Clean Air Zones - Necessary or a Nuisance?
CPD Surgical Masterclass and FREE ECG video
Alice recently travelled to London to spend a weekend away with her friends. The weather was gorgeous, the sun was out, and there were a number of events worth attending in the capital.
She travelled back to her town, reminiscing about the wonderful time she had with her friends. Alice’s partner, Frank, wanted to hear everything about her trip, and she told him all about it in great detail. She even brought back some gifts from Fortnum & Mason and a souvenir from Oxford Circus. “You need to take me next time,” said Frank.
“Yes, for sure. There’s so much to see, and hopefully we can see it together.”
A sweet end to a great trip, Alice thought….
Alice works very hard, by the way. She is a practice nurse in a busy rural practice in the UK countryside. Many of her patients are farmers, and many of the businesses around her are based on logistics—deliveries, car breakdowns, and transportation across the UK and beyond. Everybody here drives a diesel vehicle. There’s no such thing as petrol or electric around these parts.
One day, Alice returned home from work. It had been a tough day with some tricky patients. She had to convince a patient to go to the hospital after he had sliced his finger while farming. He was adamant that “it’d be okay with a strong plaster.” Alice, looking at the severed finger in horror, called 999.
“You have post, and it’s from London.” Alice was unsure what it could be. Perhaps it was HMRC requesting the self-assessment? Maybe it was one of those marketing letters. She found the envelope opener and proceeded to open the letter. It was from Transport for London. It demanded a payment of £180 for contravention of the ULEZ zone.
Certainly, a sour end to an otherwise fantastic trip to London.
You see, Ultra Low Emission Zones are popping up in many places around the country. They are designed to reduce air pollution by restricting the use of high-emission vehicles. The most stringent rules are in London, where drivers of petrol cars registered before 2006 (Euro 4) and diesel vehicles registered before 2015 (Euro 6) have to pay a daily fee to drive within the zone. Almost all vehicle types are included, including minibuses, coaches, and motorcycles. They currently exclude lorries, which are instead subject to CAZ legislation.
In other parts of the country, these zones are termed Clean Air Zones (CAZ) and operate on a different basis. Each city has its own rules, with some charging for the use of private cars, while others only charge for large goods vehicles with higher emissions.
It’s no exaggeration to say that many people have had to change their cars overnight. This has been painful for some, as it has meant selling classic cars, which for enthusiasts are unsustainable to run. The key question in all of this: what’s the science behind it?
Calls For More Legislation
The Royal College of General Practitioners reported a sharp rise in asthma presentations in 2025. From January to June 2025, this number increased by 45%, with toxic air cited as a key factor.
A similar finding was reported by the Royal College of Physicians, which found that air pollution was killing almost 500 people a week, with economic losses of approximately £27 billion. Unfortunately, the hardest-hit areas are those with high levels of socio-economic deprivation, and groups such as children are the most exposed. Both reports concluded there should be an expansion of clean air zones.
Other evidence, largely from Transport for London, reports a reduction of roadside nitrogen dioxide levels within central London by 44% and an increased adoption of compliant vehicles. Nitrogen dioxide irritates airways, increases the chances of asthma, and contributes to chest infections. It has also been found to negatively impact cardiovascular health.
ULEZ and CAZ also have other potential benefits, such as reducing noise pollution, encouraging active travel (walking, cycling, etc.), and reducing CO₂ emissions. However, there continue to be concerns about disadvantaging people from lower socio-economic backgrounds due to the high cost of ULEZ-compliant vehicles.
Ultimately, this falls within the current government strategy of focusing on disease prevention. Despite feeling the pinch in our pockets, there is a chance this could reduce the overall burden of disease for the nation as a whole.
What are your thoughts about ULEZ? Do let us know by commenting!
CPD Surgical Masterclass
Conversations with surgeons can be quite frustrating. Take a pilonidal abscess referral - it’s painful, the patient is struggling to carry out his tasks and is visibly in pain. You’ve given antibiotics and there’s no resolution. No one will blame you for picking up the call/bleeping to refer to SAU. However, surgical assessment units are HEAVING. The number of admissions to SAUs have DOUBLED since COVID19 and surgeons are trying to really manage as many patients as possible in the community.
But how confident are we as clinicians in assessment surgical pathology
How confident are we in assessing hernias?
How confident are we in differentiating haemorrhoids and thrombosed haemorrhoids
Does every unexplained abdominal pain require a referral to SAU?
Can you wait on an upper GI bleed?
How to understand a raised CRP in the context of abdominal pain?
Surgeons are desperate for primary care, urgent care and emergency department clinicians to up-skill on understanding and managing surgical pathology. It is for this reason, we have organised a CPD Surgical Masterclass delivered by Pareto Education. We will answer all the questions above and systemically go through surgical pathologies. The event will be:
Held live on 20/7/2025 from 10am - 13:00pm. If you can’t make it on the day, a RECORDING will be available
3 x externally accredited CPD points
Suitable for students and qualified professionals
ECG Interpretation - FREE Video To Boost Your Confidence
ECG interpretation isn’t easy. It’s an essential skill that is used in the diagnosis or work up of a number of conditions from hypertension, CKD, heart failure, pulmonary embolism and of course… myocardial infarction. Be sure to watch this video to upskill on this essential skill.
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