Act now to reduce climate pollutants and cut emissions – expert

Rubbish is burnt near a home in Busega, Rubaga Division in Kampala in February 2023. In 2018, the World Health Organisation said nine out of 10 people breath polluted air. PHOTO | MICHAEL KAKUMIRIZI 

What you need to know:

  • Air pollution levels in Kampala City are about eight times higher than the recommended standards. The new National Environment Air Quality Standards Regulations of 2024 have set heavy fines and jail terms for those found guilty of polluting the air. According to National Environment Management Authority (Nema), about 31,000 people die annually from diseases caused by exposure to air pollution.  Norbert Natukunda interviewed Dorothy Lsoto, an air quality scientist on the unsafe air hanging over the city.

When we talk about breathing unsafe air what does it mean?

Right now, Kampala is a culprit because it is the capital city. This is the transport hub, with a number of cars in dangerous mechanical condition. Also, because of poor waste disposal systems, people burn their waste and this releases pollution into the air. Every time that you breathe in dirty air or polluted air, you are cutting a day out of your life. Jinja City is second to Kampala in air pollution because of the proximity to the city. 

How can we improve the transport system, which is the biggest contributor to air pollution?

Transport is contested everywhere because people are on the move everyday. But, how can they do it safely? We are talking about old engines on the road, vehicles which have not been serviced, people who are stuck in traffic but keep their engines running; and even emissions from dusty roads. The air monitors from Airqo show that during peak hours, when traffic is at its highest, the percentage of air pollution goes up.

However, although transport is a huge contributor to air pollution, it is easy to manage, especially if people are encouraged to switch from diesel engines to hybrid or electric engines. During the Covid-19 lockdowns, when there were fewer cars on the roads, we saw air pollution levels drastically dropping.

The government can also encourage people to walk by incorporating walkways. Why should one drive from point A to point B yet he or she is the only person seated in the vehicle? I understand that the infrastructure is not there but KCCA [Kampala Capital City Authority] is playing an active role in encouraging biking and cycling.

Every year, we talk about poor air quality and unsafe air. It’s the same story; the only difference is that the air gets worse, with each year.

I want to push back a bit on this being talked about for a long time as you say. In Kampala, it was only in 2017 that we had our first air quality monitor and that happened at the United States Embassy.

In the same vein, a lot of the pollution is actually coming from cooking using biomass. When you light a charcoal stove, you are contributing to the emissions.

 I am actually excited that we talk about air pollution every year. When I started doing this work in 2012, you barely heard anyone talking about air quality. There were almost no reports or news about it.

Now, more people are talking about quality standards and regulations. This means, with time, people will talk about equity when discussion solutions.

If electric cars are the solution, then we can talk about how they can be made more affordable and accessible to everyone, probably by removing the tax on them.

You said biomass is also a contributor to air pollution. However, few people can afford to cook on electricity. All they can afford is charcoal and firewood.

That’s something we have to put into consideration. What are the solutions to biomass cooking for a Ugandan who earns a dollar a day?

This is where policy makers come in, to create policies that support technologies such as solar and clean cooking.

Using a clean stove is not necessary going to remove the pollution but having an LPG stove makes a huge difference. We also need policies that subsidise the cost of the technology for everyone.

 What does research say about the impact of breathing in unsafe air?

We have not yet carried out actual studies. Right now, we have short studies that give an overview, but we need to carry out cohort studies to study people in their homes and workplaces. For instance, take a traffic officer. Their jobs are very dangerous because they stand in traffic every day, breathing in dirty air. Some of them end up with lifelong respiratory illnesses.

In the studies we have that give an overview, air pollution is linked to most diseases, such as, asthma, heart conditions, high blood pressure, and diabetes.

 Dorothy Lsoto (right) responds to questions in an interview with reporter Norbert Natukunda. PHOTO /DENNIS KABUGO/NTV 

Children below the age of five suffer most because their lungs are still developing. When they breathe in dirty air, their lungs work twice as hard.                                                                                                 

It is also not all gloom, though. We have the policies, so lets make them work. As a country, we can clean up the transport system and pave the dusty roads

 As a country, do you think we spend more time lamenting than implementing policies and activities that might help us?

Yes, and that is why I think we should not wait for the government to solve the air pollution problem.

You can take the initiative as an individual. Walk to the office or to the market, or ride a bicycle. Instead of buying a second car to transport your children to school, encourage them to ride bicycles.

My personal contribution every day is to ride to work and to school.

 If all of us took those small steps, we can make a change, as we wait for the government to come in to support us.

 About air pollution

Air pollution poses a major threat to health and climate across the globe.

What is air pollution and how does it lead to disease in our bodies? 

Air pollution is the presence of one or more contaminants in the atmosphere, such as dust, fumes, gas, mist, odour, smoke or vapor, in quantities and duration that can be injurious to human health. The main pathway of exposure from air pollution is through the respiratory tract.

Breathing in these pollutants leads to inflammation, oxidative stress, immunosuppression, and mutagenicity in cells throughout our body, impacting the lungs, heart, brain among other organs and ultimately leading to disease. 

A picture showing a vehicle emitting smoke in Kampala on May 27, 2022. Vehicles have been some of the biggest contributors to air pollution in Uganda. Photo/ Abubaker Lubowa

What organs are impacted by air pollution? 

Almost every organ in the body can be impacted by air pollution. Due to their small size, some air pollutants are able to penetrate into the bloodstream via the lungs and circulate throughout the entire body leading to systemic inflammation and carcinogenicity. 

What diseases are associated with exposure to air pollution? 

Air pollution is a risk for all-cause mortality as well as specific diseases. The specific disease outcomes most strongly linked with exposure to air pollution include stroke, ischaemic heart disease, chronic obstructive pulmonary disease, lung cancer, pneumonia, and cataract (household air pollution only). 

There is suggestive evidence also linking air pollution exposure with increased risk for adverse pregnancy outcomes (i.e. low-birth weight, small for gestational age), other cancers, diabetes, cognitive impairment and neurological diseases.

What are some of the most important air pollutants leading to disease? 

Although there are many toxins that have adverse impacts on health, pollutants with the strongest evidence for public health concern include particulate matter (PM), carbon monoxide (CO), ozone (O3), nitrogen dioxide (NO2) and sulphur dioxide (SO2).

Fine particulate matter are an especially important source of health risks, as these very small particles can penetrate deep into the lungs, enter the bloodstream, and travel to organs causing systemic damages to tissues and cells.

How long does someone need to be exposed to air pollution to harm their health?                                                                                             

Health problems in children and adults can occur because of both short- and long-term exposure to air pollutants. The levels and duration of exposure that can be considered ‘safe’ vary by pollutant, as well as the related disease outcomes. For some pollutants, there are no thresholds below which adverse effects do not occur. 

Exposure to high levels of particulate matter, for example, can lead to reduced lung function, respiratory infections and aggravated asthma from short-term exposure. Whereas long-term or chronic exposure to fine particulate matter increases a person’s risk for diseases with a longer onset, like some non-communicable diseases including stroke, heart disease, chronic obstructive pulmonary disease and cancer. 

Are some populations more likely to be at higher risk for disease from air pollution? 

The children, elderly and pregnant women are more susceptible to air pollution-related diseases. Genetics, comorbidities, nutrition and socio-demographic factors also impact a person’s susceptibility to air pollution. 

Does exposure to air pollution during pregnancy impact the health of the fetus?

Maternal exposure to air pollution is associated with adverse birth outcomes, such as low birth weight, pre-term birth and small for gestational age births. A growing body of evidence also suggests that air pollution may affect diabetes and neurological development in children. 

Are the health risks the same between ambient air pollution and household air pollution? 

The health impacts from exposure to ambient air pollution or household air pollution are dependent on the types and concentrations of the pollutants in the air pollution mixture to which an individual is exposed. However, the health risks and disease pathways between ambient and household air pollution exposure are often similar, due to their similar composition. Fine particulate matter for example is a common and critical pollutant of both ambient and household air pollution leading to negative health impacts. 

Additional safety risks are associated with many of the fuels and technologies used in the home emitting air pollution. These include burns and poisonings (from kerosene ingestion), as well as physical injury related to fuel collection, including musculoskeletal damage, violence, and animal bites. It is important to note that the death and disability estimates attributed to air pollution do not account for all health outcomes associated with air pollution.

WHO estimates are likely conservative as only health outcomes for which there is strong certainty in the epidemiological evidence are included (i.e. stroke, ischemic heart disease, chronic obstructive pulmonary disease, pneumonia, and lung cancer). 

The World Health Organisation