Is air pollution killing us?
The quality of the air we breathe is something that many of us probably only give passing thought to from time to time – if at all. Yet it is something that none of us can ignore.
Every day seems to bring stories of broken temperature records, sensational stories titled: “Is this most polluted city in the world?”, and headlines which generally indicate that the damage we have done to our planet is far worse than most of us are aware.
We can only hope that the powers that be – global governments and big business for example – are serious about bringing positive change. There are no doubt some solid initiatives in motion, and although these are a long long way from becoming reality, we can take some relief in the fact that very serious discussions around the matter are being held.
Putting aside the bigger picture, this article will focus closer on the specific impact that pollution has on our health: What exactly is it doing us?
Perhaps the best place to start is with some statistics. While the numbers vary (depending on the source), they certainly all point in the same direction and show that we have a real health issue on our hands.
A 2016 report issued by the Global Burden of Disease project, which reveals that around 5.5 million people die prematurely every year as a result of air pollution. A separate study by the World Health Organisation (WHO) puts the number even higher, concluding that 7 million people died of exposure to air pollution in 2012 alone (that is one in every eight deaths that year).
Drilling down a bit, additional statistics published by the WHO highlight the issue from another perspective, revealing that 80% of people living in urban areas are exposed to air quality levels that exceed the WHO “safe limits”. What’s more, according to WHO’s 2016 urban air quality database figures, 98 percent of cities in low- and middle-income areas with more than 100,000 inhabitants do not meet air quality guidelines, while in high-income areas this figure is 56 percent - still shockingly high.
The link to specific disease has also been made, with studies showing pollution to be a contributor to a range of some of the more serious conditions of our time. Aside from the obvious lung and respiratory illnesses, pollution also increases heart disease, stroke, and cancer risk. There is even mounting evidence to suggest that air pollution is a leading cause of insulin resistance, which heightens the risk for type 2 diabetes.
Main causes of air pollution
Essentially, air pollution is the contamination of the environment by physical, chemical, and biological agents, including emissions from industrial factories, motor vehicles, tobacco smoke, and household appliances (for example, heaters, boilers, ovens, and in our part of the world those ever-present air conditioners).
In fact, those indoor risks are worth a closer look, so we can begin there with a WHO stat which tells us that indoor pollution levels can hit up to five times the levels found outside. Some factors that cause this include cleaning chemicals, mould, bacteria, stale air, and fungi and other microbes. And in the UAE, where residents spend up to 90 percent of their time indoors with those air conditioners humming away (and helping to spread the bad air) many of us are very affected by the situation without any awareness of it whatsoever.
Outdoors, on the other hand, the two most common air pollutants are carbon monoxide (CO) and ground-level ozone (O3). Carbon monoxide pollution is largely caused by fuel combustion from vehicles and factories, while ground-level ozone occurs when other pollutants such as nitrogen oxides (NO2) and volatile organic compounds react to sunlight. The images of that smog which has become synonymous with mentions of cities such as Beijing and New Delhi is made up largely of these gases, for example.
Impact on our health
Whatever the specific causes of air pollution from place to place, one thing is certain – it indeed has quite a serious impact on our health. According to research from the University of North Carolina, it is estimated that around 650 deaths occur each year in the UAE from the quality of the ambient air (that is, the quality of the outdoor air in our surrounding environment), and ambient air pollution in the country leads to more than 10,000 healthcare facility visits each year.
One of the most common air pollution-related conditions is, of course, asthma – thought to affect one in every eight adults here in the UAE. According to America’s Natural Resources Defense Council (NRDC), air pollution from cars, factories, and power plants are among the biggest contributors to the condition, and ground level ozone and nitrogen oxide are also significant factors. Other research highlights how children who live near busy roads or play outside in high ozone concentration areas are far more likely to be asthma sufferers.
Another chronic condition many don’t think of when it comes to pollution is heart disease. Particularly at risk are those living in large cities or near busy intersections and industrial sites, as studies from around the world – most notably in Los Angeles – show an increase in deaths and hospitalisations when smog concentration is high. This type of air pollution is believed to have an inflammatory effect on the heart, irritating the blood vessels and leading to chronic cardiovascular problems. According to a 2010 statement issued by the American Heart Association , even short-term exposure to air pollution can lead to an increased risk of heart attack, stroke, arrhythmias and heart failure.
Poor air-quality has also been shown to increase the risk of developing type 2 diabetes – once again largely due to pollution caused by exhaust emissions and industrial smoke. A notable study carried out by physicians at Boston’s Children’s Hospital and Harvard Medical School found that those living in areas where air-quality levels were below acceptable safety limits – even if only slightly – show a 20 percent higher prevalence of diabetes than those in areas of lower pollution. What is perhaps most worrying about this particular study is that the link between air pollution and diabetes was still evident even when the researchers factored in known diabetes risks such as obesity and sedentary lifestyles. It is once again the inflammatory effect of pollutants in the air that is thought to be responsible for this increased risk factor, as chronic inflammation is known to increase insulin resistance.
All of this is before we touch on what many would consider the most devastating disease on air pollution’s charge sheet: cancer.
Cancer and air-pollution
The link between air pollution and cancer has of course been accepted as fact for many years, but much weight was added to the argument in 2013, when WHO’s International Agency for Research on Cancer (IARC) classified outdoor air pollution as a cancer-causing agent – that is, a carcinogen. The IARC’s report, which was based on over 1,000 scientific studies, concluded that there is a significantly strong link between outdoor air pollution and lung cancer and bladder cancer in particular.
As always, we could go on and on and fill many pages with frightening stats about the extent of the problem, but the above gives us the general idea. And to be sure, whatever the causes behind it and whatever the diseases it leads to, this is a major issue for our times, and, unfortunately, only set to get worse under the current circumstances. According to the United Kingdom’s Organisation for Economic Cooperation and Development (OECD), air pollution is expected to become the biggest environmental cause of premature death in the world by 2050.
Can we protect against air pollution?
Perhaps the most worrying aspect of the air pollution issue is that, as you have probably gathered by now, there is no quick or easy fix. But, we are not helpless.
For starters, joint responsibility on the larger scale. Making small changes in how we go about our day in large scale can positively impact things. Everything from reducing the use of heating and air conditioning, to turning off those lights and electrical appliances whenever possible, to carpooling (or leaving the car at home altogether) – and so on. You get the picture: Simply reduce as much as possible those habits that are obvious contributors to the problem.
As for taking care of the you in the here and the now, some basics include reducing your use of those harmful home cleaners, properly maintaining those air conditioning units by having them cleaned regularly, avoiding secondhand smoke, and choosing non-congested areas with little through traffic to live in or spend time in (avoiding exercise in such an environment is particularly important). Also be sure to leave the house anytime pest control come by to spray, as well as open all windows to properly ventilate and remove residual fumes.
If you want to take it to the extreme, sure, those face masks you often see people wear when travelling through airports will protect your lungs by preventing some of the harmful particles from reaching them, but clearly most of us are not willing to go to such lengths given the awkwardness.
Fair to say that it is – as usual when it comes to health and wellbeing – the very obvious common sense that prevails. Yet while we all sort of know what we can and should do, actually doing it is a very different thing altogether. And we must also be honest in acknowledging that due to poverty and general circumstance, the majority of those around the world suffering the most in those congested cities can do very little about it at all.
The issue of air-pollution is one of those challenges that will only get properly addressed if humans take a good look at all the bad things we are doing on account of greed, selfishness, and that near-term thinking of ours that is a recipe for disaster when it comes to so many issues affecting our planet. We can only hope that future generations get it more right than we have gotten it until now.
The opinions in the column are by Dr Graham Simpson, the Chief Medical Officer and Founder of Intelligent Health, a preventive medical centre located in Jumeirah, Dubai, and are not necessarily those held by Esquire or Hearst International.