The Health Impact Of Air Pollution: What You Need To Know

Introduction

Understanding the severe health impacts of air pollution is crucial, as it not only erodes public health on a global scale but also threatens individual lives and well-being. The Lancet Commission on Pollution and Health, utilising data from the 2019 Global Burden of Disease Study, has found that air pollution is responsible for 9 million premature deaths each year, affirming its position as a dominant threat to health worldwide.1 This menacing issue stems not just from the growth of cities and industries but also from insufficient actions taken, especially in swiftly growing economies.

The situation gets murkier when we bring climate change into the mix. Changes in climate patterns can modify how primary pollutants spread and how secondary pollutants like near-surface ozone are formed, impacting our health. This leads to more people falling sick, increased hospital visits, and time off work. A deeper look into recent studies emphasises the pressing need for more research to better understand the evolving threat of air pollution amidst changing climate.²

The effects of air pollution vary greatly from place to place, with indoor and outdoor air quality being influenced by local climate and how energy is used, say for heating. These factors, mingling with air pollution, lead to a spectrum of health issues ranging from breathing problems to serious brain conditions.³

Realising the gravity of air pollution, it's crucial that we join hands to combat it. Despite the hurdles, we have the chance to lessen harmful emissions by embracing greener technologies and habits. The growing discussion on legal and administrative measures for better air quality shows a rising awareness, yet a stronger public conversation is needed to push this critical issue further into the limelight.⁴

Witnessing the harmful repercussions of air pollution on our health, it's evident that a collaborative, global effort in research, policy formulation, and public health measures is the way forward to tackle this dire challenge.

Main pollutants and sources

Air pollution encompasses a wide array of contaminants that pose substantial risks to our health. Among these, outdoor air pollution and harmful chemical pollutants like lead are the modern-day threats exacerbated by industrial and urban growth.¹ These pollutants primarily emanate from industrial activities, vehicle emissions, the burning of fossil fuels, and some waste management practices that inadequately contain toxic byproducts.

Outdoor air pollution

Outdoor air pollution is particularly alarming, with a mixture of different pollutants, including particulate matter (PM), nitrogen oxides, sulphur dioxide, carbon monoxide, and volatile organic compounds (VOCs). One of the most concerning pollutants is particulate matter, especially the tiny particles known as PM2.5, which can infiltrate deep into our lungs and even enter our bloodstream, leading to heart, brain, and lung diseases. The significant sources of PM emissions encompass:

• Industries
• Power plants
• Vehicles
• Residential heating

Moreover, agricultural practices contribute to air pollution by releasing substantial amounts of ammonia, a precursor to particulate matter PM.³ Another significant source of outdoor (ambient) air pollution is household emissions.

Household air pollution

Numerous households, primarily in low- and middle-income nations, depend on solid fuels such as wood, dung, and charcoal, as well as kerosene that are polluting and hazardous to cater to their energy requirements for cooking, heating, and lighting. The utilisation of these fuels, particularly through wood combustion, releases toxic chemicals, including benzene, polycyclic aromatic hydrocarbons, dioxins, and ultra-fine particles, into the environment. This biomass burning significantly deteriorates air quality both inside and outside homes, with notable emissions of fine and ultra-fine dust (PM10, PM2.5).

The household air pollution (HAP), thereby imposes a substantial and avoidable disease burden as well as an estimated 3.2 million fatalities annually. The indoor pollutants particularly impact women and children, who tend to spend more time indoors.⁵

Toxic lead emissions

Toxic lead emissions in the air often originate from industrial processes (lead smelters), improper waste disposal, and the deterioration of lead-containing paints and pipes. Despite a significant reduction in lead usage in products like gasoline and paint, it remains a lingering pollutant due to historical uses and ongoing exposures in certain regions.¹

Health effects of air pollution

The lingering health effects of air pollution are far-reaching and long-lasting. Continuous exposure to air pollutants like fine particulate matter (PM2.5) and nitrogen dioxide (NO2) is now seen as a major risk factor for several chronic ailments. These hazardous particles can trigger or aggravate breathing problems, like chronic obstructive pulmonary disease (COPD), and chip away at our lung function as time goes on. But it doesn't stop at our lungs; our hearts are on the line, too. Steady exposure to these pollutants contributes to heart disease and can even have a say in the onset of diabetes.³

Moreover, the potential toll on our minds is alarming. More and more evidence is hinting at a disturbing connection between long-term exposure to air pollutants and the occurrence of brain diseases like Alzheimer's and Parkinson's. While the exact mechanism is still under the microscope, it's becoming evident that air pollution is a significant environmental foe against our brain health.³

Impact of air pollution on respiratory health

The onslaught of air pollution on our lungs is a significant public health worry. Common culprits like particulate matter (PM2.5), nitrogen dioxide (NO2), sulphur dioxide (SO2), and ozone (O3) are known to trigger or worsen various lung conditions including asthma, chronic obstructive pulmonary disease (COPD), and even lung cancer. These pollutants enter our respiratory system, spark inflammation, and erode lung function, often resulting in urgent trips to the emergency room or hospital admissions.^3,5

Indoor air pollution risks

Indoor air pollution, also known as household air pollution (HAP), frequently stemming from the use of biomass fuels or coal for cooking and heating, poses additional hazards, especially in low- and middle-income countries (LMICs). Lung cancer, chronic obstructive pulmonary disease (COPD), stroke, and ischemic heart disease are among the non-transmissible illnesses that are brought on by exposure to household air pollution. 

Long-term effects

The damage from air pollution isn’t just a one-off; it piles up over time, leading to enduring conditions that can cut down our quality of life and overall lifespan. For instance, long-term exposure to polluted air has been tied to a decline in lung capacity and function and a heightened risk of chronic lung ailments. Moreover, particulate matter can ferry other harmful substances deep into our lungs and bloodstream, sparking systemic health issues.³

Environmental factors

Climate change adds fuel to the fire when it comes to the health impacts of air pollution. Rising temperatures and shifting climate patterns can ramp up the concentration of air pollutants, paving the way for graver health outcomes. The intertwined nature of these factors highlights the intricacy of tackling lung health in the broader frame of air quality.²

Effects of air pollution on cardiovascular health

Air pollution emerges as a formidable risk factor for cardiovascular ailments, with pollutants like fine particulate matter (PM2.5) and nitrogen dioxide (NO2) being prime offenders. When inhaled, these pollutants can spark systemic inflammation and oxidative stress in our bodies, playing a part in the onset of atherosclerosis and hypertension. These conditions, in turn, elevate the risk of heart-related incidents like myocardial infarction (heart attacks) and strokes.³

Table 1 below, adapted from de Bont J et al.'s study,⁹ provides a concise summary of some primary sources of pollution, the pollutants they release, and the associated cardiovascular  health effects:

Table 1 is adapted from information in de Bont J et al.'s study titled 'Ambient air pollution and cardiovascular diseases: An umbrella review of systematic reviews and meta-analyses' published in the Journal of Internal Medicine in 2022.⁹

Short-term vs long-term exposure

The danger to our heart health isn't confined to long-term exposure. Even short-term encounters with high pollution levels can trigger acute cardiovascular events, particularly among vulnerable groups such as the elderly or those with pre-existing health conditions. Over time, chronic exposure heightens these risks, aiding the progression of cardiovascular diseases and amplifying the mortality associated with them.²

Air pollution’s toll on children’s health

Air pollution poses a significant hurdle to children's health, affecting not just their physical growth but also their cognitive and academic capabilities. Children's developing organs, notably their lungs and nervous systems, are highly vulnerable to toxic air pollutants like particulate matter (PM), ozone (O3), and nitrogen dioxide (NO2). Exposure during crucial growth phases could lead to respiratory illnesses, reduced lung function, and cognitive development setbacks, which might also reflect in their academic performance.^3,5

Prenatal exposure

Shockingly, the womb doesn't offer a safe haven from pollution; prenatal exposure can interfere with foetal growth, leading to outcomes like low birth weight, preterm birth, and developmental delays. These early life adversities set the stage for long-term health challenges, including impaired lung function and potential cardiovascular issues that can persist into adulthood.^5,6

Mental health and academic performance

The repercussions of air pollution transcend physical health, encroaching on the mental well-being and academic performance of children, as underscored by emerging research.

Depression and Anxiety: Evidence has surfaced linking Traffic-Related Air Pollution (TRAP) exposure during early life and throughout childhood to self-reported symptoms of depression and anxiety among children. This suggests that the detrimental mental health effects of air pollution observed in adults may extend to the younger population as well​​.^10,11

General Psychopathology: A study shed light on the correlation between higher levels of Nitrogen Oxide (NO) and Particulate Matter (PM) exposure during childhood and adolescence with elevated scores on general psychopathology. This association held its ground even after accounting for family and individual variables​​.¹²

Academic Performance: Moreover, children exposed to elevated levels of air pollution were found to be more likely to have poor inhibitory control, which could potentially impact their academic performance and dim a child's future prospects and opportunities.

Respiratory health sensitivity

Children’s respiratory systems are particularly sensitive to air pollution. Conditions like asthma can be triggered or worsened by pollutants from traffic and industrial emissions. Notably, traffic-related air pollution and nitrogen dioxide are linked to asthma development, while exposure to second-hand smoke can escalate the risk of asthma attacks and other respiratory symptoms, thereby stretching healthcare resources thin, especially in developing countries where air quality may be subpar.⁷

Indoor air pollution and respiratory disorders

The issue is compounded by indoor air pollution, which is common in many developing regions due to reliance on biomass, kerosene, and coal for cooking and heating. According to WHO estimation, exposure to indoor air pollution nearly doubles the risk of childhood lower respiratory infection and accounts for 44% of pneumonia-related fatalities in children under the age of five.

Unfolding research and policy implications

A substantial body of research highlights the adverse effects of air pollution on children's lung function growth, yet there’s a dire need for more systematic research to unravel the long-term repercussions and evaluate the effectiveness of air quality improvement measures.⁸ Such research is fundamental in informing and refining national ambient air quality standards crucial for protecting sensitive subgroups, including children, given their heightened susceptibility to air pollution's harmful impacts.⁸

A multifaceted strategy

The amassed evidence heralds a call for a multifaceted strategy to combat the health risks air pollution presents to children. This strategy should span advancing research on long-term effects, bolstering public health policies, and enforcing robust pollution control measures, all aimed at ensuring a healthier and brighter future for the upcoming generations.

Global disparities in pollution control

The contrast between the advancements in high-income countries and the severe pollution challenges faced by low- and middle-income countries (LMICs) is stark.¹ This disparity is further accentuated by the lack of clean cooking access among 2.4 billion individuals, predominantly in LMICs, illuminating the global inequality in addressing pollution as a health challenge.

Individuals in less affluent communities or regions with lax air quality standards are often at a higher risk due to socioeconomic and geographic factors.⁵ This rings especially true in LMICs, where soaring pollution levels and inadequately resourced healthcare systems struggle to manage the burgeoning disease burden.⁵

Transitioning towards a solution demands a united front across diverse sectors and governance levels to foster sustainable practices like promoting clean cooking solutions and enforcing stricter air quality standards. By doing so, we can work towards alleviating the pollution burden on the most vulnerable populations and make strides in bridging the global pollution control divide.

Strategies to minimise air pollution exposure

Air pollution continues to be a concern for many, and the quest for cleaner air is a collective responsibility shared among individuals, communities, and nations. A well-rounded approach is crucial to mitigate the respiratory health effects of air pollution. This encompasses personal preventive steps like employing air purifiers and masks (N95 respirators), community-driven efforts to cut down pollution sources, and national policies geared towards upholding clean air standards and slashing industrial and vehicular emissions.^2,3,5 

There are various strategies that can be employed to minimise exposure to air pollution and subsequently safeguard our health. Here, we delve into some of the measures proposed by different scholars, which can serve as a roadmap to attaining a pollution-free environment.

Global initiatives

• A shift from the usage of fossil fuels to clean, renewable energy sources is paramount. This transition not only curtails pollution but also decelerates climate change, offering a dual advantage for our planet's health.¹
• To enhance the fight against pollution, it is vital to synchronise global efforts with other environmental policy programs akin to the strategies laid down by the Intergovernmental Panel on Climate Change and the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES).¹
• Tracking metrics such as the incorporation of pollution prevention in development strategy frameworks and the media's focus on pollution and health topics can provide insight into public awareness and engagement in pollution mitigation efforts.¹

Policy reforms

• Updating and aligning legislation concerning air pollution is crucial. Policymakers have a pivotal role in crafting robust tools for environmental and health protection that resonate with the current pollution challenges.³
• Benefits of Action to Reduce Household Air Pollution (BAR-HAP) could be utilised to assess intervention scenarios aimed at enhancing indoor air quality, especially in regions where solid fuel usage is predominant. This tool can aid policymakers in evaluating and comparing the merits of various interventions within and between different countries.
• Advocating for and implementing policies that encourage the transition from the use of solid, polluting fuels to clean fuels and technologies, especially in low-income and rural households, can significantly alleviate household air pollution (HAP) and its associated health risks.
• Community measures can range from embracing better methods of energy production and promoting active and public transport infrastructure to employing effect modifiers to reduce risk factors, all contributing to a significant reduction in air pollution and its associated health risks.⁷

Individual actions

Filtration and ventilation:

• Improving indoor air quality by reducing or removing sources of pollutants from biofuel utilised for home cooking/heating, ventilating with clean outdoor air, and supplementing these actions with effective filtration.
• Utilising portable air cleaners/purifiers or upgrading the air filter in your furnace or central heating, ventilation, and air-conditioning (HVAC) system can significantly improve indoor air quality. Although they can't remove all pollutants, they are instrumental in reducing indoor air pollution (EPA).

Masks and respirators:

• Respirators and masks designed for particle filtration can help protect against inhaling airborne particulate matter (PM).
• Employing NIOSH approved respirators, like N95 respirators, that meet rigorous standards (CDC) is a recommended step for individuals to reduce their exposure to air pollutants.

The journey to minimising air pollution exposure and its subsequent health impacts requires a concerted effort across various sectors. By adopting the above-outlined strategies, we can all contribute to a cleaner and healthier environment for ourselves and future generations.

Summary

Navigating through the haze of air pollution's health impacts can be unsettling, especially when considering the long-term effects on our well-being. Your concern echoes a global sentiment, urging us all to delve deeper into understanding and combating this pervasive threat for a breath of fresh air and a healthier future.

Key points:

• Global Concern: Air pollution, a leading health threat, causes 9 million premature deaths annually, necessitating urgent global interventions.
• Climate Change Interplay: Changes in climate patterns exacerbate air pollution effects, underscoring the intertwined challenge of mitigating both issues.
• Health Impact Spectrum: Air pollutants trigger a myriad of health issues, including cardiovascular diseases, respiratory conditions, and potential neurological impairments.
• Mitigation Strategies: A collaborative approach encompassing policy reforms, technological advancements, and individual actions is crucial to reducing pollution exposure and safeguarding public health.
• Disparities and Vulnerabilities: Global inequalities in pollution control and particular vulnerabilities among children and low-income populations underline the urgency for inclusive, effective solutions.
• Forward Path: Advancing research, strengthening public health policies, and enforcing robust pollution control measures are pivotal to combating the health risks posed by air pollution, ensuring a healthier future for all.

The insights encapsulated in the key points above pave the way towards a clearer understanding and actionable solutions in our collective pursuit for cleaner air and better health.