Air pollution—a wicked problemBMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2814 (Published 14 June 2017) Cite this as: BMJ 2017;357:j2814
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We have read the nice editorial by Professor Stephen Holgate and Dr Stokes Lampard about the long term effect of air pollution on health. Air pollution, with emissions consisting of small particulates, oxides of nitrogen (especially NO2), volatile organic chemicals, and ozone have an effect on health leading to cardiovascular diseases (CVD), Stroke and respiratory diseases (COPD) (1). A recent study by Dr Bell and colleagues has shown that air pollution is associated with lower high-density lipoprotein (HDL) cholesterol (2).Dr Miller and colleagues have observed exhaust emissions from vehicles as rich sources of ultrafine particles that cause vascular and atherosclerotic effects. There is evidence that inhaled particulate matter (PM) releases free radicals which are detrimental to cardiovascular health (3). In the last decade the use of motor vehicles has markedly increased.
Intermediate-term exposure to PM is associated with increase in serum glucose, HbA1c, low-density lipoprotein (LDL) and triglycerides, and a decrease in HDL in patients with diabetes mellitus (4).
Indoor air pollution is a major global public health threat as people are using solid fuel (Biomass and coal). This is associated with respiratory diseases like asthma, COPD, tuberculosis and lung cancer (5). 92% of the world population is living in places where the WHO air quality guidelines levels are not met. Due to exposure to air pollution, 88% of premature deaths occur in low- and middle-income countries (6). Recently a hydrogen fuel bus has been manufactured which produces less pollution and hence is environment friendly. Measures should be taken to reduce air pollution by government and public globally so as to have a positive outcome on health.
1.Holgate S Editorial .Air pollution—a wicked problem. BMJ 2017;357. 14 June 2017)Cite this as:BMJ2017;357:j2814
2. Bell G, Mora S, Greenland P, Tsai M, Gill E, Kaufman JD. Association of Air Pollution Exposures With High-Density Lipoprotein Cholesterol and Particle Number: The Multi-Ethnic Study of Atherosclerosis. Arterioscler Thromb Vasc Biol. 2017 May;37(5):976-982.
3. Miller MR1, Shaw CA, Langrish JP. From particles to patients: oxidative stress and the cardiovascular effects of air pollution. Future Cardiol. 2012 Jul;8(4):577-602.
4.Yitshak Sade M, Kloog , Liberty IF, Schwartz J, Novack C. The Association Between Air Pollution Exposure and Glucose and Lipids Levels. J Clin Endocrinol Metab. 2016 Jun;101(6):2460-7. doi: 10.1210/jc.2016-1378. Epub 2016 May 24.
6. Ambient (outdoor) air quality and healthhttp://www.who.int/mediacentre/factsheets/fs313/en/
Dr Mahantayya Math, Associate Professor In Physiology
Dr Rita M Khadkikar, Associate Professor in Department of Physiology
Dr.Yashoda R Kattimani, Assistant Professor in Department of Physiology
Department of Physiology, MGM Medical College, Navi Mumbai-410209, Maharashtra State, India
Competing interests: No competing interests
Re: 40,000 deaths from air pollution: is it hot air?
The 40.000 deaths attributable to air pollution are extraordinary when compared to 22,000 and 80,000 deaths attributable to alcohol and smoking respectively. These pollution figures derived by statistical modelling don’t pass the smell test even if one holds one's nose.
A case control study comparing a rural and urban population in one of the UK counties could have easily confirmed or refuted these figures.
Sensationalist figures if not backed up by hard evidence damages public confidence in the authorities.
Competing interests: No competing interests