Draft Freedom of Information to Great Ormond Street Hospital
Paul Scott and I have have written the draft in the hope of others will also sign and offer amendments during April, The idea is to submit the request in May and see what comes back. Great Ormond Street have been been pro-active in linking air pollution to child health. I cut and paste the Hospital press release of 16th February 2023 below:
Air pollution levels added to patient's postcodes
16 Feb 2023, 6:15 a.m.
Air pollution levels for patient’s postcodes have been added to their medical records to help families understand the risk in their local area.
Great Ormond Street Hospital for Children (GOSH) has teamed up with Imperial College London, which collected the data from across Great Britain, to make the average annual pollution rates for each of the patient’s postcode easily available.
Clinicians can compare the patient’s postcode levels to those recommended by the World Health Organisation (WHO), to explore any risk this may pose.
Why is this happening?
In December 2020, Ella Adoo Kissi Debrah, became the first person in the UK to have air pollution listed as a cause of death on her death certificate. This was a result of years of campaigning by her mum Rosamund to have a new inquest, following the nine-year-old's death in 2013.
In a report to prevent future deaths, the coroner said that clinicians must do more to warn families of the dangers of air pollution.
Last year, the chief medical officer Christopher Whitty, also made recommendations on air pollution.
For the NHS he said: “The training of healthcare staff should include the health effects of air pollution and how to minimise these, including communication with patients.”
How does this help clinical teams work with patients and families?
The clinical team will be able to see air pollution data for PM2.5 (fine particulate matter) and nitrogen dioxide on each patient’s electronic medical record, as well as the World Health Organisation guidelines for these particles, and the rates at GOSH.
There are also links to further information, training and advice on how our clinicians can speak to families about the issues.
The training and the data will help our clinicians consider whether air pollution is a factor in their child’s illness, how it affects them, and if there are steps that can be taken to help.
What else is GOSH doing?
In 2019 GOSH launched the first ever Clean Air Hospital Framework to improve air quality in and around the hospital. It also launched Play Street, as part of this goal. In 2021, we became the first London hospital to declare a Climate and Health Emergency and have set ourselves challenging Net Zero targets to drive us forward. Over 30 members of GOSH staff also cycled to Glasgow to coincide with the COP26 climate meeting as part of Ride for Their Lives.
What happens next?
Now that the air pollution data has been added to the medical records, training will be rolled out across GOSH.
Mark Hayden, Nicola Wilson and Johanna Andersson, who led the project at GOSH to add the air pollution data to medical records, hope to work with other hospitals to add air pollution to more patients’ records. END OF PRESS RELEASE
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The draft Freedom of Information request to the hospital is below.
Dear Great Ormond Street Hospital Freedom of Information Department,
We are concerned about High Rise residential being planned
across by busy roads in London. Sometimes developments are also in between busy roads and
railway tracks. Both air and noise pollution are linked to serious illness.
Sometimes these developments are designed with affordable housing in mind which
suggests the families living in them have low incomes and as a consequence may
suffer from poor diet. There is research which suggests poor diet makes
children more vulnerable to diseases.
So although the information we request may be more expensive
that that usually allowed we argue that is in the public interest for it be
released to an academic.
An example of medical information being given to an academic is
when the Fire Brigades Union have sent medical information to an academic on
behalf of their members. The study was dated January 2023, the press was titled
“Firefighters far more likely to die from cancer and heart attacks than public”
and is available at https://www.fbu.org.uk/news/2023/01/10/firefighters-far-more-likely-die-cancer-and-heart-attacks-public The study found fire
fighters more likely to die of serious diseases than the general
population.
Our expectation is that the illness and mortality data you hold
will show worse health for children located close to roads which will inform
public debate and policy making.
We can find no studies linking the impact of noise, air, magnetic field and inadequate diet on child health. The data Great Ormond Hospital holds could prove useful in discovering whether worse health child health outcomes are correlated to areas
The Goldacre review at https://www.gov.uk/government/news/goldacre-recommendations-to-improve-care-through-use-of-data aims to drive innovation and improve healthcare through safer use of health data. We argue that the data Great Ormond Street holds is likely to influence planning policy, in particular pollution hotspots where a number of pollution factors are located in one location making the health risk of building there measurably worse than elsewhere.
The Mayor of London’s office uses modelled mortality rates for
policy making purposes, we say the real data you hold will test how accurate
the Mayor’s modelling is and will be more comprehensive covering other risk factors
such as EMF, noise and poverty as well as air pollution.
We seek the following information.
1)
The full postcodes of patients, both in patients and out patients aged under 18
who have been are/receiving treatment for the following conditions living within a London Borough
a)
Cancer with a breakdown of types, for example
Leukaemia
Brain and spinal cord tumour
Neuroblastoma
Wilms tumour
Lymphoma (including both Hodgkin and non-Hodgkin)
Rhabdomyosarcoma
Retinoblastoma
Bone cancer
b) Otitis media
c) All Acute lower respiratory infections, such as pneumonia and
bronchiolitis.
d) Meningitis
e)
Asthma
For
the following periods:
23rd March 2020 to 22nd March 2021
23rd March 2019 to 22nd March 2020
These dates tie in with the lockdown period.
2) Children who have died in your care either in hospital or at home as
out-patients aged under 18 for the same time periods and same conditions with
the full postcodes set out in 1 above. It is accepted there are confidentiality
issues here, but when Councils are planning substantial housing developments
close to roads it must be right to discover if there is a health risk to
building homes in these locations.
3)
Dates of admission and deaths in (1) and (2) to discover if there is correlation
to high pollution days.
This
information may be over the usual cost limits, but it is the public interest
for the it to be published. Information relating to the slight risk of blood
clots from the astrazeneca vaccine has led to changes in the use of the
vaccine.
Many
developments are close to busy roads, some between railways and busy roads.
Some of these developments are designed for low income residents. Research
suggests a poor diet is likely to make children more vulnerable to disease
linked to air pollution. There is also evidence that suggests EMF is linked to
child cancer. This means some sites planned for development will have all four
risk factors: traffic pollution, noise pollution, EMF and poor diet. The data
Great Ormond Street Hospital holds has the potential to inform public debate
about whether it is responsible to build developments in such apparently toxic
locations.
They
are many articles linking child illness pollution one at
https://www.nature.com/articles/s41416-0...
says
“A
meta-analysis by Boothe et al.31 assessing childhood leukaemia in relation
to multiple pollutants found an increased risk for post-natal exposure but no
association with pre-natal exposure. Most studies found an association with
childhood leukaemia overall, but the association tended to be stronger when
examining just acute lymphoblastic leukaemia (ALL) or acute myeloid leukaemia
(AML) for specific pollutants32. “
Yours
faithfully,
Paul
Scott
Andy
Walker
– supporting literature
1)”
Childhood cancer and traffic-related air pollution in Switzerland: A nationwide
census-based cohort study” Environment International published in Volume 166,
August 2022, 107380
2)
“More than 90% of the world’s children breathe toxic air every day “Published
by World Health Organisation 29 October 2018. We quite “Air pollution also
impacts neurodevelopment and cognitive ability and can trigger asthma, and
childhood cancer.”
3)
Air Pollution and Otitis Media in Children: A Systematic Review of Literature Published
online 2018 Feb downloaded from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858326/#:~:text=There%20is%20an%20increasing%20body,risk%20of%20OM%20in%20children. The
quote we rely is “There is an increasing body of evidence supporting an association
between higher ambient air pollution exposure and a higher risk of OM in
children”
4
Noise Effects on Health in the Context of Air Pollution Exposure Stephen A.
Stansfeld. Int J Environ Res Public Health. 2015 Oct; 12(10): 12735–12760.
Published online 2015 Oct 14.Published online 2015 Oct 14. The
quote is:
“There is good evidence from large population studies that
environmental noise from road traffic and aircraft is associated with
cardiovascular morbidity and mortality independent of the association with air
pollution. There may be both independent mechanisms and common mechanisms
involving methylation for these associations of environmental exposures with
health. Environmental planning and policy should take both exposures into
account when assessing environmental impacts.”
4) Road proximity, air pollution, noise, green
space and neurologic disease incidence: a population-based cohort study. Weiran
Yuchi, Hind Sbihi, Hugh Davies, Lillian Tamburic & Michael Brauer
Environmental Health volume 19, Article number: 8 (2020
“Emerging evidence links road proximity and air pollution
with cognitive impairment”
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