Traffic pollution is linked to poor pregnancy outcomes and future ill health. Exposure is causing “something approaching a public health catastrophe”

A series of studies published in the past few months has started to explore the wider impact of pollutants. One, published in the British Medical Journal, suggests that the exposure of unborn children to air pollution in cities is causing “something approaching a public health catastrophe”. Pollution in the womb is now linked to low birth weight, disruption of the baby’s lung and brain development, and a series of debilitating and fatal diseases in later life.

Another report, published in the Lancet, suggests that three times as many deaths are caused by pollution as by Aids, malaria and tuberculosis combined. Pollution, the authors note, now “threatens the continuing survival of human societies”. A collection of articles in the journal PLOS Biology reveals that there is no reliable safety data on most of the 85,000 synthetic chemicals to which we may be exposed. While hundreds of these chemicals “contaminate the blood and urine of nearly every person tested”, and the volume of materials containing them rises every year, we have no idea what the likely impacts may be, either singly or in combination.

But these pathologies are not confined to “the west”. The rise of demagoguery (the pursuit of simplistic solutions to complex problems, accompanied by the dismantling of the protective state) is everywhere apparent. Environmental breakdown is accelerating worldwide. The annihilation of vertebrate populationsinsectageddonthe erasure of rainforests, mangroves, soil and aquifers, and the degradation of entire Earth systems such as the atmosphere and oceans proceed at astonishing rates. These interlocking crises will affect everyone, but the poorer nations are hit first and worst.

The forces that threaten to destroy our wellbeing are also the same everywhere: primarily the lobbying power of big business and big money, which perceive the administrative state as an impediment to their immediate interests. Amplified by the persuasive power of campaign finance, covertly funded thinktanks, embedded journalists and tame academics, these forces threaten to overwhelm democracy. If you want to know how they work, read Jane Mayer’s book Dark Money.

Up to a certain point, connectivity increases resilience. For example, if local food supplies fail, regional or global markets allow us to draw on production elsewhere. But beyond a certain level, connectivity and complexity threaten to become unmanageable. The emergent properties of the system, combined with the inability of the human brain to encompass it, could spread crises rather than contain them. We are in danger of pulling each other down. New Scientist should have asked: “Is complex society on the brink of collapse?”

Complex societies have collapsed many times before. It has not always been a bad thing. As James C Scott points out in his fascinating book, Against the Grain, when centralised power began to collapse, through epidemics, crop failure, floods, soil erosion or the self-destructive perversities of government, its corralled subjects would take the chance to flee. In many cases they joined the “barbarians”. This so-called secondary primitivism, Scott notes, “may well have been experienced as a marked improvement in safety, nutrition and social order. Becoming a barbarian was often a bid to improve one’s lot.” The dark ages that inexorably followed the glory and grandeur of the state may, in that era, have been the best times to be alive.

But today there is nowhere to turn. The wild lands and rich ecosystems that once supported hunter gatherers, nomads and the refugees from imploding early states who joined them now scarcely exist. Only a tiny fraction of the current population could survive a return to the barbarian life. (Consider that, according to one estimate, the maximum population of Britain during the Mesolithic, when people survived by hunting and gathering, was 5000). In the nominally democratic era, the complex state is now, for all its flaws, all that stands between us and disaster.

Traffic pollution is linked to poor pregnancy outcomes

BMJ 2017359 doi: https://doi.org/10.1136/bmj.j5511 (Published 05 December 2017)Cite this as: BMJ 2017;359:j5511  By Sarah J Stock and Tom Clemens

Only policy makers have the power to protect women and unborn babies

The conditions that a developing baby is exposed to in the womb can affect its growth and development, with lifelong implications for health.1 Exposure to environmental chemicals and stress in utero can lead to functional changes in tissues, and predispose the child to diseases that manifest later in life. Being born small is the most well studied marker of such future ill health, with birthweight inversely correlated with cardiovascular and metabolic diseases.1

In this issue, Smith and colleagues (doi:10.1136/bmj.j5299) report that air pollution from road traffic, but not traffic noise, is associated with low birth weight at term.2 The inference is that reducing exposure to air pollution from road traffic will not only improve the health of current adult populations, but has the potential to reduce the burden of non-communicable diseases in future generations too.

The association between air pollution, pregnancy complications, and childhood illness is not new. Small particle pollution exposure in pregnancy has previously been linked to fetal growth,3 as well as preterm birth,4 stillbirth,5and respiratory morbidity in children.6