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Even low levels of air pollution can damage health, study finds

Via The Guardian: Even low levels of air pollution can damage health, study finds. Excerpt:

A study in one of the cleanest countries in the world could help governments think about future ways to manage air pollution.  

Abundant data from London’s infamous 1952 smog onwards tells us that breathing high concentrations of air pollution harms our health. This feeds into the 20th-century idea of targets for the quality of our air. However, the new study looked at the health harm from air pollution from another angle.  

Census records for more than 7 million Canadians from between 1981 and 2016 were combined with air pollution data to find out if small amounts of particle pollution were still harmful.  

Despite the relatively clean air, the study found that nearly 8,000 Canadians were dying early each year from outdoor air pollution. Notably, even people in the cleanest areas were experiencing an impact on their health.  

Air pollution harm was seen at concentrations that were at about one half of the latest World Health Organization guideline and at just quarter of the 2040 target proposed for England.  

The Canadian study was one of three funded by the US Health Effects Institute. The other two looked at more than 60 million people in the US and 27 million people in Europe. They reached similar conclusions: there is no lower limit that can be used to define safe air quality. This means governments should not constrain their ambition around setting targets for the worst air that people should breathe.  

Prof Michael Brauer from the University of British Columbia, who led the Canadian study, said: “These findings suggest important health benefits could be gained from continued reductions in air pollution and more stringent regulatory standards, including in countries such as Canada and the UK.  

“Considering that we don’t identify a ‘safe’ level of air pollution, we should rethink our approach and focus on continued reductions year by year, rather than just setting fixed concentration standards that are only reviewed every five to 10 years. The health impacts are far too large.”

AQLI Update: Most of the world breathes unsafe air, taking more than 2 years off global life expectancy

Via AQLI: AQLI Update: Most of the World Breathes Unsafe Air, Taking More Than 2 Years Off Global Life Expectancy. Click or tap through to download the full report. Excerpt:

Particulate pollution remained high even while Covid-19 slowed the global economy. At the same time, mounting evidence on the health impacts of pollution at low levels led to new guidelines that brought most of the world into the unsafe zone. 

During the first year of the Covid-19 pandemic, the world’s economy slowed. Yet, the global annual average particulate pollution (PM2.5) was largely unchanged from 2019 levels. At the same time, growing evidence shows air pollution—even when experienced at very low levels—hurts human health. This recently led the World Health Organization (WHO) to revise its guideline (from 10 µg/m³ to 5 µg/m³) for what it considers a safe level of exposure of particulate pollution, bringing most of the world—97.3 percent of the global population—into the unsafe zone.  

The Air Quality Life Index (AQLI) finds that particulate air pollution takes 2.2 years off global average life expectancy, or a combined 17 billion life-years, relative to a world that met the WHO guideline (5 µg/m3). This impact on life expectancy is comparable to that of smoking, more than three times that of alcohol use and unsafe water, six times that of HIV/AIDS, and 89 times that of conflict and terrorism.

Tonga: Volcanic eruption and tsunami

Via ReliefWeb, a UNICEF news release: Tonga: Volcanic Eruption and Tsunami - Jan 2022. Several others are available on the website. Excerpt:

After weeks of volcanic activity emitting ash, the Hunga Tonga Hunga Ha’apai underwater volcano in Tonga erupted violently on 15 January. The eruption is said to be one of the biggest in Tonga in the last 30 years, with satellite imagery indicating a 5 km wide plume of ash, steam, and gas, rising approximately 20 km above the volcano. 

The volcanic eruption generated a 1.2-metre tsunami that crashed ashore in coastal areas of Tonga’s capital, Nuku’alofa. The estimated population within 100 km of the volcano is 76,000 people. [...]  

Tonga has been blanketed by 1-2 cm of volcanic ash, affecting the majority of the country and impacting on water and food supplies. Air quality is also of concern. Power has been disrupted, and communications with Tonga are a challenge as regular phone lines are down, the internet cable from Fiji to Tonga seems to have been damaged, and satellite phones are only working intermittently.  

Alert level 4 remains active for the volcano, meaning that eruption hazards are confined to areas near or around the volcano. 

Long-term exposure to air pollution and COVID-19 incidence: A prospective study of residents in the city of Varese, Northern Italy

Via Occupational and Environmental Medicine: Long-term exposure to air pollution and COVID-19 incidence: a prospective study of residents in the city of Varese, Northern Italy. The abstract:

Objectives 

To investigate the association between long-term exposure to airborne pollutants and the incidence of SARS-CoV-2 up to March 2021 in a prospective study of residents in Varese city.  

Methods  

Citizens of Varese aged ≥18 years as of 31 December 2019 were linked by residential address to 2018 average annual exposure to outdoor concentrations of PM2.5, PM10, NO2, NO and ozone modelled using the Flexible Air quality Regional Model (FARM) chemical transport model. Citizens were further linked to regional datasets for COVID-19 case ascertainment (positive nasopharyngeal swab specimens) and to define age, sex, living in a residential care home, population density and comorbidities. We estimated rate ratios and additional numbers of cases per 1 µg/m3 increase in air pollutants from single- and bi-pollutant Poisson regression models.  

Results  

The 62 848 residents generated 4408 cases. Yearly average PM2.5 exposure was 12.5 µg/m3. Age, living in a residential care home, history of stroke and medications for diabetes, hypertension and obstructive airway diseases were independently associated with COVID-19. In single-pollutant multivariate models, PM2.5 was associated with a 5.1% increase in the rate of COVID-19 (95% CI 2.7% to 7.5%), corresponding to 294 additional cases per 100 000 person-years. The association was confirmed in bi-pollutant models; excluding subjects in residential care homes; and further adjusting for area-based indicators of socioeconomic level and use of public transportation. Similar findings were observed for PM10, NO2 and NO. Ozone was associated with a 2% decrease in disease rate, the association being reversed in bi-pollutant models.  

Conclusions  

Long-term exposure to low levels of air pollutants, especially PM2.5, increased the incidence of COVID-19. The causality warrants confirmation in future studies; meanwhile, government efforts to further reduce air pollution should continue.

Consumption in the G20 nations causes particulate air pollution resulting in two million premature deaths annually

Via Nature Communications: Consumption in the G20 nations causes particulate air pollution resulting in two million premature deaths annually. The abstract:

Worldwide exposure to ambient PM2.5 causes over 4 million premature deaths annually. As most of these deaths are in developing countries, without internationally coordinated efforts this polarized situation will continue. As yet, however, no studies have quantified nation-to-nation consumer responsibility for global mortality due to both primary and secondary PM2.5 particles. 

Here we quantify the global footprint of PM2.5-driven premature deaths for the 19 G20 nations in a position to lead such efforts. G20 consumption in 2010 was responsible for 1.983 [95% Confidence Interval: 1.685–2.285] million premature deaths, at an average age of 67, including 78.6 [71.5–84.8] thousand infant deaths, implying that the G20 lifetime consumption of about 28 [24–33] people claims one life. 

Our results indicate that G20 nations should take responsibility for their footprint rather than focusing solely on transboundary air pollution, as this would expand opportunities for reducing PM2.5-driven premature mortality. Given the infant mortality footprint identified, it would moreover contribute to ensuring infant lives are not unfairly left behind in countries like South Africa, which have a weak relationship with G20 nations.

Air pollution—time to address the silent killer

An editorial in The Lancet Air Pollution: Air pollution—time to address the silent killer.

On Sept 21, 2021, WHO published their new Air Quality Guidelines—a welcome update on the previous report from 2005—where they recommend new air quality levels for the six main pollutants (CO, lead, NO2, O3, PM, and SO2). Meeting these new levels is likely to be a challenge without substantive buy-in from governments globally, especially as pollutant projections worldwide are set to increase.  

As one of the biggest environmental contributors to poor health, air pollution has led to 7 million premature deaths globally each year. In 2017, it was reported that more than 90% of the global population lived in areas where the concentration of particulate matter (PM)2.5 was higher than the WHO recommended (2005) annual mean of 10 μg/m3—accounting for 12% of all deaths that same year. If the 2021 guidelines had been implemented in 2016, it is estimated that 3·3 million deaths in the WHO European region alone could have been prevented. If the levels proposed in the latest update of the guidelines are met, the burden of disease related to air pollution could be reduced by 80%.  

Emerging evidence of the health effects of air pollution is not only increasing in quality, but is also becoming more inclusive, with a wider array of countries represented and more low-income and middle-income countries (LMICs) contributing to the body of research. When it comes to the harms of air pollution, the lungs are first line of defence. Studies have shown associations of high levels of air pollutants with poor lung growth in early life, development of asthma, inflammation of airways, increased respiratory infections, and impaired lung function.  

Pollutants cause production of reactive oxygen species (oxidative stress) and reactive nitrogen species in the body, which in turn promote pathogenic pathways leading to inflammation, cell death, and mitochondrial dysfunction, among others. Sustained exposure to air pollutants bombards the lung's natural defences and culminates in lung injury and disease. Damage from pollutants does not stop at the lungs; direct or indirect damage to other organs can also occur. For example, acute myocardial infarction is associated with increased pollutant concentrations in the previous few days or hours.  

In Europe, steps are being taken to tackle the issue of pollution. The European Commission has agreed to a deal—the European Green Deal—which states that Europe will aim to be the first climate neutral continent in the world. The deal, made in December, 2019, revised the European Commission's air quality standards to align more closely with the 2005 WHO guidelines; however, the new WHO guidelines show that current European standards will not be enough to improve air quality to levels that have a meaningful impact on health. Only when the new, evidence-based guidelines are followed—and are legally binding—will Europe be able to meet its goal. 

Although ambient air pollution affects both developed and developing countries, LMICs have the highest burden in terms of adverse effects on health. WHO Western Pacific and South-East Asia regions bear the brunt of this burden. If there is to be a truly global commitment to reduce the burden of air pollution, the differing threats between regions need to be taken into account, and approaches must be adaptable and sustainable to best suit these regions and the people living there. Health inequalities must also be considered in any policies put in place.  

Governments and policy makers should be encouraged to agree to legally binding standards to facilitate responsibility and accountability. Without such measures, air quality and health could be deprioritised, as happened with the 2005 standards set by WHO. Campaigns that educate on the connection between air pollution and health and that mobilise people to make change will encourage individuals to consider steps that they can take to improve their health via improving air quality—whether that be decisions on a personal level or putting pressure on their governments to meet standards set.  

The health sector can also help to raise awareness. Respiratory clinicians could be at the forefront of educating their patients on the risks of air pollution. Although personal steps are welcome, government- and corporate-level change is needed to make significant inroads into climate change and air pollution. 

The WHO Air Quality Guidelines have been published at an appropriate time, just before COP26. With an opportunity to implement real change as world leaders meet, we hope that the new guidelines will be carefully considered, and air pollution and its associated respiratory health burden pushed to the forefront of health policy agendas. The silent killer can no longer be ignored.

Association between air pollution exposure and mental health service use among individuals with first presentations of psychotic and mood disorders

Via The British Journal of Psychiatry: Association between air pollution exposure and mental health service use among individuals with first presentations of psychotic and mood disorders: retrospective cohort study. The abstract:

Background 

Growing evidence suggests that air pollution exposure may adversely affect the brain and increase risk for psychiatric disorders such as schizophrenia and depression. However, little is known about the potential role of air pollution in severity and relapse following illness onset. 

Aims 

To examine the longitudinal association between residential air pollution exposure and mental health service use (an indicator of illness severity and relapse) among individuals with first presentations of psychotic and mood disorders. 

Method 

We identified individuals aged ≥15 years who had first contact with the South London and Maudsley NHS Foundation Trust for psychotic and mood disorders in 2008–2012 (n = 13 887). High-resolution (20 × 20 m) estimates of nitrogen dioxide (NO2), nitrogen oxides (NOx) and particulate matter (PM2.5 and PM10) levels in ambient air were linked to residential addresses. In-patient days and community mental health service (CMHS) events were recorded over 1-year and 7-year follow-up periods. 

Results 

Following covariate adjustment, interquartile range increases in NO2, NOx and PM2.5 were associated with 18% (95% CI 5–34%), 18% (95% CI 5–34%) and 11% (95% CI 3–19%) increased risk for in-patient days after 1 year. Similarly, interquartile range increases in NO2, NOx, PM2.5 and PM10 were associated with 32% (95% CI 25–38%), 31% (95% CI 24–37%), 7% (95% CI 4–11%) and 9% (95% CI 5–14%) increased risk for CMHS events after 1 year. Associations persisted after 7 years. 

Conclusions 

Residential air pollution exposure is associated with increased mental health service use among people recently diagnosed with psychotic and mood disorders. Assuming causality, interventions to reduce air pollution exposure could improve mental health prognoses and reduce healthcare costs.

See also this Guardian report on the study.

Air pollution impacts of COVID-19–related containment measures

Via Science Advances: Air pollution impacts of COVID-19–related containment measures. The abstract: 

Responses to the COVID-19 outbreak resulted in one of the largest short-term decreases in anthropogenic emissions in modern history. To date, there has been no comprehensive assessment of the impact of lockdowns on air quality and human health. 

Using global satellite observations and ground measurements from 36 countries in Europe, North America, and East Asia, we find that lockdowns led to reductions in NO2 concentrations globally, resulting in ~32,000 avoided premature mortalities, including ~21,000 in China. However, we do not find corresponding reductions in PM2.5 and ozone globally. 

Using satellite measurements, we show that the disconnect between NO2 and ozone changes stems from local chemical regimes. The COVID-related lockdowns demonstrate the need for targeted air quality policies to reduce the global burden of air pollution, especially related to secondary pollutants.

As schools spend millions on air purifiers, experts warn of overblown claims and harm to children

Via Kaiser Health News, Lauren Weber and Christina Jewett write: As Schools Spend Millions on Air Purifiers, Experts Warn of Overblown Claims and Harm to Children. Excerpt:

Last summer, Global Plasma Solutions wanted to test whether the company’s air-purifying devices could kill covid-19 virus particles but could find only a lab using a chamber the size of a shoebox for its trials. In the company-funded study, the virus was blasted with 27,000 ions per cubic centimeter.

In September, the company’s founder incidentally mentioned that the devices being offered for sale actually deliver a lot less ion power — 13 times less — into a full-sized room. 

The company nonetheless used the shoebox results — over 99% viral reduction — in marketing its device heavily to schools as something that could combat covid in classrooms far, far larger than a shoebox. 

School officials desperate to calm worried parents bought these devices and others with a flood of federal funds, installing them in more than 2,000 schools across 44 states, a KHN investigation found. They use the same technology — ionization, plasma and dry hydrogen peroxide — that the Lancet COVID-19 Commission recently deemed “often unproven” and potential sources of pollution themselves. 

In the frenzy, schools are buying technology that academic air-quality experts warn can lull them into a false sense of security or even potentially harm kids. And schools often overlook the fact that their trusted contractors — typically engineering, HVAC or consulting firms — stand to earn big money from the deals, KHN found.

Academic experts are encouraging schools to pump in more fresh air and use tried-and-true filters, like HEPA, to capture the virus. Yet every ion- or hydroxyl-blasting air purifier sale strengthens a firm’s next pitch: The device is doing a great job in the neighboring town. 

 “It’s a self-fulfilling prophecy. The more people buy these technologies, the more they get legitimacy,” said Jeffrey Siegel, a civil engineering professor at the University of Toronto. “It’s really the complete wild west out there.”

North China bathed in orange as vast sandstorm descends

A sandstorm smothers Beijing Monday morning. Photo: VCG

Via Caixin Global: Update: North China Bathed in Orange as Vast Sandstorm Descends. Excerpt:

People across northern China awoke to fierce winds and orange-tinted skies Monday as some of the most severe and widespread dust storms for years disrupted transport and sent air pollution soaring. 

Weather officials in a string of cities including the capital, Beijing, warned of reduced visibility through Tuesday morning as air quality monitors surged to their maximum possible readings. 

The haze was caused by cold air and high winds in China’s arid west and other areas kicking up dust and blowing it across the country, the National Meteorological Center (NMC) said. 

Dust storms are uncommon but not unheard of in Beijing, especially in the spring. Monday’s storm followed several days of heavy air pollution in the city of 21 million people. 

The NMC issued (link in Chinese) 24-hour dust storm warnings effective 8 a.m. Monday for Beijing as well as parts of Gansu, Shaanxi, Shanxi and Hebei provinces and the Inner Mongolia and Ningxia Hui autonomous regions. 

The agency urged people in the affected areas to close doors and windows, wear masks and veils to stop the dust from damaging eyes and lungs, avoid nonessential driving, secure unstable or temporary construction and cover precision machinery. 

Beijing’s environmental monitoring center said the dust originated in southern Mongolia, which borders China. The Mongolian government said six people had died and a further 81 were missing as of 9 a.m. Monday. There have been no reports of deaths or injuries caused by the sandstorm in China. 

Elevated dust levels were first detected in northern Beijing on Sunday morning, the monitoring center said. Schools and workplaces remained open as usual Monday. Daxing International Airport took safety precautions for reduced visibility, disrupting a number of flights, the state-run Xinhua News Agency reported. 

By 9 a.m. Monday, air quality readings had far exceeded levels deemed safe for human health. 

Average concentrations of airborne PM10, fine particles that can be inhaled into the lungs, neared 10,000 micrograms per cubic meter, 200 times the one-day maximum average recommended by the World Health Organization (WHO). Readings of PM2.5, ultrafine particles that can enter the bloodstream, were around 30 times WHO guidelines. 

Videos uploaded to Chinese social media Monday morning showed Beijing landmarks swaddled in rust-hued smog. Drivers switched on headlights and slowed vehicles to a crawl as visibility plummeted. 

The picture was similar in other cities. More than 1,000 kilometers (621 miles) west of Beijing, residents of Ningxia’s capital of Yinchuan uploaded videos of the haze-choked city and claimed they could see no more than 500 meters in any direction. 

Some internet users poked fun at the weather, joking that the storms provided a readymade sepia-colored filter for their social media photos and comparing the skies with eerie scenes from the “Blade Runner” sci-fi movie franchise. 

Peng Yingdeng, a researcher at a national center for studying urban pollution control, said Monday that loose, dry soils in Inner Mongolia and Ningxia, combined with above-average air temperatures, caused winds to kick up dust and disperse it widely. 

Although dust storms are natural phenomena, human activity like open-pit mining and deforestation can contribute to their frequency and severity, he said. 

Schools and workplaces in Beijing remained open as usual. Peng said dust storms were a less serious health threat than extreme smog events as larger airborne particles interfered less with breathing and blood circulation. 

However, international organizations including the WHO say both PM 10 and PM 2.5 are linked to increased mortality and heightened risk of respiratory and cardiovascular diseases.