This week Allergy Cosmos spoke with Professor Jon Ayres as part of our series of interviews with allergy, asthma and air pollution experts across the UK. It is our hope that reading about these experts' opinions and research work will provide you with valuable insight into your own life with allergy, asthma and general air pollution.
Jon Ayres, is Professor of Environmental and Respiratory Medicine at the University of Birmingham. Prof. Ayres received his science and medical degrees at Guys Hospital, London, and has been in his post at the University of Birmingham since 2008. He currently heads the Institute of Occupational and Environmental Medicine which is part of the School of Health and Population Sciences. He also chairs two government advisory committees - the Committee on the Medical Effects of Air Pollution (COMEAP) and the Advisory Committee on Pesticides (ACP).
Dr. Susan Aldridge: "What is COMEAP's brief?"
Professor Jon Ayres: "COMEAP is a government advisory body formed in the early 1990s. Its role is to advise the Chief Medical Officer and the Department of Health on matters associated with air pollution and health."
SA: "Which of COMEAP's achievements are you most proud of and why?"
Professor Jon Ayres: "Pretty much all of them really. COMEAP has been extraordinarily effective, not only in enabling cross government departmental collaborative working in developing the air quality strategy, a remarkable achievement in itself, but also in producing a series of state of the art reviews on a range of issues from asthma and air pollution to the cardiovascular impacts of air pollution and, more recently, quantification of the extent to which air pollution impacts on health. These documents are widely respected and quoted worldwide and, indeed, are used in the development of air quality strategies around the world, including the World Health Organisation. These are available to all on the COMEAP website. which has recently been improved to make it more accessible and attractive to those who want to use it as an information source."
SA: What influence does COMEAP have on policy makers and on the public?
Professor Jon Ayres: "As far as the public is concerned, we are aware that communication of the effects of air pollution on health is difficult to understand because of its complexity. Our most recent document on the effects of air pollution on mortality has made major efforts to make difficult science more explicit and clear to the lay reader."
SA: "You recently published an interesting paper on occupational asthma in the journal Thorax. Could you summarise your conclusion for us?"
Professor Jon Ayres: "Occupational asthma is common, under recognised and preventable. If individuals are not exposed to asthmagenic substances in the workplace then they wouldn't get occupational asthma! The aim of our study was to try and see where the costs of occupational asthma lie. If there was a substantial cost to the employer then this might persuade them to improve their approaches to prevention of this condition. To our surprise only 3% of the costs fell on employers' shoulders. Yet nearly half of the burden falls on the patient themselves. This is a difficult and sensitive area. Many employees in small and medium sized businesses, which include workplaces where occupational asthma is common, do not have access to occupational health expertise. This might result in lower awareness of asthma both by employers and employees. Our findings suggest that if we are going to increase our chances of preventing occupational asthma, financial levers are not the way to go and that education will remain key."
SA: "What is the most significant threat to health, indoor or outdoor pollution?"
Professor Jon Ayres: "There is no doubt that outdoor air pollution has a major impact on health in cities worldwide, especially in those cities where emissions from vehicles are not as well regulated as they are in, for instance, the UK. Indoor air quality in the UK can affect health, especially in those environments where cigarette smoking occurs. The benefits from the ban on smoking in public places, an area in which we have done work, show how toxic second-hand smoke is. However, over half the world's population (3+ billion) are exposed on a day-to-day basis to smoke from burning of solid fuels such as coal and biomass and it is quite clear that this is conferring a major impact on health, particularly in its ability to cause illness and death from respiratory problems in infants. While attempts have been made to quantify the impact of outdoor air pollution, attempts to do the same for indoor air pollution are in my view less robust. My own view is that, worldwide, indoor air pollution is probably taking a greater toll than outdoor pollution, particularly because of the number of infants who die as a consequence of exposure, but it is certainly an issue that could be debated one way or the other."
SA: "What are the government suggestions for protecting yourself from air pollution health hazards?"
Professor Jon Ayres: "One thing to do is to read the Department of Health or Department for Environment, Food and Rural Affairs websites which alerts at-risk individuals of the impacts on health of air pollution on a day-to-day basis. Both these contain a banding system to alert individuals to the health effects of air pollution but is about to be restructured, the new version being a real improvement. From an indoor point of view, tobacco smoke is a major source of health problems and particularly for children, smoking indoors, even in the next room, will increase their chances of getting respiratory problems. As far as outdoor air pollution is concerned, being sensible in terms of exposure and if air pollution levels are forecast to be high and you are an individual at risk (e.g. a patient with existing heart or lung disease) then reducing exposures by remaining indoors, or at least not exerting while outdoors, would be sensible. Guidance on this is excellent on the Department of Health, DEFRA and COMEAP websites. The use of masks outdoors is totally unproven although people may feel that they are at least trying to do something to help themselves!"
SA: "Perfect. Thank you very much for your time Professor Ayres."
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