The greatest global health risk
The World Health Organisation (WHO) identified air pollution as the largest global health risk and estimated that it is responsible for approximately 7 million deaths every year. Interestingly, the majority (4.3 million) of these deaths were found to be attributed to household air pollution while the rest due to outdoor air pollution.
Different types of air pollution can have different negative implications on the human body. Soot particles (black carbon) get into the lungs and bloodstream and wreck havoc. It is known to exacerbate bronchitis and can lead to heart attacks and even death. Smog (ground-level ozone) irritates the eyes and the throat and is particularly damaging to the lungs. People who work outdoors, exercise outdoors, children, the elderly and asthma sufferers are particularly prone to the effects of smog. Air pollution can stunt neural development and cognitive capacities in children and newborns. As mentioned earlier, people who suffer from pollen allergies can expect to suffer more as pollen production increases and the season for this is extended due to climate change. Stroke, heart illnesses, respiratory illnesses and cancer have all been linked with air pollution.
So what does this mean for the health and wellbeing of the half a million people (according to the 2002 census) living in Skopje? A 2018 study published in the International Journal of Environmental Research and Public Health examined the health impacts as well as the economic costs of air pollution in Skopje. The researchers found that there were 1199 premature deaths attributed to air pollution in 2012. In the same year, there were 547 cases of hospital admissions for cardiovascular diseases and 937 for respiratory diseases due to air pollution. The study estimates that the social cost of air pollution in 2012 was anything between €570 and €1470 million. Other estimates have found that the increase of public spending on the health sector due to air pollution has increased to €365 million; 3.5% of the country’s GDP. Job performance in the country is also affected by the health consequences of air pollution and has cost taxpayers €4.3 million (0.13% of the GDP).
Air pollution and social injustice
Much like climate change, air pollution is a social justice issue and it tends to affect the most vulnerable members of society the strongest. Household air pollution, which is the largest source of air pollution-related deaths globally, is the result of indoor heating and cooking from using bad quality wood or other types of unsuitable materials and the use of kerosene or coal stoves. Outside of the city, air pollution is affecting the livelihood of farmers as it has been found to increase diseases in crops and lowers the overall crop yield.
Apart from industry, a lot of air pollution in North Macedonia is the result of the use of inappropriate materials for household heating. This not only signifies that a large number of people are exposing themselves to unsafe levels of air pollution inside their own homes but it also exposes a larger social problem. It shows that many people are not financially able to heat their homes in a way that won’t put their health on the line. Furthermore, it highlights the problem that too many buildings around the country are old and not properly maintained. Many people, therefore, live in housing that is badly insulated and requires more heating. With limited options to cleaner heating solutions, many people are put in a position where they have to choose between freezing or inhaling toxic air.
What is being done about this?
The WHO stresses that improvements in urban planning, transport planning, building design and waste methane capture can all significantly reduce air pollution. The organisation has also found that tackling air pollution from traffic, cookstoves, waste, agriculture, and industry could reduce global warming by as much as 0.5°C. So what are policymakers in North Macedonia doing about this highly pressing issue? The government has announced that it has set aside €1.6 million to tackle air pollution. Experts, however, have claimed that this is not enough to really make a difference. The plans to increase the amount of the country’s reliance on fossil gas is neither good news for the air pollution problem nor the climate crisis. The Skopje municipality is said to have invested €100 million in a new public transport system that should be ready by 2021. Meanwhile, the city is evidently car-centric as pedestrians and cyclists not only need to worry about weaving through cars both on the road and the pavements but also fear inhaling shockingly high levels of air pollution, much of which is being caused by the same vehicles that they’re trying to avoid. Government officials have also mentioned other measures including banning heavy vehicles from the city centre, subsidies for chimney cleaning, excusing pregnant women and people over 60 from work and even drone surveillance to monitor and punish big polluters.
Meanwhile, individuals, movements and organisations have begun to step up and speak out about the injustice of air pollution. The AirCare app which was developed by Gorjan Jovanovski has put the power of information into the hands of the people. The app has been downloaded over 200,000 times so far. Other movements speaking up about the issue include the Skopje Smog Alarm, the Green Front as well as the Fridays for Future protests which inevitably highlight the air pollution situation and how it is linked to the climate crisis. Movements from across the Balkan region are also coming together to demand clean air this Friday, February 28th. The protests have been announced in 9 cities across 5 countries. As the weather gets warmer and the smog slowly begins to lift from our cities, the air pollution problem becomes less visible but the threat and the injustices around it are not seasonal.