Breathe fresh air. Although it is an expression used throughout the planet, today, in large cities, it is almost a longing. It is that the quality of the air that enters the lungs of millions of people is not pure, since there are small particles that are imperceptible to the human eye suspended, which, in every puff, can cause illness and even death.
Smog, pollution and greenhouse gases are present all over the world and cause air quality to deteriorate. However, humans only distinguish this situation when it is too late and the air becomes very harmful, according to experts consulted by Infobae.
The process is slow. But the end for millions of people around the world is true. According to the latest document issued by the World Health Organization (WHO) with estimates for 2016, “air pollution in cities and rural areas around the world causes 4.2 million premature deaths every year”.
In recent studies, the number established by WHO doubled and it is now estimated that more than 7 million people die each year from diseases linked to poor air quality, of which 500,000 are children under 5 years of age. When considering the figures established in 2016 by the international organization, it is estimated that approximately 58% of these premature deaths were due to ischemic heart disease and stroke, 18% from chronic obstructive pulmonary diseases (COPD) and acute respiratory infections, and 6% from lung cancer.
But beyond these alarming figures, like these particles suspended in the air, this situation seems invisible. However, there is scientific evidence that this is a reality. Even the pandemic and lockdowns linked to COVID-19 showed that these deaths can be prevented if air quality is improved.
Smog, pollution and pollution
From smog in cities to smoke in homes, air pollution is a threat to health, warns the international organization. While explaining that “approximately 91% of the world's population lives in places where levels of air pollution exceed the limits set by WHO”.
Pablo Orellano, epidemiology specialist and researcher at the National Council for Scientific and Technical Research (CONICET), led one of the five teams in the world chosen by WHO to relieve the adverse effects of air pollutants.
In a dialogue with Infobae, the expert explained: “These diseases are generated by the concentration of particles or gases in the environment, which may be of natural origin, as in the case of forest fires or volcanic ash; or due to man-related anthropic causes, such as are the activities of some industries or simply the transport of people”.
“Obviously, transport does not emit as much pollution as an industry, but pollution linked to vehicular traffic is related to the fact that, generally, industries are not close to the spaces where they live, but automotive traffic is everywhere. So, while vehicle transport is not as important as a source of emission, it is important in terms of quantity and proximity.”
In this regard, Timoteo Marchini, professor of Chemistry at the University of Buenos Aires and a researcher at CONICET and the Universitätsklinikum Freiburg (Germany), explained to Infobae: “Among the pollutants present in the air, there is one especially called particulate matter or particles environmental pollution, whose abbreviation is PM2.5. They are not seen, but they are present in the air we breathe.”
“These particles have the capacity to be small enough to penetrate deep into the respiratory tree and reach the pulmonary alveoli, where cells called alveolar macrophages phagocytose them, eat them, and cause an inflammatory reaction that is half uncontrolled and exacerbated and sustained over time”, stood out professional from the UBA.
In Marchini's words, it is an inflammatory reaction that begins by affecting the lung, which is why some of the deaths are due to respiratory diseases; but “what they mainly produce, when sustained over time, a systemic inflammatory reaction that is transferred to the blood and generates an impact negative on other organs, such as the heart and brain”.
What diseases causes air pollution
Experts warn that most diseases are cardiovascular and respiratory, as noted by WHO. “There are studies that establish the doses or levels of exposure that a person may be at to begin to suffer these effects, which state that exposure levels are much lower than those regulated or regulated by the main environmental protection agencies,” said the UBA specialist currently in Germany.
“The level considered safe by WHO is two or three times below the concentration established by these agencies,” Marchini said. At the same time, he pointed out that “the most affected people or the main groups at risk, according to some studies, are workers who are especially exposed to poor quality or polluted air outside, such as police officers”.
He also stressed that those who have pre-existing diseases, especially cardiovascular diseases, diabetics and hypertensive patients, are considered as people at risk. Children under 5 years old and those over 65 years old too, due to immaturity or impairment of the immune system. While another factor is related to socioeconomic status. “It has been shown that people with fewer resources have less capacity to cope with adverse effects of pollution, due to multiple causes: overcrowded conditions, worse access to health; or, especially women, who stay longer inside the house and cook with wood or charcoal.”
“The generation of these diseases is related to how those particles or gases that we breathe affect our immune system. These are those directly related to the lungs: asthma, COPD and lung cancer; as well as cardiovascular, cerebrovascular, diabetes, and premature births. He says, there is a great diversity of diseases and there is new evidence of others that can be associated with exposure to environmental pollution,” added Orellano.
The pandemic as a “witness case”
COVID-19 will be a before and after in the history of humanity, as was the so-called Spanish flu. However, it was also a natural experiment of how many deaths could be avoided when humans generate less pollution, resulting in improved air quality.
“With the lockdown, the decline in mobility and quarantine, which were measures to slow the spread of the pandemic, mainly between March, April and May of last year, there was an improvement in air quality, there was a decrease of between 10 and 30% (depending on the city) of the concentration of these fine particles and a stronger fall, of approximately 50%, in some polluting gases, specifically nitrogen oxides,” explained Marchini.
In this regard, the expert from UBA and CONICET assured that, with these casualties, there were also falls in deaths associated with air pollution. “Some studies were done, mainly in Europe and China. In the first, due to an improvement in air quality, about 11 thousand deaths were prevented; while in the second there were about 9 thousand. That is, tens of thousands of deaths were prevented in just one month.”
“As both traffic and industrial activities were drastically reduced globally, there was a sharp drop in the concentration of pollutants and this led to an improvement in environmental health and human beings. But that decline then rose again when activities resumed and reached the same level as in the pre-pandemic period. For there to be a change in emissions, there must be a profound change in the attitudes of individuals and governments. That discussion is taking place, but it will take quite a while,” Orellano said.
Pollution as a risk factor
The evidence is clear. Poor air quality can kill. It's not fast, but it's a process that can be avoided. “Air pollution is among the 'top five' of risk factors for human health in both women and men. At the level of the health risk involved in smoking or having hypertension,” said Marchini.
For his part, Orellano said: “Epidemiologists, when we investigate the association between exposure to pollutants in the air and diseases in people, we cannot speak of an unequivocal relationship, but rather talk about probability, which is the equivalent of risk. What we measure is the relative risk of suffering from a certain disease. But it can also be calculated, for example, in years of life lost due to illness or healthy years of life. There are many parameters that account for this association between exposure and disease.”
While Marchini noted that the areas most affected by environmental pollution are, for example, East Asia, some European countries, the east and west coast of the United States and India. In addition to “some highly polluted cities such as Santiago de Chile, Sao Paulo, Mexico City, among others”.
Prevention and awareness: everyone's job, but especially governmental
The data is clear. As is commonly said, the cards are on the table. It is now necessary to raise awareness of both the different populations and the world leaders. Air pollution causes disease and death.
In the words of the epidemiologist, “prevention measures are very diverse and can be at the population or community level, such as reducing traffic; individual, cycling as much as possible; and at the provincial or national level, how to control emission sources. All of this is done through investment.” Although he said that “individuals can also do things to protect themselves, especially those most sensitive to pollution. For example, people with asthma may try to be less exposed to polluted air in big cities when pollution is higher.”
“Although there are a large number of associated deaths and plenty of evidence of the negative health impact of exposure to polluted air, there is still no real therapy or drug. There is nothing we can take to prevent these effects,” Marchini said. He added: “The diseases and deaths we name do not appear with extreme levels of pollution”
He concluded: “It is generally recommended that, first, there be information from governments and continuous air quality monitoring. Based on this information, a change of habit can be generated in the population. It has to be constant monitoring so that, when identifying that the air is of too low quality make recommendations. Individual actions are important to pollute less, but they are limited. There is not going to be a real impact on air quality without systemic changes and that will happen when the rulers are convinced that this is a real problem.”
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