Air pollution

Due to a heterogeneous group of gaseous and particulate components.

A complex mixture that varies in concentration and composition related time in place and is greatly influenced by weather.

It includes particulate and gaseous primary pollutants such as nitrogen oxides, sulfur dioxide, and carbon monoxide which are released directly into the atmosphere as well as secondary pollutants such as ozone that are formed in the atmosphere.

The main gaseous pollutants are ozone, carbon monoxide, nitrogen dioxide, and sulfur dioxide.

Additional components of air pollution are volatile and semi volatile organic aerosols such as benzene, toluene, xylene, 1,3 -butadiene, and polycyclic era mode aromatic hydrocarbons.

A consequence of modern societies.

WHO estimates that 91% of the worlds population resides in places were annual mean air pollution levels exceed 10 µg per cubic millimeter.

Air pollution includes outdoor ambient and indoor household pollution.

Ambient air pollution arises principally from fossil fuel combustion.

Pollutants released into the atmosphere from stationary sources such as call powered plants and steel mills and from mobile sources such as cars, trucks, and ships, ate the principal contributors to ambient air pollution.

Air pollution is responsible for shortening people’s lives worldwide on a large scale, and the world is facing an air pollution pandemic.

Ambient particulate matter, is the main component of air pollutants and is the main reason for the adverse effects of air pollution on health, triggering arrhythmias, hypertension, thrombosis, and progression of atherosclerosis.
Particular manner is the most important environmental risk factor contributing to global cardiovascular mortality and disability and particulate matter with aerodynamic diameter of less than 10 µm is associated with worse clinical outcomes.
Particulate matter is categorized into coarse particles less than 10 µm, fine particles less than 2.5 µm, and ultrafine particles less than 0.1 µm.
In low income countries household air pollution is caused mainly by bio mass fuel combustion-wood, cold, straw, dunk, and charcoal in home cook stoves and disproportionately affects women and children.
In high income countries, sources of household air pollution include natural gas compression combustion, wood-burning stove, fireplaces, incense, candles, aerosol sprays, and volatile cleaning products.
Household air pollution is amplified in poorly designed buildings with inadequate ventilation.
Black Americans are exposed to higher annual levels of the air pollution, containing fine particulate matter.
Higher income Black persons, low income white persons, and low income Black persons may benefit from lower PM25 levels than higher income White persons.
Pollution is the unwarranted material released into the environment by human activity, and overlooked risk factor, for Cardiovascular Disease.
Air pollution is the worlds fourth leading cause of death and disease.
Globally, approximately 246,000 annual deaths are attributable to traffic-related air pollution (PM2.5).
Deaths from household air pollution are declining, but deaths attributable to ambient air pollution have increased and continue to rise.
Exposure to higher levels of outdoor air pollution is associated with reduced lung function, asthma exacerbation, myocardial infarction, emergency department visits, hospital admissions and even deaths, primarily from respiratory and cardiovascular causes.

It is estimated that pollution was responsible for 9 million deaths worldwide in 2019, 62% of which were due to cardiovascular disease, including ischemic heart disease and stroke.

Fine particulate matter < 2.5 µm in diameter is a heterogeneous mixture of compounds including carbon, sulfates, nitrates, and metals derived principally from combustion of fossil fuels.

Particulate matter includes inhalable particles with an aerodynamic diameter of 10 µm or less and fine particles with aerodynamic diameter of 2.5 micro µm or less omitted from combustion sources or form to atmospheric chemical transformation.

The main particulate matter (PM) pollutants are defined according to their aerodynamic diameter.

Aerodynamic diameters of 10 micro molar or less is referred to as PM10, and those 2.5 micro molar or less PM2.5.

The daily and annual mean concentrations of PM10 and PM 2.5 are regulated according to WHO air quality guidelines.

PM25 levels are associated with increased risk of myocardial infarction, stroke, and death from cardiovascular disease.

Long term PM25 exposure is associated with increased carotid intima mediate thickness, coronary artery calcification, abdominal aortic calcification, susceptibility to atherosclerotic plaque formation, left ventricular hypertrophy,  progression of chronic kidney disease, insulin resistance and type2 diabetes.

The above associations extend down to pollution levels below 5 µg per cubicmm³.

Globally airborne PM 25 pollution is estimated to contribute about 3.2 million incident cases of diabetes each year and 197,000 deaths from diabetes.

The risk of these events increases by 0.1 to 1.0% for each short term increment of 10 µg per cubicmm³ in the p.m. 25 level.

Each increment in the PM 25 level of 10 µg per cubic millimeter is associated with a 2.12% increase in the risk of hospitalization or death from heart failure.

WHO air quality guidelines:  recommended no more than an annual mean of 10 µg per meter/ cubed for PM 2.5 and 40 µg/meter cubed for N02.
Air pollution is associated with increased risk of  atrial fibrillation and ventricular arrhythmias.
Ambient PM 25 pollution has been closely linked to cardiovascular risk factors most notably hypertension and diabetes.
Air pollution from different sources, such as vehicular exhaust, industrial emissions, and coal smoke, may differ in health risk, which is a reflection of chemical composition, toxic metal content, and oxidative potential.
Traffic related air pollution contains large quantities of ultrafine particles, which may contribute disproportionately to cardiovascular toxic effects.

Air pollution induces systemic prooxidative and pro inflammatory effects, and exposure to air pollutants increases the risk of cardiovascular mortality myocardial infarction, heart failure and other cardiovascular diseases.

An elevated risk of death is associated with Ozone and fine particulate matter less than 2.5 µm in aerodynamic diameter exposure in patients with COPD and a faster decline in lung function associated with long-term exposure to traffic-related air pollutants in healthy populations.

In 2016, and estimated 64,200 premature US deaths were related to adverse effects of outdoor fine particulate matter.

In the US minority populations in those living in poverty are more likely to be exposed to air pollution.

Estimated that air pollution is responsible for 800,000 premature deaths annually worldwide.

Black carbon is a component of atmospheric particulate matter that has a diameter of less than 2.5 micromilliliters.

These particles tend to stay in the air longer, because of their small size, and are prone to be inhaled.

Long-term exposure to black carbon has been associated with adverse health outcomes including: respiratory disease, diabetes, atherosclerosis, stroke, decline in cognitive function and probable increased intraocular pressure.

Short term exposure associated with increased in cardiovascular morbidity and mortality as a result of ischemia, arrhythmias and heart failure.

Long term exposure increases risk of cardiovascular deaths by 79%.

Industrialized countries have cardiovascular disease as their leading cause of mortality and is associated with significant morbidity and these countries have high pollution levels.

Decreased ambient pollution levels is associated with a decrease in bronchitic symptoms in children.

Epidemiologic studies have demonstrated associations between air pollution levels and human health based on hospital admissions, overall mortality, including pulmonary or cardiovascular mortality.

Biologic factors including: advanced stage, prior cardiovascular disease, cardiovascular risk factors, pulmonary disease, and immunosuppression can increase of person susceptibility to air pollution.

All of the main air pollutants, except for ozone on significantly associated with a near term increase in myocardial risk on the basis of a systematic review and meta-analysis (Mustafic H et al).

Relationship with cardiovascular disease strongest for fine particulate matter of less than 2.5 µm in aerodynamic diameter, of which combustion derived nonparticulate in diesel exhaust is a significant component.

Association between fine particulate matter and mortality has no threshold.

Reducing particulate matter decreases mortality.

Associations between particulate matter and respiratory related morbidity and mortality may be greater in persons with preexisting respiratory disease.

Daily changes in ambient fine particulate matter air pollution is associated with higher risk of acute cardiovascular events, excess hospitalization and deaths in (Brook RD et al).

Cardiovascular effects of particulate matter of air pollution is mediated through autonomic, hemostatic, inflammatory, and vascular endothelial disturbances and changes in cardiac and vascular function.

Social determinants of health including: income and inequality, poverty, food deserts, reduced  tree cover, proximity to highways and industrial facilities are associated with increased pollutant exposure and population related carrdiovascular disease.

In air, 3–7% of the particulate matter (PM2.5) is estimated to consist of tire wear and tear, indicating that it may contribute to the global health burden of air pollution.

PM exposure increases myocardial infarction risk by 1-2% within days, because of enormous number of individuals continuously exposed, it can account for the instigation of up to 4% of all events in a population (Nawrot TS et al and).

In a large prospective study of older women by levels of long-term exposure to particulate matter was associated with significant fast cognitive decline (Weuve J et al).

Patients with the highest exposure  to nitrogen dioxide, are 40% more likely to have Parkinson’s disease.

Several studies, but not all have linked air pollutants and stroke.

Low to middle income countries subject to severe air pollution have a disproportionate burden of global stroke mortality.

Exposure to PM2.5 increases the risk of ischemic stroke onset within hours of exposure Wellenius GA et al)

Air pollution from the burning of fossil fuels may increase the risk of Parkinson’s disease.



Patients with the highest exposure  to nitrogen dioxide, were 40% more likely to have ((Parkinson’s disease)).



Nitrogen dioxide is commonly released by vehicles and power plants.



Evidence suggests exposure to pollutants and chemicals in the environment plays an important role in the development of Parkinson’s disease.



Air pollution is responsible for shortening people’s lives worldwide on a large scale, and the world is facing an air pollution pandemic.



Parkinson’s disease has become much more common , now affecting 6 million people around the world. 



Each day, an average of about 200 people are diagnosed with the condition in the United States, 



The disease is most prevalent in regions with high levels of air pollution, such as Europe and North America.



Rates are lowest in non-industrialized areas of Africa. 



Parkinson’s diseases rates are growing fastest in parts of the world that are being developed quickly, such as China and India. 



Previous studies have also linked Parkinson’s with exposure to pesticides and industrial chemicals.



People who had been exposed to the highest levels of nitrogen dioxide over a 5-year period were about 40% more likely to have Parkinsons disease than were people with the lowest levels of exposure. 



The study found no link between the disease and five other pollutants, including ozone, particulate matter, and sulfur dioxide.



The environment, and nitrogen dioxide specifically, contribute to Parkinson’s disease.



A 2016 study in Denmark linked exposure to traffic-related pollution with a higher risk of Parkinson’s.



People often lose their sense of smell 10 to 20 years before they have the tremors and other classic symptoms of PD. 



Suggesting breathing in pollutants and chemicals may damage the olfactory system before the brain begins to decline.

Air pollution has been linked to: stroke, cancer, and Alzheimer’s disease.

Exposure to high levels of air pollution reduces lifespan by nearly 3 years worldwide.

decreasing air pollution may slow cognitive decline.

Climate change exacerbates adverse effects of air pollution on health with: higher temperatures enhancing ground level ozone information, increased risk of wildfires and dust storms.

PM 25 from wildfire smoke and the storms increase the risk of cardiovascular disease.

Higher temperatures increase the demand for electricity, which increases fossil fuel combustion and pollution.

Studies suggest a link between ambient air pollution as well as traffic related air pollution in prostate cancer risk.

High levels of particulate air pollution associated with increased risk of breast cancer incidence.

Air pollution is a trigger of asthma attacks in children with the disease, and is also a cause of asthma.

Air pollution is a risk factor for respiratory infections, bronchitis, impaired lung growth and function.

Children with higher exposure to air pollution have more severe asthma symptoms and lower levels of regulatory T cells.

Air pollution is strongly associated with increased risk of infant death and adverse birth outcomes.

Worldwide preterm births in 2019 estimated at 2 million were attributed to the ambient PM25 exposure:such births are associated with lower respiratory infections, asthma in childhood and long-term intellectual disabilities.

Prenatal and postnatal exposure to various air pollutants is associated with reduce cognition, attention problems, ADHD, and autistic traits in childhood.

Children with elevated exposure to air pollutants before birth or during childhood have structural and functional changes in their brains.

Air pollution may be a risk factor for mental health conditions in children and adolescents with associated depression and anxiety.



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