Exposure to air pollution during fetal period, early life linked with higher blood pressure

Exposure to an urban environment characterized by high levels of air pollution and noise in areas with a high building density during the fetal period and in early childhood may contribute to higher blood pressure. This was the conclusion of a study led by the Barcelona Institute for Global Health (ISGlobal) published in Environment International. ISGlobal is an institution supported by the “la Caixa” Foundation.

To study the impact of urban exposures on the cardiovascular health of children, the research team analyzed data from 4,279 children living in six European cities (Bradford in the United Kingdom, Poitiers and Nancy in France, Sabadell and Valencia in Spain, and Heraklion in Greece). All the children were participants in the European HELIX project.

The team assessed multiple aspects of the children’s environment: initially, during the prenatal period, the place of residence of the mothers during their pregnancy, and subsequently the homes of the children themselves. Factors studied included the built environment, natural spaces, traffic, air pollution, noise, climate and level of social and economic privation. Assessing the children’s blood pressure when they were between four and five years of age allowed them to study the long-term effect of the exposures analyzed.

Analysis of the results showed that exposure to higher levels of air pollution, particularly during the first two terms of pregnancy, was associated with higher blood pressure in childhood. Specifically, a 9.1 μg/m3 increase in NO2 was associated with a 0.9 mmHg increase in diastolic blood pressure. (A healthy diastolic blood pressure in children is around 50-80 mmHg) The limit value established by the World Health Organisation to protect the population from the damaging effects of NO2 is 40 μg/m3, a threshold exceeded on a regular basis in cities like Barcelona and Madrid.

Furthermore, other characteristics of the urban environment during childhood also appear to be important. High building density is associated with higher blood pressure and good urban transport connectivity is linked to lower blood pressure.

“It is possible that these associations reflect how people move around in the city and may indicate that greater connectivity promotes physical activity in the population.” Charline Warembourg, ISGlobal researcher, first author of the study

Exposure to noise also appears to be associated with higher blood pressure in children.

Based on their analysis of the results, the authors concluded that one in every five children lives in an urban environment characterised by levels of air pollution, noise, and building density that are associated with blood pressure values higher than those observed in children not exposed to these environmental factors.

The role of urbanization in cardiovascular disease

High blood pressure is one of the chief risk factors for cardiovascular disease, a condition which is currently the leading cause of death worldwide. “Numerous studies have shown that children with higher blood pressure are more likely to develop hypertension later in life,” says Martine Vrijheid, study leader and director of ISGlobal’s Childhood and Environment Programme. “The results of this study show how important it is to identify environmental exposures that contribute to hypertension in early life, from conception onwards.”

Given the increasing urbanization of the world’s population, the role that urban design and transport plays in health is a topic of growing concern. This study assessed, for the first time, the effects on the cardiovascular health of children of numerous exposures associated with the urban environment. “Our results show that, from conception onwards, the urban environment can affect blood pressure in preschool children” Warembourg points out. “This means that a commitment to urban design and transport planning designed to reduce damaging environmental exposures has the potential to reduce the risk of cardiovascular disease in adulthood”.

Exposure to air pollution during fetal period, early life linked with higher blood pressure
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Italy ‘manifestly failed’ on air pollution, EU top court rules

Italy has been “systematically and persistently” exceeding daily and annual limits of particulate matter pollution permitted by EU rules, the European Court of Justice (ECJ) ruled on Tuesday (10 November).

From 2008 to 2017, “the daily and annual limit values for PM10 particulate matter were very regularly exceeded” in several Italian cities, the court said.

The ECJ concluded that Italy has “manifestly failed” to adopt timely measures to tackle pollution as required by the timeframe set out in the EU law on clean air.

Tuesday’s ruling ends the first cycle of the infringement procedure started by the European Commission against Italy in 2014.

In 2018, the European Commission also decided to refer Hungary and Romania, France, Germany and the United Kingdom to the ECJ for failing to respect limit values for nitrogen dioxide (NO2) – another air pollutant produced as a result of road traffic and other fossil fuel combustion processes.

In 2019, Italy then joined the group of countries referred to the EU top court for exceeding the legal limits NO2.

According to the European Environment Agency, Italy has the most premature deaths in the EU related to NO2 pollution.

A report of the European public health alliance published earlier this year identified that Milan, Padua, Venice, Brescia and Turin are among the top 10 EU cities with the highest costs stemming from air pollution.

It is estimated that air pollution in Italy costs €1,535 per person each year.

According to environmental lawyer Ugo Taddei from NGO ClientEarth, “this ruling is the result of years of poor management of the issue at the regional and national level – a failure which has put people’s health on the line”.

“We need to see a complete turnaround, with new regional air quality plans that slash levels of pollution in the shortest time possible, to bring air quality within legal limits,” he also said, adding that being forced to breathe dirty air in the 21st century is “unacceptable”.

In 2017, the environmentalist NGO launched legal action against Lombardy, Italy’s most-polluted region, to force local authorities to update their air quality plan.

Earlier this year, the commission concluded that a majority of member states are off-target to deliver on their air pollution reduction commitments for 2020 and 2030.

Every year, air pollution causes about 400,000 premature deaths in the EU.

While scientists are currently carrying out studies to assess the link between air pollution and Covid-19, a 2003 study on the victims of the respiratory disease SARS found that patients in regions with ‘moderate’ air pollution levels were 84 percent more likely to die than those in regions with ‘low’ air pollution.

Italy ‘manifestly failed’ on air pollution, EU top court rules
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Spell of heavy smog in Indian capital raises fears for COVID patients

Residents of the Indian capital are enduring one of the worst spells of air pollution in years, data released on Monday showed, raising the risks to city residents posed by the novel coronavirus, doctors said.

Delhi’s overall air quality index (AQI), which includes the concentration of PM2.5 particles as well as bigger pollutants, has stayed above 400, on a scale of 500, for five consecutive days, government data showed.

The tiny PM2.5 particles can cause cardiovascular and respiratory diseases including lung cancer, and pose a particular risk for people with COVID 19.

R.V. Asokan, the honorary secretary-general of the Indian Medical Association that represents 350,000 doctors, told Reuters the air pollution made people more susceptible to coronavirus infection.

“The PM2.5 particles break the nasal passage barrier, weaken the inner lining of lungs, facilitating the spread of the coronavirus infection,” Asokan said.

Doctors and researchers around the world have also reported a link between pollution and deaths in patients whose lungs are weakened by the novel coronavirus.

PM2.5 levels were 20 times the World Health Organization’s safe limit on Monday, official data showed.

The five days with an AQI above the 400 level is the longest spell of such heavy pollution in November since 2016. November is usually the worst month for pollution across north India as farmers burn off stubble in their fields and the cooler weather can trap the pollution.

COVID-19 cases in major Indian cities COVID-19 cases in major Indian cities

Doctors in Delhi, which has reported a sharp increase in respiratory infections due to the pollution, are fearing a another jump after the Diwali festival on Sunday, which is celebrated with blizzards of smoky firecrackers, even though fireworks have been banned this year.

India’s main environment court, the National Green Tribunal, forbid the sale and use of firecrackers in the city of 20 million people, and neighbouring cities, from Monday to Dec. 1, but some people will inevitably ignore the order.

The court also told authorities to contain air pollution from all sources “in view of potential of aggravation of COVID-19”.

As well as the stubble burning, Delhi’s pollution woes are compounded by factories, vehicles and rubbish burning.

The neighbouring state of Punjab has recorded at least 50,000 crop waste fires this year, unchanged from a year ago, despite a campaign to encourage farmers to use other methods to clear stubble.

via Spell of heavy smog in Indian capital raises fears for COVID patients | Reuters

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India and Pakistan dominate WHO’s air pollution database

The region contains 16 of the world’s 20 most polluted cities. Historical data sheds light on why

At this time of year, agricultural burning adds to the air pollution problems across northern India and Pakistan. The region contains 16 of the 20 most polluted cities in the World Health Organization’s global PM2.5 database. But are these the most polluted places ever recorded? Lack of measurements make historic comparisons difficult, but we have some clues.

More than 200 years ago, Benjamin Franklin was famously among the first scientists to study electricity in the atmosphere. Lightning is the most obvious manifestation, but air pollution also changes the electrical properties of our air.

Electrical measurements near Hyde Park in about 1790 suggest 18th-century London’s particle pollution was perhaps half the annual average in the most polluted cities in modern India.

By 1900, things had deteriorated. Measurements of atmospheric electricity at Kew show air pollution on the edge of London was similar to the worst Indian cities today.

When first routine measurements of particle pollution began in the 1920s, central London was approximately twice as polluted as contemporary India. Stoke-on-Trent was more than four times greater.

However, in the 1920s, the UK was home to 44 million people. About 400 million people are exposed to the poor air in north India’s Ganges River basin, making it a far larger air pollution crisis.

India and Pakistan dominate WHO’s air pollution database | Environment | The Guardian
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Air pollution as severe in villages as in urban India, reveals study

The new study, part-funded by NASA, combined satellite data with modelling to estimate levels of small particulate matter that damage health and lead to early death

Outdoor pollution is not primarily an urban problem and ambient air is as toxic in rural parts of India as in the urban regions, found a new study part-funded by NASA that combined satellite data with modelling to estimate levels of small particulate matter (PM2.5 > 2.5 μm) that damage health and lead to early death.

In the rest of India, the average PM2.5 levels are similar in rural and urban areas, found the study by researchers from the Colorado State University and Indian Institute of Technology Bombay. It found that most people in India (84% of the population) are exposed to pollution well above the limit of India’s standard (40 μg/m3 ), and almost the entire country is exposed to levels higher than the WHO standard (10 μg/m3 ), with “a long tail of very high concentrations (>160 μg/m3 ) in the urban regions in the Indo-Gangetic plains and parts of non-urban areas in eastern and western India”.

Around 16% of India’s population is not affected by this pollution (below 40 μg/m3 ), and that is mostly confined to the very north-western parts of India, the Western Ghats, and a few regions within India. The fraction that is below the WHO standards is very small (<0.001%), said the study, which has implications for air quality monitoring, regulations, public health, and policy. It was published in the journal, Proceedings of the National Academy of Sciences (PNAS) on Tuesday.

“I was a little surprised (with the results), though our previous work was indicating this. We calculated these using satellite data, so no, there are no significant gaps,” said lead author R. Ravishankara, University Distinguished Professor, Departments of Chemistry and Atmospheric Science at Colorado State University, US, in an email.

“Only the very north western part of India appears to be below the threshold for PM2.5. We have used premature mortality as the metric to measure the health impact. In addition to premature mortality, there are other negative impacts such as asthma, hospital visits, medical costs, etc,” said Ravishankaran.

The findings are in line with the State of Global Air 2020 report released in October, which said that India had recorded the highest annual average PM2.5 concentration exposure in the world in 2019, followed by Nepal, Niger, Qatar and Nigeria.

For the PNAS study, researchers calculated the annually averaged aerosol optical depth (AOD) from three satellite instruments (Methods) that were converted to surface PM2.5 abundances using PM2.5:AOD ratios from the GEOSChem chemical transport model. They then compared the satellite-derived daily and annual PM2.5 with the surface PM2.5 measured by India’s Central Pollution Control Board at 20 monitoring sites, most of which were in urban areas.

The annual premature deaths attributable to PM2.5 alone for urban and rural India is 1.05 million, found the study, which factored in six causes of death: ischemic heart disease, stroke, lower respiratory infections, chronic obstructive pulmonary disease, lung cancer, and type-2 diabetes.

Long-term exposure to outdoor and household air pollution contributed to over 1.67 million annual premature deaths from stroke, heart attack, diabetes, lung cancer, chronic lung diseases, and neonatal diseases, in India in 2019 according to State of Global Air Report 2020.

The analysis revealed that the risk of premature deaths attributable to PM2.5 is similar in rural and urban regions, but there were more deaths in rural areas as it is home to 69% of the country’s population.

“We have used premature mortality as the metric to measure the health impact. These are quantified in the paper. In addition to premature mortality, there are other negative impacts such as asthma, hospital visits, medical costs, etc,” said Ravisankaran.

The findings suggest that efforts to monitor and curtail air pollution should not be limited to India’s urban areas. Enhancing monitoring and regulation in rural areas, which are virtually non-existent, could help better assess the risks and inform policy for pan-India reduction of PM2.5 levels keeping in mind the rural populations lower ability to reduce risks because of economic reasons.

“The Global Burden of Disease 2019 shows us that possibly 100% of India is exposed to air that is not meeting the WHO guidelines, and anywhere between 69% to 85% of the population is exposed to air that doesn’t meet the national standard. Now there is a mix of satellite, chemical transport and ground monitor data to prove this. There are studies now showing that 30% to 50% of outdoor air pollution is contributed by household sources of emissions. The health impacts on both rural and urban populations could range from cardio-respiratory, cardiovascular conditions, diabetes, low birthweight, preterm birth and neonatal mortality,” said Kalpana Balakrishnan, the director of the Indian Council of Medical Research Centre for Advanced Research on Air Quality, Climate and Health, Chennai.

“My key message is: Please don’t forget non-urban India when dealing with air pollution. The second key message is: Science, measurements, and analyses can help overcome this problem with good information to the policymakers,” said Ravisankaran.

via https://www.hindustantimes.com/india-news/air-pollution-as-severe-in-villages-as-in-urban-india-reveals-study/story-OvuzR1U64HEE2hsW8sANNM.html

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116,000 infants killed within months due to air pollution in India: Study

Particulate matter 30 times finer than human hair that enters the bloodstream and causes severe health risks

Air pollution killed around 116,000 infants in India within the first month of being born, found a new global study on air pollution’s burden on health worldwide.

More than half the infant deaths were due to PM 2.5 (particulate matter 30 times finer than human hair that enters the bloodstream and causes severe health risks) in outdoor air and the rest were linked to household air pollution due to use of solid fuels, such as charcoal, wood, and animal dung for cooking, found the State of Global Air 2020 report (SoGA 2020) released on October 21. The report published by the US-based think-tank, Health Effects Institute, claims to be the first-ever comprehensive analysis of air pollution’s global impact on newborns.

Among the youngest infants, most deaths were related to complications from low birth weight and premature birth — direct outcomes of mothers’ exposure to air pollution during pregnancy, found the study. Babies born with a low birth weight are more susceptible to childhood infections and pneumonia. The lungs of pre-term babies can also not be fully developed.

“By limiting the growth and development of babies and children, air pollution lowers their lifelong health and productivity,” said Dean Spears, founding executive director, Research Institute for Compassionate Economics (r.i.c.e.). “Yet, the consequences of air pollution for children do not get the attention that they deserve.” Spears has spent years studying the impact of air pollution on children in India.

Children’s early-life health directly impacts their adult economic productivity and the harm done to children makes air pollution such an economic cost that addressing the problem could be an economic policy that pays for itself, said Spears. His research found children born in places and times when the air pollution was especially bad grew up to be not as tall as children born in less-polluted times in the same locality.

“This newest evidence suggests an especially high risk for infants born in South Asia and sub-Saharan Africa,” said Dan Greenbaum, president, Health Effects Institute, on October 21.

116,000 infants killed within months due to air pollution in India: Study | Business Standard News

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Bucharest, Sofia, Zagreb among 24 cities with EU’s highest air pollution costs

Bucharest, Sofia, and Zagreb are on the list of the 24 cities with the highest total damage from air pollution, according to a study conducted by SE Delft on health-related social costs in 432 cities in the European Union, United Kingdom, Norway and Switzerland.

In total, over 130 million people live in the places covered in the 30 countries, with an average of 301,754 inhabitants per city. In 2018, total social costs for all 432 cities surpassed EUR 166 billion. The average cost per city is over EUR 385 million, the study finds.

Social costs are costs affecting welfare and comprise both direct health care expenditures and indirect health impacts

Social costs affect welfare and they comprise both direct health care expenditures (e.g. for hospital admissions) and indirect health impacts (e.g. diseases such as chronic obstructive pulmonary disease, or reduced life expectancy due to air pollution). They affect welfare because people have a clear preference for healthy life years in a good and clean environment.

Air pollution in cities stems from transport activities, household heating and a range of other activities including agriculture and industry. The study focused on the role of transport in explaining the social costs.

A 1% increase in the average journey time to work increases the social costs of PM10 emissions by 0.29% and those of NO2 emissions by 0.54%. A 1% increase in the number of cars in a city increases overall social costs by almost 0.5%, the Health costs of air pollution in European cities and the linkage with transport study reads.

Every inhabitant of a European city suffered a welfare loss of over EUR 1,250 a year on average

In 2018, every inhabitant of a European city suffered an average welfare loss of over EUR 1,250 a year owing to direct and indirect health losses associated with poor air quality. It is equivalent to 3.9% of income earned in cities.

There is a substantial spread between the figures among cities. In the Romanian capital Bucharest, total welfare loss amounts to over EUR 3,000 per capita/year, while in Santa Cruz de Tenerife in Spain it is under EUR 400.

In Bulgaria, Romania and Poland, health-related social costs are between 8% and 10% of income earned

In many cities in Bulgaria, Romania and Poland, health-related social costs are 8% to 10% of income earned. Most relate to premature mortality: for the 432 cities investigated, the average contribution of mortality to total social costs is 76.1%.

Bucharest, Sofia, Zagreb among 24 cities with EU’s highest air pollution costs
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New study links air pollution to 15 percent of COVID-19 deaths

Researchers say deaths linked to COVID-19 and air pollution represents ‘potentially avoidable, excess mortality’.

Long-term exposure to air pollution may be linked to 15 percent of COVID-19 deaths globally, according to a new study.

Published in the journal Cardiovascular Research on Tuesday, the research from German and Cypriot experts analysed health and disease data from the United States and China relating to air pollution, COVID-19 and SARS – a respiratory illness similar to the new coronavirus disease.

The authors combined this with satellite data of global exposure to particulate matter – microscopic particles – as well as ground-based pollution monitoring networks, to calculate the extent to which air pollution could be blamed for COVID-19 deaths.

In East Asia, which has some of the highest levels of harmful pollution on the planet, the authors found that 27 percent of COVID-19 deaths could be attributed to the health effects of poor air quality.

The proportion was 19 percent in Europe, and 17 percent in North America.

The authors said the deaths linked to COVID-19 and air pollution represented a “potentially avoidable, excess mortality” and that exposure to particulate matter in air likely aggravated “co-morbidities that lead to fatal outcomes” of infection by SARS-CoV-2, the virus that causes COVID-19.

“If both long-term exposure to air pollution and infection with the COVID-19 virus come together then we have an adverse effect on health, particularly with respect to the heart and blood vessels,” said the paper’s co-author Thomas Munzel.

He said that air pollution made known COVID-19 risk factors such as lung and heart problems more likely. Specifically, the team noted that particulate matter appeared to increase the activity of a receptor on lung cell surfaces, ACE-2, which is known to be involved in the way COVID-19 infects patients.

“So, we have a double hit: air pollution damages the lungs and increases the activity of ACE-2, which in turn leads to enhanced uptake of the virus,” said Munzel, a professor at the University Medical Center of the Johannes Gutenberg University, Mainz.

‘Reduce emissions’

The authors stressed that attributing COVID-19 deaths to air pollution did not mean that pollution itself was killing people with the disease, although they did not rule out such a cause-effect linkage.

Jos Lelieveld, of the Max Planck Institute for Chemistry, told the AFP news agency that the research suggested “the pollution particles are a co-factor in aggravating the disease”.

He said their estimates suggested that more than 6,100 coronavirus deaths in the United Kingdom could be attributed to air pollution. In the US that figure is approximately 40,000.

More than 1.1 million people worldwide have died from COVID-19 since the start of the pandemic, according to data from the Johns Hopkins University.

The authors said that without a fundamental change in how cities power themselves, including a transition to clean and renewable energy sources, air pollution would continue to kill huge numbers of people even after the pandemic recedes.

“The pandemic ends with the vaccination of the population or with herd immunity through extensive infection of the population,” they wrote.

“However, there are no vaccines against poor air quality and climate change. The remedy is to mitigate emissions.”

New study links air pollution to 15 percent of COVID-19 deaths | China | Al Jazeera
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