulmonary Disease” – never

    “10% overeating, 20% bad genes, 40% being old, 15% falling over, 10% smoking, AND LASTLY, 5% BREATHING LONDON AIR FOR EIGHTY YEARS. ”

    Cost accountants and economists know that “attribution” of an outcome to the various parts of an input process is MEANINGLESS.

    • April 15, 2017 3:47 pm

      Not so, nigel! It means you have another trough to get stuck into. It means fame. It means knighthoods. It means you are one up on your colleagues. It means your name in The Times, It means interviews on Today. It means an escape from your ‘sad, wretched lives” (to quote Tom Lehrer).
      Oh no. Meaningless it ain’t. Except to the rest of us.

  10. April 16, 2017 12:58 am

    In 2015, The Lancet issued The 2015 Lancet Commission on Health and Climate Change.

    This was critiqued by Dr D Weston Allen:

  11. dennisambler permalink
    April 16, 2017 4:57 pm

    “Although the the European emission standards are based upon NOx levels [Nitric Oxide and Nitrogen Dioxide] the estimated 72,000 premature deaths in Europe are only attributed to NO2 [Nitrogen Dioxide].

    NOx is a generic term for the mono-nitrogen oxides NO and NO2 (nitric oxide and nitrogen dioxide).

    The mismatch between EU emission standards [based on NOx] and estimated deaths [based upon NO2] opens up the curious [and unanswered] question:

    Does a 5 seater VW diesel car emit less NOx than 5 bicyclists?”

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