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To LEZ or not to LEZ – the reality for human health

Air pollution has devastating effects on our health – the facts on low emissions zones and proof that they work

Dr Jill Belch by Dr Jill Belch
26-06-2024 17:00
in Health
Reading Time: 5 mins read
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cars in polluted air LEZ

Photo by Jacek Dylag on Unsplash

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So, the Tories have pledged to scrap the London Ultra Low Emissions Zone (ULEZ). Furthermore, it’s claimed they won the Uxbridge by-election based on their objection to it – never mind it was first mooted by Boris Johnson, and Transport for London funding was made dependent on its introduction by Michael Gove –  #Hypocrisy.

In Scotland, LEZs are now in operation in Aberdeen, Glasgow, Dundee and Edinburgh. Given the polls, Conservatives are unlikely to be in any position – north or south of the border – to interfere with LEZ or ULEZs. They are with us for the foreseeable future. Mainly because they are essential tools in fighting air pollution and its terrible effects on human health.  Lots of claims were made against the ULEZ. But what are the facts surrounding LEZs?

Air pollution is a public nightmare

37% of all emissions in Scotland come from transport. And no one can argue that air pollution doesn’t kill. Around 800k deaths in Europe each year – that’s more than all the malaria deaths globally. And new estimates suggest that the burden of long-term exposure to air pollution in the UK has an effect equivalent to 29-43k deaths for adults aged 30 and over, 27k of them in Scotland. Although Scotland has the tightest air pollution regulations in Europe (well done us), breaches do occur.

And where these do happen, hospital admissions go up, with children affected at lower levels of pollution than adults. Research shows smaller brains in children exposed to air pollution, higher child deaths before the age of two, and decreased lung growth. This loss of cognition, lung function, and immune damage is permanent. We are damaging our children forever. In adults, the attrition continues with increased incidence of heart attack, stroke, diabetes and dementia. 40% of lung cancer in non-smokers is caused by air pollution – the evidence is abundantly clear that it is a public health nightmare.

How effective are low-emission zones?

And do LEZs work? Yes, unequivocally. The UK is behind with LEZs and so our UK evidence is not yet there, but there is plenty from other countries where the concept is better established. Tokyo LEZs significantly decreased baby deaths. In the USA it’s a similar story. Children exposed to cleaner air in utero, and in their first year of life require less medication, a five-year study found.  Paris LEZ studies show a reduction in air pollution round about the LEZ, ranging between 13-43% – a significant benefit to residential areas close to the city centre LEZs.

So, what’s not to like? It has been suggested that a LEZ disadvantages the less well-off. However, analysis by the UK’s Office of National Statistics found that 70% of households that earn less than £10k annually do not own a car and 53% of households that earn between £10-19k do not own a car yet must breathe high levels of traffic fumes. Less than 10% of cars were not compliant, and studies have shown these are most likely to be old second-hand SUVs, predominantly purchased as second cars by the better off. The less well-off tend to have smaller compliant petrol cars.

Will businesses suffer from LEZs?


It has also been suggested that city centre businesses will suffer, and indeed with the Glasgow LEZ a small decrease in footfall was shown, but it has been demonstrated that there were other reasons for this fall such as working at home, and weekend and evening footfall was back at pre LEZ levels very quickly.

So, although an initial small dip can be shown in many LEZs, the recovery is quick. A Chinese study followed the financial returns of hundreds of businesses across China. Those with a LEZ showed decreased child deaths, lowered pollution levels, and no change in profitability in over 500 businesses within the LEZs, compared to those out with the zones. Indeed, making city centres more pleasant to be in encourages a café-like culture and footfall has, in many cases, increased. Just look at Glasgow’s bustling Buchanan Street and, most famously, Covent Garden Plaza. Cars and truck fumes once choked the area. Now it is one of London’s most successful traffic-free tourism, shopping and eating destinations.

So frankly, to LEZ or not to LEZ isn’t even a question we should be asking. LEZs save lives, we owe them to our children.

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Dr Jill Belch

Dr Jill Belch

Jill Belch is a professor of medicine, specialising in vascular diseases. She has a major interest in air pollution and its effects on vascular health. She was a founder fellow of the Academy of Medical Sciences and is a Fellow of the Royal Society of Edinburgh. In 2022, she received the Saltire Society’s Outstanding Woman of Scotland award.

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