The causes behind respiratory illnesses are two-fold being a combination of genetic background and environmental conditions. However, with its prevalence increasing in industrialised countries, air pollution is a critical factor in inducing symptoms in genetically susceptible people.

To put it simply, a person born with a genetic disposition but lives in an area with good air quality is unlikely to ever develop a chronic respiratory illness.

Children, studies show, are more susceptible to developing both acute and chronic respiratory illnesses.

2. How is a country’s air quality measured?

To not bore readers with convoluted scientific jargon, EU directives establish five main pollutants, however, PM 2.5 is by far the most harmful, accounting for 90% of all deaths caused by air pollution in Malta.

PM 2.5 is a fine particulate matter that has a diameter of fewer than 2.5 micrometers (3% the size of a human hair). Since they’re so small, the particles tend to stay longer in the air and also able to bypass any biological filters to penetrate deep into the lungs and circulatory system.

The particle is mostly present in diesel-powered cars, given that petrol vehicles use a catalytic converter. There’s a catch; however, catalytic converters take roughly 15 minutes to kick in, about a third of drive-time in rush-hour.

3. Why is the situation worse in Malta?

A high population density, coupled with a never-ending traffic problem means that levels of PM 2.5 could be the leading cause behind the rate of respiratory illness.

While numbers have seemingly plateaued, the situation isn’t getting any better while the country remains at a high rate.

A Maltese study, authored by Dr Martin Balzan and Dr Stephen Monteford, comparing the prevalence of respiratory illnesses in Malta and a rural town in Sicily that neighboured a series of petrochemical plants makes for interesting reading.

Forming part of the Respira Project, the study found that Maltese people were between two to fives times as likely to develop a respiratory illness than their Sicilian counterparts.

Finding official figures is an issue, with ERA’s system currently undergoing maintenance. However, the most recent EU statistics (2015) found that Malta has the fourth-worst levels of harmful particles, standing at 50 micrograms per cubic metre right on the EU daily limit value.

With cars having increased substantially since then, it is unlikely that the situation has gotten better.

4. How can we improve the situation?

Solving traffic, at least in the case of Malta, is crucial in alleviating this public health concern. Wider roads and less traffic (in the short term) would reduce congestion, as the government has pointed out, and do some bit in addressing the environmental and health issues.

However, it does little to solve climate change and simply encourages vehicle use, adding to a stock that is already spiraling out of control.

Speaking to Lovin Malta, Respiratory Specialist Martin Balzan said that increasing trees, while important, was not the main determinant to affect the widespread air quality issue with a switch in the modes of transportation a much more crucial step.

The long-heralded switch to electric cars may seem like the decisive mve, but it fails to address the issues concerning climate change and carbon dioxide emissions without a renewable energy source.

Public transport, experts explained, is the route to follow. However, alleviating both climate change and traffic through an improved system, through what would most likely be a mass transport system, comes at a massive capital expense.

But rather than looking at a system that should cater for every corner for the island, maybe the government (and the public for that matter) would be better off calling a system that focuses solely on the areas worst affected, rather a nation-wide project.

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