Study underlines impact of air pollution on people with asthma

Posted on December 18, 2023 by Respro® UK Ltd

New research by the University of Stirling has offered a greater understanding of how people with asthma in Scotland are affected by air pollution.

The study could offer an opportunity to improve the effectiveness of advice aimed at helping individuals to reduce their personal exposure to air pollution.

Asthma is the world’s most widespread chronic respiratory condition and more than 368,000 people receive treatment for asthma in Scotland, 7% of the population.

Meanwhile, air pollution causes seven million premature deaths every year, with an estimated 2500–3500 of those in Scotland.

Exposure to air pollution is a known asthma trigger and University of Stirling researchers interviewed 36 people in Scotland who spoke in detail about the impact on their lives.

One woman was advised by her GP that her health would only improve if she moved house while another said if air quality is poor, she does not go out.

Another participant from Glasgow said she consciously walks quickly through Charing Cross, which is next to the busy M8 motorway, while another woman said she closes every window in her house if traffic is heavy outside.

The new study comes after previous research by the University of Stirling’s Faculty of Natural Sciences found that better air quality monitoring is needed to assess the acute impacts of air pollution on people with asthma.

PhD researcher Amy McCarron who led both studies said: “While the physiological connections between air pollution and asthma have been extensively studied, this study sought to explore the nuanced perspectives, daily experiences and management strategies of individuals.

“This research offers a greater understanding of the challenges faced by at-risk groups, such as individuals with asthma, in managing their condition relating to air pollution exposure.”

Behavioural change

Previous research has found that current advice often proves ineffective in promoting behavioural change to minimise personal exposure, as it tends to be generic and overlooks individual circumstances and past experiences.

Ms McCarron said “By better understanding how air pollution impacts those most vulnerable in their day to day lives and how they practically manage this, we can work towards creating more effective communications and advice aimed at encouraging behaviour change, taking into account these experiences.

“In turn, this could encourage greater uptake of behaviour change, ultimately reducing personal exposure to air pollution.”

Researchers interviewed 36 non-smoking adults living in Scotland who been diagnosed with asthma by a healthcare professional. Interviews took place between September 2021 and September 2022.

The paper “I have to stay inside …”: Experiences of air pollution for people with asthma was published in the journal Health and Place.

It was funded by NERC IAPETUS2 and the Scottish Environment Protection Agency.

Study underlines impact of air pollution on people with asthma in Scotland | About | University of Stirling

https://www.stir.ac.uk/news/2023/12/study-underlines-impact-of-air-pollution-on-people-with-asthma-in-scotland/

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Three quarters of high streets have air pollution levels above WHO annual recommendations

Posted on December 11, 2023 by Respro® UK Ltd

Around three quarters (76%) of British high streets may exceed the World Health Organisation’s recommended annual level of air pollution.

That’s according to a new study from sustainable energy provider GRIDSERVE, which used an air quality measuring device to conduct air pollution spot checks on the main high streets of the 25 largest towns and cities in Britain over a two-week period.

Specifically, researchers measured the level of PM2.5 pollutants in the air, meaning particulate matter that is less than 2.5 micrometres in diameter. Particulate matter (PM) is everything in the air that’s not gas and consists of many chemical compounds and materials. Because of their small size, they can enter the bloodstream and cause illnesses such as asthma, heart disease and lung cancer.

The World Health Organisation’s recommendation, acknowledged by the Government’s Committee on the Medical Effects of Air Pollutants, is that annual levels of PM2.5 should not exceed 5 micrograms per cubic meter air (µg/m3).

Only six of the 25 high streets in the study recorded an average reading of 5 µg/m3 or lower. Stoke-on-Trent had the highest average level of PM2.5 in the air (11.7), followed by Newcastle (11.5) and Leicester (11.2). Newcastle also registered the highest single reading of 20.5.Conversely, Glasgow was shown to have the cleanest air with a PM2.5 reading of just 2.2 µg/m3, followed by Edinburgh (2.7). Interestingly, Scotland was the first country in Europe to adopt the WHO recommended limit for PM2.5 in 2016.

While no pattern was found regarding whether the high streets were pedestrianised or not, high streets were found to have on average 53% more PM2.5 in the air than the closest park (park average 4.7 µg/m3 compared to high street average 7.2).

Additional research among 2,000 adults reveals 40% of adults are concerned about the air quality on the street where they do most of their shopping, with emissions from cars being the main reason (60%). Nearly half of people think more plants (46%) or fewer cars (44%) would improve air quality, while a third think more electric vehicles would help (36%).

As a result, more than a third of people (36%) have concerns over the health of the local community due to air pollution, or the health of their family or themselves (26%/25%). Around a quarter of people are trying to find greener ways to travel (26%), while just over one in 10 avoid shopping where there are lots of cars (12%) or just forgo the high street in favour of online shopping (11%). A similar number are going to do more of their Christmas shopping virtually this year to avoid high street pollution (10%).

Sam Clarke, Chief Vehicle Officer at GRIDSERVE, said: “With millions set to hit the high street this festive period, we wanted to look at the state of the nation’s air quality in the locations people will be doing most of their Christmas shopping. It’s shocking to see that so many were above the World Health Organisation’s annual recommendations for air pollution, and that one in 10 shoppers are even planning on foregoing the high streets altogether due to air quality.”

“If we’re to reach the World Health Organisation’s annual target of 5 µg/m3 of PM2.5 in our air, collectively we need to change our behaviours. With vehicle emissions being a key contributor, anything we can do to travel more greenly, from walking more to cycling, and including electric vehicles, is a very valuable set forward to improve the air we breathe daily.”

Three quarters of high streets have air pollution levels above WHO annual recommendations – FleetPoint

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Air pollution from fossil fuels ‘kills 5 million people a year’

Posted on November 30, 2023 by Respro® UK Ltd

Of more than 8 million deaths worldwide from outdoor air pollution, 61% linked to fossil fuels, finds study

Air pollution from fossil fuel use is killing 5 million people worldwide every year, a death toll much higher than previously estimated, according to the largest study of its kind.

The stark figures, published on the eve of the Cop28 climate summit in Dubai, will increase pressure on world leaders to take action. Among the decisions they must make at the UN conference will be whether to agree, for the first time, to gradually “phase out” fossil fuels.

Research has shown that switching from fossil fuels to clean, renewable energy sources would save many lives from air pollution and help combat global heating. However, until now, mortality estimates have varied widely.

A new modelling study suggests air pollution, from the use of fossil fuels in industry, power generation, and transportation, accounts for 5.1 million avoidable deaths a year globally. These findings were published in The BMJ.

The contribution of fossil fuels equates to 61% of a total estimated 8.3 million deaths worldwide due to outdoor air pollution from all sources in 2019.

The new estimates of fossil fuel-related deaths are larger than most previously reported values, suggesting that phasing out fossil fuels might have a greater impact on attributable mortality than previously thought.

“Our results suggest that a global phase-out of fossil fuels will have large health benefits, much larger than indicated by most previous studies,” the global team of researchers wrote in the BMJ. “These data support increasing the share of clean, renewable energy, advocated by the UN through the sustainable development goals for 2030 and the ambition of climate neutrality for 2050.”

Ambient air pollution is the leading environmental health risk factor for illness and death, but few global studies have attributed deaths to specific air pollution sources and their results widely differ.

To address this, an international team of researchers from the UK, US, Germany, Spain and Cyprus, used a new model to estimate deaths due to air pollution related to fossil fuels, and to assess potential health benefits from policies that replace fossil fuels with clean, renewable energy sources.

They assessed excess deaths using data from the Global Burden of Disease 2019 study, as well as Nasa satellite-based fine particulate matter and population data, and atmospheric chemistry, aerosol, and relative risk modelling for 2019.

The results show that in 2019, 8.3 million deaths worldwide were attributable to fine particles (PM2.5) and ozone (O3) in ambient air, of which 61% (5.1 million) were linked to fossil fuels.

“Major reductions in air pollution emissions, notably through a phase-out of fossil fuels, could have large, positive health outcomes. Results show that the mortality burden attributable to air pollution from fossil fuel use is higher than most previous estimates,” the researchers wrote.

They said one reason for their model producing larger estimates than most previous studies was its being based solely on studies of outdoor air pollution. Uncertainty remained but given the Paris climate agreement’s goal of climate neutrality by 2050, “the replacement of fossil fuels by clean, renewable energy sources would have tremendous public health and climate co-benefits”.

Air pollution from fossil fuels ‘kills 5 million people a year’ | Air pollution | The Guardian

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Summer wildfire and winter air pollution and particulates linked to different risks of heart attack and severe chest pain, new study finds

Posted on November 13, 2023 by Respro® UK Ltd

Short-term increases in air pollution can cause problems for a lot of people, but especially to those with diagnosed or undiagnosed heart disease. But it’s not just a potential issue for pollution coming from cars and industrial processes.

New research from Intermountain Health in Salt Lake City shows that pollutants trapped in lower, colder layers of air in mountain-region communities present sometimes higher risk for this population, while wildfire smoke from often distant locales may also impact risk.

“We’re finding that air pollution is affecting different people, in different ways, in different seasons,” said Benjamin Horne, PhD, a professor of research and director of cardiovascular and genetic epidemiology at Intermountain Health. “This study reinforces that, if someone is having chest pains, they should go to the hospital, no matter what season it is.”

Findings from the Intermountain research were presented in a pair of studies at the American Heart Association’s Scientific Sessions 2023, which is being held in Philadelphia.

In the first study, researchers from Intermountain examined the association between fine particulate matter (PM2.5) and ozone air pollution, and hospitalizations for unstable angina (unstable chest pain that does not result in organ damage) and acute myocardial infarction (heart attack in which part of the muscle dies) during two distinct seasons in Utah when these types of pollution is at higher levels.

Researchers studied patients during summer wildfire season (June to October), and during the winter inversion season (November to March), when cold air is trapped by surrounding mountain ranges. Temperatures rise during an inversion along with elevation, which keeps pollutants like those from vehicles and industry in that cold, lower layer, but inversions don’t happen in the summer. Short-term PM2.5 elevations in summer come from wildfire smoke and usually that smoke is generated in places like California or Oregon that are 700 or more miles away.

For the study, researchers surveyed the health records of 21,414 people treated for heart attack or unstable chest pain between 1999 and 2022 at 11 hospitals throughout Utah’s Wasatch Front region.

Researchers found that increases in PM2.5 particulate matter were associated with increased risk of heart attack during the winter inversion season, but not summer wildfire season.

They also found that risk of unstable chest pain increased during both seasons, but that people waited up to two weeks to seek treatment for it during the winter. The research team found no association between hospitalization rates and ozone pollution levels.

In the second study, researchers looked at the association between PM2.5 and ozone, and hospitalization of patients with atrial fibrillation. To do so, they surveyed the electronic heath records of 347,157 people with a previous atrial fibrillation diagnosis who were hospitalized for any reason; 25,601 hospitalized specifically for atrial fibrillation, and 77,893 given a first-time atrial fibrillation diagnosis between 1999 and 2022 at the same 11 hospitals.

They found that short-term increases in PM2.5 led to higher all-cause hospitalization in patients already diagnosed with atrial fibrillation, but no increase in first-time atrial fibrillation diagnosis.

Researchers found hospitalization primarily for atrial fibrillation was also higher during the summer wildfire season (about 9% to 10% increase for each day of high PM2.5 levels, and only 3% in winter). The research team found no association between hospitalization rates and ozone pollution levels.

These findings suggest that “atrial fibrillation is being triggered by air pollution, but it’s something else that’s making them go to the hospital,” said Horne.

“It could be that when air pollutants are inhaled, it causes inflammation in your lungs or your circulation or heart, and changes the way your body’s functioning,” he added.

The differences in people coming into the hospital during the summer and winter could also be behavioral, Dr. Horne noted, that their perception of risk may be different in the summer, and also that Utah’s population tends to swell in the warmer months due to tourism.

“The bottom line is that if someone is thinking maybe they should go to the hospital or maybe they shouldn’t, they should fall on the side of caution and get themselves evaluated,” Dr. Horne said.

Summer wildfire and winter air pollution and | EurekAlert!

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25-year Swedish study reveals link between road traffic pollution and increased mortality risk

Posted on November 9, 2023 by Respro® UK Ltd

In a recent study published in Toxics, researchers analyzed the long-term mortality impacts related to exposure to particulate matter of diameter ≤2.5 mm (PM2.5), PM10, black carbon (BC), and nitrogen oxides [NOx, including nitrogen monoxide (NO) and nitrogen dioxide (NO2)] among Swedish individuals between 1991 and 2016.

Background

In several studies, exposure to air pollution has been associated with adverse health impacts in the long run.

Investigating the association between air pollution and mortality could inform health policy-making and strategy development aimed at curtailing air pollutant exposure and improving the longevity of individuals across the globe.

About the study

In the present study, researchers determined the links between PM2.5, PM10, NOx, and BC air pollutant long-term exposures and natural (due to causes other than trauma and injuries) mortality in the Malmö Diet and Cancer Cohort (MDC) cohort, diagnosed using International Classification of Diseases, tenth revision (ICD-10) codes.

The study included 30,438 MDC participants with birth years ranging from 1923-1950, living in the Malmö city of Sweden, and recruited between 1991 and 1996. 

At recruitment, 30,438 individuals underwent medical screening, including diet and lifestyle questionnaires, clinical examinations, and serum sampling. Mortality-related data were obtained from the National Mortality Cause Register of Sweden.

The modeled PM2.5, PM10, NOx, and BC concentrations at the participants’ Statistics Sweden-geocoded residential addresses were analyzed to evaluate exposure to air pollutants. The Environmental Department of Malmö modeled air pollutant concentrations in 18 kilometer-by-18-kilometer-areas.

Modeled pollutant concentrations denoted the cumulative traffic-exhaust emissions, non-exhaust emissions (particles from wear of brakes, tires, and roads, including resuspension), shipping, heating, households, industry, and transport emissions over long distances.

The modeled air pollutant concentrations were represented as grids with a 50-meter-by-50-meter spatial resolution. 

Cox proportional hazards regression modeling was performed to calculate the hazard ratio (HR) values related to each interquartile range (IQR) elevation in every air pollutant based on lag windows denoting exposure in the same calendar year (lag0), one to five years (lag1 to lag5), and six to ten years (lag6 to lag10). 

The models were adjusted for covariables such as age, sex, educational attainment, cohabitation, smoking status, alcohol intake, physical activity, waist/hip ratio, blood pressure, and antihypertensive medication use.

Results

Of 30,438 individuals, 17,551 (58%) survived through the study period, 12,663 (42%) died, and 264 (a percent) shifted out of the study location. The mean NOx concentrations during the study ranged from 25 to 30 µg/m3.

Adjusting for all covariables, the hazard ratios for PM2.5, PM10, black carbon, and nitrogen oxides obtained in single-pollutant modeling at lag1 to lag5 were 1.0, 1.1, 1.1, and 1.1 per increase in IQR, respectively. The hazard ratios were most robust for the elderly aged 60 to 70.

The hazard ratios, in the majority of cases, were reduced after including more covariables in the modeled estimations. Nitrogen oxides yielded the strongest associations, with significant positive hazard ratios in all models. The quadratic polynomial analysis findings indicated a linear association between NOx exposure and survival times.

The more profound impacts at lag1 to lag5 and lag6 to lag10 compared to lag0 for pollutant particles indicated a delay between pollutant exposure and their effects on mortality. Another probable explanation could be that the air pollutants were more hazardous in the earlier periods.

Unspecified-type PM does not denote a uniform estimate of particles concerning their physical properties and chemical composition. The particles may originate from various sources with spatiotemporal variations in a single city.

Given that the study analyzed the effects of exposure over ≤25 years, the physical properties, chemical composition, and toxicity of the pollutant particles to which the study participants were exposed may have varied considerably during the period. Seasonal variations may have occurred.

The weak associations between nitrogen oxides and particulate matter (PM2.5 and PM10) indicated that particulate matter may have originated from non-traffic sources.

PM toxic fractions, including dust on roads, could have been more robustly associated with nitrogen oxides and might, thus, not contribute considerably to the hazard ratios using unspecified PM as exposure variables.

Conclusions

Overall, the study findings showed that exposure to air pollutants linked with road traffic, such as nitrogen oxides, was strongly connected with death, emphasizing the relevance of traffic-related air pollution in early mortality.

Further research is needed to understand the health impacts of exhaust components like VOCs and PAHs and metals from engine wear, lubricating fluids, and fuels that bond to exhaust particles.

Non-exhaust emissions are becoming more significant, but epidemiological research on road traffic-related pollutants is scarce. Future research should incorporate ultrafine particles and compensate for different components using high-quality air pollution data.

Addressing fuel characteristics like aromatic and metal content is crucial as they influence the toxicity of PM emissions from diesel, gasoline, and ethanol-powered cars and non-road machines.

25-year Swedish study reveals link between road traffic pollution and increased mortality risk

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Air pollution raises risk of type 2 diabetes, says landmark Indian study

Posted on November 1, 2023 by Respro® UK Ltd

Seven-year study of 12,000 residents of Delhi and Chennai finds link between PM2.5 particles and increased blood sugar levels

Inhaling polluted air increases the risk of type 2 diabetes, the first study of its kind in India has found. Research conducted in Delhi and the southern city of Chennai found that inhaling air with high amounts of PM2.5 particles led to high blood sugar levels and increased type 2 diabetes incidence.

When inhaled, PM2.5 particles – which are 30 times thinner than a strand of hair – can enter the bloodstream and cause several respiratory and cardiovascular diseases.

The study is part of ongoing research into chronic diseases in India that began in 2010. It is the first to focus on the link between exposure to ambient PM2.5 and type 2 diabetes in India, one of the worst countries in the world for air pollution.

The average annual PM2.5 levels in Delhi was 82-100μg/m3 and in Chennai was 30-40μg/m3, according to the study, many times the WHO limits of 5μg/m3. India’s national air quality standards are 40μg/m3.

There is also a high burden of non-communicable diseases, including diabetes, hypertension and heart disease in India; 11.4% of the population – 101 million people – are living with diabetes, and about 136 million are pre-diabetic, according to a paper published in the Lancet in June. The average diabetes prevalence in the European Union was 6.2% in 2019, and 8.6% in the UK in 2016.

The Lancet study found India’s diabetes prevalence to be higher than previous estimations and showed a higher number of diabetics in urban than rural India.

In the BMJ study, the researchers followed a cohort of 12,000 men and women in Delhi and Chennai from 2010 to 2017 and measured their blood sugar levels periodically. Using satellite data and air pollution exposure models, they determined the air pollution in the locality of each participant in that timeframe.

They found that one month of exposure to PM2.5 led to elevated levels of blood sugar and prolonged exposure of one year or more led to increased risk of diabetes. They found for every 10μg/m3 increase in annual average PM2.5 level in the two cities, the risk for diabetes increased by 22%.

“Given the pathophysiology of Indians – low BMI with a high proportion of fat – we are more prone to diabetes than the western population,” said Siddhartha Mandal, lead investigator of the study and a researcher at Centre for Chronic Disease Control, Delhi.

The addition of air pollution – an environmental factor – with lifestyle changes in the past 20 to 30 years is fuelling the increasing burden of diabetes, he said.

“Until now, we had assumed that diet, obesity and physical exercise were some of the factors explaining why urban Indians had higher prevalence of diabetes than rural Indians,” said Dr V Mohan, chairman of the Madras Diabetes Research Foundation and one of the authors of the paper. “This study is an eye-opener because now we have found a new cause for diabetes that is pollution.”

Another study on the same cohort in Delhi, found average annual exposure to PM2.5 in Delhi (92μg/m3) led to increase in blood pressure levels and higher likelihood of developing hypertension.

Together, the studies show that the higher than safe levels of PM2.5 in the air in Indian cities cause diabetes and hypertension that could lead to atherosclerosis (the build up of fatty deposits in the arteries), heart attacks and heart failures, said Mandal.

PM2.5 contains sulfates, nitrates, heavy metals and black carbon that can damage the lining of blood vessels and increase blood pressure by stiffening the arteries. The particles can get deposited in the fat cells and cause inflammation and can also attack the heart muscle directly, said Dr Dorairaj Prabhakaran, cardiologist and executive director of the Centre for Chronic Disease Control and one of the authors of the paper.

Acting as an endocrine disruptor, PM2.5 hampers insulin production in the body as well as its effect.

In urban India there has been a rise of hypothyroidism, polycystic ovarian syndrome (PCOS) and gestational diabetes. This study shows that pollution may play a part in causing all of these as it disrupts the endocrine system that produces all hormones in the body, said Mohan.

The researchers are now working to understand the impact of pollution on cholesterol and vitamin D levels in the body, and its impact on the life cycle of individuals, including birth weight, pregnant women’s health, insulin resistance in adolescents, and the risk for Parkinson’s and Alzheimer’s disease, among others.

While its findings are alarming, the study gives scientists hope that bringing down pollution can decrease the burden of diabetes, as well as other non-communicable diseases, said Prabhakaran.

Some public policy initiatives have shown results. Since a public outcry about air pollution in 2016, the central and Delhi government have banned older diesel vehicles, limited construction, built highways that bypass the city, and banned the burning of crops. Reports suggest there was a 22% reduction in PM2.5 levels between 2016 and 2021.

“This is a modest but welcome reduction. Similar measures adapted to local conditions are urgently needed across the country,” said Prabhakaran.

Air pollution raises risk of type 2 diabetes, says landmark Indian study | Diabetes | The Guardian

https://www.theguardian.com/global-development/2023/nov/01/air-pollution-raises-risk-of-type-2-diabetes-says-landmark-indian-study-acc

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Personal air pollution monitoring needed for people with asthma

Posted on October 24, 2023 by Respro® UK Ltd

Better air quality monitoring techniques are needed to assess the acute impacts of pollution on people with asthma, new research by the University of Stirling has found.

Researchers say wearable monitors offer more accurate data which could lead to better management of the lung condition.

The study found, despite short-term exposure to microscopic particulate matter being linked with asthma symptoms, such as coughing, wheezing and breathlessness, participants did not increase the use of reliever inhalers.

Researchers in the Faculty of Natural Sciences say this suggests people with asthma may not be linking symptoms to invisible air pollution, compared to more visible triggers such as pet dander and cold weather.

The study saw 28 people with asthma in Scotland wear customised air quality monitors to track their personal exposure to air pollution for one week. Participants kept a detailed time-activity diary, noting their activities, locations, symptoms, and inhaler use. Exposure to air pollution was later assessed against self-reported symptoms in order to assess the acute impact.

Scotland’s air quality monitoring network consists of around 100 sites. Previous studies exploring the link between air pollution exposure and individual-level asthma symptoms have been based on data from fixed site air quality monitors, which can often be many miles from a participant’s home address.

University of Stirling researchers believe this is inadequate and instead propose personal exposure monitoring so that symptoms can be managed more effectively. They also suggested healthcare professionals could use the data in asthma management strategies and called for more research into how it could be used in clinical practice.

Pollution exposure

PhD researcher Amy McCarron, who led the study, said: “Current air quality monitoring methods are not designed to detect personal exposure to air pollution and are inadequate to detect acute individual-level health impacts. To uncover this requires high resolution data, both in terms of air quality data and health data. 

“This study demonstrates the important role of personal exposure monitoring and self-monitoring for asthma in tracking how air pollution affects asthma-related health.

“We also believe that the lack of association between exposure to air pollution and reliever inhaler use is important. We propose that this may be due to air pollution being largely imperceivable compared to other triggers and, consequently, people aren’t using their reliever inhalers to alleviate asthma symptoms triggered by air pollution exposure.”

Exposure to air pollution is a known asthma trigger. In 2013, nine-year-old London resident Ella Kissi-Debrah died following an asthma attack and in December 2020 she became the first person to have air pollution officially recognised as a cause of death on a death certificate.

She had been exposed to excessive levels of pollution and in the three years before her death, she had multiple seizures and was admitted to hospital 27 times.
Air pollution causes seven million premature deaths every year, with an estimated 2500–3500 of those in Scotland.  

Miss McCarron added: “The widely publicised case of Ella Kissi-Debrah has highlighted the critical impact of air pollution on health. In our research, we advocate for the incorporation of personal exposure monitoring in the management of asthma-related health. 

“By further refining this approach, assessing its capacity to inform effective behaviour change interventions, and testing the feasibility of its application, we hope to provide individuals with asthma a valuable tool to gain more control over their own exposures and health.”

The study titled Personal exposure to fine particulate matter (PM2.5) and self-reported asthma-related health was published in the journal Social Science and Medicine.

The research was funded by NERC IAPETUS2 and the Scottish Environment Protection Agency (SEPA).

Personal air pollution monitoring needed for people with asthma | About | University of Stirling

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Air pollution linked to increased breast cancer risk in women

Posted on October 18, 2023 by Respro® UK Ltd

Women living and working in places with higher levels of fine particle air pollution are more likely to get breast cancer than those living and working in less polluted areas. Results of the first study to take account of the effects of both residential and workplace exposure to air pollution on breast cancer risk are presented at the ESMO Congress 2023 in Madrid, Spain.

“Our data showed a statistically significant association between long term exposure to fine particle air pollution, at home and at work, and risk of breast cancer. This contrasts with previous research which looked only at fine particle exposure where women were living, and showed small or no effects on breast cancer risk.” – Professor Béatrice Fervers, Head of Prevention Cancer Environment Department, Léon Bérard Comprehensive Cancer Centre, France

In the study, home and workplace exposure to pollution in 2419 women with breast cancer was compared to that in 2984 women without breast cancer over the period 1990-2011. The results showed that breast cancer risk increased by 28% when exposure to fine particle (PM2.5) air pollution increased by 10 µg/m3 – approximately equivalent to the difference in PM2.5 particle concentration typically seen in rural versus urban areas of Europe. Smaller increases in breast cancer risk were also recorded in women exposed to high levels of larger particle air pollution (PM10 and nitrogen dioxide). Fervers and colleagues now plan to investigate the effects of pollution exposure during commuting to get a complete picture of effects on breast cancer risk.

Professor Charles Swanton, the Francis Crick Institute, London, UK, whose research suggesting how PM2.5 particles may trigger lung cancer in non-smokers was presented at ESMO Congress 2022 (2), stressed the importance of the new findings with breast cancer.

“These very small particles can penetrate deep into the lung and get into the bloodstream from where they are absorbed into breast and other tissues. There is already evidence that air pollutants can change the architecture of the breast. It will be important to test if pollutants allow cells in breast tissue with pre-existing mutations to expand and drive tumor promotion possibly through inflammatory processes, similar to our observations in non-smokers with lung cancer,” he said. “It is very concerning that small pollutant particles in the air and indeed microplastic particles of similar size are getting into the environment when we don’t yet understand their potential to promote cancer. There is an urgent need to set up laboratory studies to investigate the effects of these small air pollutant particles on the latency, grade, aggression and progression of breast tumors,” he added.

“There is now strong epidemiological and biological evidence for the link between PM2.5 particle exposure and cancer, and there are good clinical and economic reasons for reducing pollution in order to prevent cancers,” said Professor Jean-Yves Blay, ESMO Director of Public Policy.

Following on a proposal from the European Commission in October 2022 to reduce the limit for PM2.5 particles in the air from the current 25 µg/m3 to 10 µg/m3 by 2030, ESMO urged a reduction in the PM2.5 limit still further to 5 µg/m3, in line with the World Health Organisation’s air quality guidance (5). “Reducing PM2.5 particles in the air to the WHO recommended level is critical because of their association with a variety of tumor types, including breast cancer,” Blay added. “We have a responsibility to push for this change, not only for people in Europe but worldwide where there are big variations in the pollution landscape.” The lower limit was indeed adopted by the European Parliament’s Environment, Public Health and Food Safety Committee in June 2023.

More recently, in September 2023, the European Parliament adopted in plenary session its report on the ongoing revision of the EU Ambient Air Quality Directives, which reflects ESMO’s recommendations to set the annual limit value for Fine Particulate Matter (PM2.5) at 5 µg/m³. This adoption opens interinstitutional negotiations between the co-legislators – European Parliament, European Commission and EU Council – to agree on the final text of the directive.

“By supporting our requests with solid scientific evidence, we are offering a new dimension to health public policy. The work is not over, and change will not happen overnight, but we are moving in the right direction,” the ESMO Public Policy Director concluded.

Source:European Society for Medical Oncology

Air pollution linked to increased breast cancer risk in women

https://www.news-medical.net/news/20231017/Air-pollution-linked-to-increased-breast-cancer-risk-in-women.aspx

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