84% of the population in European cities is exposed to PM2.5 levels above the maximum recommended by the World Health Organization
A new study has for the first time estimated the mortality burden attributable to Air Pollution in 1,000 European cities
World Health Organization estimates air pollution kills more than 7 million people each year
Limiting air pollution to levels recommended by the World Health Organization could prevent more than 50,000 deaths in Europe annually, according to research.
The WHO estimates air pollution kills more than 7 million people each year and is one of the leading causes of sickness and absence from work globally.
Cities, with their crowded streets and high energy use, are hotspots for illness and disease linked to air pollution.
The WHO recommends that fine particulate matter (PM2.5) not exceed 10 milligrams per cubic metre of air, averaged annually. For nitrous oxide (NO2), the threshold not to be exceeded is 40mg/m3.
Wednesday’s study, published in the Lancet Planetary Health journal, estimated the premature death burden due to these two pollutants in nearly 1,000 cities across Europe.
It found that reducing PM2.5 and NO2 to safe WHO levels could prevent 51,213 premature deaths each year.
Nearly 125,000 deaths annually could be saved if air pollution levels were reduced to the lowest recorded in the study, its authors said.
Mark Nieuwenhuijsen of the Barcelona Institute for Global Health (ISGlobal) said the research “proves that many cities are still not doing enough to tackle air pollution”.
“Levels above WHO guidelines are leading to unnecessary deaths,” he said.
Using city-specific data on air pollution models combined with mortality figures, the researchers formed a “mortality burden score” ranking individual cities from best to worst.
Deaths due to air pollution varied widely, with NO2 levels in Madrid, for example, responsible for 7% of annual deaths there. Cities in the Po Valley region of northern Italy, Poland, and the Czech Republic were the highest in mortality burden, with the Italian cities of Brescia, Bergamo and Vicenza all within the top five for PM2.5 concentrations.
Those with the lowest mortality burden included Tromso in Norway, Umea in Sweden and Oulu in Finland, as well as the Icelandic capital, Reykjavik.
On average, 84% of the population in cities studied were exposed to PM2.5 levels above the WHO guideline. Nine per cent were exposed to higher-than-recommended NO2 levels, the study found.
Sasha Khomenko, co-author of the study from ISGlobal, said it was important to implement local emissions reductions measures in light of the high variability in mortality linked to poor air.
“We need an urgent change from private motorised traffic to public and active transportation (and) a reduction of emissions from industry, airports and ports,” she said.
Khomenko also said a ban on domestic wood and coal burning would help heavily polluted cities in central Europe, and called for more trees and green spaces in urban areas.
Limiting air pollution ‘could prevent 50,000 deaths in Europe’ | Air pollution | The Guardian
New data from China show that greater exposure to some forms of air pollution, even in the short term, is linked to an increased risk of dying from myocardial infarction.
The relationship was seen for particulate matter with an aerodynamic diameter of ≤ 2.5 µg (PM2.5) and ≤ 10 µg (PM10), as well as for nitrogen dioxide (NO2), Yuewei Liu, MD, PhD (Sun Yat-sen University, Guangzhou, China), and colleagues report in their paper published online today in the Journal of the American College of Cardiology.
Earlier studies have shown a connection between air pollution and more-chronic forms of heart disease, as well as for MI itself. This study takes a different angle, the researchers explain. “Because MI is a leading cause of death that accounts for over 30% of all deaths from ischemic heart diseases, it is of great importance to understand whether air pollutant exposures also trigger deaths from MI.”
Physicians who commented on the results for TCTMD said this is indeed a relevant question. Its answer, they said, confirms the long-held suspicion that air pollution—whether short- or long-term—is bad for cardiovascular health.
Jonathan D. Newman, MD, MPH (NYU Langone Health, New York, NY), drew attention to the fact that the biggest upswing in risk with particulate matter was actually seen among people with lower exposures. “That is relevant worldwide and to other populations that are less highly exposed to anthropogenic or fossil fuel combustion-related air pollution,” he said, adding, “There’s a significant risk even in the lower groups of exposure, which argues for the importance of control measures even for populations that are less highly exposed.”
Here, mean exposures of PM2.5 and PM10 were 63.4 and 100.4 µg/m3, respectively, on days when the MI deaths occurred (on control days, mean levels were slightly lower at 62.1 and 99.5 µg/m3). By comparison, Newman noted, the Environmental Protection Agency’s “gold standard is less than 12 µg/m3 in the United States” for PM2.5.
Robert Kloner, MD, PhD (Huntington Medical Research Institutes, Pasadena, CA), agreed that while the findings are confirmatory, this doesn’t mean they are uninteresting. What’s unique here is not only the primary endpoint but also the precision by which the time of exposure was captured, he said. Their design “is quite a sophisticated approach” that provides hints on mechanism, specifically oxidative stress, inflammation, thrombosis, and vascular dysfunction. His own research has shown, in animal models, that ultrafine particles delivered directly to the heart can impair function, irrespective of age and whether there’s preexisting cardiovascular disease.
“You don’t get atherosclerosis in 1 day,” stressed Kloner. “This really does point to the concept that air pollution can act as an acute trigger, as an acute risk factor, for death from heart attack.”
Pollution Close to Home
For their study, Liu and colleagues used a time-stratified, case-crossover design to look at 151,608 MI-related deaths that took place in China’s Hubei province from 2013 to 2018. Exposure to air pollution—particulate matter, sulfur dioxide, NO2, carbon monoxide, and ozone—was assessed based on each person’s home address, with data drawn from local air-quality monitoring stations.
They compared mean exposure on the day of death and the day prior with other weekdays in the same month, finding significant relationships between MI death risk for PM2.5, PM10, and NO2. With PM2.5 and PM10, the risk associated with exposure increased up until the breakpoints of 33.3 µg/m3 and 57.3 µg/m3, respectively, then flattened out, whereas relationship was nearly linear for NO2.
“These findings add to the understanding of acute adverse effects of air pollution on cardiovascular mortality and highlight the needs for either general population or policy practitioners to take effective measures in reducing air pollution exposures, especially for older adults and those with higher risk of MI occurrence,” the investigators conclude.
From Policy to Personal
Next steps may indeed come at the policy level, and now the world has had a glimpse of what positive changes can produce.
“One silver lining in the dark cloud of COVID-19 has been the singular impact of the pandemic on global air pollution emissions. Early in the pandemic, with complete cessation of road traffic and air travel in many parts of the world, there was a dramatic impact on air pollution levels,” Sanjay Rajagopalan, MD (University Hospitals and Case Western Reserve University, Cleveland, OH), and Jagat Narula, MD (Icahn School of Medicine at Mount Sinai, New York, NY), write in an accompanying editorial. “PM2.5 plummeted across the globe resulting in ‘blue sky days,’ allowing anyone to ponder a future free from air pollution.”
Newman said that there is a clear need for policies that shift away from fossil fuels, as well as evidence to support these broad interventions. But, as he and others addressed in a recent review on pollution’s cardiopulmonary impact, far less is known about “personal-level interventions,” like face masks or air filters, which could be studied in randomized controlled trials.
As of now, “I would wager that there’s little advice being given in regards to air pollution exposure and risk-mitigation strategies in routine clinical practice,” partly due to the need to address traditional risk factors during the limited time frame of an office visit, Newman said, adding that physicians may be stymied by a lack of knowledge on what to offer, particularly when evidence is absent.
Yet there is growing awareness, he added, and modern tools like smartphones might be leveraged to provide details on air quality for specific regions. Less obvious is how to apply this information. “There are always unintended consequences. For example, I think in general with physical activity, the benefits . . . outweigh for most people any potential added [risk] from air pollution, so you wouldn’t necessarily want to caution people not to exercise or do things outdoors,” he suggested, though this added risk might be more relevant for individuals with comorbidities or in situations, like forest fires, when pollution levels are particularly noxious.
For Kloner, the main advice is for patients to avoid polluted air when possible, especially if they live near a major highway or other potent source. “It will be interesting to see if during the COVID era maybe there are fewer problems with this, because people have been wearing masks. As masks become the norm, maybe we’ll see some changes,” he added. It’s also key that patients otherwise at high risk get the best preventive therapies.
The mounting evidence is consistent, Kloner concluded. “Every little bit of knowledge is helpful. And the arrows all point to one direction, which is: air pollution is bad for your heart.”
via Acute Exposure to Air Pollution Can Trigger MI-Related Death | tctmd.com
Even as pollution emissions declined from other sources including vehicle exhaust and power plants, the amount from fires increased sharply.
Wildfire smoke accounted for up to half of all health-damaging small particle air pollution in the western U.S. in recent years as warming temperatures fueled more destructive blazes, according to a study released Monday.
Even as pollution emissions declined from other sources including vehicle exhaust and power plants, the amount from fires increased sharply, said researchers at Stanford University and the University of California, San Diego.
The findings underscore the growing public health threat posed by climate change as it contributes to catastrophic wildfires such as those that charred huge areas of California and the Pacific Northwest in 2020. Nationwide, wildfires were the source of up to 25% of small particle pollution in some years, the researchers said. “From a climate perspective, wildfires should be the first things on our minds for many of us in the U.S.,” said Marshall Burke, an associate professor of earth system science at Stanford and lead author of the study.
“Most people do not see sea-level rise. Most people do not ever see hurricanes. Many, many people will see wildfire smoke from climate change,” Burke added. The study was published in the Proceedings of the National Academy of Sciences.
The researchers used satellite images of smoke plumes and government air quality data to model how much pollution was generated nationwide by fires from 2016 to 2018 compared to a decade earlier. Their results were in line with previous studies of smoke emissions across earlier time periods and more limited geographic areas.
Large wildfires churn out plumes of smoke thick with microscopic pollution particles that can drift hundreds or even thousands of miles. Driving the explosion in fires in recent years were warmer temperatures, drought and decades of aggressive fire fighting tactics that allowed forest fuels to accumulate.
Air pollution experts say that residents of the West Coast and Northern Rockies in particular should expect major smoke events from wildfires to become more frequent.
There’s little doubt air quality regulations helped decrease other sources of pollution even as wildfire smoke increased, said Loretta Mickley, an atmospheric chemist at Harvard University. But it’s difficult to separate how much of the increase in smoke pollution is driven by climate change versus the forest fuel buildup, she added.
Mickley and researchers from Colorado State University also cautioned that fires can vary significantly from year to year because of weather changes, making it hard to identify trends over relatively short periods such as the decade examined in the new study.
An AP analysis of data from government monitoring stations found that at least 38 million people in California, Oregon, Washington, Idaho and Montana were exposed to unhealthy levels of wildfire smoke for at least five days in 2020. Major cities in Oregon suffered the highest pollution levels they had ever recorded.
Smoke particles from those wildfires were blamed for health problems ranging from difficulty breathing to a projected spike in premature deaths, according to health authorities and researchers.
Fires across the West emitted more than a million tons of particulate pollution in 2012, 2015 and 2017, and almost as much in 2018.
Scientists studying long-term health problems have found correlations between smoke exposure and decreased lung function, weakened immune systems and higher rates of flu.
The new study matches up with previous research documenting the increasing proportion of pollution that comes from wildfire smoke, said Dan Jaffe, a wildfire pollution expert at the University of Washington. Jaffe added that it also raises significant questions about how to better manage forests and the role that prescribed burns might play.
“We have been making tremendous progress on improving pollution in this country, but at the same time we have this other part of the puzzle that has not been under control,” Jaffe said. “We’re now at the point where we have to think about how to manage the planet a whole lot more carefully than we’ve done.”
Wildfires Caused Half Of Western America’s Pollution: Study | Seattle, WA Patch
The Polish city of Kraków registered the third worst air pollution in the world this morning, as Poland once again suffers from its annual winter smog problems. The country has Europe’s worst air, with pollutants causing tens of thousands of premature deaths annually.
According to the live ranking produced by IQAir, a Swiss air quality technology company, this morning Kraków was the city with the third worst air quality in the world, behind only Lahore in Pakistan and Delhi in India, reports Radio Eska. Warsaw was 13th on the list.
The European Air Quality Index – which is compiled by the European Environment Agency (EEA), an EU body, and uses slightly different methodology – also showed southern Poland as having the worst air on the continent this morning.
However, it found Silesia Province – especially the cities of Katowice and Bielsko-Biała – to have higher pollution levels (with the worst classification of “extremely poor”) than Kraków (which was “very poor”).
Poland, and in particular the south of the country, has been hit by poor air quality in recent days, with pollution indicators in many places far exceeding safe levels.
In Kraków this morning, pollutants were three times over the permissible maximum safe level. Figures in many surrounding towns and villages were even worse – the nearby village of Racławice was 11 times over the limit, reports Gazeta Wyborcza. Katowice was yesterday 2.5 times above safe levels.
Public transport was free yesterday in Kraków, after the city crossed an air pollution threshold at which the authorities drop fees for buses and trams in an effort to discourage people from using cars.
As well as vehicle exhausts, a major contributor to Poland’s smog is the widespread burning of dirty fuels – including coal, but also sometimes household waste – to heat homes. Incinerating rubbish is illegal, and in 2019 Kraków became the first city in Poland to ban the burning of coal and wood too.
The city also launched an app that allows residents to not only be updated on air quality, but also to report any houses they suspect of burning illegal materials (with brown smoke from chimneys often a giveaway). A geotagged photo can be submitted via the app.
As a result of such efforts – which have also included the use of drones to check what is being emitted from chimneys – the city has noted an improvement in air quality, although there are still a significant number of smoggy days.
As well as vehicle exhausts, a major contributor to Poland’s smog is the widespread burning of dirty fuels – including coal, but also sometimes household waste – to heat homes. Incinerating rubbish is illegal, and in 2019 Kraków became the first city in Poland to ban the burning of coal and wood too.
The city also launched an app that allows residents to not only be updated on air quality, but also to report any houses they suspect of burning illegal materials (with brown smoke from chimneys often a giveaway). A geotagged photo can be submitted via the app.
As a result of such efforts – which have also included the use of drones to check what is being emitted from chimneys – the city has noted an improvement in air quality, although there are still a significant number of smoggy days.
In November, a report by the EEA identified Poland as having the European Union’s most polluted air. Its data showed that pollution in almost all areas of the country exceed European air standards, and that air pollutants caused nearly 50,000 premature deaths in Poland in 2018.
Earlier in the year, a ranking by the Air Quality Life Index (AQLI) also found Poland to have the most polluted air in Europe. In 2018, the World Health Organisation found that 36 of the EU’s most polluted cities were in Poland.
To tackle this longstanding problem, the government in 2018 launched a “Clean Air” programme – theoretically one of the largest of its kind in Europe – which aimed to reduce smog by providing households with funds to replace old heaters and to improve insulation.
However, the initiative has not had the hoped-for impact. Poor implementation and resultant low take-up of the subsidies led the European Commission to consider withdrawing funding for the programme.
Poles living in rural communities had particular difficulties in accessing funds. In September, the climate ministry moved to close a loophole that had previously left many of the poorest households excluded from subsidies.
The same month, the ministry unveiled an updated energy strategy for the next two decades, which outlines a faster withdrawal from coal than previously planned. Soon after, a landmark agreement concluded between the government and mining unions pledged to close all coal mines by 2049.
A government scheme to subsidise the installation of solar panels in private homes has also been a success, with funds designated for the programme already running low.
This winter, Polish Smog Alert, a grassroots social movement, is again running a “See What You Breathe” campaign, during which giant “breathing” lung installations have been touring Polish towns and cities to show residents how much pollution they are inhaling on a daily basis.
Kraków records third worst air pollution in the world as smog descends on Poland
Court says man would face ‘worsening of his respiratory pathology due to air pollution’ in country of origin
A Bangladeshi man with asthma has avoided deportation from France after his lawyer argued that he risked a severe deterioration in his condition, and possibly premature death, due to the dangerous levels of pollution in his homeland.
In a ruling believed to be the first of its kind in France, the appeals court in Bordeaux overturned an expulsion order against the 40-year-old man because he would face “a worsening of his respiratory pathology due to air pollution” in his country of origin.
“To my knowledge, this is the first time a French court has applied the environment as one of its criteria in such a case,” the unnamed man’s lawyer, Ludovic Rivière, said. “It decided my client’s life would be endangered by the air quality in Bangladesh.”
Yale and Columbia universities’ Environmental Performance Index ranks Bangladesh 179th in the world for air quality in 2020, while the concentration of fine particles in the air is six times the World Health Organization’s recommended maximum. Air pollution, both ambient and household, was an extremely high risk factor in the 572,600 deaths in Bangladesh that were caused by noncommunicable disease in 2018, according to WHO figures.
The court took into consideration the fact that the drugs the man is receiving in France are not available in Bangladesh, and that the Bangladeshi health system can only provide the night-time ventilation equipment he needs for his sleep apnoea in hospital.
It also heard evidence that the man’s father had died of an asthma attack at the age of 54, Rivière said, and that since arriving in France and beginning treatment, his respiratory capacity had increased from 58% in 2013 to 70% in 2018.
“For all these reasons, the court decided that sending my client back to his country would mean putting him at real risk of death,” the lawyer said. “Respiratory failure as a result of an asthma attack would be almost inevitable.”
The man arrived in France in 2011 after fleeing persecution in his home country. He settled in Toulouse, found work as a waiter, and in 2015 was given a temporary residence permit as a foreign national requiring medical treatment.
In 2017, however, doctors advising the French immigration authorities recommended that his condition “could be adequately treated in Bangladesh”, and two years later the local Haute-Garonne prefecture issued an expulsion order.
A lower court in Toulouse overturned the deportation order in June last year, purely on the grounds that the relevant drugs were not in fact available in the man’s home country. The Bordeaux court went even further in rejecting the prefecture’s appeal, saying that the environmental criterion must also be taken into account.
Dr Gary Fuller, an air pollution scientist at Imperial College London, said this was the first case he was aware of in which the environment had been cited by a court in an extradition hearing. “The court has effectively declared that the environment – air pollution – meant it was unsafe to send this man back,” he said.
Fuller said the case fed into a steadily growing broader agenda about the right to a healthy environment. “There’s a UN rapporteur on this issue, and people around the world – particularly in countries with less developed environmental and health laws – who are developing thinking about declaring a right to a healthy environment.”
Many countries set standards for air and water quality, for example, but “stop short of actually saying you have a right to be protected from environmental harm”, Fuller said. The recent case of Ella Kissi-Debrah, the nine-year-old London girl who died in February 2013, could be seen as part of the same process, he said.
A London coroner made legal history last month by ruling that air pollution was a cause of Ella’s death, with acute respiratory failure and severe asthma. Court cases were being brought in other countries in Europe, Fuller said, as part of a growing trend around the world to seek institutional accountability for unhealthy environments.
Man saved from deportation after pollution plea in French legal ‘first’ | France | The Guardian
Tens of thousands of Dutch people want to move due to air pollution, according to Longfonds, a non-profit organization specialized in improving lung health and helping people with lung disease. They state that 12 percent of lung patients want to move due to bad air quality.
“That is really worrisome”, says director of Longfonds, Michael Rutgers. “We’re talking here about tens of thousands of people that suffer so much due to air pollution that they want to move. This is unacceptable.”
55-year-old Desirée Brouwer who has asthma is one of those people. She lives in Capelle aan den Ijssel “directly under the smoke of Rotterdam”. In an interview with Longfonds she describes what her day looks like “When I walk out of the door in the morning, I notice that the air is really dirty.”
Due to the unclean air which causes her extreme difficulty breathing and fatigue, she has expressed the wish to relocate. “We tried to move to Sweden and now we would like to go to Gelderland but it is not financially possible. We’re literally stuck in our home.”
A quarter of the 1.2 million people with some form of lung disease in the Netherlands are negatively affected by poor air quality every week. The most common culprits named by lung patients are wood-burning stoves, road traffic, barbecues and fire pits.
“Exposure to particulate matter, nitrogen dioxide and ozone causes and worsens lung cancer, asthma, COPD and cardiovascular disease, among other things”, statd Longfonds. The organization claims that one in five Dutch children develop asthma due to high nitrogen dioxide levels, awarding the Netherlands an unwanted first place in Europe in that respect.
Longfonds is working together with a range of Dutch municipalities to improve air quality. In January 2020, state secretary, Stientje van Veldhoven together with 36 municipalities and nine provinces signed the Schone Lucht Akkoord. Currently, 56 municipalities and 11 provinces are part of the deal. “Only together can we work for cleaner air for our children”, says Rutgers.
The deal is a promise to consistently improve air quality with the goal to achieve a 50 percent health gain from 2016 to 2030. “This means that people live longer, healthier and with better quality”, said Minister Veldhoven when she placed her signature last year.
Bad air quality in the Netherlands makes thousands of people want to move | NL Times
It may be clear now in Salt Lake City, but could get worse
The air quality conditions along the Wasatch Front Wednesday are good, with values of fine-particulate pollution well below the federal threshold set by the U.S. Environmental Protection Agency.
So why does the forecast from the Utah Department of Environmental Quality over the next three days describe conditions as moderate?
The contradiction is part of the agency’s efforts to be proactive, sort of a shot over the bow to urge residents to reduce emissions from homes and vehicles before conditions get worse.
“We are very proactive in our forecasting,” said Bo Call, monitoring section manager for the department’s Division of Air Quality. “Historically we have seen that pollution levels can double from day to day.”
Regulators hosted an air quality briefing Wednesday as part of one way to get the word out about the Wasatch Front inversion season, which typically is at its worst in January and the first part of February.
The state’s periodic struggle with air pollution is a critical challenge the division and residents face after a stagnant weather system settles in and traps emissions in the valley like a lid.
“All the pollution we create can’t escape or go anywhere,” Call said.
The manager likened action now to filling a bathtub.
Instead of turning on the water full blast, any action people can take to slow the flow of pollutants and try to reduce it to a drip will keep that bathtub from overflowing.
For the last couple years, the inversion season in Utah has been mild and regulators are hoping to keep it that way.
While weather forecasts dwindle in accuracy the farther out they go, Call said it looks to be that the Wasatch Front might get lucky this year if a series of small storms keep the air stirred up and flush out pollutants.
Fine-particulate pollution is linked to a variety of harmful health effects, including increased incidences of stroke and respiratory ailments, and in some studies excess pollution is blamed for early onset of dementia and decreased mental acuity.
The Wasatch Front, which for many years was designated by the EPA as out of attainment for the federal standard of 35 micrograms of PM2.5 per cubic meter, recently was reclassified as in attainment after meeting the rolling three year average for the pollutant.
While the state’s metropolitan areas did have episodic spikes in fine-particulate pollution, Call said it hasn’t been enough to put the state back on EPA’s list of noncomplying regions.
Call said the most effective way to fight pollution is for motorists to seek the cleaner burning Tier 3 fuel sold at a variety of gas stations and, if they have a choice, get behind the wheel of the newest car at their disposal.
The website tier3gas.org/locations provides information to motorists on where to buy the fuel.
Coupled with a newer model car, using Tier 3 fuel can result in a reduction in emissions by as much as 80%, according Call. While Utah regulators have not yet been able to quantify how much of an impact use of the fuel has made so far, Call anticipates significant reductions over time.
“The benefits are potentially huge.”
Wasatch Front’s inversion season starting to set up – Deseret News
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