Air pollution tied to shorter survival with lung cancer 

Posted on August 9, 2016 by Respro® UK Ltd

Exposure to air pollution has long been associated with an increased risk of lung cancer, and a new study suggests it might also be tied to a faster death from the disease.

Researchers examined cancer registry data on more than 350,000 people diagnosed with lung cancer in California and found patients who lived in communities with higher than average levels of air pollution typically died sooner than their peers who lived in places with cleaner air.

Patients with lung cancer may be a new subgroup of people susceptible to the health impacts of air pollution, since exposures after diagnosis may impact how long they live, said lead study author Sandrah Eckel, a researcher at the University of Southern California in Los Angeles.

Worldwide, lung malignancies kill about 1.6 million people a year, causing nearly one in five cancer deaths, Eckel and colleagues note in the journal Thorax.

To assess how air pollution may contribute to these deaths, researchers examined concentrations of ozone, nitrogen dioxide and so-called particulate matter.

Ozone is an unstable form of oxygen produced when various types of traffic and industrial pollution react with sunlight. Nitrogen dioxide is a byproduct of fossil fuel combustion that can contribute to smog. And so-called particulate matter is a mixture of solid particles and liquid droplets that can include dust, dirt, soot and smoke.

All of these pollutants have been found to damage the lungs.

Almost half the patients in the current study lived at least 1,500 meters (almost one mile) away from a major interstate highway, while fewer than 10 percent lived with 300 meters (about one-fifth of a mile) of one. Air pollution is usually worse closer to these highways.

Researchers tracked health outcomes for patients diagnosed with lung cancer from 1988 to 2009 based on the level of air pollution near their homes.

Patients were 69 years old on average at the time of diagnosis.

More than half were diagnosed at an advanced stage when tumors had spread.

Overall, the average survival time was about 3.6 years for people diagnosed with early stage disease and about four months for those with advanced tumors that had spread beyond the lungs.

Air pollution appeared to have the greatest effect on survival for people diagnosed with early-stage adenocarcinoma, the most common type of lung cancer and the form that often afflicts non-smokers.

In particular, patients diagnosed with early-stage disease had average survival times of about 2.4 years with high exposure to fine particulate matter, compared with 5.7 years with low exposure, the researchers report.

For these early-stage patients, the risk of death from any cause during the study period was 30 percent greater with exposure to nitrogen dioxide, 26 percent higher with exposure to large particulate matter and 38 percent bigger with fine particulate matter, the study found.

One limitation of the study is that researchers focused on pollution near residential addresses, which doesn’t account for how much time patients spent outdoors breathing this air, the authors note.

Even so, the findings add to a small but growing body of evidence linking pollution to worse outcomes after a lung cancer diagnosis, Dr. Jaime Hart, a researcher at Brigham and Women’s and Harvard Medical School in Boston, noted in an accompanying editorial.

“Studies have shown that pollution increases inflammation and oxidative stress, both of which have been linked to increased mortality,” Hart said by email. “Those studies weren’t done in lung cancer patients, but it is reasonable to think that similar things may be occurring.”

Taken together, this emerging research suggests that patients with lung cancer should consider reducing pollution exposure along with other lifestyle changes aimed at boosting longevity such as smoking cessation or dietary changes, Hart said.

“There are a number of common-sense precautions that anyone can take to reduce their exposures to air pollution, including monitoring daily air pollution alerts and reducing outdoor activities – especially outdoor exercise – during high pollution periods, using air filtration systems while indoors, and using the recirculate setting of your car ventilation system while traveling in heavy traffic,” Eckel noted.

Source: Air pollution tied to shorter survival with lung cancer | Reuters

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Rio 2016 Olympics: Team GB stars told not to breathe polluted air through mouths 

Posted on August 8, 2016 by Respro® UK Ltd

TEAM GB stars are being told not to breathe in through their mouths because Rio’s air could give them cancer.

Experts have warned athletes to wear face masks when not competing and stay indoors as much as possible.

Local pollution could damage airways, spark heart attacks and cause cancer in the long term, says air purifier firm Blueair.

The advice came as tennis ace Andy Murray practised his Olympic flag-bearer duties – and nearly poked a shocked Princess Anne’s eye out.

Team GB’s patriotic opening ceremony outfits were also on display.

The Games headlines to date have been dominated by fears over the Zika virus, but now athletes are being warned to beware of the thick, polluted air.

Blueair founder Bengt Rittri also told spectators to “mask-up” if they want to protect their health.

He said: “Our advice to all athletes in Rio is to wear pollution face masks when ever possible. It is a city suffering from severe air pollution caused by unfettered traffic and industrial activities.”

 

Source: Rio Olympics: Team GB stars told not to breathe polluted air through mouths | Daily Star

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London Tube stations and bus stops to display toxic air warnings 

Posted on August 5, 2016 by Respro® UK Ltd

Toxic air warnings will be displayed at hundreds of Tube stations and bus stops during pollution peaks in London.

Mayor Sadiq Khan announced that filthy air levels, and advice on how  to respond, will appear on a huge network of public signs across the  capital.

The alerts will be issued when air pollution reaches “high” or “very high”, which has happened four or five times a year recently. They will be shown on 2,500 bus countdown signs, electronic update signs in the entrances of all 270 Underground stations, 140 roadside message signs on the busiest main roads, and river pier signs.

The system will go live from Monday August 15. Mr Khan said: “Londoners have a right to know about the quality of the air that they breathe.

“These new alerts will allow them to take precautions and help them plan ahead to avoid the worst instances of air pollution.” Information on the signs will depend on the level of pollution and may include telling motorists to switch their engine off when stationary to cut emissions and advising people to walk, cycle or use public transport.

It could also include warnings to reduce strenuous activity if someone experiences symptoms or advising asthma sufferers and other vulnerable groups that they may need to use their reliever inhaler more often or take other precautionary measures.

Four out of five of nearly 15,000 people who responded to a public consultation on Mr Khan’s air quality master plan said they wanted to be told when pollution is high or very high so they can take action to protect their health and reduce its impact.

The warnings will be displayed on the day before forecast high and very high air pollution, as well as the day itself.

Leon Daniels, Transport for London’s managing director of surface transport, said: “We are working with the Mayor to deliver an ambitious and wide-ranging programme to improve air quality across the capital.

“An important part of this work is to raise awareness and provide advice to people on how they can personally contribute to this work.”

Londoners with particular health needs will continue to have access to the airTEXT service for regular air quality forecasts via text, voicemail, email, mobile app and online.

Mr Khan has also consulted on a new “T-charge” of £10 a day for the worst-polluting vehicles —broadly those registered before 2005 — to drive into central London from next year.

In addition, he has proposed introducing the central London Ultra Low Emission Zone one year earlier in 2019. Cars, vans and motorbikes not meeting set emission standards would have to pay £12.50 a day, and lorries, coaches and buses £100.

The ULEZ may also be extended London-wide for lorries, buses and coaches from 2020.

Source: London Tube stations and bus stops to display toxic air warnings | London | News | London Evening Standard

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Air Pollution Could Affect Survival in Lung Cancer

Posted on August 5, 2016 by Respro® UK Ltd

Exposure to air pollution after a diagnosis of lung cancer can negatively affect survival, according to a new study published online August 4 in Thorax.

The effect was most pronounced for patients with early-stage disease, and in particular those with adenocarcinoma, which accounts for 80% of lung cancer cases.

In a population-based study of more than 352,000 patients with newly diagnosed lung cancer, higher exposure to nitrogen dioxide (NO2) and particulate matter of less than 10 microns in aerodynamic diameter (PM10) and less than 2.5 (PM2.5) was associated with shorter survival.

These observed associations were clinically significant, note the authors, led by Sandrah P. Eckel, PhD, assistant professor in the Division of Biostatistics at the University of Southern California in Los Angeles.

There was an increased risk for death (≤38%, dependent on cancer stage and pollutant), suggesting that “reductions in exposure have the potential to improve lung cancer survival,” they write.

Compelling Evidence

Speaking in a BMJ podcast interview, Jaime E. Hart, ScD, from the Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School in Boston, Massachusetts, noted that the findings from the study were “a little surprising.”

“Before this study, there was very little evidence of the impact of air pollution on survival in individuals with lung cancer,” said Dr Hart, who is also the author of an accompanying editorial published in the same issue.

“The most interesting findings were that the impacts of pollution were very different by stage and histology at diagnosis, and the impact was strongest among those who traditionally have the highest survival rate,” she said.

While the results of this study aren’t conclusive, Dr Hart pointed out that this paper suggests patients with lung cancer may be particularly affected by air pollution. “The effect size was higher than in the general population, so it suggests that they may be more susceptible,” she said.

However, this is the first study to show this effect, and so “we have to be a little cautious in interpreting it.” Ideally, the results should be replicated, and Dr Hart noted that she would like to see a study that included information about patient behavior patterns, which was impossible to tease out in the current paper because the information came from a database.

Despite its limitations, such as being unable to account for potential confounding by changes in lifestyle habits or subsequent treatments, the study provides “compelling evidence that air pollution may be a potential target for future prevention and intervention studies to increase cancer survival,” writes Dr Hart in her editorial.

Overall, this study adds to the immense weight that current levels of air pollution are affecting health, she added.

Early Stage Most Affected

Underlying the study is the authors’ hypothesis that, if ambient air pollution can influence the development of lung cancer, then inhaled pollutants may also drive tumor progression “through the same mechanistic pathways to shorten survival after diagnosis.”

To address that question, Dr Eckel and colleagues conducted a population-based cohort study that included 352,053 California residents who were newly diagnosed with lung cancer from 1988 to 2009.

They estimated the average residential exposures to air pollutants from diagnosis to the end of follow-up, and this information was applied to all-cause mortality and lung cancer–specific mortality by stage and tumor histology at the time of diagnosis.

More than half of lung cancers (53%) were diagnosed at an advanced stage, and 324,266 patients died (92.1%) during the study period.

The authors used four different air pollution measures (PM10, PM2.5, NO2, and ozone), which were calculated by using data from US Environmental Protection Agency air quality monitoring stations and then mapped to the residential addresses of each individual at the time of diagnosis.

They also calculated the distance to the nearest highways to account for exposures to local traffic, and they included area-level information on measures of urbanicity and socioeconomic status.

Just under half of the cohort (45.4%) lived more than 1500 meters away from a major interstate highway, and only 8.7% lived within a 300-meter radius of one.

There was a pattern of shorter median and 5-year survival for patients with local or regional-stage disease who had higher exposure to NO2, PM10, or PM2.5.

As an example, the median survival for patients with local disease was 2.4 years if they had high PM2.5exposures (≥16 μg/m3) and 5.7 years for low PM2.5 exposures (<10 μg/m3).

Across all types of pollutants, the authors observed larger hazard ratios for patients diagnosed at earlier stages, and the effects of the various pollutants seemed to be greater for patients with adenocarcinoma than patients with small-cell cancer at the same stage.

Survival for patients with distant stage at diagnosis was poor, regardless of exposure to air pollutants.

The study was supported by the Southern California Environmental Health Sciences Center; the Hastings Foundation; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries. The study authors and editorialist have disclosed no relevant financial relationships.

Thorax. Published online August 4, 2016. Abstract Editorial

 

Source: Air Pollution Could Affect Survival in Lung Cancer

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Brexit May Turn London’s Fog to Smog If U.K. Ditches EU Rules

Posted on August 4, 2016 by Respro® UK Ltd

Londoners may find it harder to catch their breath if the U.K.’s decision to leave the European Union weakens air-quality standards, according to S&P Global Inc.

Inside the 28-nation bloc, the U.K. is legally bound to keep air pollution below regulatory thresholds. Once the country formally makes its exit, there’s no guarantee those EU limits will still be observed.

“This is a very serious issue for the U.K.,” said Michael Wilkins, managing director of infrastructure ratings at S&P, in a report on Wednesday. “Post-Brexit, it could be more difficult to hold the government accountable for air quality standards.”

London has repeatedly broken EU air-quality rules. It took the city just eight days in 2016 to breach the annual cap on nitrogen dioxide concentrations. Almost all the pollution is emitted by cars and trucks, according to the International Energy Agency. The World Heath Organization estimates air pollution annually costs the U.K. 62 billion pounds ($83 billion).

Government officials are divided on this issue. The Department for Environment, Food & Rural Affairs previously sought to slow the pace of implementing EU pollution limits, saying it was unable to meet 2010 rules until at least 2025. London mayor Sadiq Khan, elected in May, has said he will fight to keep pollution on the capital city’s agenda.

The EU regulations will still apply until the U.K. formally leaves the union, which will take at least two years. Even if the U.K. strikes a deal to remain in the European Economic Area free-trade zone, enforcing the standards could become more difficult.

“Leaving the EU would mean that the U.K. government would no longer face fines from the European Court of Justice,” said Alan Andrews, a lawyer at ClientEarth, a legal group that successfully sued the U.K. government in 2011 over its failure to cut pollution. “The future is obviously uncertain and depends what the deal is with our exit from the EU.”

Source: Brexit May Turn London’s Fog to Smog If U.K. Ditches EU Rules – Bloomberg

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Seoul to limit old diesel vehicles to fight air pollution 

Posted on August 4, 2016 by Respro® UK Ltd

South Korea’s capital of Seoul will limit the number of old diesel vehicles on the roads starting next year, as the country tackles rising air pollution.

Asia’s fourth-biggest economy in June announced a string of measures to address growing concerns about air quality following fine dust particle warnings and Volkswagen’s emissions-test cheating scandal. Seoul aims to bring its air quality to the levels of European peers like London and Paris within a decade.

South Korea’s environment ministry said on Thursday that Seoul will introduce the restriction in 2017 on diesel vehicles registered before 2006, followed by the nearby city of Incheon and then 17 cities in Gyeonggi Province in 2018.

About 1.04 million vehicles will be subject to the regulations.

Older diesel vehicle weighing 2.5 tonnes or more will not be allowed into the so-called “low emission zones” if it is not equipped with an emission-reducing device or a low-pollution engine. A car which does not undergo a regular emission check, or fails to pass the test will be also banned from entering the city.

Whenever a camera spots a non-compliant vehicle being driven in the region, a penalty charge of 200,000 won ($179) will be issued.

The government also plans to implement a diesel car scrappage program in which an automaker offers a discount of up to 1.2 million won to those who trade old diesel cars in for new ones.

Major European cities are also fighting air pollution. Paris last month started to bar old vehicles from the city’s streets from 8 a.m. to 8 p.m. on Mondays to Fridays, while London could introduce an extra charge on the most polluting vehicles entering the center of town.

Source: Seoul to limit old diesel vehicles to fight air pollution | Reuters

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Diesel vehicle purchases banned by City of London Corporation

Posted on August 3, 2016 by Respro® UK Ltd

London’s struggling attempt to battle rising air pollution was given a welcome boost on Monday (1 August), after the City of London Corporation announced a ban on the purchase of diesel vehicles for its business fleets.

With a fleet of more than 300 vehicles, the City Corporation arrived at an agreement to ban the purchase of diesel vehicles and will instead explore the benefits of hybrid vehicles.

Head of Procurement at the City of London Corporation Chris Bell said: “This agreement is a major step forward in our drive to protect the millions of London tourists, workers and residents from air pollution.

“The City Corporation takes air quality extremely seriously. We are taking responsibility for the cleanliness of our fleet and encouraging the use of low and zero emission vehicles with our partners.

“It complements the work that we are doing to support many City businesses who are also cutting back on vehicle deliveries and using more hybrid vehicles.”

With diesel being the main source of nitrogen dioxide (NOx) emissions and particulate matter (PM10), the City Corporation is continuing to clamp down on its usage of diesel vehicles. It has already seen a 40% reduction of NOx and 50% of PM10 since 2009. This is due to a reduction of fleet sizes and purchasing low-emission vehicles. However, some diesel vehicles such as tractors will still be procured due to the lack of a non-diesel alternative.

The City of London Corporation has also created the ‘City Air’ app, which offers low-pollution travel routes around the capital. It joins the growing trend of mobile apps geared towards tackling air pollution, which includes the CleanSpace app that visualises pollution levels.

Additionally, the Corporation has also introduced a city wide 20mph zone and a city wide cutback on engine idling and tighter restrictions on bulldozers and generators.

Death of diesel

The announcement comes just a week after the approval of the London City Airports expansion, a move criticised by green groups as a ‘reckless and irresponsible’ decision. Also, with London having breached its annual air pollution limits within a single week earlier this year, eyes are on the city to crackdown on its environmental impact.

However, there is a series of business-orientated changes that aim to tackle the serious air pollution problem in London. With such a large number of fleets active in the UK, steps have already been introduced to mitigate the potential environmental impact.

In April this year, a Department for Transport (DfT) investigation revealed that some vehicles in the UK are still producing up to 12 times the EU maximum limit for road-tested emissions, tarnishing the Government’s claims that it “leading the push” for greater emissions testing in diesel cars.

London was also absent from the list of 20 European cities calling for more stringent regulations to be put in place across the continent to tackle the deadly levels of air pollution caused by diesel vehicles.

However, London’s dormant approach to tackling diesel emissions could be rejuvenated by new Mayor of London Sadiq Khan, who has vowed to introduce Clean Bus Corridors and a diesel vehicle scrappage scheme.

Source: Diesel vehicle purchases banned by City of London Corporation

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Dutch activists sue government over air pollution

Posted on August 3, 2016 by Respro® UK Ltd

Dutch environmentalists said Tuesday they are suing the government over poor air quality, saying people’s “fundamental” rights to good health were being infringed.

In a lawsuit filed on Monday, the Milieudefensie group alleged “the Netherlands exceeds the legal standards for air quality and is violating fundamental human rights by doing too little to combat air pollution.”

“This pollution causes thousands of deaths every year, and leaves tens of thousands of people seriously ill. That is unacceptable,” added the group’s campaign manager, Anne Knol, in a statement.

The suit launched in The Hague is the first step in a lengthy process which could lead to a trial. The first hearing is due to be held on August 17.

Environmental activists say under the constitution “the state has a duty to protect citizens from unhealthy air.”

The group alleges that, in tests carried out at 58 sites across the country last year, the levels of nitrogen dioxide exceeded European norms in 11 places.

The indictment has been signed by 57 Dutch citizens, and the lawsuit has been launched after a crowd-funding campaign raised some 30,000 euros ($33,593) to cover the costs.

This latest action comes after another Dutch environmental rights group, Urgenda, last year won a landmark ruling ordering the government to slash greenhouse gases by a quarter by 2020.

Climate experts hailed the June 2015 ruling as “a milestone” in a case brought by 900 Dutch citizens seeking to force a national reduction of the emissions blamed for global warming. The government is appealing.

Source: Dutch activists sue government over air pollution

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