Like many children, 10-year-old Nancy Hewings loves sports and playing out with her friends – but breathing problems her family believe are linked to toxic air where she lives can leave her so ill she is unable to even go to school.

Nancy is one of an estimated 2.3 million people in the UK who have reported breathlessness in the last six months due to air pollution, according to research.

Charity Asthma + Lung UK, in a survey carried out by YouGov, found 15 per cent of Britons with a lung condition and 6 per cent who have never been diagnosed with such a condition had reported an episode of breathlessness they believed was triggered by air pollution in the last six months.

Nancy lives in Haringey, north London, where at the age of four she developed breathing problems and was diagnosed with pneumonia. She had become listless and fatigued over a period of weeks which confounded doctors, until a chest X-ray revealed the condition. By age six, she was diagnosed with asthma.

Her father, Robin Hewings, believes his daughter’s conditions may have been caused by air pollution and has noted her symptoms flare up on days when the air quality is poor. It causes her to get breathless, exhausting her for days.

“It’s scary in the moment when she can’t catch her breath, the other scary thing is the long term point about whether she is missing out on things because of air pollution or whether her lungs are damaged,” Mr Hewings told i.

The Asthma + Lung UK research comes after a stark report from Imperial College London released earlier this week, which drew together more than 35,000 studies on air pollution, found toxic air causes wide-ranging impacts at all stages of life.

The report, commissioned by the Greater London Authority, found exposure to certain particles can lead to miscarriages, low sperm count and stunt children’s lung growth. Air pollution causes an estimated 29,000 to 43,000 premature deaths in the UK each year.

Mr Hewings said on heavily polluted days, Nancy’s asthma forces her to stay home from school. She also often has to miss out on activities she enjoys, including gymnastics and taking part in mile-long jogs with her classmates.

“It’s been a real blight, firstly it has impacted her health and also I think there have been a number of things she has missed out on – including coming home early from school camps, or playing outside.”

He often thinks about whether living in north London has led to a lasting impacts on her lungs.

“If she lived somewhere with perfect air, would she have developed asthma? I don’t know – but I do know that her asthma is really clearly exacerbated by the air pollution that she experiences.”

He said his wife and Nancy’s mother, Ellen, has also developed adult-onset asthma and both of their conditions clear considerably on family trips to the west of Ireland – where Nancy does not need to use her inhaler.

“When she is in Ireland, Nancy is much freer, she doesn’t have a constant worry about whether she will have a flare up with her asthma.”

The issue of air quality in the capital was highlighted by the death of nine-year-old Ella Kissi-Debrah, who suffered a fatal asthma attack in 2013.

A 2018 report found that unlawful levels of pollution found near Ella’s home in Lewisham contributed to her death.

Her mother, Rosamund Adoo Kissi-Debrah, has called air pollution a “public emergency”, urging for more education about the dangers.

A separate study last year by Imperial College London found 97 per cent of homes in the UK are in an area where World Health Organisation targets are being exceeded for at least one of three key pollutants, while 70 per cent are in an area which exceeds all three.

Towns and cities such as Slough, London, Portsmouth, Leeds and Manchester were in the UK’s top 10 for people living in polluted areas.

A car emits fumes from its exhaust as it waits in traffic in central London, England on October 23, 2017. Drivers of the most polluting vehicles will face an extra daily charge for driving into central London on weekdays from Monday in a bid to improve air quality in one of Europe's most polluted cities. / AFP PHOTO / Daniel LEAL-OLIVAS (Photo credit should read DANIEL LEAL-OLIVAS/AFP via Getty Images)
Nitrogen Dioxide and fine particulate matter are among the main pollutants harming people’s health (Photo: Daniel Leal-Olivas/Getty Images)

What are the main pollutants causing breathlessness?

Nitrogen Dioxide (NO2) and fine particles are among the main pollutants causing harm to people’s health. Both are linked to high vehicle emissions and found at high levels in built-up urban areas.

Exposure to NO2 inflames the airways, increasing susceptibility to infection. Fine particulate matter – including PM2.5, PM5 and PM10 – are inhaled deep into the lungs, lodging themselves there and causing inflammation.

Dr Richard Russell, an expert in respiratory medicine at Kings College London, told i doctors are often able to tell whether people live in a city by the condition of their airways.

He said: “When we look inside people’s lungs with a telescope which we do routinely in respiratory medicine, we can tell whether someone comes from the city or the countryside because there is a change in colour of their airways.

“Their airways are darker and sometimes have little deposits of these small particles which we can actually see.”

He said many people who may have asthma or COPD could be developing symptoms without realising and that monitoring pollution levels or wearing a mask in high-traffic areas could help people’s lungs.

He added: “We breathe 12,000 times a day. But we don’t consider what we are breathing, we take our lungs for granted – being aware of lung pollution is a good way of the population started to become aware of lung health.”

Professor of primary care at Queen Mary University of London, Chris Griffiths, has done research which found that London children who were breathing polluted air had stunted lung growth. The pollution inflames the lining of the airway, stunting their development.

“That’s really important because if you reach adulthood and your lungs are smaller than they should have been, that puts you at ill health in adult life and possibly an earlier death. We currently have a generation of children growing up with lungs smaller than they should be,” he told i.

Professor Griffiths is doing new research which he expects will show children’s lung growth has improved in London, since the establishment of the ULEZ policy which has caused air quality to improve in some areas of the capital.

Air pollution can also inhibit foetal development. This is because fine particles get into the mother’s bloodstream, traversing the placenta and then reaching the baby’s bloodstream.

Professor Griffiths said: “Even before a baby is born that pollution is altering the entire system of the baby in a way that predisposes it to conditions like asthma and wheezing.”

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