According to the World Health Organization, air pollution is the fourth leading cause of disease and premature death worldwide (after hypertension, smoking, and malnutrition). It is estimated that due to pollution, the European population loses an average of almost one year of life. The Healthy Lungs for Life campaign, promoted by the European Lung Foundation (ELF) in collaboration with the European Respiratory Society (ERS), was launched today in Milan with a press conference attended by the Mayor of Milan Giuseppe Sala, the President of the Lombardy Region Attilio Fontana, and Senator Roberta Toffanin, representing the Minister of the Environment and Energy Security.

A global campaign on long-term health

Healthy Lungs for Life is a global awareness campaign on long-term health that aims to address not only those already affected by lung diseases, to improve their quality of life, but also those who might be affected in the future. It is one of the largest lung health awareness campaigns, targeting all stakeholders in the respiratory landscape: healthcare professionals, scientists, general practitioners, policymakers, and the public. The goal is to focus on prevention and public education, to try to reduce the burden of lung diseases on society. The campaign was created and is led by ERS and ELF and is a partnership between organizations worldwide.

For the Healthy Lungs for Life 2023 edition in Milan, the focus is on the importance of breathing clean air for lung health. An alarming situation, that of air pollution, but still silent, according to the event organizers, which requires awareness from institutions that need to make non-deferrable choices and adopt stricter measures in terms of pollution reduction and promotion of healthier lifestyles.

"Pollution, climate change, and sustainable development should be priority points on everyone's agenda. We chose to highlight these topics at this year's ERS congress to increase interest in environmental issues in Italy and Europe, not only for the scientific community but also for citizens," said Marisa Bonsignore, from the University of Palermo, president of the ERS congress held concurrently in Milan these days.

By raising public awareness, involving decision-makers, and presenting research, studies, and data, ELF and ERS aim to gather support for policies that promote clean air, with particular attention to the EU directive on air quality that will be voted on in the European Parliament on September 13, and fully support the WHO guidelines on clean air limit values, a proposal adopted by the European Parliamentary Committee for the Environment in June 2020.

"We should all be concerned about the air we breathe and work together to change our habits, but also support our politicians who promote strategies to protect lung health," said Barbara Hoffman, ERS Advocacy Chair, from the University of Dusseldorf. "The cost of inaction is immense: every year Europe faces losses of billions of euros due to healthcare costs and absences from work due to diseases related to air pollution. The WHO guidelines on air quality should be the standard we all work towards." It is estimated that if the air pollution limit levels in European cities conformed to the WHO guidelines on air quality, the benefit in terms of quality of life would be measurable, in some cases, as almost two additional years of life.

"Milan is located in one of the most polluted areas of Europe, the Po Valley. The air quality in the region has significantly improved over the last two decades, but we are far from the values recommended by the WHO. In recent years, little progress has been made, and it is time to act more radically," said Sergio Harari, from the State University of Milan, president of the ERS Congress. "Awareness and commitment to improvement are now essential, both from a public and political perspective. As president, together with Professor Bonsignore, of the largest international congress in the world, hosted here in Milan, we believe that the Healthy Lungs for Life campaign is a fantastic opportunity to connect with the people of the city and the region, to help them better understand the importance of health and the role that air pollution can play in the development of lung diseases." It's also a matter of vision, Harari further emphasizes: it's important to move beyond the shortsighted attitude where only the costs related to measures to combat air pollution are seen, without realizing that the results of these measures are also advantageous from an economic point of view, in terms of lower future expenses for the national health service, as well as fewer lost workdays. And not only that. As Harari points out: "Economic data also emerges showing how the development of green policies and the conversion of industrial processes result in a positive return even in strictly economic terms. Of course, we need a policy that looks a little further than tomorrow."

The orographic situation of the Po Valley, both Fontana and Sala emphasized, favors the stagnation of pollutants, making the situation more difficult and the compliance with European regulations harder.

Fontana specified that sustainability is essential and must be present in all choices, but without blocking development: in particular, the new European directive, he argues, would require very drastic reductions in production activities, livestock farming, car circulation, and heating.

For Sala, "today's great challenge for Milan is to improve the air quality in the city, to improve the health and life of its citizens: a recent survey commissioned by C40 shows that this is a concern for Milanese. The studies and the awareness campaign carried out by ERS and ELF aim to explain the social, health, but also economic impact of the damage caused by bad air and how these can be prevented. Milan has adopted an Air Regulation and has initiated a series of policies aimed at reducing harmful emissions, aware of its geographical location not favorable to air exchange. For this reason, we have worked with other European cities so that areas disadvantaged from an orographic and meteorological point of view, such as the Po Valley, can obtain funding for interventions that have better air quality as their main purpose."

The ERS congress held concurrently in Milan

The Healthy Lungs for Life campaign is held concurrently with the ERS congress, from September 9 to 13, 2023, at the MiCo in Milan, which will see the participation of thousands of doctors, healthcare professionals, and patients (estimated over 15,000 participants), to address issues related to lung health.

"ERS is committed to ensuring that doctors are the biggest supporters of clean air, as they treat patients daily who could be seriously affected by the negative impact of air pollution," said Carlos Robalo Cordeiro, ERS president.

During the congress, numerous studies will be presented, for example, on the impact of pollution on pregnant women, but also interesting data on how the presence of greenery in cities not only can counteract pollution but also reduce the onset of respiratory diseases in children during their growth phase.

In this regard, it is worth noting that ERS and ELF have partnered with Forestami – the urban afforestation project that is increasing the natural capital of the Metropolitan City of Milan with the goal of planting 3 million trees by 2030 – to leave a tangible mark of their presence in the city, thanks also to a donation made by the European society to the project.