Children in London who had been suffering from stunted lung growth have seen significant improvements following the introduction of the capital’s Ultra Low Emission Zone, according to a major new study.
Researchers found that improvements in air quality were linked to faster lung development among children living in London, with their lung health eventually catching up with children living in areas with lower levels of pollution.
Scientists led by Queen Mary University of London monitored the lung health of more than 3,400 children aged between six and nine every year from 2018 to 2022.
The study compared children attending 84 primary schools across London and Luton. Luton does not have a clean air zone but has lower levels of pollution while experiencing a similar mixture of pollutants.
Before ULEZ was introduced in 2019, researchers found that children living in London had significantly smaller lungs than children in Luton.
However, following the introduction of ULEZ, lung growth among children in London accelerated. Over time, their lung size and health improved to levels similar to those recorded among children in Luton.
The findings, published in The Lancet Public Health, provide new evidence of the impact reducing traffic pollution can have on children’s health.
ULEZ requires drivers of vehicles that do not meet minimum emissions standards to pay a daily £12.50 charge to drive within the zone.
Professor Chris Griffiths, professor of primary care at the University of Oxford and Queen Mary University of London and joint senior author of the study, said traffic pollution in cities damages children’s health and development.
He said the research provides some of the strongest evidence yet that these effects can be prevented and argued that ambitious clean air zones should be considered by cities around the world dealing with traffic related pollution.
London Mayor Sadiq Khan has faced years of criticism over ULEZ, particularly over the £12.50 daily charge and his decision to expand the scheme across all London boroughs.
Responding to the findings, Khan said introducing the policy had been difficult but insisted he could not stand by while pollution continued to damage the health of Londoners.
He said the research showed the decision to introduce ULEZ was the right one and supported his decision to expand the scheme so children across the capital could benefit from cleaner air.
As part of the study, scientists measured how much air children could forcefully breathe out in one second after taking a full breath, a measurement known as FEV1.
Researchers then compared the results with children’s exposure to nitrogen dioxide, or NO2, which is strongly associated with road traffic emissions.
During the five years following the introduction of ULEZ, children’s exposure to NO2 in London fell more than twice as much and twice as quickly as it did among children in Luton.
Researchers found that the reduction in NO2 was associated with London children being able to exhale an additional 10ml of air per year compared with children in Luton. After five years, lung measurements among children in London had caught up with those recorded in Luton.
There was also a significant fall in the number of London children considered to have clinically impaired lung function.
The proportion fell from 14% to 9% in London, compared with a smaller decline from 9% to 7% in Luton.
Ian Mudway, associate professor at Imperial College London’s School of Public Health and joint senior author of the study, said air pollution remains a global problem and argued that bold measures are needed to protect children growing up in areas with heavy traffic.
He said the findings demonstrate that clean air zones can be an effective public health measure capable of preventing damage to developing lungs.
The findings have also led to calls for similar schemes to be introduced elsewhere in the country.
Sarah Sleet, chief executive of Asthma + Lung UK, said the research offered “real cause for hope” and argued that the evidence should move the debate beyond the political arguments surrounding ULEZ.
She said children are particularly vulnerable to polluted air because their lungs are still developing, they breathe faster than adults and are often physically closer to vehicle exhaust emissions.
Sleet described London’s ULEZ as a major public health success and called for similar measures to be introduced in urban areas across England.
She argued there was little justification for children elsewhere in the country continuing to experience stunted lung development when evidence increasingly shows that reducing traffic pollution can protect their health.
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