Introduction by Croakey: The Royal Australian College of General Practitioners, the Lung Foundation of Australia, Asthma Australia, the Heart Foundation and the Australasian College for Infection Prevention and Control are among those supporting a call for a National Healthy Air Strategy.
Below, Dr Sharon Campbell, from the Centre for Safe Air, and Plum Stone and Amy Lewis, from the Safer Air Project, put forward their arguments for a systematic approach to address “a critical public health gap” through comprehensive policies and practices related to safer air.
“Action on clean air is one of the most cost-effective health investments the Commonwealth Government can make,” they write.
Sharon Campbell, Plum Stone and Amy Lewis write:
Breathing clean air is fundamental to life, yet many people in Australia are routinely exposed to unhealthy air in the places they live, learn, work, travel, play and age. Invisible threats in our air undermine our health, healthcare service capacity, productivity, climate resilience, accessibility and equity.
In contrast to the well-established health protection arrangements for food safety and water quality, Australia lacks a systematic approach to protect health through comprehensive policies and practices related to safer air. This is a critical public health gap.
While there is leadership in environmental management policies and practices related to air quality, further action is needed to safeguard health.
Prioritising health and air quality presents an enormous opportunity to deliver lasting benefits for current and future generations, while strengthening Australia’s resilience to emerging health and environmental challenges.
The air we breathe can carry a wide range of harmful pollutants and infectious pathogens, with most exposure occurring indoors where we spend 90 percent of our time.
Key hazards include airborne pathogens, bushfire smoke, emissions from burning gas and wood for heating and cooking, emissions from transport and industry, airborne mould, pollen, and emerging concerns including microplastics and ‘forever chemicals’.
Most of the indoor settings in which we live, learn, work, travel, play and age are not held to a standard which can protect us from infectious disease transmission or the infiltration of outdoor air pollution.
The Australian Centre for Disease Control (CDC) acknowledges that everyone is at risk from poor indoor air quality, identifying that air quality in buildings is a core public health issue, with clear links to respiratory impacts, inflammation, infectious disease, heart disease, cancer and premature death.
Furthermore, many people are at disproportionately higher risk of harm due to age (older or very young), pregnancy, social disadvantage or chronic illness. Safeguarding schools, childcare centres, healthcare centres, residential and aged care facilities, workplaces, community transport and homes are urgent priorities.
Health and economic impacts
Unsafe air is the leading environmental cause of preventable illness and premature death in Australia.
Long-term exposure shapes population patterns of chronic disease, such as diabetes and cancer, while short-term exposure can precipitate serious, sometimes fatal exacerbations of heart and lung conditions.
There is evidence that links poor air quality with adverse pregnancy outcomes, and emerging research showing links between poor air quality and harms to brain health, bone health and poorer academic performance.
The upshot? Without action on air quality, Australia faces a growing burden of acute and chronic disease, challenging the capacity of our already overstretched healthcare system.
The health-related economic costs stemming from lost productivity, reduced quality of life, increased demands on health services and premature deaths related to unsafe air are enormous.
For example, fine particle emissions from transport, industry and wood heaters have an estimated economic burden of more than $6 billion per year, while the direct health costs of allergic respiratory diseases are estimated at $1 billion per year.
The smoke-related mortality burden from the 2019-20 Australian fires was estimated at $2 billion.
Analyses of indoor air quality in Australia show that impacts from long COVID alone are estimated at almost $10 billion per year, with acute respiratory illnesses leading to a 58-74 percent workplace productivity loss.
Reducing hospital admissions related to airborne infections has the potential to save millions of dollars each year, while reducing fine particulate matter in Australia by just five percent can provide an economic benefit of over $1.6 billion each year.
Education matters
Environmental hazards such as temperature and sun exposure have national community recognition and associated frameworks for action.
However, there is a general lack of recognition that poor air quality causes and exacerbates a wide range of serious acute and chronic health conditions.
Consequently, there remains a substantial gap between the scientific evidence on the health impacts of air quality, and community awareness of those risks.
Action on clean air is one of the most cost-effective health investments the Commonwealth Government can make.
Cost-benefit analyses of interventions for managing air quality are overwhelmingly positive, with published benefits exceeding costs by margins ranging from three to 30 times the investment in Australia, New Zealand and the United States.
A CSIRO report on the cost of poor indoor air in Australia is expected to be released later in 2026.
A National Healthy Air Strategy would provide a coordinated and efficient framework to address air quality risks across all environments.
Solutions for safer air need to be comprehensive and synergistic. By addressing all air quality issues under a single national strategy, Australia can deliver a more consistent, evidence-based and cost-effective approach to protecting public health.
This strategy will overcome the fragmentation of expertise across environmental, health and social sciences, and regulatory responsibilities across multiple portfolios and levels of government.
Clean air is too important to remain underfunded and fragmented across health, environment and other agencies, and across different levels of government.
Australia already has the knowledge, capability and policy pathways to address this multi-portfolio, multi-jurisdictional challenge.
Calls to action
Sign the call to support a National Healthy Air Strategy. Add your voice to the unprecedented coalition of leaders and experts, from researchers to health professionals and advocates, representing universities, medical research institutes, health practitioner colleges, unions, peak bodies, patient organisations and industry.
These organisations are united behind a single objective: the development and implementation of a National Healthy Air Strategy for Australia.
We call on the Australian Government to:
- Invest $4.5 million over three years to establish a time-limited National Healthy Air Taskforce to undertake national consultation and deliver a National Healthy Air Strategy within 12 months
- Invest $36 million over three years to develop and launch a national public awareness and education campaign on air quality.
Funding in these areas will accelerate a much-needed recognition of the impacts of unsafe air across Australia.
About the authors
Dr Sharon Campbell is a postdoctoral research fellow in the Environmental Health Research team at the Menzies Institute for Medical Research (University of Tasmania). She specialises in the human health impacts of climate change. Her research interests include climate-related extreme events such as heatwaves and poor air quality, and the impact of these events on healthcare systems and vulnerable populations. With a background in public health policy, Sharon concentrates on the translation of research into policy and practice, emphasising the communication of research and public education. She is working with the Centre for Safe Air to develop a call for a National Healthy Air Strategy.
Plum Stone has worked in health policy and public affairs for the last 20 years, with experience in the UK Parliament, international public affairs agencies and in-house for patient advocacy organisations. Plum wrote her undergraduate dissertation on learning the lessons of pandemics of the past to prepare for pandemics of the future and has an MSc in Public Health (Nutrition). As a result of Plum’s professional background, and personal lived experience with an immunocompromised and high-risk family, she founded The Safer Air Project, with a mission to get indoor air quality recognised as a critical accessibility and inclusion issue for people living with chronic health conditions, in order to make indoor air safer for everyone to breathe.
Amy Lewis is a communications professional and safer air advocate with more than 25 years’ experience in communications, marketing and design. In recent years, her work has increasingly focused on health equity, indoor air quality and equitable access to shared spaces. She co-founded the Safer Air Project with Plum Stone, working to create safer, healthier indoor environments for everyone. This work is informed by lived experience of chronic illness and family experience of solid organ transplantation and immunocompromise, giving Amy a particular interest in making healthcare, workplaces, education and other shared spaces safer and more accessible for people at increased risk from respiratory infections.
The authors declare that this work is being conducted strictly in the public interest. We confirm that no author stands to financially benefit from the implementation of this work.
The latest edition of The Health Wrap examines the health impacts of bushfire smoke
See Croakey’s archive of articles on air pollution and health
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