Doctors and health experts have criticised a government review of vehicle emissions and air pollution for under-reporting the health risks, sidelining the Minister for Health, and potentially putting thousands of Australians' lives at risk.
Australian fuel quality and emissions standards are "appalling", the atmospheric and respiratory specialists say. Of the 35 countries in the OECD, our petrol quality is ranked last, below Mexico, Turkey and Estonia.
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Draft proposals to address these quality concerns were quietly released days before Christmas by the Minister for the Environment and Energy, Josh Frydenberg, and the Minister for Urban Infrastructure, Paul Fletcher.
The review acknowledges 1483 premature deaths in 2012 were due to outdoor air pollution (a sharp increase from 882 in 2005), about half of which could be attributed to road transport pollution. It indicates the cost to the Australian economy from these premature deaths at $7.8 billion.
But environmental scientists say these figures are understated, with one study estimating around 3000 deaths a year in Australia are attributable to air pollution. They say the government's modelling also overlooks recent research and extrapolates from OECD data in ways that may significantly discount the current Australian health costs and contribution of pollution to local mortality and morbidity rates.
Scientists fear this discounting will strengthen the hand of those opposed to better quality standards, including climate-change sceptics in and outside of government. (Some of the proposed standards could reduce Australia's greenhouse gas emissions by up to 65 million tonnes and help meet the government's targets under the Paris Agreement.)
Fuel producers and the road lobby have already signalled concerns about the impact of new rules on the cost of petrol, new cars and upgrades to refineries that could "threaten their economic viability".
"It's going to be hard to do - we already know refiners aren't going to like it, and there's going to be a consumer backlash," said University of Melbourne atmospheric scientist Professor Peter Rayner. "The [government has] weakened [its] own position because there is almost certainly more money to be saved in health costs."
Respiratory physician Louis Irving described Health Minister Sussan Ley's absence from the debate about new regulatory standards as "incredibly alarming."
"The small particles [from poor quality fuel emissions] get absorbed straight through the lungs into the blood, and they are responsible for a number of chronic effects including cardiovascular disease.
"The large particles lodge in the lung and can cause effects such as cancer, asthma and chronic respiratory disease.
"The health minister needs to be there to highlight the dangers … and advocate for stronger monitoring," said Professor Irving, who works at the Royal Melbourne Hospital and the Peter MacCallum Cancer Centre.
The recent "thunderstorm asthma" public health crisis in Melbourne, in which eight people died and thousands sought emergency hospital treatment, showed the consequences of a lack of real-time monitoring of air quality and its impact on vulnerable populations, Professor Irving said.
"Thunderstorm asthma was an extreme example of how air quality can have very significant population effects," Professor Irving said. "It was a real wake-up call."
Sticking with the current regulations is among the five alternatives contained in the government's December discussion paper - a policy approach rated as "neutral" (without costs or benefits) in its analysis.
Health scientists are highly critical of this alternative.
"It's a cost to our community, but manufacturer's don't pay it, refineries don't pay it," said climate systems scientist Dr Robyn Schofield. "It's a hidden cost, shifted into the health sector."
Spokespeople for the ministers for Health and Environment and Energy said interested stakeholders were encouraged to lodge submissions to the proposals, including those in the health sector.