News Paula Radcliffe: elite athlete and clean air advocate Paula Radcliffe tells Gary Humphreys about her journey from athlete to clean air advocate and her hopes for a clean air initiative launched by the International Association of Athletics Federation. Q: When did you start running? A: When I was seven years old I Born in 1973 in Northwich, in the United Kingdom used to run with my father who was a of Great Britain and Northern Ireland, Paula Radcliffe keen runner himself. In fact, he ran the took up running at the age of nine, and won her first London Marathon several times. I only national title in 1991. Despite being diagnosed with started to get serious about running when I was nine and I joined Frodsham asthma at the age of 14, she went on to win multiple Athletics Club in Cheshire. Then I saw World Cross Country and Half Marathon titles, 5000 and Ingrid Kristiansen break the world mar- 10 000 metres titles, three New York and three London athon record at the London Marathon in marathons, and a gold medal at the 2005 Helsinki World Courtesy of WHO 1985, and that really inspired me. The Paula Radcliffe Championships. She is the current world record holder following year my parents moved to for the women's marathon, with a time of 2:15:25 which Bedfordshire and I joined the Bedford she set during the 2003 London Marathon. Since 1998 she has been a Patron & County Athletics Club. of the charity, Asthma UK, and became an Ambassador for the International Association of Athletics Federation’s (IAAF) clean air initiative in 2018. Q: Was that when you started compet- ing? A: No, I was already competing for the Frodsham Harriers, but it was a to have to use inhalers and learn how areas. But I still used my basic peak flow while before I won at the national level. I to manage and control your condition, monitor, and still do. competed in my first race at the national but he also said that doing sport is going level – the girls English Schools Cross to make your lungs stronger, which was Q: One way or another you’ve been pre- Country Championships – when I was exactly what I wanted to hear. He also occupied with air quality for a long time. 12, and I came in 299th out of a field of gave me a peak flow monitor, which is A: I certainly have, especially 600. The following year I came in fourth, a tube that measures the volume of air as a marathon runner. You have to and a couple of years later I won the that you can blow out fast and hard in understand that a marathon runner English Schools 1500 metres title. That one breath. The idea was that I would breathes in as much air in three hours was my first big win. be able to monitor my asthma and see as a sedentary person would over two when I needed to increase the dosage of days, and the air he or she is breathing Q: Had you already been diagnosed with my asthma preventer inhaler. is not always the cleanest. So someone asthma at that point? like me or Haile Gebreselassie, who A: No, I was diagnosed with asthma is also a clean air ambassador for the when I was about 14. I was getting Athletes are International Association of Athlet- dizzy after training sessions and having not just exposed to ics Federation (IAAF), and also has trouble breathing. My mum took me to “ asthma, is going to be very exposed to the doctor after I blacked out in training. polluted air, they air pollution. actually monitor their Q: Do you know what triggered it? exposure. Q: Didn’t Haile Gebreselassie withdraw A: I think it was a culmination of from the marathon at the 2008 Beijing things. We had moved from Cheshire ” Olympics because of the air quality down to Bedfordshire the year before there? and there was a lot more oilseed rape A: He did. He was afraid that (Brassica napus) in the fields, which it breathing the air would harm his turned out was one of my main triggers. Q: So you were in control at that point. chances of breaking the marathon world Also, it was more of a built-up area and A: Exactly. It made a huge differ- record, which was something he wanted so there was a bit more pollution. ence. It took away a lot of the uncertainty to do. So he ran in the stadium for the and the anxiety that went with it and 10 000 metres, but he didn’t run in the Q: You must have wondered if your run- allowed me to compete and train as hard streets. ning days were over. as I wanted to. It also made me a lot more A: Nothing was ever going to stop aware of the air I was breathing. Later, Q: How did you get involved in clean air me running, but I was worried that my approach to air-quality monitoring advocacy? the doctors were going to say you’re became more sophisticated. I had sports A: I was approached by the IAAF not going to be able to run anymore. science teams looking at which specific to be an ambassador for their clean air Luckily, my family doctor was very types of pollen would trigger my asthma initiative and I accepted. I was already forward-thinking. He said you’re going so that I could avoid certain training working in advocacy, having been with 176 Bull World Health Organ 2019;97:176–177 | doi: http://dx.doi.org/10.2471/BLT.19.030319 News Asthma UK since 1998, a charity I con- Q: What exactly are the monitors de- ally being exposed to health risks. This tinue to work with because it means a signed to track? is especially true in cities. If you go for lot to me at a personal level. A: A variety of pollutants, includ- a run in a city like New Delhi in India, ing fine particulate matter down to 2.5 as I did a few months ago, only the first Q: What is the focus of your advocacy microns which, as you know, not only five minutes is beneficial for your health work with Asthma UK? lodges deep inside the lungs, but can because you are exercising; beyond that A: Getting across the message that cross the lung barrier and enter the point the pollution that you are inhaling youngsters who are diagnosed with blood stream. Chronic exposure to such is harming you. We need to give runners asthma can do whatever they set their particles is known to contribute to the information so they have choices about minds to. I tell them, you should control risk of developing cardiovascular and where it is good to run and what time your asthma and not let it control you. respiratory diseases, as well as lung can- of day is good to run. Ultimately, of That means taking the right medication cer. The monitors will also track levels course, we need to encourage cities to and learning to manage their condition. of ozone and nitrogen dioxide. clean up their air. Q: Can you tell me a little about the clean Q: What do you hope the clean air initia- air initiative? People are being tive will achieve? A: It’s a joint effort of the United encouraged to run for A: An estimated seven million Nations Environment Programme “ people a year die from illnesses related (UNEP) and the IAAF which has started their health, but if the to air pollution. We need to act now to a programme to monitor the air in ath- air they are running address that, starting by getting a better letics stadiums around the world. The in is polluted they are understanding of the impact of poor partnership is going to be supported actually being exposed air quality on our bodies. But we also by the Climate and Clean Air Coalition to health risks. need to make people more aware of (CCAC) which is going to create an air the problem, so they can put pressure quality monitoring network. ” on their governments to introduce the policies needed to bring about change. Q: Why the focus on stadiums? My hope is that the clean air initiative A: Because stadiums are where the will help achieve those goals. ■ athletes are. Elite athletes have a key Q: What will the IAAF do with the data role to play in raising awareness about once they have it? the health impacts of air pollution. Not A: They’ll use it to establish a basis just because they have the visibility, but for education and awareness-raising, because they are particularly exposed to and to inform discussions about the air the problem they’re trying to help ad- quality issue and policy development. dress. Also, athletes are not just exposed The IAAF Health and Science Depart- to polluted air, they actually monitor ment also hopes to be able to study the their exposure. Monitoring performance correlation between air quality and and air quality over time is going to give athletes’ performance. Finally, data will us a much better understanding of the be used to help runners choose the best impact of poor air quality on our bod- times of day to run in their cities, as a ies. So we want to use our visibility, our kind of public service.