FYI: Increasing Air Pollution Polluted air kills each year more people than malaria or tuberculosis.
Air Pollution and Respiratory Problems
Air pollution affects our health in different ways from simple to serious problems.
Air quality has an impact on the health of our lungs and the entire respiratory system. In addition to oxygen, the air contains other substances such as pollutants, which can be harmful to health. The inhalation of those pollutants may have harmful effects on the lungs and other organs of the body.
Many air pollutants can travel long distances from their source, posing risks to our health even in concentrations below the threshold of smell. In other words, we might not even feel that we are breathing polluted air. However, over long periods of time, even low concentrations of contaminants in the air may have devastating health effects. Obviously, the most exposed people are those working and living in polluted air environments (e.g. various industries and buildings with pollutants in indoor air due to various causes). Additionally, big city smog is a reality all over the world, involving outdoor air pollution and potentially affecting a large number of people.
There are two main types of air pollutants:
Gases (inefficient combustion of fuels for transport, power generation and other human activities like home heating and cooking.)
Particulate matter (tiny solid particles suspended in the air, such as dust particles).
PM10 particles, which are particles of 10 micrometers or less, can penetrate into the lungs and may enter the bloodstream, causing heart disease, lung cancer, asthma, and acute lower respiratory infections
Combustion processes produce a complex mixture of pollutants that comprises both primary emissions, such as diesel soot particles and lead and the products of atmospheric transformation, such as ozone and sulfate particles.
Indoor cooking and heating with biomass fuels (agricultural residues, dung, straw, wood) or coal produce high levels of indoor smoke that contains a variety of health-damaging pollutants. There is consistent evidence that exposure to indoor air pollution can lead to acute lower respiratory infections in children under age five, and chronic obstructive pulmonary disease and lung cancer in adults. Children are particularly at risk due to the immaturity of their respiratory organ systems. Acute lower respiratory infections, in particular, pneumonia, continue to be the biggest killer of young children
Mechanism of action of air pollutants
The respiratory system is particularly sensitive to air pollutants because it is made up of a mucous membrane covering its internal surface. The lungs are designed to absorb large amounts of air (400 million liters on average over a lifetime) in close contact with the bloodstream and facilitate the transport of oxygen.
The cells of the lung tissue can be damaged by air pollutants such as ozone, metals and free radicals. Ozone can cause damage to the alveoli – air sac in the lungs where the exchange of oxygen and carbon dioxide is produced. More specifically, the airway tissues, which contain a large number of bio-activation enzymes, can transform organic pollutants into reactive metabolites, which can cause lung injuries, neuro-behavioral disorders, and cancers possibly including breast cancer.
Effects of Air Pollution on Human Health
The level of effect usually depends on the length of time of exposure, as well the kind and concentration of chemicals and particles exposed to.
Short-term effects include irritation to the eyes, nose, and throat, and upper respiratory infections such as bronchitis and pneumonia. Others include headaches, nausea, and allergic reactions. Short-term air pollution can aggravate the medical conditions of individuals with asthma and emphysema. Long-term health effects can include chronic respiratory disease, lung cancer, heart disease, and even damage to the brain, nerves, liver, or kidneys. Continual exposure to air pollution affects the lungs of growing children and may aggravate or complicate medical conditions in the elderly.
Respiratory and lung diseases:
Asthma: Asthma is the result of chronic inflammation of the conducting zone of the airways (most especially the bronchi and bronchioles), which subsequently results in increased contractability of the surrounding smooth muscles. This among other factors leads to bouts of narrowing of the airway, causing airflow obstruction, and bronchospasm and the classic symptoms of wheezing, coughing and shortness of breath.
Low air quality from factors such as traffic pollution or high ozone levels has been associated with both asthma development and increased asthma severity.
The most effective treatment for asthma is identifying triggers, such as cigarette smoke, allergens, etc and eliminating exposure to them. If trigger avoidance is insufficient, the use of medication is recommended. Bronchodilators are recommended for short-term relief of symptoms.
Bronchitis: Bronchitis is an inflammation or swelling of the bronchial tubes (bronchi), the air passages between the mouth and nose and the lungs. Individuals with bronchitis have a reduced ability to breathe air and oxygen into their lungs; also, they cannot clear heavy mucus or phlegm from their airways.
Bronchitis can be caused by viruses, bacteria, and other particles that irritate the bronchial tubes. Symptoms include coughing up mucus, wheezing, shortness of breath, and chest discomfort. Bronchitis is divided into two types: acute and chronic.
Acute bronchitis is a short-term illness that often follows a cold or viral infection. It consists of a cough with mucus, chest discomfort or soreness, fever, and, sometimes, shortness of breath. Acute bronchitis usually lasts a few days or weeks. It is normally caused by viruses, typically those that also cause colds and flu. It can also be caused by bacterial infection and exposure to substances that irritate the lungs, such as tobacco smoke, dust, fumes, vapors, and air pollution.
Chronic bronchitis is a serious, long-term illness characterized by a persistent, mucus-producing cough that lasts longer than 3 months out of the year for more than 2 years. People with chronic bronchitis have varying degrees of breathing difficulties, and symptoms may get better and worse during different parts of the year.
If chronic bronchitis occurs with emphysema, it may become chronic obstructive pulmonary disease (COPD).
Chronic bronchitis is caused by repeated irritation and damage to the lung and airway tissue. Smoking is the most common cause with other causes including long-term exposure to air pollution, dust, and fumes from the environment, and repeated episodes of acute bronchitis.
Diagnosis is typically based on a person’s signs and symptoms.
Treatment for acute bronchitis usually involves rest, paracetamol, and NSAIDs to help with the fever. Cough medicine has little support for its use.
Chronic bronchitis is treated symptomatically and may be treated in a nonpharmacologic manner or with pharmacologic therapeutic agents. Typical nonpharmacologic approaches to the management of COPD including bronchitis may include pulmonary rehabilitation, lung volume reduction surgery, and lung transplantation. Inflammation and edema of the respiratory epithelium may be reduced with inhaled corticosteroids. Wheezing and shortness of breath can be treated by reducing bronchospasm (reversible narrowing of smaller bronchi due to constriction of the smooth muscle) with bronchodilators.
- Avoid lung irritants such as smoke, dust, fumes, vapors, and air pollution. If avoiding exposure is not possible, wear a mask that covers the nose and mouth.
Chronic Obstructive Pulmonary Disease –COPD
A type of obstructive lung disease characterized by long-term breathing problems and poor airflow. The main symptoms include shortness of breath and cough with sputum production. COPD is a progressive disease, meaning it typically worsens over time. Eventually, everyday activities, such as walking or getting dressed, become difficult.
Tobacco smoking is the most common cause of COPD, along with air pollution. One of the common sources of air pollution is poorly vented heating and cooking fires. Long-term exposure to these irritants causes an inflammatory response in the lungs, resulting in narrowing of the small airways and breakdown of lung tissue. The diagnosis is based on poor airflow as measured by lung function tests. In contrast to asthma, the airflow reduction does not improve much with the use of a bronchodilator.
While treatment can slow worsening, no cure is known. COPD treatments include smoking cessation, vaccinations, respiratory rehabilitation, and often inhaled bronchodilators and steroids.
Conditions like a chronic obstructive pulmonary disease, asthma may predispose to pneumonia eventually.
An inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of a productive or a dry cough, chest pain, fever, and trouble breathing. Severity is variable.
Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune diseases.
In a research, it was found out that long-term exposure to higher levels of nitrogen dioxide and particulate matter is significantly associated with hospitalization for community-acquired pneumonia. The ground level NO2 is derived predominantly from emissions from vehicles during traffic. Prolonged exposure to ambient air pollution predisposes patients to pneumonia.
Also, nitrogen dioxide exposure may lead to epithelial cell damage, reducing mucociliary clearance. This could lead to reductions in bronchial macrophages, natural killer cells, macrophages, and CD4 to CD8 ratios — which may increase susceptibility to bacterial pathogens.
Pneumonia is typically diagnosed based on a combination of physical signs and a chest X-ray
Prevention includes vaccination, environmental measures and appropriate treatment of other health problems
Reducing indoor air pollution, such as that from cooking indoors with wood or dung, are both recommended. Smoking appears to be the single biggest risk factor for pneumococcal pneumonia in otherwise healthy adults.
Pulmonary cancer: Exposure to air pollution can cause “oxidative stress,” that is, damage to the cells of the body caused by oxidation. This, in turn, can lead to the development of cancer. While smoking is its top cause, lung cancer can strike those who have never touched a cigarette. For example, radon, a radioactive gas found in homes and businesses, can cause lung cancer. Pollution coupled with the body’s inability to detoxify the carcinogens causes inflammation which turns on tumor-promoting genes and increases insulin-like growth factor, interleukin six, and activating protein one, all of which promote the development of lung cancer.
Lung cancer, also called pulmonary carcinoma, is divided into three main categories. Non-small cell lung cancer is a variety that encompasses several similar sub-types, including adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. This type is the most common, accounting for 85 percent of lung cancers, according to the American Cancer Society (ACS). Small cell lung cancer comprises about 10 percent to 15 percent of all cases and is a fast-growing form of lung cancer, according to the ACS. Lung carcinoid tumors are rare, grow very slowly and usually do not spread.
Cases that include both main types are called mixed small cell/large cell lung cancer, according to the National Institutes of Health (NIH).
Symptoms include: Persistent, prolonged cough, Coughing up blood, Wheezing and shortness of breath, Chest pain, Appetite loss, Hoarseness, Unexplainable weight loss, Fatigue or weakness, Difficulty swallowing.
Diagnosis include : Imaging tests such X-rays, positron emission tomography (PET) scans, CT scans or MRI scans of the chest, Sputum test, which examines coughing-induced phlegm for abnormal cells ,Biopsy, which examines cells from one or more procedures that retrieve a tissue sample, Bronchoscopy, Mediastinoscopy (wherein a lighted tube is inserted above the breastbone through a small incision to see the center of the chest cavity) which helps to determine the extent of the cancer, or stage.
How lung cancer is treated depends on a number of factors, such as the overall health of the patient, the type of cancer, the stage of cancer and the size of cells present and whether they have spread. Often, combinations of therapies are used.
Surgery is often used to remove the cancerous tissue. Chemotherapy or Radiation therapy is used to kill the cancer cells.
Pleural mesothelioma: Mesothelioma is a type of cancer that develops from the thin layer of tissue that covers many of the internal organs (known as the mesothelium). The most common area affected is the lining of the lungs and chest wall.
Symptoms or signs of mesothelioma may not appear until 20 to 50 years (or more) after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space (pleural effusion) are often symptoms of pleural mesothelioma.
More than 80% of mesothelioma cases are caused by exposure to asbestos. The greater the exposure the greater the risk. High rates of disease occur in people who mine asbestos, produce products from asbestos, work with asbestos products or work in buildings containing asbestos. Asbestos exposure and the onset of cancer are generally separated by about 40 years. Washing the clothing of someone who worked with asbestos also increases the risk.
The diagnosis may be suspected based on chest X-ray and CT scan findings and is confirmed by either examining fluid produced by cancer or by a tissue biopsy of cancer.
Mesothelioma is generally resistant to radiation and chemotherapy treatment. Long-term survival and cures are exceedingly rare. Mesothelioma can be prevented in most cases by preventing exposure to asbestos. The US National Institute for Occupational Safety and Health maintains a recommended exposure limit of 0.1 asbestos fiber per cubic centimeter.
Although the government is enforcing stricter regulations to prevent further emissions of air pollutants, there is still a lot to do on an individual level. The key to adopting measures that do not pollute the air as much so that e can have a healthier and disease-free life.
Consult our specialist at CMC.