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Wake up and smell the exhaust fumes – they’re making us sick!

Introduction by Croakey: When Federal Government Ministers Catherine King and Chris Bowen recently announced the watering down of a long-overdue vehicle efficiency standard, they stood next to leaders from Toyota, Hyundai, the Electric Vehicle Council and Tesla.

How different might have been the media coverage and the Ministers’ announcement, if they had instead chosen to stand alongside health and medical leaders, and experts on the health impacts of air pollution?

In the article below, public health researcher Clare Walter laments a lack of political and public focus on the health impacts of the related legislation and air pollution more generally, and proposes some ways forward.


Clare Walter writes:

To see the federal parliament water down the proposed new vehicle efficiency standards (NVES) and witness the rhetoric degenerate into the same old arguments and mud-slinging between industry lobbyists and environmental groups is beyond frustrating.

We need to move past this. Whether you care about carbon trajectories or not, one thing is indisputable and is against everyone’s common interest — vehicle emissions make us sick.

Every breath of traffic exhaust transports a mixture of harmful gases and tiny combusted particles of carbon that act as vectors for the range of toxic chemicals produced by fuel combustion to enter our bodies.

These particles are so small when they reach the bottom of our lungs they cross into the bloodstream, travelling throughout our bodies, where they may impact organs and trigger a systemic inflammatory response that puts our bodies into a stressed state.

An acute inflammatory response can begin within minutes of exposure and for most, goes by unnoticed. However, for those with asthma, there is a marked increase in the risk of asthma exacerbations.  Acute (short-duration) exposures such as those experienced during the daily commute also increase the risk of upper and lower respiratory infections.

Chronic exposures, such as those experienced by Australians living, working, or attending schools or childcare centres near heavily trafficked roads, constitute the lion’s share of health impacts.

As evidence mounts, the range of diseases associated with traffic exhaust is rapidly widening, and the risks keep escalating.

Traffic-related air pollution is known to cause asthma onset in children, lung cancer, ischaemic heart disease, chronic obstructive lung disease (COPD), stroke, diabetes, and adverse birth outcomes (premature birth and low birth weights). The list keeps expanding. Emerging evidence points to possible associations with Parkinson’s disease, Alzheimer’s disease, a range of other cancers, cognitive decline in the elderly, and reduced cognitive development in children.

Health experts and scientists have known about these impacts for some time, but the evidence is not reaching the public or policymakers. The NVES is scheduled to be put to the Senate in May.

Meanwhile the debate will continue to swirl and, if it continues to be dominated by industry and environmental groups, health will be overlooked.

The ramifications of this policy decision to our already embattled health system are enormous. How many Australians are already experiencing difficulty in procuring an appointment time with their GP, or have sat for interminable hours in a hospital emergency department with a loved one, waiting to be seen?

Preventing illness and disease could and should be the core focus in this debate. Whatever our ideological positions may be, safeguarding our health and our children’s health is surely something we can all agree is important?

So why aren’t we paying attention?

Familiarity: By now, almost all Australians have grown up with ‘car culture’, particularly in major cities known for their car-centric infrastructure, traffic has seamlessly woven into the daily routine for most Australians.

This familiarity has inadvertently led many of us to overlook the potential health implications of vehicle emissions.

In contrast to other pollution sources that may be more visibly apparent, the insidious nature of traffic pollution often goes unnoticed, and we remain complacent.

Unlike the US and the UK, Australia has yet to launch a comprehensive public awareness campaign addressing the significant health impacts associated with traffic-related pollution. The lack of targeted awareness efforts further contributes to the limited understanding of the potential risks posed by exposure to traffic emissions.

Narratives: There is a dominant narrative that ‘air quality in Australia is good’.

However, it’s important to recognise that air quality is merely an index of air pollution levels, and there is no safe threshold for air pollution exposure.

Labelling air quality as “good” implies a sense of acceptability of safety, which is misleading given that even minimal levels of air pollution contribute to mortality and disease.

Drawing a parallel, we consistently strive to improve road safety, acknowledging that even in years with comparatively lower road tolls, there’s still room for improvement.

Labelling any given year’s road toll as “good” would rightfully be deemed inappropriate and counterproductive to our efforts to reduce accidents. Similarly, using the term “good” to describe air quality creates a false sense of security and fails to address the ongoing need for mitigation and improvement measures to safeguard public health.

Metrics: Our air pollution monitoring network lacks road-side data, and there is a downward bias in estimating population exposure.

We then apply conservative risk coefficients, derived from outdated international studies that have been shown to underestimate the impacts, particularly in regions with lower pollution levels like Australia.

This failure to integrate updated scientific findings has resulted in our country lagging behind others. Consequently, the metrics we rely on exhibit a significant downward bias, resulting in a disparity when compared to other countries.

Notably, New Zealand now reports a higher number of premature deaths per annum attributed to vehicle exhaust than Australia, emphasising the urgent need for a more robust and current approach to air quality assessment in Australia.

Economics: The cost benefit analysis guiding the current policy decision was not disclosed to the public.

We do know it was produced by external consultants in 2018, and estimated the annual economic cost attributed to health impacts from vehicle emissions to be $3.9 billion.

A stark inconsistency emerges when comparing figures with those from New Zealand. The HAPINZ 3.0 study, published in 2022, meticulously detailed its methodologies, incorporating advanced air quality monitoring techniques, including road-side data, and updated risk coefficients that represented the local population.

In New Zealand, a country with a population of five million, boasting superior fleet emission factors and less urbanisation compared to Australia, the study revealed an annual toll of 2,200 premature deaths attributed to vehicle exhaust, with associated costs of $10.4 billion (NZD).

If we were to extrapolate these findings to Australia, assuming all other factors remain constant, it would suggest a staggering toll of 11,105 premature deaths each year, accompanied by a hefty price tag of $48.1 billion (AUD) in health expenditure and societal costs.

This estimation stands 12 times higher than the costs currently relied upon, emphasising the urgency for a re-evaluation of our approach to understanding and addressing the impacts of vehicle emissions on public health and economic well-being.

What’s the solution?

First and foremost, the public needs to be made aware of the substantial threat vehicle emissions pose to their health.

In turn, this will motivate behavioural change and generate the social licence required for the further reforms required for Australia to transition away from car dependency.

Secondly, risk assessment methods and metrics urgently require updating to align with the most recent and robust science.

Policymakers and external consultants must break free from entrenched practices that rely on outdated methodologies, which in turn are based on obsolete estimates, and instead embrace the wealth of scientific progress made over the past decade.

When policymakers fail to base their decisions on the most accurate methods and data, it inevitably compromises the quality of their choices. This oversight has contributed to our current predicament, where Australia has become a receptacle for some of the world’s most polluting vehicles.

We need tighter emission standards, but also need to do more.

Break the unhealthy cycle

We must address the fundamental issue of perpetuating the cycle of road construction, which serves to induce further demand and necessitate even more road development.

This cycle must be broken. Other countries have successfully pursued this strategy, resulting in a transformative shift towards investing in active and public transport infrastructure.

This approach not only curtails all vehicle emissions (both exhaust and non-exhaust) but also delivers a dual benefit of improving both physical and mental well-being through increased uptake of active transport options.

Such a transition cannot take root in Australia until individuals feel safe cycling on roads or, better yet, have access to more dedicated cycling paths and routes.

Some of the money our governments keep tipping into road infrastructure would likely yield better long-term economic returns if diverted into active transport infrastructure.

Count the health costs

It’s high time Australians recognise this is about more than the cost of our fuel, it’s about the cost of our health, and our children’s health. These costs need to be considered and accounted for.

Consider this:  if we were embroiled in a debate about water quality, the public outcry would be deafening.

Yet, we mustn’t forget that we also “consume” air, and its quality directly impacts our health.

We have one of the highest asthma rates in the world, and it is the leading burden of disease in Australian children. While multiple factors are implicated, vehicle emissions are a significant contributor.

Compounding this issue, childcare centres and schools are often situated along major traffic routes, exposing our most vulnerable members of society to dangerously high levels of vehicle pollution.

As the saying goes, “you get the democracy you deserve”.

Australians need to open their eyes to this issue and engage in shaping the policies that will affect our future. If not for our environment, then at least, for our health.

We deserve better. Our children deserve better.

Author details

Clare Walter is a public health PhD candidate at the University of Queensland, researching the health impacts of air pollution in Australia and the barriers to policy action. She is also an honorary research fellow at the University of Melbourne. Walter previously worked in lung cancer clinics as a specialist pharmacist, and advocacy work began in response to the growing number of lung cancer patients with no smoking history, and the categorisation of diesel exhaust as a group 1 carcinogen.


Further reading

Inside Climate News, ‘How Two Top Car Salesmen Pitch EVs, One in Trump Country and One on Biden’s Turf’ (March 2024): This feature article includes details about how the car industry lobbies against air quality improvements. For example, the National Automobile Dealers Association has long argued to slow down requirements that cars become more fuel efficient. They recently took aim at the Biden administration’s most important executive action on climate: tailpipe pollution rules designed to spur the switch to electric passenger cars and trucks. The administration recently released moved to slow down the timeline for the shift to EVs, in response in part to pressure from the dealers’ group. The administration now projects 30 to 56 percent new vehicle sales for purely battery-driven cars by 2032, instead of two-thirds of sales, as had been previously proposed.

Croakey Health Media, ‘Vehicle emissions standards are necessary, but much more is needed to stop transport systems harming our health’ (March 2024): Dr Rosalie Schultz writes that proposed new vehicle emissions standards are welcome, but they are only part of a comprehensive transport strategy that should promote better public transport and support more active transport.

Croakey Health Media, ‘Twelve best ways to get cars out of cities – ranked by new research’ (April 2022): Swedish scientist Associate Professor Kimberly Nicholas reports on research that ranks the 12 most effective measures that European cities have introduced in recent decades to reduce car use, based on real-world data on innovations ranging from the “carrot” of bike and walk-to-work schemes to the “stick” of removing free parking. The ranking reflects cities’ successes not only in terms of measurable reductions in car use, but in achieving improved quality of life and sustainable mobility for their residents.


See Croakey’s archive of articles on air pollu