Young activists and NHS doctors warn ‘breathing kills’ as London air pollution hits deprived areas and communities of colour

Call for London mayoral candidates to address pollution inequity

March 12, 2021
Catherine Ittner, +44 (0) 7510376417,
  • Young ‘Choked Up’ activists who live near polluted roads set up guerrilla campaign of road signs in pollution hotspots such as Tower Hamlets, Lewisham and Brixton warning that “breathing kills.” 
  • A joint letter signed by around 100 NHS medics in London today supports the call for action to reduce air pollution, organised by Medact. 
  • New research shows that NO2 pollution is on average 24-31% higher in areas where people from Black, Asian or minority ethnic backgrounds are most likely to live.
  • The research also reveals the most deprived Londoners are over six times more likely to live in areas with higher pollution than the least deprived.
  • Call for London mayoral candidates to commit to address pollution inequity and to transform some of the busiest roads in the capital.

(LONDON, UK) A group of Black and brown teens called ‘Choked Up’ have installed ‘hacked’ road signs across London, highlighting air pollution and its disproportionate impact on people of colour and deprived communities. The signs, which read “POLLUTION ZONE” and warn that “Breathing Kills,” have been installed in a guerilla campaign in areas of toxic and harmful air pollution including Whitechapel, Catford and Brixton.

The signs coincide with new research released today by Environmental Defense Fund Europe (EDF Europe) using modelled NO2 data produced by Cambridge Environmental Research Consultants as part of the Breathe London pilot project showing the burden of London’s air pollution is not equal. EDF Europe’s analysis found that modelled NO2 pollution is on average 24-31% higher in areas where people from Black, Asian or minority ethnic backgrounds are most likely to live, compared to areas where white people are most likely to live.1 Additionally, the most deprived Londoners are over six times more likely to live in areas with higher pollution than the least deprived.2

The campaign is organised by Choked Up, a youth organisation set up by Black and brown teenagers who live along highly polluted roads in South London. They are most concerned about the lack of sufficient action, care or intervention on air pollution. After the recent inquest into Ella Kissi-Debrah’s death showed toxic air directly contributed to her death, Choked Up are fighting to ensure that this never happens again. 

Anjali Raman-Middleton, a 17 year- old co-founder of Choked Up: “The landmark ruling of the Ella Adoo-Kissi-Debrah inquest proved that the road I live less than five minutes from can kill. I am terrified that my daily commute to school along the South Circular has already had a negative impact on my lungs. I urge London mayoral candidates to commit to transform these roads to give me and my generation a greener future.”

Health professionals join the call for action

A group of around 100 London health professionals who work in the NHS have backed the call for action with a letter warning that air pollution is having a “devastating impact” on health, particularly with various communities of colour and those from deprived backgrounds. Ahead of the London mayoral elections in May, the joint letter asks candidates to commit to tackle air pollution inequalities and develop an “urgent action plan to…reduce our dependence on cars.”3

The letter was coordinated by Medact, a coalition of health professionals campaigning on health inequalities particularly linked to the environment. 

Dr LJ Smith, Respiratory Consultant at King’s College Hospital, representing Medact said: “The levels of air pollution across the capital are nothing short of a public health emergency. There are far too many people in our hospital wards and clinics who might otherwise be healthy if it wasn’t for the toxic air they breathe. 

Air pollution affects every single one of us from birth to old age, but we know the least well off and marginalised communities, including those from Black and Asian backgrounds are being hardest hit. If we are serious about tackling health inequalities in our capital city, we need to urgently address the air pollution crisis. We are emerging now from one of the worst health crises this country has ever faced and are now sleep-walking right into another one. Action we take today will have immediate benefits. This can’t wait.”

Air pollution takes a huge toll on the health of Londoners, with an estimated 4,000 of the capital’s residents dying prematurely in 2019 from air pollution.4 Studies show living with dirty air also increases the risk of heart disease and heart attacks, as well as stunts lung growth in children.5

But the health impact of air pollution is not evenly felt. In Tower Hamlets, for example, air pollution is among the worst in London, and asthma hospital admissions for young children are 42% higher than the England average.6

Call for next London Mayor to transform the Red Routes

The hacked signs have been placed on the capital’s Red Routes network, which was established in the early 1990’s to improve traffic flow across the city and is currently under the Mayor’s control. These major roads account for around 5% of London’s roads but carry up to a third of London’s traffic on an average day. The Red Routes network has led to an unequal health burden in the city with Londoners living, working, and going to school near these roads breathing higher and often illegal levels of air pollution. 

New analysis by EDF Europe using modelled NO2 and PM2.5 data produced by CERC as part of the Breathe London pilot project shows that NO2 pollution levels on Red Routes are 57% higher than an average road and PM2.5 levels are 35% higher.7 They will likely be some of the last areas in the UK to meet legal NO2 pollution limits, which should have been met over a decade ago - in 2010. Tyre and brake wear from vehicles is also a dominant local source of PM2.5, of which many parts of London do not meet safe and healthy levels set by the World Health Organization (WHO).8Campaigners are urgently questioning how the Red Routes fit with a cleaner and greener London as the city recovers from the pandemic. They are calling on mayoral candidates to reduce health inequities by committing to transform these roads, which will demand a fresh approach to freight and firm targets to reduce car use in the capital. Rethinking the Red Routes will require a world class walking and cycling network, as well as affordable and accessible zero-emission public transport. 

Oliver Lord, Head of Policy and Campaigns at Environmental Defense Fund Europe, said: 

“Like the COVID-19 pandemic, air pollution is disproportionately impacting marginalised communities and Black, Asian and minority ethnic people. It’s clear London’s busy roads are a root cause of health inequities and air pollution levels are a major contributor. 

For years, the major ‘Red Routes’ have been a toxic thread running through our communities, polluting the doorsteps of homes and kids’ playgrounds. We need a green recovery that undoes decades of damage, using a clear traffic reduction plan – one where polluting trucks can no longer cut across the city and parking for cars becomes parks for people. As we approach the mayoral elections we are asking candidates to commit to transform the Red Routes road network, putting people’s health and our climate first. 

We are calling on all of the London mayoral candidates to make three bold manifesto commitments for a cleaner, brighter London: rethink the harmful Red Routes, expand the Ultra Low Emission Zone and deliver a zero-emission bus fleet this decade.” 

The campaign is also backed by Mums for Lungs, a group of parent campaigners on air pollution.

Jemima Hartshorn, a parent who lives in Herne Hill and is part of the Mums for Lungs group, said: “The street signs are hard hitting because we want people to take notice of the huge damage being done to their health by air pollution. It is crucial that the message is heeded by politicians that if we do not take action on air inequality there will be more and more hospital admission and sadly more needless deaths of children.”

NO2 pollution forms when fossil fuels such as coal, oil, gas or diesel are burned at high temperatures. It can cause reduced lung function in children, trigger asthma attacks and hospital admissions for children. Recent studies have linked the pollutant to lung cancer, cardiovascular harm, lower birth weight in newborns and increased risk of premature death.9

PM2.5 pollution refers to very fine particulates - with a size generally less than 2.5 micrometres (µm). It is contained in pollution from petrol and diesel vehicles as well as woodsmoke and industry. This microscopic material when breathed in can penetrate deep into the lungs and can then be absorbed into the bloodstream. This form of pollution is associated with health conditions such as heart disease, stroke, lung cancer as well as diabetes and dementia. High levels of PM2.5 pollution can trigger asthma attacks, heart attacks and other serious medical emergencies, and has a long term impact on lung function particularly in children.10

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Medact (www.medact.orghas a mission to support health professionals from all disciplines to work together towards a world in which everyone can truly achieve and exercise their human right to health. We do this through research and evidence-based campaigning for solutions to the social, political and economic conditions which damage health, deepen health inequalities and threaten peace and security. 

Environmental Defense Fund Europe (, a leading international nonprofit organization, creates transformational solutions to the most serious environmental problems. EDF links science, economics, law and innovative private-sector partnerships. With offices in the United States, China, Mexico, United Kingdom and Indonesia, EDF’s 750 scientists, economists, attorneys — and our allies — work in 28 countries to turn our solutions into action. 

Choked Up (@ChokedUp_UK) is a campaign group of Black & brown teens living in areas affected by air pollution. Founded in 2020, Choked Up explores the inequalities associated with air pollution and aims to enshrine our right to clean air in law. 

Mums for Lungs ( is a group of London parents that campaigns for clean air. The group was established in Brixton in 2017, when a number of us were on maternity leave together. Walking around South London with small babies we became aware of the toxic levels of air pollution on London’s streets. 

About the Road Signs

In the style of Parking Zone signs, they read POLLUTION ZONE. In the red ring is a silhouette of a mother and child, wearing afros and holding hands. Behind them are clouds of toxic air, with the caption, “People of colour are more likely to live in an area with illegal pollution levels”, “BREATHING KILLS” and at the amber base of the sign the rallying cry: “Clean air for all.” The signs in Whitechapel have been translated into Bengali given that Tower Hamlets has the largest Bangladeshi population in England.

Data Sources:

  1. EDF Europe analysis using Cambridge Environmental Research Consultants (CERC) high-resolution modelled NO2 2019 annual averages produced as part of the Breathe London pilot project and census 2011 data from the Office for National Statistics.
  2. EDF Europe analysis using CERC’s high-resolution modelled NO2 2019 annual averages produced as part of the Breathe London pilot project and Index of Multiple Deprivation data from the Ministry of Housing, Communities & Local Government.
  3. Medact: Letter to all 2021 Mayoral candidates
  4. Environmental Research Group at Imperial College London: The London Health Burden of Current Air Pollution and Future Health Benefits of Mayoral Air Quality Policies
  5. King’s College London: Living near a busy road can stunt children’s lung growth
  6. Public Health England: Tower Hamlets Indicator - Admissions for asthma for children aged 0 to 9 (2018-2019)
  7. EDF Europe analysis using CERC’s high-resolution modelled NO2 and PM2.5 2019 annual averages produced as part of the Breathe London pilot project.
  8. London Atmospheric Emissions Inventory 2016.
  9. American Lung Association: Nitrogen Dioxide
  10. Public Health England: Health matters: air pollution