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The 19 June 2025 marked Clean Air Day, a focal point in the campaign against air pollution, and opportunity for global advocacy. It was also marked by a report from the Royal College of Physicians, on the importance of fresh air and a host of fantastic events across the UK amplifying the clean air agenda and the report's asks. 

On the day, we coordinated a synchronised 'Walk and Wheel' with paediatric colleagues across the country. RCPCH staff, members and associates also took part in the , a local event that saw over 100 doctors, nurses, patients and supporters make their way from Great Ormond Street Hospital for Children to Parliament Square. There, they delivered a letter to the Government, signed by more than 400 health professionals, including a large number of paediatric colleagues. The letter calls for three main streams of action: 

1. Policy: to meet the World Health Organisation (WHO) air quality guidelines, and to treat air quality as a public health issue rather than a solely environmental one  
2. Awareness: the Department of Health and Social Care to lead a public health education campaign on the harms of air pollution, as well as calling for all medical professionals to have comprehensive and ongoing education around air pollution and its impacts  
3. Role modelling: to implement clean air frameworks across the NHS, recognising it as an anchor institution, employer and a contributor to air pollution. 

The sentiment, and this urgency, is echoed in the RCP report, . It highlights evidence linking the detrimental effects of air pollution to almost every organ. Headline figures include estimates that dirty air will play a role in the equivalent of 30,000 deaths in the UK in 2025, with an economic cost of £27 billion due to healthcare costs, productivity losses and reduced quality of life.  

The RCP report also hammers home the case for action on childhood exposures, mirroring the sentiments from the RCPCH air pollution position statement on the vulnerability of children and perpetuated inequalities, fuelled by inaction. It features a foreword by Professor Chris Whitty, the chief medical officer, describing air pollution as "a societal problem: one polluting industry or road can lead to many thousands of people being affected without having any choice about the matter". 

Our report Clean air, healthy childhoods: Innovative clinical responses to environmental health inequalities was released a week later, on 25 June, and reviews the work of two novel ‘Clean Air Clinics’. It explores innovative clinical responses to environmental health inequalities, combining findings from interviews with clinic teams, a survey of paediatricians and engagement with children, young people and families. Dr Helena Clements, RCPCH Officer for Climate Change introduces the report, saying "To build a healthier future for children, we need urgent, collaborative action across housing, health and environmental policy.” 

The report’s recommendations are clear in calling for action at every level, with asks for the UK government, local authorities, hospital Trusts and boards as well as Royal Colleges and clinicians as individual advocates and practitioners, including: 

• The UK Government to pass a UK-wide Clean Air Act, set strict air quality standards and aligning with WHO Air Quality Guidelines 
• Expand Awaab’s Law across the UK to cover private renters 
• Local authorities and housing teams to improve housing conditions with faster response to mould and damp complaints 
• Royal Colleges and medical schools to embed environmental health in core curriculum 
• Clinicians to incorporate environmental history into routine care. 

All of this work is part of an increasing recognition of the threat air pollution poses to health, wellbeing and economic development. As paediatricians it seems we often witness the starkest reminders of this crisis and have the greatest opportunity for early intervention that can alter the health trajectory of our patients. When discussing health inequalities with members, I was struck by the sentiment from one consultant who said she had written more letters about the effects of housing on health in the last two years than in the preceding 18 years of her career. 

It is abundantly clear to us that disparities in the antenatal environment right through to the conditions in which adolescents exercise or attend school, drive cumulative inequalities and widening health and social outcomes. We know air pollution affects lung growth, development and function. Data on the long term health outcomes associated with variation in childhood lung function highlights just how profoundly these early insults affect our whole life course. 

The message from RCP, from the letter to the Government and from RCPCH is shared, and it’s clear. We have plentiful evidence, we have responsibility and we have hope in coordinated action driving positive change, both in legislation and for individual children we look after.

Explore our Air Pollution Companion for ideas and resources to support clean air for children and young people. 

Written by Dr Harry Apperley recent RCPCH Clinical Fellow Clean Air Fund partnership and registrar in paediatric respiratory medicine at the Royal Brompton Hospital, London