Air pollution trims years off life | Daily News


 

Air pollution trims years off life

Outdoor air pollution is a major environmental health problem affecting everyone in low, middle, and high-income countries. Ambient (outdoor) air pollution in both cities and rural areas was estimated to cause 4.2 million premature deaths worldwide per year in 2016; this mortality is due to exposure to small particulate matter of 2.5 microns or less in diameter (PM2.5), which causes cardiovascular and respiratory disease, and cancers.

People living in low- and middle-income countries disproportionately experience the burden of outdoor air pollution with 91 per cent (of the 4.2 million premature deaths) occurring in low- and middle-income countries, and the greatest burden in the WHO South-East Asia and Western Pacific regions. The latest burden estimates reflect the very significant role air pollution plays in cardiovascular illness and death. More and more, evidence demonstrating the linkages between ambient air pollution and the cardiovascular disease risk is becoming available, including studies from highly polluted areas.

WHO estimates that in 2016, some 58 per cent of outdoor air pollution-related premature deaths were due to ischaemic heart disease and strokes, while 18 per cent of deaths were due to chronic obstructive pulmonary disease and acute lower respiratory infections respectively, and 6 per cent of deaths were due to lung cancer.

Some deaths may be attributed to more than one risk factor at the same time. For example, both smoking and ambient air pollution affect lung cancer. Some lung cancer deaths could have been averted by improving ambient air quality, or by reducing tobacco smoking.

A 2013 assessment by WHO’s International Agency for Research on Cancer (IARC) concluded that outdoor air pollution is carcinogenic to humans, with the particulate matter component of air pollution most closely associated with increased cancer incidence, especially lung cancer. An association also has been observed between outdoor air pollution and increase in cancer of the urinary tract/bladder.

Addressing all risk factors for noncommunicable diseases – including air pollution – is key to protecting public health. Most sources of outdoor air pollution are well beyond the control of individuals and demands concerted action by local, national and regional level policy-makers working in sectors like transport, energy, waste management, urban planning, and agriculture.

There are many examples of successful policies in transport, urban planning, power generation and industry that reduce air pollution:

* for industry: clean technologies that reduce industrial smokestack emissions; improved management of urban and agricultural waste, including capture of methane gas emitted from waste sites as an alternative to incineration (for use as biogas);

* for energy: ensuring access to affordable clean household energy solutions for cooking, heating and lighting;

* for transport: shifting to clean modes of power generation; prioritizing rapid urban transit, walking and cycling networks in cities as well as rail interurban freight and passenger travel; shifting to cleaner heavy-duty diesel vehicles and low-emissions vehicles and fuels, including fuels with reduced sulfur content;

* for urban planning: improving the energy efficiency of buildings and making cities more green and compact, and thus energy efficient;

* for power generation: increased use of low-emissions fuels and renewable combustion-free power sources (like solar, wind or hydropower); co-generation of heat and power; and distributed energy generation (e.g. mini-grids and rooftop solar power generation);

* for municipal and agricultural waste management: strategies for waste reduction, waste separation, recycling and reuse or waste reprocessing; as well as improved methods of biological waste management such as anaerobic waste digestion to produce biogas, are feasible, low cost alternatives to the open incineration of solid waste. Where incineration is unavoidable, then combustion technologies with strict emission controls are critical.

In addition to outdoor air pollution, indoor smoke from household air pollution is a serious health risk for some three billion people who cook and heat their homes with biomass fuels and coal. Some 3.8 million premature deaths were attributable to household air pollution in 2016. Almost the entire burden was in low-middle-income countries. Household air pollution is also a major source of outdoor air pollution in both urban and rural areas.

The 2005 WHO Air quality guidelines offer global guidance on thresholds and limits for key air pollutants that pose health risks. The Guidelines indicate that by reducing particulate matter (PM10) pollution from 70 to 20 micrograms per cubic metre (μg/m), we can cut air pollution-related deaths by around 15 per cent. WHO Air quality guidelines are currently under revision with an expected publication date this year.

Health effects

There is a close, quantitative relationship between exposure to high concentrations of small particulates (PM10 and PM2.5) and increased mortality or morbidity, both daily and over time. Conversely, when concentrations of small and fine particulates are reduced, related mortality will also go down – presuming other factors remain the same. This allows policy-makers to project the population health improvements that could be expected if particulate air pollution is reduced.

Small particulate pollution has health impacts even at very low concentrations – indeed no threshold has been identified below which no damage to health is observed. Therefore, the WHO 2005 guideline limits aimed to achieve the lowest concentrations of PM possible.

WHO response

WHO Member States recently adopted a resolution (2015) and a road map (2016) for an enhanced global response to the adverse health effects of air pollution.

WHO is custodial agency for three air pollution-related Sustainable Development Goals indicators - mortality from air pollution, access to clean fuels and technologies and air quality in cities. WHO develops and produces air quality guidelines recommending exposure limits to key air pollutants (indoor and outdoor). The organization also creates detailed health-related assessments of different types of air pollutants, including particulates and black carbon particles, and ozone.

WHO produces evidence regarding the linkage of air pollution to specific diseases, such as cardiovascular and respiratory diseases and cancers, as well as burden of disease estimates from existing air pollution exposures, at country, regional, and global levels. WHO develops tools such as AirQ+ for assessing the health impacts from various pollutants, but also the Health Economic Assessment Tool (HEAT) to assess walking and cycling interventions, the Green+ tool to raise importance of green space and health, the Sustainable Transport Health Assessment Tool (STHAT) and the Integrated Transport and Health Impact Modelling Tool (ITHIM).

WHO is developing a Clean Household Energy Solutions Toolkit (CHEST) to provide countries and programmes with the tools needed to create or evaluate policies that expand clean household energy access and use, which is particularly important as pollutants released in and around the household (household air pollution) contribute significantly to ambient pollution. CHEST tools include modules on needs assessment, guidance on standards and testing for household energy devices, monitoring and evaluation, and materials to empower the health sector to tackle household air pollution. It assists Member States in sharing information on successful approaches, on methods of exposure assessment and monitoring of health impacts of pollution.

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Key facts

* Air pollution is a major environmental risk to health. By reducing air pollution levels, countries can reduce the burden of disease from stroke, heart disease, lung cancer, and both chronic and acute respiratory diseases, including asthma.

* The lower the levels of air pollution, the better the cardiovascular and respiratory health of the population will be, both long- and short-term.

* The WHO Air Quality Guidelines: Global Update 2005 provide an assessment of health effects of air pollution and thresholds for health–harmful pollution levels.

* In 2016, 91% of the world population was living in places where the WHO air quality guidelines levels were not met.

* Ambient (outdoor air pollution) in both cities and rural areas was estimated to cause 4.2 million premature deaths worldwide in 2016.

* Some 91% of those premature deaths occurred in low- and middle-income countries, and the greatest number in the WHO South-East Asia and Western Pacific regions.

* Policies and investments supporting cleaner transport, energy-efficient homes, power generation, industry and better municipal waste management would reduce key sources of outdoor air pollution.

* In addition to outdoor air pollution, indoor smoke is a serious health risk for some 3 billion people who cook and heat their homes with biomass, kerosene fuels and coal.

- WHO


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