Presentation on theme: "Air pollution and health Emission – primary, secondary Immission: Solid phase – dust, aerosols Gas phase Radioactive components."— Presentation transcript:
Air pollution and health Emission – primary, secondary Immission: Solid phase – dust, aerosols Gas phase Radioactive components
Disasters connected with air pollution Ancient Roman Empire – Plinius Jr –Vesuvius eruption Maas river, Belgium, 1930: Fog, inversion, heavy industry, production of sulphuric acid, irritation of respiratory ways, death Donora, USA, 1948: Inversion etc.- Respiratory disease in about 6000 inhabitants, cardiopulmonary problems London, 1952: Inversion, increase of mortality, especially among older people and children. Smoke, fog, increased level of SO 2. Smog (reductive) Los Angeles: Heavy traffic, exhaust gases, intensive insolation, Smog (photochemical)
London, 5. – Big Smoke episode (combustion of coal of poor quality with a high content of sulphur, adverse meteorological conditions) Concentration of PM10 was estimated to cca 3000 g/m 3 Increase of hospital admission, pneumonia, COPD, asthmatic problems, increased mortality in the period of several months after the episode The number of deaths „over the normal level“ was estimated to be Nowadays, the level of air pollution in London (PM10) is about 30 g/m 3 which means approx. 380 premature mortality and 350 hospitalized for respiratory problems per year
Smog episodes in Middle Europe in I ndustrial part in Germany – Rhine area and Erfurt Episodes characterized with high concentration of SO 2 (till 5 mg/m3 !!!) and total suspended particles (TSP – till 2,4 mg/ m3). Traffic load was more important than industrial. Dust particles concentration had higher importance than SO 2 Increase of daily mortality, hospitalization for respiratory and CV diseases, outpatients visits – with 1 to 2 day of delay from episode. The risk of CVD was more expressive, as well as the risk for seniors.
Smog episodes in the Czech Republic Coal field areas – Black triangles Northern Bohemia close to Germany and Polen (Teplice, Most) – Program TepliceNorthern Bohemia close to Germany and Polen (Teplice, Most) – Program Teplice Northern Moravia - Ostravsko-karvinská area (close to industrial area in Polen) - Program SilesiaNorthern Moravia - Ostravsko-karvinská area (close to industrial area in Polen) - Program Silesia
Disasters connected with air pollution (cont.) Seveso, Italy, 1976: Explosion in chemical plant producing trichlorophenol Dioxins: long-term health effects Endocrine disrupting effects, carcinogenicity Bhópál, India, 1984: Outflow of methylisocyanate from chemical plant Several hundreds or thousands of dead inhabitants
Sources of air pollution Industrial processes Coal power plant Local heating (fossil fuel) Transportation (gasoline engine, diesel engine, steam engine) Smoking (?) Outdoor
What is smog? Two types of smog: Reductive (London type): Necessary prerequisites:smoke from burning of fossil fuels, sulphur oxides, fly-ash, fog, low temperature (early morning, in winter), inversion fog, low temperature (early morning, in winter), inversion Oxidative (fotochemical, Los Angeles smog): engine exhaust emissions, exhaust fumes, engine exhaust emissions, exhaust fumes, Sunny weather without clouds, UV radiation, temperature 25-30°C, fotochemical reactions of NOx, oxygen, sulphur oxides, hydrocarbons, ozone, peroxiradicals (peroxyacetylnitrates PAN) Sunny weather without clouds, UV radiation, temperature 25-30°C, fotochemical reactions of NOx, oxygen, sulphur oxides, hydrocarbons, ozone, peroxiradicals (peroxyacetylnitrates PAN)
… transport, fotochemical and fysical chemical reactions sources (emissions) sun recipient (Imissions – adverse effects UV záření
According to size - big - big - medium - small According to type - mobile (liniové) - areas - points According to the origin - natural - antrhopogenic OutdoorTraffic Local heating with fossil fuels Industry Coal power station Agriculture Indoor Building material. Household chemicals, cosmetics, furniture etc. Sources of air pollution
Anthropogenic Natural Sources of outdoor air pollution
CookingSmoking Human activities Pets Outdoor air Indoor air
Sources of air pollution Indoor SmokingCookingHeatingRadonEquipment: – furniture, curtains, carpets - paintwork -Domestic chemicals - detergents, cosmetics, insecticides etc. insecticides etc. Human activity
Basic air pollutants (indicators) ParticlesParticles GasesGases Chemicals like heavy metals, polycyclic aromatic hydrocarbons, dioxins etc.Chemicals like heavy metals, polycyclic aromatic hydrocarbons, dioxins etc.
Typical sources of air pollutants grouped by origin - Predominantly outdoor Sulfur oxidesFuel combustion OzonePhotochemical reactions in the atmosphere PollensTree, plants LeadAutomobiles, industrial emissions Organic substances: persistent chlorinated organic compounds – dioxins PAU Petrochemical solvents, incinerator emissions
Typical sources of air pollutants grouped by origin Sources both outdoor and indoor Nitric oxide, nitrogen dioxide Fuel-burning, traffic fuels, tobacco smoke Polycyclic aromatic hydrocarbons Fuel-burning, tobacco smoke, combustion of organic matter, cooking Carbon monooxide Carbon dioxide Fuel-burning, tobacco smoke combustion Suspended particulate matter Combustion products Organic substances Volatization, combustion, paint, pesticides, metabolic action SporesFungi
Health effects of basic air pollutants Air particles – inorganic origin - organic origin (microbes, pollen) - organic origin (microbes, pollen) less than 10 µm (PM10) - retention in airways (thoracal particles) Les than 3 µm (PM2,5) - captured in alveoli (respirable particles) Nanoparticles? Inert air particles Biological aggressive – lung conioses (silicosis, asbestosis) Adsorption of inorganic (heavy metals) or organic compounds (PAHs, nitroPAHs) on the surface of particle
Dimension ofdust particles in comparison with human hair Dimension of dust particles in comparison with human hair
Effect of dust aerosol in respiratory tract Irritation Decreasing of self-cleaning facilities Complicated removing of phlegm „Facilitating“ conditions for respiratory infections Release of mediators of inflammation from macrophages during phagocytosis Carcinogenicity
Effects of dust aerosol on CVD Increase of blood coagulation by means of increased production of factors supporting koagulation in lung Mediators released in lung influence the production pro-koagulative factors in liver Inflammation in lung tissue Depression of immunity Oxidative stress, production of free radicals
Effects of PM10 on health status Increase of PM10 for 10 g/m 3 means according to WHO: 0,7 % increase of total mortality 0,8 % increase of acute hospitalization for respiratory diseases 3 % higher need to use bronchodilatantia 3,6 % increase of cough 3,2 % increase of acute symptoms of lower respiratory tract
WHO air quality guidelines To offer guidance in reducing the health impacts of air pollution. They are applicable across all WHO regions and inform policy-makers considering various options for air quality management in different parts of world about the targets for air quality. Guideline values cannot fully protect human health. Some countries might decide to adopt lower concentrations that the WHO standard values.
WHO air quality guidelines Particulate matter PM2.5 = 10 g/m3 annual mean 25 g/m3 24-hour mean 25 g/m3 24-hour mean PM10 = 20 g/m3 annual mean 50 g/m3 24-hour mean 50 g/m3 24-hour mean Broad range of health effects – respiratory and CV systems following both short-term and long-term exposures. No evidence of threshold PM2.5/PM10 = cca 0.5
Calculated health effects of polluted air Am. Cancer Society: increased risk of Ca pulm. and increased mortality for CVD Increase of PM2,5 by 10 g/m 3 = RR 1,14 Ireland: prohibition of combustion of poor-quality coal in Dublin leads to the decrease of black smoke by 70%, to the decrease of respiratory disease mortality by 15,5% and CVD by 10,3 %. It means that 116 and 243 persons per year can survive- Decrease of PM10 to 20 g/m 3 = decrease of mortality by 43 per 1000 inhabitants Program Teplice: Increase of TSP to 100 g/m 3 = increase of daily mortality by 3,4% with two days delay.
Chemical pollutants of air SO 2 and related oxides – irritating effect on mucous membranes, childhood respiratory diseases, hospital admission for cardiac diseases, increased mortality Combustion of fossil fuels (coal containing sulphur). Chemical industry Indicator of air pollution. Downward time trend. Gas phase
Sulphur dioxide – WHO guidelines 20 µg/m hour mean 500 µg/m3 – 10-minute mean Short-term exposure – changes in pulmonary function Long-term exposure – association with daily mortality rate
Chemical pollutants of air (cont.) NO x – nitrogen dioxide Source: Chemical industry, traffic Irritating for the lung. Oedema pulmonale. Depression of lung functions. Bronchitis symptoms of asthma etc. Photochemical reactions with UV and ozone – production of radicals (peroxycetylnitrate). Source of nitrate for metHb, or for the production of nitroPAHs.
Nitrogen dioxide – WHO guidelines 40 µg/m3 - annual mean 200 µg/m3 – 1-hour mean Marker of combustion emitted by road traffic
Chemical pollutants of air (cont.) Carbon oxides (CO, CO 2 )– motor vehicles, boiler houses (carboxyhemoglobin, risk for cardiovascular system) Halogenated components (fluorides etc.) Irritating compounds – formaldehyde, formic acid, acrolein Polycyclic aromatic hydrocarbons (PAHs) – mutagenic, carcinogenic, reproductive toxicity Nitro PAHs – strong mutagens (e.g. 1-nitropyrene)
Ozone 100 µg/m3 – 8-hour-mean The increase in the number of attributable deaths is estimated to be 1-2% on days when the 8-h mean ozone reaches 100 µg/m3 Inflammatory lung effects especially in children
Chemical pollutants of air - complex mixtures Photochemical reactions Reaction of sulphuric acid with metal oxides: acidic rain Radicals – potential carcinogens Ozone – oxidation of sulfhydryle amino acids, oxidation of PUFA´s to peroxides of fatty acids. Irritation effect. Dioxins – incinerators, local heating, smoking
Chemical pollutants of air related to traffic Lead (leaded fuel lead-free fuel) Nitrogen oxides NitropyrenesPAHs Hydrocarbons with the short chain AldehydesDioxins (asbestos from brake pad, Pt?)
Health effects of air pollution Health indicators: Data on mortality, morbidity and reproductive health Biomarkers – changes of selected parameters of bodily functions (haematological, biochemical, immunological, pneumological etc.) Biomarkers of biological effective dose (changes on the cell and molecular levels)
Air pollution and health problems Lung cancer Allergy and hypersensitivity Asthma Respiratory disorders Prenatal health problems, IUGR Reproductive disorders Sudden infant death syndrome (?) Chronic Obstructive Pulmonary Disease (COPD)
Why are children more susceptible? They need more air (water, food) per kg bw than adult.They need more air (water, food) per kg bw than adult. They have increased physical activity and therefore higher exposure to air pollutants.They have increased physical activity and therefore higher exposure to air pollutants. Hand – mouth activityHand – mouth activity Possibility of transplacental exposurePossibility of transplacental exposure Prenatal and postnatal exposure during the developmental CNS windowsPrenatal and postnatal exposure during the developmental CNS windows Ripening of enzymes important for biotransformationRipening of enzymes important for biotransformation
Air pollution-related studies in the Czech Republic After 1989 – international cooperation Program Teplice – Northern Bohemia Program Silesia – Northern Moravia Resolution No. 369/1991 of the Government of the CR Environmental Health Monitoring System in the Czech Republic – routinely run since 1994 (Subsystem 1: Health consequences and risks related to air pollution)
Basic elements of Teplice Program Monitoring of trends in the levels of air pollutants Influence of air pollution on the population health status respiratory diseases neurobehavioral problems (As, Pb, Hg?) reproductive adverse effects (pregnancy outcome, sperm quality) mortality, oncological diseases use of biomarkers of exposure, effect and susceptibility
Important outputs of Teplice Program Local heating facilities and boiles-rooms are important sources of air pollution Decreasing trend of SO 2 and PM10, no changes in NOx levels, small decline of PAHs PAHs are responsible for genotoxic effects of air pollution (mutagenicity, DNA adducts, embryotoxicity, reproductive toxicity) Increased presence of IUGR in women exposed to PM10 >40 ug/m 3 in the 1st month of pregnancy. Changes in morphology and motility of sperm cells correlate with the level of air pollution. Increased susceptibility of children to the infections (otitis media, respiratory infections, pneumonia) Socioeconomic and lifestyle factors modulate the health effects.
Health effects of selected indoor pollutants Carbon monooxideHeadache, nausea, unconsiousness, death Nitrogen oxidesHeadache, pulmonary edema AsbestosAsbestosis, lung cancer mesothelioma RadonLung cancer FormaldehydeEye and upper respiratory tract irritation, sensitization, cancer Organic compoundsEye and respiratory irritant, cancer Particles (dust, fungi, pollens)Allergic reactions, eye and upperrespiratory irritation, Bacteria, virusesinfections
Sick - building syndrome Headache, distress, lack of concentration Respiration problems: irritation of nose mucous, rhinitis, allergic syndromes, clogged nose, loss of voice, cough Eye irritation, feeling of dry eyes Dry skin, allergic symptoms
Sick Building Syndrome (SBS) Multifactorial problem: 1. Sensory irritation in eye, nose or throat dryness, stinging, smarting, hoarseness, changed voice 2. Skin irritation: reddening of skin, stinging, smarting, itching sensation, dry skin 3. Neurotoxic symptoms: mental fatigue, reduced memory, lethargy, drowsiness, reduced concentration, headache, dizziness, nausea, tiredness 4. Unspecific hyperreactions: running nose and eye, asthma-like symptoms in non-asthmatic persons, respiratory sounds 5. Odour and taste complaints, changes sensitivity
Environmental tobacco smoke (ETS) Potential health effects of ETS: Eye and respiratory tract irritation Respiratory disease Lung cancer Cancer of other sites Hearth disease Estimated No of deaths per year (in 1991) in the USA from ETS: Estimate No of deaths worldwide: 5 mio/year
Smoking - the worst health-related problem Complex chemical mixtures Health problems: Cancer (lung, mouth, larynx, oesophagus, urinary bladder, cervix) Asthma bronchiale, COPD chronicle bronchitis, Angina pectoris, IM, reproductive problems, premature aging etc.
Preventive measures WHO – Air quality guidelines for Europe EU Directives Czech Ministry of Environment: Act No. 86/2002 on air protection and related legislation Regulation of emissions and immissions Reduction of the use of fossil fuels International cooperation (e.g. Stockholm convention - POPs) Czech Ministry of Health: Act 258/2001 on Public Health
Community and individual preventive measures Not use fosil fuels for heating Reduce the use of cars for individual transport Separate residential parts from industrial and traffics Clean the dust from streets and pavements Not burn the rest of vegetation from gardens Cut the grass before blossoming (prevention of allergic attack Not smoke
Clean air It is considered to be a basic requirement of human health and well-being. More that 2 mio premature deaths worldwide each year can be attributed to the effects of urban outdoor and indoor air pollution. CAFE – clean air for Europe