Dr Ameera Patel, CEO of TidalSense, an AI respiratory healthtech pioneer for COPD and asthma solutions, highlights the importance of Clean Air Day on June 15
We may not be able to see air pollution, but it is all around us.
99 per cent of the global population is exposed to polluted air that exceeds the World Health Organization’s safe limits, and this exposure is responsible for an estimated 7 million premature deaths globally each year.
In the UK, polluted air – which is largely driven by emissions from road transport and domestic wood and coal burning – causes around 40,000 deaths and over 20,000 hospital admissions annually.
A 2019 review found that exposure to polluted air has the potential to damage every organ in the body, causing a range of health problems including respiratory conditions, cardio-vascular disease and high blood pressure.
And a growing body of evidence suggests that air pollution also adversely impacts brain function, increasing the likelihood of conditions such as depression, anxiety and dementia.
Putting more lives at risk
Although no one is immune to the threats posed by air pollution, it disproportionately impacts the most vulnerable in our society – the elderly, pregnant women, children, those with pre-existing conditions, and people on or below the poverty line.
Concerningly, almost all UK schools are located in areas that surpass WHO safe air pollution limits, exposing millions of children to dangerously high levels of pollutants.
Indoor air pollution in workplaces, schools and homes is also a significant and widely unreported problem – it is estimated to cause around 3.2 million deaths per year.
Cleaning up our air is absolutely critical and this requires action on many fronts – from international agreements and national and local policy changes through to modifying people’s behaviours.
This is why campaigns such as Clean Air Day, the UK’s largest air pollution campaign which raises awareness of the impacts of air pollution and campaigns for cleaner air, are so important.
However, although vital to protect our longer-term health, improvements to air quality won’t fix the health emergency that is already upon us.
The diagnosis burden
Exposure to indoor and outdoor air pollution causes and aggravates lung conditions such as chronic obstructive pulmonary disease (COPD) and asthma, caused by the pollutants Nitrogen dioxide and sulphur dioxide, which can irritate and inflame the airway lining, and high ozone levels which can reduce lung capacity and cause discomfort when breathing.
This helps explain why there is a growing number of people living with respiratory diseases worldwide.
Yet diagnosis in the UK is poor and delayed, and treatment is often ineffective and costly.
Two thirds of COPD patients are unaware they have the condition, and severe asthma also remains widely underdiagnosed, leaving many people without access to the care they desperately need and putting lives at risk.
The UK has the second highest death rate from asthma in Europe – behind only Turkey.
This is placing an additional and unnecessary burden on the NHS, which is already dealing with an increased demand for its services, overworked clinicians and thinly-stretched budgets.
COPD alone is the second most common reason for an emergency hospital admission, and total admissions for COPD are estimated to cost the NHS £491m annually.
Early detection and diagnosis are essential to support clinicians in providing effective treatment to patients during the early stages of respiratory disease.
For example, although early diagnosis for COPD can’t cure or reverse the condition, it can open up access to vital treatment that slows the progression of the disease, improves patients’ quality of life and drastically reduces the number of hospitalisations.
The long road to diagnosis
Current testing for COPD and asthma is largely reliant on spirometry – an outdated, 180-year-old technique that is difficult to operate and produces notoriously unreliable results.
What’s more, waiting times for these tests can be as long as ten years. It’s no surprise that misdiagnosis and underdiagnosis are commonplace.
Better technology that offers fast, accurate results is urgently needed to close the diagnosis gap for respiratory conditions and relieve pressure on the NHS.
This need is only growing as respiratory diseases such as COPD and asthma continue to increase in frequency and severity, driven in part due to worsening air quality.
AI-based technologies are showing particular promise in diagnostics. By analysing and interpreting large quantities of data, these tools can enable faster, more accurate diagnosis.
AI tools are already being piloted and rolled out across the NHS in areas as wide ranging as stroke detection and retinal screening, to automate the detection of patterns of disease.
AI has also been successfully used to support the diagnosis of lung cancer and pulmonary fibrosis, helping clinicians identify at-risk patients, speed up decision-making and reduce unnecessary procedures.
As the technology continues to develop at pace, there will be a continued need for validation studies, as well as education programmes to build clinician and patient awareness and confidence.
Bringing diagnostic capabilities up-to-speed
Air pollution is a global health emergency and is recognised by the UK government as the largest environmental issue threatening our health today.
But just as important as cleaning up our air is dealing with the health consequences.
Respiratory conditions, as well as other diseases, are already having disastrous, life-changing impacts on the UK population, but our diagnostic capabilities have not kept up.
The current clinical pathway for respiratory conditions is broken.
Healthcare systems must embrace the potential of innovative technologies to enable access to early diagnosis and intervention, reducing healthcare costs, slowing disease progression and improving patient outcomes.
