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Air pollution: Health effects
Contaminación del aire: efectos sobre la salud
Gurmeet Singh Sarla
1
1
1. Classified Specialist in Surgery, Military Hospital Devlali Cantt Nasik Maharashtra India
Dr Gurmeet Singh Sarla -rijak1@gmail.com
Recibido: 24-10-2019 Aceptado: 23-01-2020
Abstract
Background: Air contamination happens when unsafe or inordinate amounts of substances including gases,
particles, and organic atoms are brought into Earth's climate. Objective: This review article defines air
pollution, describes the types of pollutants, enumerates the various causative factors, enumerates the ways
it impacts human health and suggests preventive measures to reduce the impact of air pollution on human
health. Methods: Literature was studied extensively and effects of air pollution on human health have been
described. Results and Conclusion: Air pollution has tremendous effects on human health in the form of
respiratory diseases and aggravations in the form of asthma and lung cancer, cardiovascular dysfunctions,
and malignant growth. An affiliation has been found to exist between male infertility and air pollution and
a relationship has been established between air contamination and higher danger of immune dysfunction,
neuroinflammation, neurobehavioral hyperactivity, crime, age-unseemly behaviours, Alzheimer's and
Parkinson's disease. Traffic-related air pollutants have been found to affect skin aging and cause pigmented
spots on the face. An association exists between air pollution and irritation of the eyes, dry eye syndrome,
risk for retinopathy and adverse ocular outcomes. Chronic exposure to air pollutants during pregnancy has
been associated with adverse effects on the developing foetus in the form of low birth weight and still birth.
Air contamination has been seen as a significant supporter of the expanded predominance of allergic
diseases in children.
Key words
Air pollution, particulate matter, fog, smog, mist, deforestation, volcanoes
Introduction
Air pollution means the presence of chemicals or compounds in the air which are usually not present and
which lower the quality of the air or cause detrimental changes to the quality of life such as the damaging
of the ozone layer or causing global warming. Air contamination happens when unsafe or inordinate
amounts of substances including gases, particles, and organic atoms are brought into Earth's climate. Both
human activity and natural processes can generate air pollution.
Aim
REVISTA MEDICINA LEGAL DE COSTA RICA ISSN 2215 -5287 Vol. 37 (1) Marzo 2020
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This review article defines air pollution, describes the types of pollutants, enumerates the various causative
factors, enumerates the ways it impacts human health and suggests preventive measures to reduce the impact
of air pollution on human health.
Methods
Literature was studied extensively and effects of air pollution on human health have been described. In order
to locate research studies and interventions that examined the health effects of air pollution, databases were
searched through Google Scholar. The key words entered into the database were air pollution, health effects
and articles from 1979 to 2014 were searched.
Results
Definition
Air pollution is caused by solid and liquid particles and certain gases that are suspended in the air. These
particles and gases regularly originate from vehicle and truck fumes, manufacturing plants, dust, volcanoes
and wild fires. The solid and liquid particles suspended in air are called aerosols [1].
Types:
• Primary pollutants: There are many types of primary pollutants, including carbon oxides, nitrogen oxides,
sulphur oxides, particulates, lead, and volatile organic compounds.
• Secondary pollutants: Secondary pollutants form from chemical reactions that occur when pollution is
exposed to sunlight.
The major air pollutants include particulate matter, nitrogen dioxide, carbon mono-oxide and sulphur
dioxide [1].
Causes
The wellsprings of contamination shift from little unit of cigarettes and common sources, for example,
volcanic exercises to enormous volume of emanation from engine motors of cars and mechanical
activities[2].Emission from vehicles, burning of petroleum products, contamination from Air Conditioners,
dust and soil, family contamination, contamination from characteristic occasions, for example, volcanoes,
deforestation and contamination from industrial facilities discharging hurtful gases like carbon monoxide,
nitrogen oxide as final results are the principle reasons of air contamination [3].
Fog
Fog is a kind of cloud that touches the ground. Fog forms when the air near the ground cools enough to turn
its water vapour into liquid water or ice. Urban areas are facing increasing fog frequencies that may result
due to increased air pollution emanating from variety of sources. The increased pollution levels may lead to
the atmospheric reactions resulting into the formation of secondary pollutants that may also lead to
increased pollutants in the atmosphere.
Mist
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Mist and fog are caused by water droplets in the air, and the only difference is how far you can see. Haze is
the reflection of sunlight off air pollution, while smog is what happens when pollution causes low-lying
ozone. Mist and fog both occur when there are water droplets in the air.
Smog
Smog is a kind of air pollution, originally named for the mixture of smoke and fog in the air.
Classic smog results from large amounts of coal burning in an area and is caused by a mixture of smoke and
sulfur dioxide. Smog is a problem in a number of cities and continues to harm human health [4].
Health effects
Long haul impacts of air contamination on the beginning of maladies, for example, respiratory diseases and
aggravations, cardiovascular dysfunctions, and malignant growth is generally accepted [5]. An affiliation
has been found to exist between male infertility and air pollution in a study by Zhou et al [6]. Wheezing,
cough, dry mouth, and limitation in activities due to breathing problems are the most predominant clinical
indications of respiratory sickness because of air pollution [7,8]. Air contamination is likewise considered
as the major natural hazard factor for some respiratory illnesses, for example, asthma and lung cancer [9,10].
Epidemiologic examinations have demonstrated the immediate relationship of air toxin presentation and
heart related illnesses [11].
Neuropsychiatry manifestations
Studies have announced the connection between air contamination and neurobehavioral hyperactivity,
crime, and age-unseemly behaviours [12,13]. Studies have likewise uncovered the relationship between air
contamination and higher danger of neuroinflammation [14], Alzheimer's and Parkinson's disease [15]. A
few investigations demonstrated that hostility and tension in megacities are in close association with the
significant level of air pollutants [16].
Skin changes
Studies have uncovered that traffic-related air pollutants affect skin aging and cause pigmented spots on the
face [17].
Immune system
Poor air quality can cause serious complications in the immune system such as an abnormal increase in the
serum levels of the immunoglobulin (Ig); IgA, IgM, and the complement component C
3
in humans as well
as chronic inflammatory diseases of the respiratory system [18]. Exposure to these immunotoxicants may
also cause immune dysfunction at different stages which can serve as the basis for increased risks of
numerous diseases such as neuroinflammation [15].
Effects on eyes
Chronic exposure to air pollutants increases the risk for retinopathy and adverse ocular outcomes. In
addition, there are now evidence suggesting the association between air pollution and irritation of the eyes,
dry eye syndrome, and some of the major blinding [19].
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Pregnancy
Recent studies have shown that air pollution can affect the developing foetus via maternal exposure,
resulting in preterm birth, low birth weight, growth restriction, and potentially adverse cardiovascular and
respiratory outcomes [20]. A number of epidemiological and clinical studies conducted in low-income
countries found an association between exposure to indoor air pollution during pregnancy and low birth
weight and still birth [21].
Allergy
Air contamination has been seen as a significant supporter of the expanded predominance of allergic
diseases in children [22].
Preventive measures
Legitimate cooking stoves might be utilized rather than wood-consuming cooking stoves to decrease air
contamination. In rural Mexico, a randomized trial of properly vented wood-burning cooking stoves versus
open fires showed reductions in the longitudinal decline in forced expiratory volume in one second and
improvements in respiratory symptoms, when proper cooking stoves were used [23]. The use of improved
cooking stoves has also been found to halve the exposure to carbon monoxide and resulted in a lower rate
of diagnosis of pneumonia [24].
Government has a huge task to carry out in controlling air contamination and measures planned for
decreasing environmental change, including exacting laws to diminish carbon dioxide emanations ought to
be authorized.
Urban forests and green roofs should be proposed as strategies for reducing pollution in urban areas [25].
Vegetation removes pollutants in several ways; by absorbing gaseous pollutants, through interception of
particulate matter by leaves, and by breaking down organic compounds such as polycyclic aromatic
hydrocarbons [26].
Upgrades in the ventilation of homes in which biomass fuels are used will reduce the health effects of air
pollution.
Empowering walking and cycling as opposed to utilizing vehicles and bikes while voyaging short distances
will help check air contamination.
Conclusions
Air pollution is caused by solid and liquid particles and certain gases that are suspended in the air which
may originate from vehicle and truck fumes, manufacturing plants, dust, volcanoes and wildfires.
Air pollution has tremendous effects on human health in the form of respiratory diseases and aggravations
in the form of asthma and lung cancer, cardiovascular dysfunctions, and malignant growth.
An affiliation has been found to exist between male infertility and air pollution.
A relationship has been established between air contamination and higher danger of immune dysfunction,
neuroinflammation, neurobehavioral hyperactivity, crime, age-unseemly behaviours, Alzheimer's and
Parkinson's disease.
Traffic-related air pollutants have been found to affect skin aging and cause pigmented spots on the face.
Evidence suggests an association between air pollution and irritation of the eyes, dry eye syndrome, risk for
retinopathy and adverse ocular outcomes.
REVISTA MEDICINA LEGAL DE COSTA RICA ISSN 2215 -5287 Vol. 37 (1) Marzo 2020
37
Chronic exposure to air pollutants during pregnancy has been associated with adverse effects on the
developing foetus in the form of low birth weight and still birth.
Air contamination has been seen as a significant supporter of the expanded predominance of allergic
diseases in children.
References
1. Falcon-Rodriguez CI, Osornio-Vargas AR, Sada-Ovalle I and Segura-Medina P (2016)
Aeroparticles, Composition, and Lung Diseases. Front. Immunol. 7:3. doi:
10.3389/fimmu.2016.00003
2. Kelly FJ, Fussell JC. Air pollution and public health: emerging hazards and improved understanding
of risk. Environ Geochem Health. 2015;37(4):631–649. doi:10.1007/s10653-015-9720-1
3. Rumana HS, Sharma RC, Beniwal V, Sharma AK. A retrospective approach to assess human health
risks associated with growing air pollution in urbanized area of Thar Desert, Western Rajasthan,
India. J Environ Health Sci Eng. 2014;12:23.
4. Yamamoto SS, Phalkey R, Malik AA. A systematic review of air pollution as a risk factor for
cardiovascular disease in South Asia: Limited evidence from India and Pakistan. Int J Hyg Environ
Health. 2014;217:133–44.
5. Zhang W, Qian CN, Zeng YX. Air pollution: A smoking gun for cancer. Chin J
Cancer. 2014;33:173–5.
6. Zhou N, Cui Z, Yang S, Han X, Chen G, Zhou Z, et al. Air pollution and decreased semen quality:
A comparative study of Chongqing urban and rural areas. Environ Pollut. 2014;187:145–52.
7. Bentayeb M, Simoni M, Norback D, Baldacci S, Maio S, Viegi G, et al. Indoor air pollution and
respiratory health in the elderly. J Environ Sci Health A Tox Hazard Subst Environ
Eng. 2013;48:1783–9.
8. Gao Y, Chan EY, Li L, Lau PW, Wong TW. Chronic effects of ambient air pollution on respiratory
morbidities among Chinese children: A cross-sectional study in Hong Kong. BMC Public
Health. 2014;14:105.
9. Weisel CP. Assessing exposure to air toxics relative to asthma. Environ Health
Perspect. 2002;110(Suppl 4):527–37.
10. Brunekreef B, Beelen R, Hoek G, Schouten L, Bausch-Goldbohm S, Fischer P, et al. Effects of long-
term exposure to traffic-related air pollution on respiratory and cardiovascular mortality in the
Netherlands: The NLCS-AIR study. Res Rep Health Eff Inst. 2009;139:5–71.
11. Nogueira JB. Air pollution and cardiovascular disease. Rev Port Cardiol. 2009;28:715–33.
12. Newman NC, Ryan P, Lemasters G, Levin L, Bernstein D, Hershey GK, et al. Traffic-related air
pollution exposure in the first year of life and behavioral scores at 7 years of age. Environ Health
Perspect. 2013;121:731–6.
13. Haynes EN, Chen A, Ryan P, Succop P, Wright J, Dietrich KN. Exposure to airborne metals and
particulate matter and risk for youth adjudicated for criminal activity. Environ Res. 2011;111:1243–
8.
14. Calderón-Garcidueñas L, Mora-Tiscareño A, Ontiveros E, Gómez-Garza G, Barragán-Mejía G,
Broadway J, et al. Air pollution, cognitive deficits and brain abnormalities: A pilot study with
children and dogs. Brain Cogn. 2008;68:117–27.
REVISTA MEDICINA LEGAL DE COSTA RICA ISSN 2215 -5287 Vol. 37 (1) Marzo 2020
38
15. Calderón-Garcidueñas L, Solt AC, Henríquez-Roldán C, Torres-Jardón R, Nuse B, Herritt L, et al.
Long-term air pollution exposure is associated with neuroinflammation, an altered innate immune
response, disruption of the blood-brain barrier, ultrafine particulate deposition, and accumulation of
amyloid beta-42 and alpha-synuclein in children and young adults. Toxicol Pathol. 2008;36:289–
310.
16. Rotton J, Frey J, Barry T, Milligan M, Fitzpatrick M. The air pollution experience and physical
aggression1. J Appl Soc Psychol. 1979;9:397–412.
17. Vierkötter A, Schikowski T, Ranft U, Sugiri D, Matsui M, Krämer U, et al. Airborne particle
exposure and extrinsic skin aging. J Invest Dermatol. 2010;130:2719–26.
18. Hadnagy W, Stiller-Winkler R, Idel H. Immunological alterations in sera of persons living in areas
with different air pollution. Toxicol Lett. 1996;88:147–53.
19. Rozanova E, Heilig P, Godnic-Cvar J. The eye – A neglected organ in environmental and
occupational medicine: An overview of known environmental and occupational non-traumatic
effects on the eyes. Arh Hig Rada Toksikol. 2009;60:205–15.
20. Backes C.H., Nelin T., Gorr M.W., Wold L.E. Early life exposure to air pollution: How bad is
it? Toxicol. Lett. 2013;216:47–53. doi: 10.1016/j.toxlet.2012.11.007.
21. Lakshmi P.V.M., Virdi N.K., Sharma A., Tripathy J.P., Smith K.R., Bates M.N., Kumar R. Hosehold
air pollution and stillbirth in India: Analysis of the DLHS-II National Survey. Environ.
Res. 2013;121:17–22. doi: 10.1016/j.envres.2012.12.004.
22. Leung T.F., Ko F.W., Wong G.W. Roles of pollution in the prevalence and exacerbations of allergic
diseases in Asia. J. Allergy Clin. Immunol. 2012;129:42–47. doi: 10.1016/j.jaci.2011.11.031.
23. Romieu I, Riojas-Rodríguez H, Marrón-Mares AT, et al. Improved biomass stove intervention in
rural Mexico: impact on the respiratory health of women. Am. J. Respir. Crit. Care
Med. 2009;180:649–56.
24. Smith-Sivertsen T, Díaz E, Pope D, et al. Effect of reducing indoor air pollution on women's
respiratory symptoms and lung function: the Respire Randomized Trial, Guatemala. Am. J.
Epidemiol. 2009;170:211–20.
25. Escobedo FJ, Kroeger T, Wagner JE. Urban forests and pollution mitigation: analyzing ecosystem
services and disservices. Environ. Pollut. 2011;159:2078–87.
26. Smith KR, McCracken JP, Weber MW, et al. Effect of reduction in household air pollution on
childhood pneumonia in Guatemala (RESPIRE): a randomized controlled
trial. Lancet. 2011;378:1717–26.
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