Dr Malcolm White clean air specialist at Global Action Plan - on clean air day

Dr. Malcolm White, a clean air specialist at Global Action Plan, joined hosts Dom Burch and Saira Arif to discuss the critical issue of air pollution and its health impacts. Malcolm highlighted his background in hospital medicine and environmentalism, sharing insights from his experience working in deprived areas where environmental factors significantly affect health.

He's recently led healthcare education projects, delivering teaching to healthcare professionals in primary care and developing supporting materials to complement these projects.

The teaching significantly improved clinician understanding and confidence with regards air pollution. The resources have proved popular and have been adopted by organisations such as the Royal College of Physicians. Malcolm is currently working on encouraging greater actions from the NHS on air pollution at the Integrated Care Systems (ICS) level, in particular working with a cluster of ICSs that represent the South East of England.

The interview delved into the historical context of air pollution in the UK, referencing the deadly smogs of the 1950s and the Clean Air Act that followed. Malcolm emphasised that despite improvements, air pollution remains a significant issue, causing up to 43,000 deaths annually in the UK.

Malcolm explained the importance of clean air zones, although he noted they are not a comprehensive solution. He discussed the extensive health impacts of air pollution, affecting not only respiratory health but also cardiovascular health and even fetal development.

The conversation includes practical steps individuals can take to reduce air pollution, such as using active travel, public transport, and improving indoor ventilation. Malcolm also stresses the crucial role of educating healthcare professionals about air pollution, advocating for its inclusion in healthcare curricula.

Global Action Plan’s initiatives, including the Clean Air Hospital Framework, aim to help hospitals and the NHS reduce their air pollution contributions. Malcolm called for enhanced government action on clean air and improved transport infrastructure.

The podcast concluded with a call to action for listeners to visit the Global Action Plan’s Knowledge Hub for resources and support Clean Air Day efforts.

Transcript

Dom Burch: 0:08

Welcome back to The up and away podcast from tiny medical apps. My name is Dom Burch and my co presenter is Saira Arif, who is not in Dubai. But back in London, Saira

Saira Arif: 0:21

London. I've been hit with a tonne of bricks. I've got a cold. I've got a cough. I've gotten congested, though. Yeah, all good. They're all good.

Dom Burch: 0:31

And I am wondering out loud wherever that is to do with the air quality in our capital city. And some of you might know the answer to that question is our guest this week. absolutely delighted to welcome on to the podcast, Dr. Malcolm white. Now, Malcolm is a clean air specialist at global action plan, amongst many other things. But Malcolm, why don't you introduce yourself. Welcome to the Up up and away podcast.

Malcolm White: 0:52

Thanks, Dom. And Thanks, Saira. Yeah, it's great to be invited and lovely to speak to you today. I've worked for the charity global action plan. We're an environmental charity. But we also work in other areas as well, all sorts of aiming to mobilise action on the systems that homeless on the planet, in terms of how I came to that, and my background is in hospital medicine, I did about 10 years of that, and I still go back and do the old shifts to keep my hand and yeah, kind of working in hospitals, a lot of which in the east end of Glasgow, which is unfortunately, a very deprived part of the country. And you see a lot of the same patients coming in day after day with like, issues that are brought on by things that are impactful from the environment, or things which are impactful from like social deprivation, and things like that. So a lot of obesity, smoking related issues, drug issues, alcohol, and a lot of people who are impacted definitely by the environment, and poor air quality as well. And so when the IPCC report of 2018 came out, I think it was a really big wake up call to a lot of people of sort of my generation. And I got me very invested and interested in environmentalism. So I did quite a lot of activism for a year or so, and then got a bit burnt out from that, if I'm perfectly honest, trying to work full time, at the same time, it seemed like the right idea to try and move in a direction where I could combine environment and health in my work. So given a couple of years, or pandemic work to the sides, but after that, I decided to make the step in to working with global action plan.

Dom Burch: 2:36

And particularly Malcolm, I guess, in relation to air pollution. And there'll be people listening, who, I guess they're getting more and more aware and becoming more interested in air pollution, partly because of some of the big initiatives in London. And you know, I live in Bradford, and we have a clear air zone here in Bradford. And, you know, sometimes their first introduction to it might be, oh, here we go. Here's another tax for me going about my daily routine. But you know, I sort of liken it to 25 years ago, when speed cameras started popping up everywhere. People didn't like them, but they slow down because it was a speed camera. So what is the current state of air pollution in the UK? I mean, are we are we sort of moving in the right direction, or are things still pretty bad.

Malcolm White: 3:18

So it kind of depends on how far back you look, to some degree. I mean, if we just even really briefly talk about how air pollution used to be in the sort of 1940s and 50s, that led, you know, that they had loads of people burning open coal fires within the city, lots of industrial work going on inside cities and things to that as well. And a lot of that coal burning, in particular created these deadly smog, which was essentially when you get fog mixing with this nasty smoke, and it creates this smog, which really, really impacted people's health extremely significantly and cause things like what was known as the Great Smog of London in 1950s. And that actually killed it was about 12,000 people within a number of weeks. And then over the next six months more 1000s of people died because of really, really bad respiratory and cardiovascular issues that they had after that as well. And that brought in the first Clean Air Act, which was at the time, sort of, you know, pretty much the first legislation on in the world as far as I understand. And we do see over time that as more and more big legislation or policy changes have come in, it's really those things that have actually meant that the UK is is a relative success story in terms of bringing levels of air pollution down. So the picture is much, much better than it used to be. But it is still definitely a significant problem. For many reasons. And, and unfortunately, it still leads to it's, you know, sought to be up to 43,000 people each year die in the UK relating to air pollution

Dom Burch: 4:59

Blimey.

Malcolm White: 5:00

Yeah, yeah, and lots of things that contribute to that. But yeah, I'm sure we'll go into that more too.

Dom Burch: 5:08

But that but that sort of thing is really interesting, because when I was involved in road safety 20 odd years ago, it was 10,000 deaths a year on the roads. And that's come down, partly because of things like speed cameras, seatbelt use, but also cars becoming, you know, safer, frankly, if you bang into each other. And that number was such a shocking number on a daily basis. And yet, we're talking about four times that number for air pollution, but it's more of a hidden killer, I guess it's not obvious. It's not big accidents happening. And, you know, dramatic news, it's, it's sort of there in the background in everyday life.

Malcolm White: 5:41

Absolutely. And air pollution is often called the invisible killer, that, again, is partly due to the success story. So we've got much less coal burning, and other sort of really, really visible forms of air pollution like that, for example, cars have become a lot cleaner over the generations of time, so that the engines are much better at not producing loads and loads of black carbon and nasty chemicals. But at the same time, air pollution from traffic still contributes a very big proportion of the air pollution that we see today. It's more than it's shifted towards being this invisible killer, so to speak, as well.

Dom Burch: 6:20

And what sort of things you know, what sort of things can be done and what sort of things need to go faster, because I guess, clear air zones are something quite visible, and that is going to change the behaviour. And when I notice that come down to London, right? You just feel like the air is a little bit cleaner. Now I'm say that Saira is somebody doesn't suffer asthma, right? And you're gonna know, and I sort of feel guilty even mentioned it, but there are a lot more people cycling, the buses are cleaner. And there is a sense that things are starting to move in the right direction there. But I would imagine, you know, in plenty other places, Birmingham, for example, Manchester, have shelved their as own clean air zone, as you drive around, I'm gonna go, you know, actually, I think it was Manchester particularly, you know, they felt they couldn't introduce it because of the impact of COVID. But, I mean, it must be really frustrating as a specialist in this area, just to kind of go, come on everybody, the science is clear, what we need to do is clear, surely the time for action has come?

Malcolm White: 7:14

Realistically, the the time for action was 25, or 30 years ago, but I think global action plan, we're definitely supportive of clean air zones as an initiative, they need to be done right and implemented in a way which is as fair as possible, knowing that it will impact people in their businesses, etc. But significantly, reducing the amount of air pollution that we have in our cities is definitely going to improve people's health. And you know, it's going to save 1000s of lives each year. So it is an absolutely vital element. And I will say as well, that clean air zones, while impactful are by no means a silver bullet, though, and I know that, you know, ends up being a really big thing in the media, everyone focuses on them a lot. But actually, it's only part of a whole ream of measures that we need to do in order to improve air quality. And so there's loads of things that society needs to do collectively, and we need to do as individuals. But I will say, again, that many of the biggest changes in air quality have come from Central legislation and policy.

Saira Arif: 8:20

I think I mentioned that I've got asthma. And you know, one of the things that I was pretty confident about was actually bad equalities linked to respiratory health. I mean, I think we all know that. But I've read recently that actually bad air quality doesn't only affect respiratory health, it actually affects everything.

Malcolm White: 8:39

Yeah, absolutely. So there are many different types of air pollution. And that is, obviously a mixture of like little tiny particles that float around in the air or gases that are created when we burn things, or lots of additional chemicals that we use, say, and paints and varnishes, and things like that. So air pollution means a whole lot of different things that are all mixed into the air that we're breathing. And we breathe them into our bodies in through our lungs. And that's why inherently people can understand that air pollution impacts the lungs. But actually, once we breathe that in, the body does have some defences in terms of like, say, the mucus that lines our airways, and other things like that. But there's so much air pollution, often that it sort of overwhelms and bypasses those defences. And then it actually reaches the edges of the lungs and gets into the bloodstream that way, and having gotten into the bloodstream, it travels all around the body. And that's why there are effects throughout the whole body that we noticed because of air pollution. And indeed, while everyone is very familiar, or at least could understand the air pollution causes respiratory disease. It's actually a cardiovascular disease to say heart to heart attacks, strokes and other diseases like that, that are actually the main cause of death relating to air pollution.

Saira Arif: 10:02

So it's really interesting because as a asthmatic, I'm always sort of concerned about my lungs and lung health. But actually, there's so many other sort of areas that I don't even think about. But that's, that's really, that's really good to explore that.

Dom Burch: 10:16

You know, one of the things we picked up with Mon Fletcher, when we interviewed last week was this idea about health inequalities. Right. And I, presumably because of the varying degrees of air quality in different parts of the country, in different parts of a town or a city and where you live, if you live in by major road, or if you live in by manufacturing plants, and all that kind of stuff. You know, which populations are most vulnerable in the UK to the effects of air pollution? And how does it affect children differently from from adults?

Malcolm White: 10:44

really important questions there. So first of all, air pollution is a really, really big contributor to health inequalities in the UK. That means that some people have worse impacts on their house because of where they live, or the environment around them or their housing or things like that, too. So if you can just imagine some examples of a family who live in a council or private rented apartments in high rise flats beside a major road, then these people don't necessarily have much power or financial ability to change their situation. And so they're being exposed to high levels of air pollution every time they go outside their house. And it could be that they actually have poor air quality within the house as well. So say if the housing is of poor quality, it's got lots of damp and mould, or it's really poorly ventilated or anything like that. Some people can't even open the windows, then, again, these people don't necessarily have the power and the ability or the finances to be able to change their situation. That doesn't mean that for a loss of people who are socially deprived, or people who come from different different ethnicities in the UK often suffer much worse health effects as a consequence of air pollution. And that's why it's so important for us to tackle it. It's a justice and fairness issue as well as a health issue.

Dom Burch: 12:06

Absolutely. And apologies, because I asked you sort of so many questions in the last question all at once. And there's so many different directions we go to maybe if we've got time, we'll we'll delve into all of those things about not being as open windows and, and also all the other things within the house that are adding to the air pollution or air quality. But in terms of young people and adults, what are the different impacts of of air quality or air pollution on a young person, versus perhaps somebody who's older.

Malcolm White: 12:32

And the way that air pollution impacts us does change throughout our lives, or at least our bodies change. So therefore, the impacts are different as well. But it's actually worth even mentioning the air pollution impacts us before we're even born. And it impacts people in terms of their ability to conceive and their fertility. It then impacts the mother during pregnancy, in terms of increasing blood pressure, and higher risk of getting gestational diabetes, higher risk of preeclampsia and other conditions like that. And then it has impact on the unborn child. Because as the cells are rapidly developing within the womb, they actually get exposure to air pollution because of it getting through the mother's placenta as well. And studies will definitely show that people who have a high exposure to air pollution, during pregnancy during their own development are much more likely to to develop health conditions like asthma and things like that as they grow. And so that's even before they're born. But once the children are born, then there are many impacts on the children as well. And you can actually see, for example, studies have shown that in areas of high air pollution that the children have decreased learning, as in their learning is poorer compared to areas where the air pollution is better. So it means that it has direct impacts on the children as they're developing. And this is completely seen in terms of their lung development as well. So in terms of the sorts of measurements, we normally take, like the full lung volume, and the ability to breathe out quickly and things like that, as we try and do an asthma, those measurements are less because the children's lungs are developing less well as a consequence of higher air pollution.

Dom Burch: 14:20

What can we do about it? Right? So I mean, I think thank you, by the way, because that's just set such a great context for the conversation. One of the things that we need to do then as a sector as healthcare sector, you know, we talked about educating health professionals as an example, what are those sorts of things that need to happen and are happening?

Malcolm White: 14:39

There are some fabulous like really, really good examples of where we've been able to educate healthcare professionals or when other organisations are doing it too, but with global action plan. With my time I've educated hundreds of health professionals or students now about your pollution, which is great, but it is fair to say it's not included in the curricula of healthcare, and staff, which includes nursing, pharmacy doctors, other allied health professionals, etc. Which means that we're having to sort of come in at the back end and try and grow bar in some education. Whereas actually, it's really nice sort of strong opinion. And the sort of campaign I'd love us to push forward with in the future is that we include it in the healthcare curriculum, and, but the sorts of things that we end up teaching, first of all, there's sort of top line messages that we want to pass on to healthcare professionals, so that they can pass them on to patients is that air pollution impacts everyone. So that's not just people who are already particularly vulnerable, it impacts our staff, our patients, and the wider public, there are some things that we can do to reduce our exposure to air pollution, and some things that we can do to reduce our contributions to air pollution, as well the amount that we create in our daily lives, and overall, that there will take bigger societal changes in order to really tackle air pollution. And if we want to drill down into that a bit, because I think the things that health professionals get concerned about when talking about air pollution, is that they can inherently understand it's a problem that air pollution is a problem. But what do we do about it? What sort of advice can I give my patients, there are many different subtle bits of information we can give. So in terms of out door, we'd like to encourage people to use active travel, for those who are able to do so increasing the amount of exercise that people do by walking, wheeling cycling, or whatever active travel is that's available to you, that reduces the amount of cars on the road, especially for like short journeys that people might be able to do with other forms of transport. And then of course, using more public transport, again, reduces the number of cars on the road, for people who already walk, then trying to do so through green spaces, or a long path that are further away from main roads when it's safe to do so that's really one of the major some of the major steps really, because again, it reduces the number of cars on the road. But it can improve people's physical fitness and actually reduce that injury behaviour, which we'll know as well is a big issue for people's health. And then for people who do have to drive because it's important to recognise that some people still have to drive. And that if you come forward to every patient and say, Oh, by the way, you'll obviously never drive again, now that you know that air pollution is a problem, you've lost that patient, you haven't brought them along with you, and you've not understood the context in which they live. Because you could imagine one patient who has two kids has to take them to different schools, and then go to work themselves now that that parent might just need to drive. And that's the only way in which they can do it. Because the public transport infrastructure is not suitable for their situation, there are a lot of actions that can be taken in the indoor space, people will generally understand that most of us will spend over 80% of our days indoors. So actually thinking about the indoor space is really important too. And a lot of those actions involve reducing the amount of air pollution that we are creating. And so that can be things like when we are say cooking, and being sure to open the windows to ventilate. And that can be if you're using induction gas or oven or however you cook, but you can find it. For example, if you're making a roast beef joint or something like that, you have the oven on for at least a couple of hours, then actually all of that vaporising fat and all of the cooking that happens alongside it actually really, really impairs the air quality and that space for a time. So being sure to open open doors, or at least open windows as best you can at that time. If you use things like paints and varnishes, than trying to use ones which are labelled low VOC, and then another major area, because you couldn't go into all of them today is about burning things. So there are some things we naturally need to do at home. Like if you've got a gas cooker and you don't have the money or power to change that situation you still need to cook but trying to ventilate when you do that. But also trying to eliminate or reduce things like incense, candles, fragrances, and particularly burning things at home such as wood burning stoves and open fires, because actually increasingly, for one type of air pollution called particulate matter, things like wood burning stoves are actually the biggest source of this particulate matter in the UK. So, in summary, there's loads of things that you could do inside the home and outside the home in order to advise our patients on how they can reduce the air pollution that they're producing, and reduce their exposure to air pollution at the same time.

Dom Burch: 19:54

It reminds me of being back at GCSE geography and having that conversation about water security. And you know saving water? And it was like do you clean your teeth with a tap on and it was just kind of like habitual, everyone did just the taps on it and clean my teeth. So why don't you turn the tap off we only need a little bit of water and toothpaste. And there's that sense of ownership that if everybody does a little bit together that adds up this multiplier effect if everybody you know reduced the amount of times they use The Log burners or just got rid of them. If people were more mindful about having ventilation in the house when they're cooking or when they're cleaning or whether you're using any product that has a sharp smell even you know if you can smell something if you can smell something your nose is detecting that there's particulates going up it right?

Malcolm White: 20:37

It's strong chemcicals, totally.

Dom Burch: 20:40

Yeah, well listen, we could go there all day. But I want to move on. So tell me a little bit more what would you you know, if you wanted to embolden the NHS to do more? What's on your Salah? hitless when you're banging the drum or when you're talking to colleagues or conferences? What is it the things that you just think Come on, these are the kind of priorities we need to really focus in on?

Malcolm White: 20:57

Yeah, it's definitely worth recognising that the NHS itself creates air pollution through its actions. And that is, you know, has about 4% of the total road miles in the UK, for example, though, a lot of the steps that the NHS can take, will help reduce the amount of air pollution and really lead in the space. And so yeah, a big part of that is the education of health professionals and the education of our staff, and more generally, but actually, global action plan along with other partners, such as Great Ormond Street Hospital five years ago, and I created what was called the Clean Air hospital framework, which is essentially a large spreadsheet type document in which there are loads of actions that hospitals and trusts can do in order to reduce the amount of air pollution that they're creating. And then a couple of years ago now, and we sort of took this to the next level and created what is the ICS level framework, which aims to bring partners in together like local authorities, academic institutions, and the NHS, in order to fulfil some of the ambitions of ICS is more generally, which is to tackle health inequalities through air pollution, that's still a document that we are evolving over time, but it's been long for a year and a bit now. And it's been really great in terms of bringing ICS leaders an understanding of air pollution, and helping them focus their energies and efforts because trying to tackle air pollution from just an NHS perspective, can definitely seem like an overwhelming task. And so the way in which we're going to drive this forward is by bringing the correct partners together, you establish governance, you make sure that you've got the right meetings happening, that you know, all of the players and and you'll develop a plan by just understanding what the baseline is, and then making a plan from there. And that's really what the sort of the ICS CleanAir framework does. And that's why we're keen the ICS is up and down the country adopt that and move forward.

Dom Burch: 22:57

Like being aware of the data, right. And, and I think about that, also, at the personal level, I mean, Saira, and I talk about, you know, the importance of having that daily air quality alert that pops up on your phone in the morning. And it could be the you know, that is in relation to your own personal triggers. And then you're able then to actually track your symptoms. And then over time with that kind of diary, and bringing in those environmental factors, or those air quality or air pollution factors, you can start to really arrest back a little sense of control. And then with that sense of control, also comes confidence and a sense of well being because you're you're less stressed about things that you're not you're not aware of even

Malcolm White: 23:40

Yeah, absolutely. In terms of some of the main areas that we aim that, you know, the NHS and ICS is take forward as actions in order to move forward. There are headings like transport, and strategic thinking, the infrastructure, the buildings and things like that education of health professionals, but one of the main ones as well as digitalization in a digital health passport is a really great example of that. And there are lots of other ways in which we can use data in order to improve the health of our population. I mean, it's just for example, one of the ICS is that we were working with the Hampshire Isle of Wight use a sort of a mapping tool called shape in which they could overlay data about air pollution over their local map and match that to the GP surgeries and and map match it to levels of inequality and things like that as well, so that you can really pick out the key areas, but then your ICS to understand where the air pollution is going to be impacting those people most. And then there will also be lots of data in terms of rates of COPD at the local hospital rates of asthma exacerbations rates of admissions, rates of deaths, all of these sorts of things. And that that we have actually been working with some partners to bring out big data like that, but it's it's sort of yet yet to becoming forth, but it's, it's it's on the way. But also the loads of data out there. And it is a case of bringing that forward and understanding that as part of driving a plan forward to tackle air pollution on scale,

Saira Arif: 25:13

Is it right that global action plan offer support to help hospitals become sort of, you know, cleaning hospitals and your there's a way of life sort of implementing that framework that you spoke about earlier? Can you tell us a bit more about that?

Malcolm White: 25:26

First of all, will be delighted to hear from any trust hospital or ICS, who wants to get in touch and sort of get some advice essentially, about how to get started. And we've done with a number of trusts and ICS, has now offered that early support. And if we sort of want to almost take it forward as a project together, then we'd be delighted to talk about that as well. Because essentially, it takes a while to get it straight in your head, as, for example, the sustainability leader within a trust, or for the chief executive team or anything like that. And we can definitely help with that process as well. So and we've worked with quite a few trusts across the greater London area and outside that as well. And then as I say, I think it's approximately half of the ICS is in the country have been at least downloaded and started making some progress towards the ICS clean air framework. But part of actually process that we're going through at the moment is to develop it onto into an online tool. And because previously, it's just been downloaded to still really, really effective. But what we'd love to see and like to bring forward more is the sharing of best practice, the sharing of case studies between different ICs is so that they can see lots of examples of how to bring forward some of these changes that are needed in for air quality. And by making that into this online tool, that's going to be a great way for us to be able to share that.

Saira Arif: 27:05

Absolutely, I think it's important to try and establish some sort of community practice around this sort of stuff. So you know, those lessons and, you know, successes can be shared, because I think that's the, you know, from from just from my experience implementing different programmes. One thing I feel like is a massive challenge is, you know, ICVs, asking, you know, what's the other ICB doing or what's the neighbouring region doing and I think it's nice to be able to share their successes with each other.

Malcolm White: 27:30

Absolutely, it's been really great to work with a number of ICs is and we sort of worked with the South East cluster altogether. And it was great to share those ideas between them as well.

Dom Burch: 27:39

Absolutely brilliant. And hopefully, this podcast in a very, very small way is getting the message out there. And as Malcolm said, if you're listening, and you're genuinely interested in finding out more getting involved or sharing best practice with one another, then please get in touch and get in touch with us. And we'll put you in touch with Malcolm or you can obviously, Google, Malcolm, and you'll find him on LinkedIn. Malcolm has been a pleasure talking to you. We could talk more, and I think maybe we need to talk some more on another podcast. There's so many other places we could go to, but we're almost at a time. As you look ahead, you know, I mean, obviously huge challenges, what are the opportunities that you're going to zoom in on over the next 12 to 18 months, what's kind of beckoning you towards it? What are the things that are giving you the energy and the impetus to sort of keep on with this good fight.

Malcolm White: 28:23

So certainly, at the time of recording, we're just in the time of coming up towards an election and whoever was to win that, you know, global action plan are, we're calling on this new government to really ramp up action on clean air. And in particular, releasing at the moment, we have a petition going out a political in the sense of not calling in on any specific party, but it's calling on a great improvement on travel and transport infrastructure, including public transport. So and if people were to Google Clean Air Day petition than they would find that, in addition, I'm certainly really excited what feels like momentum growing in terms of educating health professionals in the space. And just to say, if you look on the what we call the Clean Air Knowledge Hub, but it's just a branch of the gap website. Essentially, there's loads of free resources that we have available, leaflets, slides that we've used for educating healthcare professionals, videos from experts, and all sorts of things like that in order to bring that information to your colleagues and then to your patients. Because while we're waiting on this becoming mainstream education within the health sector, and the more that we can do to spread this message, the better overall, it also is really exciting to see a growing momentum within the sort of the ICS and NHS management structure to have a much greater understanding about air pollution and how tackling air pollution will not just improve the health of the population, it will decrease the stress and burden on our NHS and it will reduce the morbidity and mortality relating to air pollution, which will, it'll actually save the NHS a lot of money as well. It's it's preventative medicine in many senses as well. So yeah, loads of things. And I agree Dom and Saira that there's, you know, we could go on about this all day.

Dom Burch: 30:18

Well, listen, we thank you for giving up your time. And it's been absolutely fascinating talking to you. If people are listening and want to find out more, and particularly around that Knowledge Hub, then just go to global action plan.org.uk, forward slash, knowledge, hyphen, hub, and you'll find all of those resources that Malcolm was just describing and what a fantastic website is, it's absolutely rammed pack with brilliant, brilliant information. Malcolm, thank you so much for coming on. It's been an absolute pleasure talking to you. And we look forward to keeping a close eye on all of the things that you're up to global action plan. And wherever possible, we'll be doing our bit to champion clean air to from a from the perspective of digital health passport.

Malcolm White: 30:55

Yeah, and thank you both so much for having me on. And just as we were recording, it's a week before Clean Air Day. So yes, we're obviously frantically working on a global action plan for that biggest day of the year in the UK is fight against air pollution.

Dom Burch: 31:10

Well, let me get my editing scissors out and see if we can get this podcast out on that day. That would be a nice thing to do. So for the time being Malcolm, thank you so much for coming on. Thanks. . Thank you both. Thank you. You've been listening to the Up up and away podcast from tiny medical apps with me DOM Burch and my co host. Saira Arif, if you're interested in hearing on the podcast, please get in touch. You can find us at Tiny medical apps.com or digital health passport.co Or you can just look for us on LinkedIn in all the usual places.