EnviroHealth Podcast - Season 2, Episode 3: Dr. Sabena Kagalwalla on 'The Childhood Health Crisis: From Deprivation to Digital Age Challenges'

Host Dr. Joseph Levermore speaks with Dr. Sabena Kagalwalla, consultant paediatrician and innovation fellow at Guy's and St. Thomas' NHS Foundation Trust. They examine why the UK has fallen from world leader to 30th out of 49 OECD countries in infant mortality, and explore the complex web of factors undermining children's health in the 21st century.

Topics Covered:

• How the UK built its paediatric health leadership through hygiene, vaccination, and universal healthcare
• The stark reality: 700 preventable child deaths annually linked to social deprivation
• Rising lifestyle-based pathologies replacing traditional genetic conditions
• Type 2 diabetes now appearing in children - a phenomenon virtually unknown during medical training
• Mental health crises hitting younger ages: suicide attempts in children as young as 10-11
• The lost generation of breastfeeding knowledge and its impact on infant mortality
• How single-parent families, dual-income pressures, and housing instability create health vulnerabilities
• Social media's double-edged impact on developing brains and adolescent mental health
• The intersection of culture, technology, and generational gaps in healthcare

Key Insights:

• Children now present with constipation and abdominal pain as early indicators of lifestyle-related health issues
• Healthcare systems designed for acute medical conditions struggle with multifactorial social problems
• Frontline paediatric staff lack training for adolescent mental health, sexual health, and substance use discussions
• Nordic countries demonstrate how early investment in family support creates healthier populations
• Technology provides unprecedented access to health information while simultaneously creating new vulnerabilities

The Prediction Pattern: Dr. Kagalwalla reveals how toddler constipation can predict later obesity, dental problems, behavioural issues, and eating disorders - a cascade that healthcare systems aren't equipped to interrupt.

Quotes: "When I was training, you would never see someone with type 2 diabetes during their paediatric lifespan. Now you are getting patients with type 2 diabetes before the age of 18."

"It's not as simple as throwing a medication at it anymore. It's almost not as simple as throwing a load of money at it either."

"We're living in an age where the differences between grandparents and parents and their children are massive, and we have not been able to build our healthcare systems to address these problems."

Credits:

• Host: Dr. Joseph Levermore
• Guest: Dr. Sabena Kagalwalla (Guy's and St. Thomas' NHS Foundation Trust)
• Executive Producer: Neil Japtha
• Production: EnviroHealth Podcast

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© 2025 EnviroHealth Podcast. All rights reserved.

EnviroHealth Podcast - Season 2, Episode 2: Dr. Gary Fuller on 'The Evolution of Air Pollution' - Part Two

Host Dr. Joseph Levermore continues his conversation with Dr. Gary Fuller, a clean air champion and senior lecturer in the Environmental Research Group at Imperial College London. In this second part, they explore modern air pollution challenges, the devastating health impacts across our entire lifespan, and the surprising truth about wood burning as a supposed green alternative.

Topics Covered:

• Global air quality crisis in rapidly industrialising nations like Lahore and New Delhi
• How air pollution affects us from foetal development through to dementia in old age
• The myth of "safe thresholds" - why there's no harmless level of air pollution
• Children in East London developing smaller lungs due to pollution exposure
• The WHO's innovative fifth percentile approach to setting achievable guidelines
• Wood burning: why it's terrible for both air quality and climate goals
• Environmental injustice and inequality in air pollution exposure
• The landmark case of Ella Kissi-Debra and air pollution's role in her death
• Ultra Low Emission Zones: dramatic 44% reductions in central London pollution
• Why 70 years after the Great Smog, we still haven't solved air pollution

Key Insights:

• Just 8% of UK homes using solid fuel produce more particle pollution than all vehicles on the road
• Burning wood creates more carbon emissions than fossil fuels for the same amount of heat
• Air pollution disproportionately affects the poorest communities who own fewer cars but live near busy roads
• London's pre-ULEZ trajectory showed it would take 193 years to meet legal air quality limits

Quotes: "It seems absolutely ridiculous that we're going to save the planet by burning the trees. No, no we're not."

"Why on earth are you and I still working in this field of science when 70 odd years ago we knew it was harmful? Why haven't we solved this problem?"

Credits:

• Host: Dr. Joseph Levermore
• Co-host: Steve Campbell
• Guest: Dr. Gary Fuller (Imperial College London)
• Executive Producer: Neil Japtha
• Production: EnviroHealth Podcast

Resources: Dr. Gary Fuller's book: The Invisible Killer: The Rising Global Threat of Air Pollution and How We Fight Back

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Follow EnviroHealth Podcast on LinkedIn, X, YouTube, Instagram and Spotify.

© 2025 EnviroHealth Podcast. All rights reserved.

EnviroHealth Podcast - Season 2, Episode 1: Dr. Gary Fuller on 'The Evolution of Air Pollution' - Part One

Host Dr. Joseph Levermore speaks with Dr. Gary Fuller, a clean air champion and expert in air pollution from Imperial College London's Environmental Research Group. They discuss the fascinating history of air pollution from the deadly London smog of 1952 to current challenges and research.

Topics Covered:

• Dr. Fuller's unconventional career path from physics to air pollution research
• The Great London Smog of 1952 that claimed approximately 12,000 lives
• Historical perspectives on air pollution through art (Monet, Turner) and measurements
• Victorian London's PM2.5 levels (~200 μg/m³) compared to today's levels (~10-15 μg/m³)
• How smoke was once viewed as a symbol of prosperity and health
• The first air pollution measurement networks in the UK
• The importance of preserving historical air pollution data and samples

Quotes:

"Even though we look back on these times and say they were very polluted, we have to think about now and the health impact of air pollution still today that persists... just because we can't see it doesn't mean it's not there."

Credits:

• Host: Dr. Joseph Levermore
• Co-host: Steve Campbell
• Guest: Dr. Gary Fuller (Imperial College London)
• Executive Producer: Neil Japtha
• Production: EnviroHealth Podcast

Resources:

For more information about air pollution and its health impacts, visit here.

Connect with us:

Follow EnviroHealth Podcast on LinkedIn, X, YouTube, Instagram and Spotify.

© 2025 EnviroHealth Podcast. All rights reserved.