AJPH BOOK & MEDIA London Fog—The Biography

LONDON FOG—THE BIOGRAPHY BY CHRISTINE L. CORTON Cambridge, MA, The Belknap Press of Harvard University Press, 2015 408 pp.; $35.00 ISBN 0-6740-8835-2

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Book Review

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For many years, in scientific presentations on the health consequences of air pollution, I have started with a graphic on the London Fog of 1952, showing daily mortality and levels of two air pollutants (smoke—an indicator of airborne particles— and sulfur dioxide) over the several days before, the days of the fog, and several days afterward (Figure 1). By eye, the impact of the air pollution on mortality is dramatic with the death count more than tripling at the peak of the fog. For reference, the air pollution levels were approximately 100-fold greater than in major cities in the United States today. Such dramatic episodes of excess mortality, similarly documented in the United States in Donora, Pennsylvania, in 1948, played a critical role in motivating research on air pollution and clean air legislation in the United Kingdom and the United States. The new book, London Fog, provides sweeping coverage of the London fogs in an account that ranges from the history and sources of the fogs to their impact on art and portrayal in literature and film. Corton, a Senior Member of Wolfson College, Cambridge, brings a new perspective to a saga that has largely been viewed through a public health lens. London Fog’s chapters cover, for example, Dickens’ intertwining of the fogs into his inevitably bleak books set in London. The fogs also were a key back drop for the Sherlock Holmes mysteries and portrayals of the “Jack the

Ripper” murders, and lesser known mysteries. Corton also captures the use of the London fogs in movies, such as Midnight Lace, starring Doris Day, which includes a threat against Day made by an assailant invisible in the fog. I was particularly engaged by descriptions of the influence of the fogs on paintings by artists such as Monet. The book is beautifully illustrated with paintings such as Turner’s The Thames above Waterloo Bridge. Corton describes this 1835 painting as one of the first to portray the fog; it was left unfinished because a buyer could not be found. The literary and artistic use of the London fogs speaks to their place in everyday life in London. They were pervasive and noted for centuries, called “pea-soupers” because of their impact on visibility, sometimes so severe as to threaten pedestrian movement and transport. One critical source of the fog that increased for centuries was coal combustion, primarily for residential heating and cooking, along with industrialization. The coal’s sulfur content was substantial and its combustion generated sulfur oxides and the acidic

particles from chemical transformations of these gases. Thus, the disastrous London Fog of 1952 was perhaps inevitable, culminating fogs that Corton traces back for centuries. One of the earliest accounts of the fogs was by John Evelyn in Fumifugium; or, The Inconvenience of the Aer and Smoak of London Disappated, published in 1661. Given the severity of the fogs and the understanding of coal combustion as a dominant cause, why was a public health disaster needed to motivate action? The delays reflected the interfering actions of manufacturers and the powerful coal industry. The London Fog of 1952 proved pivotal through the horrifying scale of its consequences. In its aftermath, the government formed the Beaver Committee, which released a forceful, interim report in 1953 that was far more useful than the issuance of masks—completely ineffective protection against urban air pollution—by the National Health Service. The Beaver Committee’s report called for reduction of burning and other measures. The Clean Air Act, motivated by the fogs, was passed in 1956 and led to the implementation of smokeless zones. Air quality improved in London, and the last major fog was in 1962.

ABOUT THE AUTHOR Jonathan M. Samet is Distinguished Professor and Flora L. Thorton Chair, Department of Preventive Medicine, University of Southern California (USC), Keck School of Medicine, Los Angeles. Correspondence should be sent to Jonathan M. Samet, MD, MS, Distinguished Professor and Flora L. Thorton Chair, Department of Preventive Medicine, Keck School of Medicine of USC, Director, USC Institute for Global Health, University of Southern California, 2001 N. Soto Street Building, Suite 330, Los Angeles, CA 90089, (e-mail: [email protected]). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link. This book review was accepted May 27, 2016. doi: 10.2105/AJPH.2016.303292

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1000

4.0

Fog period

750

3.0

500

2.0 Sulphur dioxide

250

1.0

Smoke and Sulphur dioxide (mg/m3)

Deaths

Deaths

Smoke

0 1

2

3

4

5

6

7

8

9

10

11

12

13 14 15

Date December 1952 Source. Brimblecombe.1 Permission to reprint from Methuen publishing.

FIGURE 1—Deaths and pollutant concentrations during the London fog of 1952.

The London Fog of 1952 had impact beyond the United Kingdom. Epidemiological research on air pollution originated with pioneering investigators in the United Kingdom, beginning in the 1950s. Their approaches, including population-based studies and assessment of respiratory symptoms with questionnaires and lung function testing, were adopted by researchers in the United States and Canada. The landmark Harvard Six Cities Study of air pollution extended this early research, adding detailed exposure assessment to its approach. In the United States, the Clean Air Act was passed in 1970; it was grounded in scientific understanding of air pollution and its health effects as have been subsequent revisions (1977 and 1990). As noted by another distinguished air pollution researcher, David Bates, who was in

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London at the time of the 1952 fog: This is why the London Disaster of 1952 should be commemorated; the many efforts to limit ambient air pollution that have occurred in the past 50 years are the proper memorial to those who were its unheralded victims. 1(pA735)

There are other resources on the London Fog of 1952. Logan’s report in Lancet in 1953 provides a summary2 and there is an official report, released in 1954.3 Brimblecombe’s 1987 book, The Big Smoke: A History of Air Pollution in London Since Medieval Times, provides a more detailed account of the atmospheric pollution in London and its health consequences.4 Corton’s book nicely complements these publications, adding the rich story of the broad societal reach of the fogs. The book is a demanding read, given

the depth of its scholarship. For example, for me, the works of Dickens were never easy and, perhaps not surprisingly, the chapter on Dickens is correspondingly dense. Nevertheless, readers of AJPH will learn from London Fog, and all those involved with air pollution should read the book. I also recommend When Smoke Ran Like Water by Devra Davis, which tells the story of the air pollution disaster in Donora, Pennsylvania—a critical event in the United States.5 London Fog inevitably raises the question: could there be another air pollution disaster like the London Fog of 1952? Looking at air pollution levels around the world, there should be concern for that possibility. For major cities in many countries, air pollution monitoring data are available in real time for airborne particulate matter and

other pollutants; the US State Department has now installed monitors for the small particles that can penetrate deeply into the lungs—PM2.5 (particulate matter < 2.5 microns in aerodynamic diameter). A sampling of PM2.5 levels as this review was written (May 25, 2016) shows the following 48-hour maximum air quality indices from real-time air quality stations (AQICN.org): 261 in Delhi, India; 183 in Beijing, China; 118 in Mexico City, Mexico; 91 in London; and 42 in Los Angeles, California. While not approaching levels in London in 1952, the higher concentrations are alarming and air pollution has been worsening in China, India, and elsewhere. The increases now relate to rapid industrialization and introduction of large vehicle fleets, particularly with the possibility of ownership of cars by an increasing number of people. The London Fog experience speaks to the need for aggressive pollution control so that we will not be writing in the future about the Beijing or Delhi Fog of 2022. Jonathan M. Samet MD, MS REFERENCES 1. Bates DV. A half century later: recollections of the London fog. Environ Health Perspect. 2002;110(12):A735. 2. Logan WP. Mortality in the London fog incident, 1952. Lancet. 1953;1(6755): 336–338. 3. Ministry of Health. Mortality and Morbidity During the London Fog of December 1952. Reports on Public Health and Medical Subjects No 95. London, UK: London Ministry of Health; 1954. 4. Brimblecombe P. The Big Smoke: A History of Air Pollution in London Since Medieval Times. 1st ed. London, UK: Routledge Kegan & Paul; 1987. 5. Davis D. When Smoke Ran Like Water: Tales of Environmental Deception and the Battle Against Pollution. 1st ed. New York, NY: Basic Books; 2002.

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Book Review

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London Fog-The Biography.

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