It is estimated that 4,2 million people die worldwide each year from air pollution. Another 3,8 million people die due to indoor air pollution caused by inoperative stoves, poor quality fuel and a lack of effective ventilation. The World Health Organization (WHO) estimates that as much as 91% of the world’s population lives in areas where poor air quality threatens life and health (1). In many Polish towns and cities, smog is a threat to health and life – a special, periodically occurring form of air pollution.
Worldwide, according to WHO, air pollution is the cause of:
- 29 percent all deaths and diseases related to lung cancer,
- 17 percent all deaths and illnesses from acute lower respiratory tract infections
- 24 percent deaths due to stroke,
- 25 percent deaths and diseases caused by ischemic heart disease,
- 43 percent all deaths and diseases caused by chronic obstructive pulmonary disease (2).
According to estimates from the latest report of the European Environment Agency, air pollution with only one of the smog components – fine particulate matter PM2,5 and what it contains, in 2016 caused the premature death of approx. 412 inhabitants of forty-one European countries, including 000 374 citizens of the European Union. Among them, there were about 000 Poles (43).
The fight against air pollution has therefore become one of the most important challenges. The WHO placed them, along with climate change, in the first place on the Ten threats to global health in 2019 list (Ten health threats in the world in 2019) (4).
Problem sources
Air pollutants with the best documented (according to WHO) and the most thoroughly studied harmful effects on human health include, among others particulate matter (PM), ozone (O3), nitrogen dioxide (NO2) and sulfur dioxide (SO2) (5). These are the main components of smog, the first definition of which was formulated several dozen years ago. The term smog appeared in the mid-twentieth century in England, when it was found that high air smoke and the persistent windless, foggy autumn-winter weather had a tragic impact on the health of the inhabitants of London. In Poland, the term smog has been used in dictionaries since the 80s.
The word comes from the English language, being a combination of the words smoke – ‘smoke’ and fog – ‘fog’, meaning air pollution caused by human activity in unfavorable weather conditions.
Currently, there are two types of smog – winter and summer smog, which are formed in different weather conditions, but have a similar effect on health.
The definition formulated by the Chief Inspectorate of Environmental Protection says that aerosol smog, also known as “winter” is the occurrence of high concentrations of suspended dust in the air with particles of different diameter. The appearance of this type of smog is related to the high emission of dust from its primary sources to the air and the formation of secondary dust as a result of chemical reactions occurring in certain weather conditions: in the absence of wind, strong thermal inversion and an average temperature below 5 ° C (an additional contributing factor may also be haze). The main components of winter smog are PM10 dust – a fraction of dust with a particle diameter of up to 10 micrometers – which is a suspension of solid and liquid particles in the air – and PM2,5 dust (less than 2,5 micrometers in diameter) and chemical compounds contained in dust particles.
Summer smog, photochemical usually occurs from June to September, during hot, windless and often humid days. Ozone (an oxygen molecule composed of three atoms, which is a strong oxidant) and road pollution with particulate matter (which is also produced by abrasion of tires and brakes), nitrogen oxides, carbon monoxide and volatile organic compounds have the greatest share in the formation of summer smog.
Chief Inspectorate of Environmental Protection, a central government administration body established to control the condition of the natural environment in Poland and to take actions to protect it.
In Poland, as in many other countries of the world, air pollution standards are in force, the exceeding of which requires taking specific actions, including announcing smog warnings and alerts for people staying in a given area. The air condition is constantly monitored. The air pollution standards in force in Poland can be found, for example, on the website of the Chief Inspectorate for Environmental Protection, at: https://powiekieta.gios.gov.pl/pjp/content/annual_assessment_air_acceptable_level#
For example, according to the reports of the Chief Inspectorate of Environmental Protection, during the periods conducive to the formation of smog, daily PM10 concentrations higher than 50 µg / m³, which according to the standards may be exceeded for no more than 35 days a year, are recorded at the vast majority of measuring stations in Poland. PM2,5 limits are also notoriously exceeded in some regions; the worst situation is in cities and agglomerations located in southern and central Poland (Małopolskie, Śląskie and Łódzkie voivodships). When it comes to the largest cities – the worst air to breathe in this respect is Kraków (6).
According to the data of the National Center for Emission Management and Balancing (KOBIZE), the main sources of PM2,5 pollution in Poland are:
- 46,5 percent – combustion processes outside industry (mainly in households),
- 4,1% – combustion processes in the energy production and transformation sector,
- 21,1 percent – combustion processes in industry,
- 10,2 percent – road transport,
- 7,8 percent – other vehicles and devices,
- 4,8 percent – production processes,
- 3 percent – waste management,
- 2,1 percent – agriculture (7).
National Center for Balancing and Management of Emissions – a center within the structures of the Institute of Environmental Protection – National Research Institute supervised by the Minister of the Environment, one of the main tasks of which is to administer the EU emissions trading system (in accordance with EU emission limits for certain pollutants, established for individual countries) .
The health impact of air pollution
Research into the effects of air pollution on human health has been going on for decades. Unfortunately, each year brings new evidence of the harmfulness of living in a contaminated environment. The smallest particles of pollutants penetrate the whole organism and have an impact on humans at the stage of the formation of reproductive cells, through fetal life, childhood, adulthood to late old age. The spectrum of diseases that can develop as a result of breathing polluted air is very wide.
Short-term exposure to air pollution
The quickest and mildest reaction to a high concentration of particulate matter can be:
- eye, nose, throat irritation, and reactions such as runny nose, cough, and sinusitis (8),
- exacerbation of already existing respiratory diseases such as bronchial asthma, chronic obstructive pulmonary disease; inflammation of the respiratory tract (9),
- exacerbation of cardiovascular diseases, arrhythmias, occurrence of acute heart failure, and stroke (10).
In turn, high ozone concentration in the air causes an inflammatory reaction in the eyes, drowsiness, headaches, fatigue, and a drop in blood pressure. In order to defend against ozone, the lungs take in less oxygen, which may aggravate cardiovascular disease (11).
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The impact of smog on humans
Air pollution and human development
Air pollution already affects unborn children, the smallest dust particles, 0,1 micrometers in diameter, can penetrate the placental-vascular barrier. The well-documented effects of a negative impact on the health of the future mother and her baby include a higher risk of premature birth, lower birth weight and poorer physical development. New evidence also suggests that atmospheric air pollution may affect the neurological development of young children, as well as the subsequent development of diabetes and other diseases (12).
This harmful effect on humans begins earlier, as microplastics of dust can even damage the genetic material contained in sperm. Research initiated several years ago in Krakow by a team of scientists from the Department of Epidemiology and Preventive Medicine at Collegium Medicum of the Jagiellonian University under the supervision of prof. Wiesław Jędrychowski and the Health and Environment Foundation confirmed the impact of environmental pollution not only on the course of pregnancy and the development of the fetus, but also – in the following years of children’s life – on the impairment of their respiratory system efficiency, the development of allergies and asthma, and poorer cognitive development (13). Italian and Chinese studies showed a relationship between the exposure of a pregnant woman to smog and an increased risk of developing a congenital heart defect and developing neural tube defects in a child (14). In April 2019, the prestigious international journal “The Lancet” in its edition “The Lancet – Planetary Health” reported that air pollution, especially nitrogen dioxide, may be responsible for about 4 million new cases of asthma in children worldwide each year ( 15).
Influence of air quality on the respiratory system
Air pollution has the fastest and strongest impact on the respiratory system and is one of the main factors in the exacerbation of obstructive diseases. Evidence is provided every day when air pollution standards are heavily exceeded – in Kraków or Silesia, where it is common in winter, clinics and hospitals fill up. Long-term exposure to irritants weakens the defenses of the respiratory system, which under normal conditions is capable of capturing and removing harmful particles from the body. Dust larger than 10 microns remains in the respiratory tract, penetrates the lungs into the bloodstream and beyond. Each contamination damages tissues, from the mucosa of the respiratory tract to alveoli, and weakens the immune system (16). Long-term exposure to irritants causes chronic inflammation, followed by irreversible changes in the respiratory system. In extreme situations, constant exposure to air pollution leads to the development of lung cancer. WHO estimates the number of people suffering from asthma at over 235 million. About 400 are dying. patients annually (17). Over 210 million people worldwide suffer from COPD (18). In Poland, the number of patients with asthma or COPD is estimated at over 6 million people, but many cases remain undiagnosed.
Air pollution and the cardiovascular system
The risk for the cardiovascular system is both long-term and short-term exposure to high air pollution, and it is difficult to talk about “safe” levels in this case, because the negative impact on the circulatory system is observed even at indications lower than the permissible pollution standards adopted in countries European Union (19). There is always an increasing risk of so-called coronary events.
Of course, the body’s response depends on general health, so in general, elderly people and those already suffering from cardiovascular diseases are at greater risk. However, there is ample evidence that smog components damage the circulatory system also in young and healthy people, which was shown, among others, by scientists from the Jagiellonian University. Atherosclerotic plaques, which can block blood flow through the vessels, often form in children as young as a few years old, and the quality of the air in which they live is not without significance (20).
In turn, according to data published by the American Heart Association (AHA), air pollution associated with road traffic reduces the concentration of “good” cholesterol in the blood, which protects us from the appearance of atherosclerotic plaques in the vessels. This mechanism may be one of the important elements linking exposure to smog with the increased risk of developing diseases of the cardiovascular system (21). Numerous studies (also in Poland) have also proved the direct impact of smog on a marked increase in the number of acute cardiovascular incidents and strokes, as well as on mortality due to heart attack or stroke.
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Influence of air pollution on the development of neoplastic diseases
Summer and winter smog contain many chemical compounds with proven carcinogenic effect. Therefore, lung cancer is detected not only in heavy and passive tobacco smokers or in people working in conditions harmful to the respiratory system. WHO warns that for approx. 15 percent. lung cancer cases correspond to air pollution. For example, children in the most polluted cities in China can be a proof of this. Unfortunately, in some Polish cities, air contamination with carcinogenic benzo (a) pyrene – one of the components of smog – may have the same health impact as smoking from several hundred to even several thousand cigarettes a year. Since smoking also promotes the development of bladder cancer, it can be assumed that breathing polluted air has similar effects. What’s more, scientists also suggest the influence of nitrogen oxides (an essential component of summer smog) on the development of brain and cervical cancer. It is also believed that exposure of a pregnant woman to breathing polluted air increases the risk of developing lymphoblastic leukemia or eyeball cancer early in her child’s life.
Air pollution and diseases of old age
Older people, like young children, are the worst at dealing with the effects of air pollution because their bodies are generally less agile. In addition, in the elderly, most people are already burdened with diseases of the cardiovascular and respiratory systems. If they live in smog, their chronic diseases exacerbate more often than in younger people. The milder consequences of frequent exposure to smog include: mood drops and depression. Research is being carried out on the relationship between breathing polluted air and the occurrence of Alzheimer’s disease.
Virtually every month brings new reports on health hazards and deteriorating quality of life related to air pollution. It’s time to learn from this.
Press material prepared by the Journalists for Health Association as part of the “Time for clean air” campaign, November 2019.
Bibliography:
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2. https://www.who.int/airpollution/ambient/health-impacts/en/ [access: 14.11.2019/XNUMX/XNUMX].
3. Air quality in Europe 2019, European Environment Agency, 16.10.2019/2019/14.11.2019, published online: https://www.eea.europa.eu/publications/air-quality-in-europe-XNUMX/ [accessed: XNUMX/XNUMX/XNUMX] .
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5. Ambient air pollution: Health impacts, dz. cyt.
6. The state of the environment in Poland. Report 2018, Chief Inspectorate of Environmental Protection, online publication: http://www.gios.gov.pl/images/dokumenty/pms/raporty/Stan_srodowiska_w_Polsce-Raport_2018.pdf [accessed on 10.09/2019. 94], p. XNUMX.
7. National emission balance, IOŚ-PIB, KOBiZE, Warsaw 2019, online publication: https://www.kobize.pl/uploads/materialy/materialy_do_pobrania/krajowa_inwentaryzacja_emycji/Bilans_emycji_za_2017.pdf [access: 14.11.2019].
8. Jędrak et al., The impact of air pollution on health, Krakow Smog Alarm, online publication: http://krakowskialarmsmogowy.pl/files/images/ck/14882713101616070935.pdf, [access: 14.11.2019/20/XNUMX], p. XNUMX.
9. Ibid., Pp. 36–47.
10. Ibid., Pp. 58–64.
11. The state of the environment in Poland. Report 2018, op. Cit., P. 87.
12. Ambient air pollution: Health impacts, dz. cyt.
13. W. Jędrychowski et al., Influence of air pollution with fine particulate matter and polycyclic aromatic hydrocarbons in the prenatal period on the health of a child, Kraków 2018, online publication: https://powiewię.malopolska.pl/wp-content/uploads/2018/ 03 / Zanieczyoszenia_powietrza_w_Krakowie_a_zdrowie_dzieci.pdf [access: 14.11.2019].
14. A. Wdowiak et al., The impact of air pollution on human reproduction, Lublin 2018, online publication: https://phmd.pl/api/files/view/302252.pdf [access: 14.11.2019], p. 38 .
15. R. N. Naidoo, NO2 increases the risk for childhood asthma: a global concern „The Lancet – Planetary Health” nr 3, t. 4, 04.2019, publikacja online: https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(19)30059-2/fulltext [dostęp: 14.11.2019].
16. P. Dąbrowiecki, The impact of air pollution on the respiratory system, Military Medical Institute, online publication: http://www.wim.mil.pl/images/stories/Konferencje/spero/9.pdf [access: 14.11.2019] .
17. Asthma, WHO, published online: https://www.who.int/news-room/fact-sheets/detail/asthma [access: 14.11.2019/XNUMX/XNUMX].
18. Ibid.
19. M. Wojdat, A. Stańczyk, G. Gielerak, Air pollution and diseases of the cardiovascular system – an underestimated problem, “Military doctor” 1/2016, available online: https://issuu.com/medycynapraktyczna/docs/__lw_2016_01 [access: 14.11.2019/XNUMX/XNUMX].
20. K. Kojzar, The first symptoms of heart disease appear in children …, interview with prof. T. Guzikiem, SmogLab, 2017, published online: https://smoglab.pl/profesor-tomasz-guzik-pierwsze-symptomy-choroby-niedokrwiennej-serca-pojawiaa-sie-juz-u-dzieci-rodzice-mysla-ze -to-by-fast-food-but-smog-not-is-indifferent / [access: 14.11.2019/XNUMX/XNUMX].
21. P. Ćwik, “Bad” air lowers “good” cholesterol. And it contributes to the development of heart disease, https://smoglab.pl/zle-szym-obniza-dobry-cholesterol-przyczynia-sie-rozkieta-chorob-serca/ online publication [access: 14.11.2019/XNUMX/XNUMX]