The danger of air pollution

Autovía con coches y cartel de alta contaminación

It's bad for everybody. Even more so for children, pregnant women and the elderly. And harmful to those who suffer from conditions such as asthma and chronic obstructive pulmonary disease ( COPD). We refer to air pollution, whose danger is supported by data from the Spanish Society of Pneumology and Thoracic Surgery (SEPAR): in our country, 10,000 people die every year as a result of poor air quality. With respect to those diagnosed with chronic respiratory disease, Isabel Urrutia, a pulmonologist and coordinator of the SEPAR Environment area, explains that "when pollution increases, symptoms increase, and it has been documented that more people go to the emergency room and there are more hospitalizations".

Some of the consequences of these episodes of high contamination are, in the words of Dr. Urrutia, "an increase in respiratory infections and pneumonia, especially in children, although there is also an increase in the latter disease in older people". Beyond these cases or the complications in asthma or COPD patients, the specialist points out that other serious health problems associated with poor air quality have been observed, such as lung embolism and myocardial infarction. It should be noted that among the conditions linked in some way to pollution, COPD has the highest mortality rate, along with pneumonia in the elderly.

Air pollution not only has implications for diseases of the respiratory system

Dr. Urrutia explains that "there is a very important study led by Jordi Sunyer, Professor of Preventive Medicine and Public Health at the Pompeu Fabra University (Barcelona), which establishes that pollution has a direct influence on the cognitive deterioration of children". This work evaluates the role of prenatal and early life exposure to fine particles in suspension, which are those with a diameter less than or equal to 2.5 microns (one micron is equivalent to one-millionth of a metre). This research concluded that children from four to six years old exposed to poor quality air have a worse working memory, also called operational memory, which is what allows us to keep in our heads the necessary information to complete the task we are performing at any given time. However, this negative association does not occur among girls who work in the same environments. Among the illnesses linked to increased exposure to fine particles are attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD).

The children of pregnant women exposed to an unhealthy atmosphere also do quite poorly. "They are more likely to be premature, die in childbirth, or suffer from lung disease. In addition, the lung function of children whose schools are located in highly polluted places is declining over the years," warns Dr. Urrutia. It appears that these children are more likely to develop chronic diseases in adulthood.

In this scenario, is it necessary for public administrations to take measures to improve the state of the air?

The tyre specialist is emphatic: "Yes, we must reduce the emission of pollutants. And to exemplify the positive effects of the fall in pollution, she cites the case of Central Madrid, the low-emission zone that began to be implemented in November 2018: "When vehicle traffic was reduced, air quality improved considerably. But there is still a need for a political strategy implemented by technicians". To maximize the positive effects of these projects "we all have to get involved", says Dr. Urrutia, who also advocates strengthening the role of health professionals.

"We pneumologists must incorporate environmental training into our knowledge and contribute to raising people's awareness. We already provide health education to asthmatics and COPD patients: we raise their awareness to reduce exposure and teach them how to do it". Should we wear masks to protect ourselves? "Some work and some don't, you have to look at each individual case.

As for the measures that can be taken by citizens, Dr. Urrutia believes that they are few and far between.

Panorámica de Madrid con contaminación

"Patients, especially chronic respiratory patients, have to inform themselves and avoid walking the streets for a long time on the days of greatest pollution. Despite the benefits of walking or playing sports outdoors, they should avoid breathing this air directly".

Less pollution = less mortality

The World Health Organization (WHO) directly associates improved air quality with lower mortality rates and states that if the presence of PM10 suspended particles (those less than 10 microns in diameter) were to fall from 70 to 20 micrograms per cubic metre (a target set in its air quality guidelines), deaths associated with pollution, as well as respiratory and cardiovascular diseases linked to it, could be reduced by 15%. According to the WHO, reducing pollution to the levels set out in its guidelines would also reduce "emissions of greenhouse gases and other pollutants that contribute to climate change".

The latter is important because scientists link global climate disruption to the abundance of extreme weather events (major storms, hurricanes, floods...), which have health consequences. How? They facilitate the spread of diseases that can be transmitted by water or insects. This is the case with the dengue virus and the malaria parasite, which travel in certain mosquitoes.

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