Alongside measures such as investing in greener homes and cleaner transport, stronger workplace protections—including updated occupational air quality standards—are “achievable and have strong public support everywhere”, Mr Castro says. However, such interventions remain elusive partly because those most affected by chronic respiratory diseases often remain unheard, which translates into their absence from policy decisions. He has called for the introduction of universal spirometry testing in primary care practices, which could dramatically reduce hospitalisations, as well as providing local authorities with better tools to track how pollution, heat and indoor air quality affect at-risk groups.
Such progress is possible, says Mr Castro, although, like Dr Marmot, he emphasises that it will require a collaborative effort by local authorities, businesses, healthcare, housing providers, social services, voluntary groups and communities.
“If we take this issue seriously now, Europe could become a global leader again, pioneering clean-air cities, resilient health systems and workplaces that protect rather than endanger the health of workers,” Mr Castro adds. “We could see fewer children developing asthma, fewer workers developing COPD and fewer families suffering avoidable tragedy.”