Silent killer: Is air pollution deadlier than was feared?

Introduction

Ella Kissi-Debrah’s little body could take it no more. In 2013, the nine-year-old died after an acute asthma attack after living the whole of her short life 30 metres from London’s busy South Circular road, with repeated visits to the hospital following frequent seizures.

The coroner pronounced in 2020 that the toxic fumes she had breathed because of the traffic on the roadway were partly to blame. It was the first known instance of the law recognising air pollution as a cause of death.

Global Emergency

Yet public health experts believe that Kissi-Debrah was a victim of a far more widespread, global emergency. The World Health Organization (WHO) estimates that air pollution is responsible for more than seven million premature deaths every year around the world, contributing to pulmonary and heart diseases, lung cancer and respiratory infections. Almost all of the world’s population – 99 percent – breathes air that is dirtier than levels recommended by the WHO.

Research Findings

In August, research published in The Lancet journal by a team of Chinese scientists showed that air pollution increases antibiotic resistance, which – their calculations suggest – in turn led to 480,000 premature deaths and 18 million years lost globally in 2018.

The same month, Harvard scientists showed an association between pollutants in emissions from carbon combustion and an increased risk of some cancers.

Severity of Air Pollution

The short answer: Very. In fact, air pollution, by some estimates, is a leading cause of death internationally. Carbon emissions are down, but wildfires are up, and the global hunger for energy continues to mount, posing new threats that do not affect everyone equally. Like with many other public health challenges, where people live and how much they earn determines the risks they face from toxic air.

Gas and Particles

Airborne pollutants principally fall into two categories, said Sophie Gumy, a technical lead for the WHO’s Department of Environment, Climate Change and Health: gases and particulate matter that are either produced directly from carbon combustion or through secondary mechanisms.

• Nitrous oxides – a group of gases commonly produced by vehicles, fossil fuel-based power production, industrial refineries and chemical plants – are an example.

As a primary pollutant, nitrogen dioxide has been shown to exacerbate asthma and respiratory conditions. However, nitrogen dioxide, along with other nitrogen oxides, can also interact with the sun’s ultraviolet light and a category of gases known as volatile organic compounds to produce secondary pollutants like ground-level ozone, which can pose health problems such as inflammation and damage to the airways. This evolution of pollutants also complicates the problem of understanding where to stem the tide.

These same nitrogen oxides can also contribute to the formation of airborne particulates. And though both the ozone and the particle originated from the same sources, such as tailpipe nitrogen dioxide – their effects and magnitude are markedly different.

“The particulate pollutants are the ones that are particularly important for public health,” said Scott Budinger, chief of pulmonary and critical care at Northwestern University Feinberg School of Medicine. In fact, he notes, research has found that following just days after upswings in particulate exposure, there is often an increase in deaths from a wide range of health complications.

“What epidemiologists have noted,” said Budinger, “is that if you look at daily particle exposure in any large, urban city, you’ll see about a two- to three-day lag, then an increase in all-cause mortality.”

The biggest burden is on the heart.

“People think ‘air pollutant’,” said Gumy, “and they think ‘respiratory problems’.” However, she said, particulates, taken up by the lungs and transported through the bloodstream, cause inflammation in cells. This strains the heart, contributing to cardiovascular issues, such as heart attacks and strokes.

The worst offenders are particles smaller than 2.5 microns, approximately 20-28 times smaller than the diameter of a human hair. At that size, the particulates can even get into the placenta, and thus, the brains of foetuses, said Maria Neira, director of the WHO’s Department of Environment, Climate Change, and Health.

Several studies have even found high exposure to these fine particles, known as PM2.5, to be a significant risk factor for premature birth. Long-term PM2.5 exposure has also been associated with an increased risk of developing neurodegenerative diseases such as dementia, Parkinson’s and Alzheimer’s.

And often, the worst sufferers are already disadvantaged communities.

Deadly Exposure

According to the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, air pollution is the fourth-leading cause of mortality among all metabolic and behavioural risk factors, after high systolic blood pressure, tobacco use and dietary risks.

But that toll is not distributed equally.

According to WHO, Indoor air pollution is associated with 3.2 million deaths a year. Most of that is in regions such as Sub-Saharan Africa, the Indian subcontinent, several Southeast Asian countries and Russia, where many households still use dirtier-burning fuels such as kerosene, wood or coal for primary heating or cooking.

The associated increase in stroke, ischaemic heart disease, chronic obstructive pulmonary disease (COPD), and lung cancer

SDGs, Targets, and Indicators

SDGs, Targets, and Indicators

1. SDG 3: Good Health and Well-being

   • Target 3.9: By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination.
   • Indicator: Number of deaths and illnesses attributed to air pollution.

2. SDG 11: Sustainable Cities and Communities

   • Target 11.6: By 2030, reduce the adverse per capita environmental impact of cities, including by paying special attention to air quality and municipal and other waste management.
   • Indicator: Proportion of urban population living in areas where air pollution levels exceed the WHO guidelines.

3. SDG 13: Climate Action

   • Target 13.2: Integrate climate change measures into national policies, strategies, and planning.
   • Indicator: Number of countries that have integrated measures to reduce air pollution into their national policies.

Analysis

The article discusses the issue of air pollution and its impact on public health. Based on the content of the article, the following SDGs, targets, and indicators can be identified:

1. SDG 3: Good Health and Well-being

The article highlights the health risks associated with air pollution, including respiratory diseases, heart diseases, lung cancer, and respiratory infections. Ella Kissi-Debrah’s case is mentioned as an example of the impact of air pollution on premature deaths. This connects to SDG 3, which aims to ensure good health and well-being for all.

Target 3.9: By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination.

The target specifically mentions reducing deaths and illnesses from air pollution, which is directly relevant to the issues discussed in the article.

Indicator: Number of deaths and illnesses attributed to air pollution.

The article mentions that air pollution is responsible for more than seven million premature deaths every year worldwide. This indicates that the number of deaths attributed to air pollution can be used as an indicator to measure progress towards this target.

2. SDG 11: Sustainable Cities and Communities

The article emphasizes that air pollution is a significant problem in urban areas, where a large population is exposed to polluted air. This aligns with SDG 11, which focuses on creating sustainable cities and communities.

Target 11.6: By 2030, reduce the adverse per capita environmental impact of cities, including by paying special attention to air quality and municipal and other waste management.

The target specifically mentions paying special attention to air quality in cities, which is directly relevant to the issues discussed in the article.

Indicator: Proportion of urban population living in areas where air pollution levels exceed the WHO guidelines.

The article states that almost all of the world’s population breathes air that is dirtier than levels recommended by the WHO. This indicates that the proportion of the urban population living in areas with air pollution levels exceeding the WHO guidelines can be used as an indicator to measure progress towards this target.

3. SDG 13: Climate Action

The article highlights the connection between air pollution and climate change. It mentions that carbon emissions are down, but wildfires are up, posing new threats to air quality. This connects to SDG 13, which focuses on taking urgent action to combat climate change and its impacts.

Target 13.2: Integrate climate change measures into national policies, strategies, and planning.

The target emphasizes the integration of measures to address air pollution and its connection to climate change into national policies. This is relevant to the issues discussed in the article.

Indicator: Number of countries that have integrated measures to reduce air pollution into their national policies.

The article mentions that reductions in air pollution have been achieved through measures implemented in different countries. This indicates that the number of countries that have integrated measures to reduce air pollution into their national policies can be used as an indicator to measure progress towards this target.

Table: SDGs, Targets, and Indicators

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Source: aljazeera.com

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