£27 Billion NHS Bill: How Toxic Air is Costing Lives

Viv
Oct 6
6 min read

You shouldn't have to fight for the air you breathe. Every inhale should be life-giving, yet invisible pollution is eroding health across the UK and the world. New evidence shows airborne toxins attack nearly every organ, cut lives short, stunt children’s growth, overload public services, and deepen inequality. This post examines a hard-hitting Royal College of Physicians report demanding urgent government action to treat air pollution as the preventable health crisis it is.

Why air pollution matters for everyone

Air pollution isn’t just a city problem or something that affects other people. It begins to harm us before birth and continues across a lifetime. Tiny particles and gaseous pollutants from traffic, agriculture, heating systems and everyday household products enter the lungs, cross into the bloodstream and reach organs including the heart, brain and placenta. The consequences are wide-ranging:

Couple smiling, holding a fluffy gray cat upside down in a cozy living room with plants on a mantel. Warm, joyful atmosphere.

Pregnancy and early life: Exposure before birth increases the risk of low birth weight, preterm birth and developmental delays, shaping health from day one.
Children and adolescents: Pollutants impair lung growth and raise the likelihood of asthma and other chronic respiratory illnesses, potentially altering lifelong respiratory health.
Adults: Particulate matter and gaseous pollutants trigger asthma attacks, worsen heart disease, raise stroke risk and increase the likelihood of some cancers.
Older adults and cognition: Long-term exposure accelerates cognitive decline and contributes to dementia risk, adding an often-overlooked dimension to the public-health burden.

Air pollution adds up. It’s not one dramatic event but a daily insult, a background hazard that compounds with other pressures like poor housing, stress and limited access to healthcare.

"In 2019 alone, costs for healthcare, productivity losses and reduced quality of life due to air pollution cost the UK upwards of £27 billion – and may be as much as £50 billion when wider impacts, such as dementia, are accounted for." ( Royal College of Physicians, 2025)

Indoor air is a hidden risk — and often worse than outdoors

We spend up to 90% of our time inside homes, workplaces, schools and other buildings. That’s where pollution can become concentrated and persistent. Common indoor sources include gas cookers, mould, cleaning products, scented candles, fragranced air fresheners and poorly maintained heating systems. When ventilation is inadequate, these pollutants accumulate and create what experts call a “toxic cocktail.”

Ventilation matters: Sealed, energy-efficient buildings can trap pollutants if airflow isn’t designed alongside insulation. Building tighter without considering fresh-air supply can inadvertently increase health harms.
Daily activities add up: Cooking, cleaning, DIY, burning candles and using aerosols all release a mix of fine particles and volatile organic compounds that directly affect occupants.
Workplaces and schools: Children and workers spend long periods in these environments, so poor indoor air disproportionately affects learning, productivity and long-term health.

Improving indoor air is a powerful, immediate health lever: better ventilation, smarter product choices and small behaviour changes can dramatically reduce exposure.

Air pollution is an equity issue

Pollution doesn’t fall evenly across society. People living in deprived areas and many ethnic minority communities face higher exposure because of proximity to busy roads, industrial sites or under-invested neighbourhoods. These groups often have fewer resources to mitigate exposure and face worse baseline health, creating a vicious cycle:

Unequal exposure: Homes near major traffic, industrial activity or busy freight routes experience higher pollutant concentrations.
Compounded disadvantage: Those same communities can have less access to green spaces and higher housing density.
Policy blind spots: If clean-air policies are designed without an equity lens, they risk leaving the most affected communities behind.

Tackling air pollution fairly means centring the needs of the most exposed communities in policy and planning, and ensuring interventions reduce inequalities rather than widen them.

The economic cost is huge — but so are the savings from acting

Air pollution carries a heavy economic toll through healthcare costs, lost productivity, school absences and reduced quality of life. The financial burden on health services and the wider economy is substantial, and those costs will grow unless we change course. At the same time, strong clean-air measures deliver economic returns:

Reduced healthcare demand: Fewer pollution-related respiratory and cardiovascular events ease pressure on hospitals and clinics.
Productivity gains: Healthier children and workers mean less absenteeism and better life-course productivity.
Long-term savings: Preventing early-life harms reduces chronic disease decades later, saving on long-term care costs.

Five priority actions that will move the needle

Meaningful change requires both big-picture policy and practical, everyday steps. Here are five high-impact priorities that everyone can support:

Make air quality a public-health priority across all departments
- Integrate air-quality goals into transport, housing, energy and health strategies so policies reinforce each other rather than work at cross-purposes.
Adopt legally binding interim targets aligned with the best science
- Targets create accountability and keep policy responsive as scientific evidence evolves.
Run a national clean-air public-health campaign
- Provide trusted, practical guidance: how to reduce exposure on commutes, ways to ventilate homes safely, and how to make healthier consumer choices.
Design an indoor air strategy that balances energy efficiency with ventilation
- Ensure building standards require adequate fresh air, especially in schools, care homes and workplaces.
Equip clinicians to talk about air pollution with patients
- Doctors, midwives and nurses can help people reduce exposure and advocate for community-level solutions.

These actions work together: national targets and campaigns set direction, building standards and transport policies change exposure at scale, and clinicians empower individuals with practical steps.

Cleaner transport and greener places: practical system changes

Transport and urban planning are powerful levers for cutting pollution at source. The following system-level moves will bring benefits visible from the roadside to the rooftop:

Expand low-emission zones and reduce high-polluting vehicles in dense areas.
Accelerate the shift to zero-emission vehicles while investing in public transport and active travel.
Invest in green infrastructure: street trees, pocket parks and permeable surfaces all help lower pollutant concentrations and improve wellbeing.
Design streets for people first: safer walking and cycling infrastructure encourages modal shift and reduces traffic emissions.

Urban design that prioritises clean air also produces co-benefits: quieter streets, more physical activity, and warmer, more attractive neighbourhoods.

Practical actions you can take today — small changes that make real differences

Individual choices matter, and combined they reshape demand, markets and local air quality. Here are clear, practical steps anyone can start using immediately:

Open windows daily for short bursts of cross-ventilation. Fifteen minutes of airflow can refresh indoor air quickly; cross-ventilate by opening windows on opposite sides of a room when possible.
Choose low-emission cooking habits. Use extractor hoods when frying or boiling, and consider electric cooking if you can.
Pick low-toxicity products. Replace heavily fragranced cleaners, air fresheners and candles with unscented or naturally derived alternatives.
Keep dust down with damp cloths and HEPA-capable vacuums. Dust traps particles that worsen respiratory problems; dusting with a damp cloth captures them instead of spreading them.
Add greenery where sensible. Certain houseplants can contribute to indoor air quality, and community green spaces reduce neighbourhood pollutant concentrations.
Walk, cycle or use public transport when you can. Fewer private vehicle trips lower local emissions and improve air where people live and work.
Support local action. Back safer cycling routes and tree-planting schemes in your area.

These measures are low-cost, low-regret and stack with larger policy efforts to reduce emissions at source.

A collective opportunity — not a distant problem

Air pollution is often framed as bleak and unavoidable, but that’s a false choice. It’s a challenge with clear solutions that deliver wide benefits: fewer hospital admissions, longer lives, fairer outcomes and greener, more pleasant towns and cities. The transformation we need is both technical and social — cleaner vehicles and smarter buildings, coupled with policies that prioritise health and fairness.

We already know what works. The remaining obstacles are political will, investment and a focus on equity. When policymakers, clinicians, businesses and communities act together, the payoff is immediate and lasting: better health, lower costs and more resilient communities.

Final note

Clean air is one of the most powerful public-health opportunities we have. It touches pregnancy outcomes, childhood development, heart and lung disease, mental health and social justice. By treating air quality as a core responsibility rather than an afterthought, and by combining national policy with local action and everyday choices, we can turn an invisible crisis into a visible victory. Every window opened, every low-emission street, and every cleaner building brings us closer to a future where breathing is safe for every community.