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A global concern: Air pollution increases risk of disease | Aug 24, 2017

The vast majority of the world deals with air pollution; this is a health issue that cannot be ignored. Not only outdoor air pollution can be harmful, indoor air pollution can also have a considerable impact on an individual’s overall health if air quality is low and a person has a long-term exposure to the polluted air.

Air pollution impacts everyone – from those working in factories to young children walking to school. As a health professional, it is well within the role and responsibility to help combat this pervasive issue before it gets worse.

Air quality and pollution: A look at the numbers

Air pollution can greatly differ depending upon where a person lives. Some regions might be impacted by industrial operations that can lower the air quality of entire cities; whereas other locations may be sheltered by mountains and other geographical barriers. Despite these differences, air quality concerns everyone.

The current state of air quality across the globe may be lower than many expected, as demonstrated by these statistics gathered by the World Economic Forum:
● Overall, 92 percent of the entire population lives in locations where air pollution surpasses safe health limits.
● 6.5 million people died in a single year as a result of illnesses linked to air pollution.
● 94 percent of air pollution-related deaths take place in low-income and middle-income countries with fewer resources to combat the issue.
● Countries with the highest-recorded air pollution-related deaths include Ukraine, Bulgaria, Belarus, Russia and Armenia.
● A study from the World Bank and the Institute for Health Metrics and Evaluation found that in 2013, air pollution caused one in every 10 deaths worldwide, costing the global economy an estimated $225 billion in lost labor income.

These numbers show how impactful air pollution can be, as well as why it’s become a top concern for many professionals in the health care field.

Understanding air quality: Types of pollution

Air pollution can come from numerous different sources. According to the National Institute of Environmental Health Sciences, air pollution includes both man-made substances as well as those found in nature, and is usually grouped into two different categories:

Outdoor air pollution, which can be caused by the burning of fossil fuels including coal and petroleum; the creation of noxious gases like sulfur dioxide, carbon monoxide and other chemical vapors; tobacco smoke, and ground-level ozone made up of reactive oxygen and smog.

Indoor air pollution, include carbon monoxide and other gases, household product chemicals, building materials like asbestos and lead, mold, pollen and tobacco smoke.

How does air pollution impact public health?

While people both in and outside of the professional health industry understand that air pollution can be harmful, many don’t understand the extent of the impact that this issue can have on public health.

“People exposed to toxic air pollutants at sufficient concentrations and durations may have an increased chance of getting cancer or experiencing other serious health effects,” the Environmental Protection Agency noted. “Like humans, animals may experience health problems if exposed to sufficient quantities of air toxics over time.”

Serious health issues like cancer aren’t the only impact air pollution can have on individuals’ overall well-being. Even short-term exposure to toxic air conditions like particulate matter and ground-level ozone can cause temporary irritation in the eyes, nose and throat, shortness of breath, tightness in the chest and coughing in healthy individuals. Those with existing conditions who are exposed to air pollution can experience asthma attacks, acute bronchitis, respiratory infections, heart attack and arrhythmia, even if exposure is only short term.

Other health problems tied to air pollution can include:
● Accelerated aging in lungs
● Cardiovascular and respiratory illnesses
● Chest pain
● Development of long-term, serious conditions including asthma, bronchitis and emphysema
● Dry throat
● Headache
● Nausea
● Overall decreased lung function
● Reduced lung capacity
● Reduced resistance to infections
● Shortened lifespan

These illnesses can develop in anyone exposed to low-quality air conditions for short and longer periods of time. However, some groups of the population are much more susceptible to these effects, including people with existing conditions like heart disease, congestive heart failure, asthma and chronic obstructive pulmonary disease; pregnant women, elderly persons, children under the age of 14, and individuals who work outdoor.

Study shows impact of air pollution on antibiotics

In addition to causing health conditions, a newly released study also shows that air pollution has the potential to reduce the effectiveness of antibiotics, thus raising the chances for disease and overall poor public health.

MedicalNewsToday reported on the study, which was the work of the FANTOM5 consortium which consists of researchers from Japan and Australia and included the creation of an extensive atlas encompassing more than 27,000 long non-coding ribonucleic acids (RNAs). Researchers leveraged this data alongside genomic and genetic information to examine how black carbon can affect a person’s respiratory tract.

The study showed, for the first time ever, that the bacteria known to cause respiratory infections is directly related to air pollution, and can raise the risk for infections while impacting the overall effectiveness of antibiotic treatments.

“A major component of air pollution is black carbon, which is produced through the burning of fossil fuels such as diesel, biofuels and biomass,” MedicalNewsToday noted. “The research shows that this pollutant changes the way in which bacteria grow and form communities which could affect how they survive on the lining of our respiratory tracts and how well they are able to [hide] from, and combat, our immune system.”

Researchers focused their efforts on two pathogens known to be main causes of respiratory illnesses – Staphylococcus aureus and Streptococcus pneumoniae. While these already exhibited considerable resistance to antibiotic treatment, researchers found that the introduction of black carbon only increases this resistance even more. Worse still, air pollutants can also cause Streptococcus pneumoniae to spread from the nose to the lower respiratory tract, and increase its resistance to stronger treatments like penicillin.

With these types of findings setting new standards for public health, it’s no wonder why the World Health Organization branded air pollution as the “largest single environmental health risk.”

Researchers and others in the community are urging health professionals to join in efforts to better understand the effects of air pollution, as well as the fight to combat its causes.

Indoor air pollution is also a concern

Although studies and prevention efforts typically center around outdoor pollution, indoor air quality has increasingly become a concern for health professionals as well. This is particularly true in low- and middle-income areas where individuals cook inside with solid fuels like charcoal and coal, according to information from the World Health Organization.

According to The Guardian, WHO discovered that inefficient, indoor cooking using solid fuels causes 4.3 million premature deaths each year, including those due to:
● Stroke (34 percent)
● Ischaemic heart disease (26 percent)
● Chronic obstructive pulmonary disease (22 percent)
● Pneumonia (12 percent)
● Lung cancer (6 percent)

Overall, 3 billion people use harmful, solid fuels to cook indoors, increasing their risk of disease as well as premature death.

Large-scale efforts to reduce air pollution in China

China is a well-known epicenter for air pollution – according to National Geographic, air pollution causes over 1 million deaths in the region each year. Recently, it has become a topic of high priority in the country, with Premier Li Keqiang declaring war on air pollution in China at the Communist Party’s annual congress in 2014. This year, Keqiang echoed that declaration, and promised to “make our skies blue again.”

Now, the country is working to combat one of the largest contributors to its pollution problem: the burning of coal in steel production. As an alternative, China is deploying one of the largest clean air movements, investing heavily in wind and solar power to replace harmful coal-fired electricity.

“The benefits, if it’s successful, will be felt not just in Tangshan but all over the planet: China is the world’s largest emitter of climate-warming greenhouse gases,” National Geographic contributor Beth Gardiner wrote.

Reducing the risks of air pollution: How health professionals can help

China’s massive efforts represent a step-forward for the entire globe, but this doesn’t mean that smaller-scale efforts can’t be made at work and at home. Public health professionals play a critical role here and can participate in a few important efforts to help, including:

● Educating the public on the health risks of air pollution, including conditions tied to short-term exposure, as well as the potential impact of long-term exposure.
● Spread awareness about the top causes of air pollution, especially those in citizens’ own homes.
● Provide information about health best practices. These can encompass ensuring good ventilation within homes and buildings, preventing the buildup of mold and dust that can cause pollution and removing chemicals like aerosols.

In order to make an impact, health professionals must have the level of knowledge and skill to ensure they can affect change within their community. An online Master of Public Health from the University of Arizona Mel & Enid Zuckerman College of Public Health can put you on the right track. With concentrations in applied epidemiology, health services administration and health promotion, you can glean the expertise needed to further your career and improve overall public health.

Recommended Readings:
WHO map shows 92% of world lives with poor air quality
Climate change and its impact on public health
Cigarette smoking continues to decline in the U.S.
Flying and flu season – Tips public health officials should share to promote healthy travel

Sources:

https://www.weforum.org/agenda/2016/10/air-pollution-the-true-cost-in-numbers

https://www.epa.gov/haps/health-and-environmental-effects-hazardous-air-pollutants

https://www.niehs.nih.gov/health/topics/agents/air-pollution/index.cfm

http://www.sparetheair.com/health.cfm?page=healthoverall

http://www.medicalnewstoday.com/releases/316194.php

https://guardian.ng/features/household-air-pollution-causes-4-3m-premature-deaths-yearly-says-who/

http://news.nationalgeographic.com/2017/05/china-air-pollution-solutions-environment-tangshan/