In an open letter to the First Minister, Nicola Sturgeon, published as part of our joint investigation, over 60 leading health professionals – including consultants, GPs and medical academics – are calling for more action to be taken on air pollution to save lives. 

Councils must enforce laws, they say, air monitoring should be increased, including outside schools, while the Scottish Government should invest more heavily in active travel, public transport and green infrastructure.

Here is the letter in full:

Dear First Minister, 

We are a group of Scotland-wide healthcare workers writing to request that the Scottish Government take the strongest possible action to control vehicular produced air pollution by mandating immediate local council action, allowing improved health, and reducing adverse effects on the current climate crisis. We appreciate that the Scottish Government has been active and that we have some of the lowest regulation levels for particulate matter in our air. However, Scottish councils are not always enforcing these laws.

Globally it is estimated that 16 per cent of all deaths are related to air pollution with around 40,000 deaths each year in the UK attributable to air pollution, most of it from vehicular traffic. It has been linked to cancer, asthma, diabetes, and dementia. Two Scottish studies have shown significant increases in hospital admissions on days of illegal pollution with new onset heart disease, lung disease, and blood clots in the arteries of the legs (which can lead to amputation)  when compared to days when air pollution is within legal limits.

Babies can be still-born or born prematurely while children subjected to air pollution are more likely to die in their first two years, to attend A&E with chest infections, and suffer from asthma. A Scottish study has shown many more children are admitted to hospital on days of illegally high pollution.

Scottish researchers have also shown that keeping air pollution within legal limits would reduce hospital admissions by 10 percent, a major reduction in ill-health which would save money for our NHS. It is estimated that air pollution costs the UK £20bn per annum in health and social care.

We know that those who are already disadvantaged are disproportionately affected – often living in city centres or beside main roads. They have less access to less green space, which can absorb some of the noxious pollutants and are the least able to afford a car, thus suffering the ill effects without contributing to them.

Addressing these issues is critical. We believe that immediate and medium-term action must now be taken including:

  • Implementing more low emission zones within six months in all Air Quality Management Areas (AQMA).
  • Installing more air pollution monitors, which should be obligatory on roads beside every school.
  • Removing speed bumps – as braking then accelerating is recognised as a source of excess fumes, these should be replaced by 20mph zones.
  • Making idling an offence, enforceable by traffic wardens able to issue tickets.
  • Preventing major roads going through new developments.

In the medium term the Scottish Government should further support

  • Active travel: We need protected cycle routes of the correct width that don’t end suddenly, increasing the risk of injury.
  • Better public transport: Investment in rail service will play a big part in reducing air pollution. 
  • Investment in green space: Greening our roads will produce more pleasant streets and the correct planting will allow significant decreases in air pollution.

We are happy to discuss all of the above at your convenience.


  • Jill Belch, Professor of Vascular Medicine NHS Tayside University of Dundee
  • James Chalmers, Professor of Respiratory Medicine NHS Tayside University of Dundee
  • Munro Stewart, GP NHS Tayside Sustainability Group
  • Tom Fardon, Respiratory lead for the Scottish Access Collaborative at The Scottish Government
  • Plus 60 more health professionals including consultants, GPs and academics from across Scotland.

How Green is Scotland? is a week-long series for The Herald by The Ferret, an award-winning investigative journalism platform in Scotland.

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