Air pollution from fires hits world’s poorest hardest: study

Posted on September 28, 2023 by Respro® UK Ltd

People in poorer countries are disproportionately suffering from air pollution spewed from the increasing scourge of fires in forests and fields around the world, according to new research published Wednesday.

Landscape fires include blazes in forests, shrub, grass, pastures and agricultural lands, whether planned or uncontrolled such as the wildfires that have ravaged countries including Algeria, Canada and Greece this year.

They generate smoke that can travel up to thousands of kilometers, creating public health risks, including increases in mortality and worsening of heart and lung-related illnesses.

Ambient air pollution caused some 4.5 million deaths in 2019, according to a study published in Lancet Planetary Health last year.

In a new study published in the journal Nature, researchers used data, machine learning and modeling to estimate global daily quantities of fine particles called PM2.5 and surface ozone concentrations emitted by landscape fires between 2000 and 2019.

The annual air pollution from landscape fires in low-income countries was around four times higher than in rich nations, they found, with central Africa, Southeast Asia, South America and Siberia experiencing the highest levels.

Increasing temperatures linked to human-caused climate change are increasing the risk of fire.

Shandy Li, an associate professor at Monash University in Melbourne, Australia who co-authored the study, said warming meant that the pollution “phenomena might be worse in the future”.

“Available evidence shows that fire smoke could increase health risks including mortality and morbidity, which means people should pay attention to reduce exposure to fire air pollution,” she told AFP.

Some 2.18 billion people a year on average were exposed to at least one day of “substantial” air pollution coming from landscape fire sources between 2010 and 2019, an increase of almost seven percent on the previous decade.

That includes daily average PM2.5 levels above 2021 WHO guidelines of 15 micrograms per cubic meter of air, where pollution from fire sources accounts for at least half of the total.

Africa had the highest average number of days of exposure to “substantial” fire-derived air pollution per person every year at 32.5, followed by South America at 23.1.

In contrast, Europeans were exposed to around one day of substantial pollution per year on average during the decade.

The five countries with the highest average annual number of days of exposure to substantial fire-sourced pollution per person were all African: Angola, the Democratic Republic of Congo, Zambia, Congo-Brazzaville and Gabon.

‘Climate injustice’

In a separate study also published in Nature on Wednesday, scientists said wildfire smoke in the United States had eroded air quality progress achieved over decades.

Cities in rich countries also battle with poor air quality that breaches WHO guidelines, mostly due to pollution linked to transport, heating and industry.

Earlier this month, the UN World Meteorological Organization said climate change was driving more intense and frequent heat waves and a subsequent “witch’s brew” of pollution.

Reducing extreme weather events by mitigating climate change would help limit the risk, Li said.

The researchers said their findings provided further evidence of “climate injustice” as those least responsible for human-induced climate change suffered the most from wildfires made more intense and frequent by it.

Changes to land management techniques, notably the burning of agricultural waste or blazes started deliberately to convert wildland for agricultural or commercial purposes, could also help reduce the extent of fires, they added.

Air pollution from fires hits world’s poorest hardest: study

https://phys.org/news/2023-09-air-pollution-world-poorest-hardest.html

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Sydney faces months of smoke as authorities race to conduct hazard reduction burns

Posted on September 13, 2023 by Respro® UK Ltd

NSW RFS says it is ‘significantly behind’ schedule and will ‘continue to do hazard reductions as long as it’s safe’

The New South Wales Rural Fire Service commissioner says that as long as it’s safe, firefighters will continue conducting hazard reduction burns over the next few months, which could result in smoke being trapped in the Sydney basin.

Sydney awoke to a blanket of smoke over parts of the city on Monday from hazard reduction burns at the weekend.

“Smoke goes in there overnight and the inversion layer comes in and just traps that in the morning until a bit of a breeze picks up,” the commissioner, Rob Rogers, said on Monday.

“So that’s what happened this morning and that’s what we’ll probably see again tomorrow. For some people, it is just an inconvenience, but to others, it does have health impacts on them.”

The RFS measures its hazard reduction burns by the financial year. Last year, up to 30 June, only 24% of the program was completed, and Rogers said “it was similar the year before” due to the extreme rain.

“We’re significantly behind and hence, we’ll continue to do hazard reductions as long as it’s safe,” he said.

When asked if there were areas of particular concern, Rogers said “it’s everywhere”. “Anywhere where there are properties you’ll find that we [are] trying to get burns done,” he said.

Communities are being urged to prepare for what is likely to be the most significant bushfire season since the 2019-20 black summer fires.

Rogers said a lot of the areas being targeted for hazard reduction burns weren’t affected during the 2019-2o bushfires.

“If you look at even just Sydney, there’s the northern beaches area [where] there’s about a dozen that they want to try and get done,” he said.

“There are burns in the Sutherland area, in the Hornsby area, and then right up and down the coast and in the ranges again, where they didn’t burn in 2019-20.”

Air quality degraded to “very poor” conditions in Sydney’s east on Monday morning, with residents urged to remain indoors and keep their windows and doors closed until conditions improved.

The smoke could linger for days, emergency services warned.

According to the NSW RFS, smoke settled over Sydney on Sunday afternoon and Monday morning.

“While the smoke will begin to clear later this morning further burning is scheduled for today and as a result smoke is expected to remain over parts of Sydney and the Central Coast until midweek,” a spokesperson said.

The RFS issued a smoke warning just after 5.30am, urging asthma sufferers and those with a lung condition to keep their puffers handy and reduce outdoor activities if smoke levels were high.

The smoke was caused by hazard reduction burns in Sutherland, Ku-ring-gai, Hawkesbury, Hornsby and the Central Coast.

They were originally scheduled for Friday but postponed until Sunday due to wet weather.

Heavy smoke settled in areas close to the burns and in the eastern suburbs, the RFS said.

According to the NSW Department of Planning and Environment, air quality in Sydney’s east degraded to “very poor”. Randwick recorded 102.8μg/m3 PM2.5 fine particles between 6 and 7am.

The NSW premier, Chris Minns, said the hazard reduction burns were “necessary”.

“My understanding is that it will improve tomorrow,” Minns said.

“Obviously, it’s far better than a bushfire raging down your street. This is necessary work that the RFS and Fire and Rescue NSW are undertaking.”

Sydney faces months of smoke as authorities race to conduct hazard reduction burns | Sydney | The Guardian

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Breast cancer incidence linked to high particulate air pollution

Posted on September 12, 2023 by Respro® UK Ltd

Recent findings by scientists at the National Institutes of Health (NIH) have raised concerns about the potential impacts of particulate air pollution on breast cancer rates. 

This research, published in the Journal of the National Cancer Institute, is one of the most extensive examinations to date on how outdoor air pollution, specifically fine particulate matter, might influence breast cancer incidence.

The study was led by a team of researchers from the National Institute of Environmental Health Sciences (NIEHS) and the National Cancer Institute (NCI), both prominent divisions of NIH. 

Focus of the study

The focus of the research was on particulate matter of 2.5 microns in diameter or smaller (PM2.5). 

These minute particles are known to originate from several sources, including vehicle emissions, combustion of materials like oil and coal, industrial releases, and even the burning of wood and vegetation. 

Given their size, these particles can easily penetrate the deeper parts of our respiratory system when inhaled.

Significant findings

“We observed an 8% increase in breast cancer incidence for living in areas with higher PM2.5 exposure. Although this is a relatively modest increase, these findings are significant given that air pollution is a ubiquitous exposure that impacts almost everyone,” said Alexandra White, Ph.D., lead author and head of the Environment and Cancer Epidemiology Group at NIEHS. 

“These findings add to a growing body of literature suggesting that air pollution is related to breast cancer.” 

How the research was conducted 

To obtain a comprehensive dataset, the team used information from the NIH-AARP Diet and Health Study. This exhaustive research had enrolled over half a million men and women from six states and two metropolitan areas between 1995 and 1996. 

The primary demographic in focus was women, with an average age of 62, predominantly non-Hispanic white. Over a span of two decades, a total of 15,870 breast cancer cases emerged within this cohort.

Historic pollution levels 

A unique aspect of this study was the researchers’ method to estimate PM2.5 exposure. Instead of just considering the pollution levels at the time of enrollment, they also factored in historical pollution levels from the past 10-15 years. 

“The ability to consider historic air pollution levels is an important strength of this research,” said Rena Jones, Ph.D., senior author and principal investigator of the study at NCI. “It can take many years for breast cancer to develop and, in the past, air pollution levels tended to be higher, which may make previous exposure levels particularly relevant for cancer development.”

What the researchers learned

Furthermore, the experts delved deeper into the connection between air pollution and specific types of breast cancer. They found a higher incidence of estrogen receptor-positive (ER+) breast cancer linked with PM2.5 exposure. 

However, no such correlation was observed with estrogen receptor-negative (ER-) tumors. This intriguing discovery points towards the possibility that PM2.5 might be influencing breast cancer through endocrine disruption pathways. Notably, ER+ tumors are the predominant type diagnosed in U.S. women.

Study limitations

The researchers acknowledged that the study did not account for regional variances in the relationship between breast cancer and air pollution. 

They recommend that future research should factor in regional pollution differences, especially the various PM2.5 types women encounter, to fully understand their potential risk.

For those curious about the air quality in their region, the Environmental Protection Agency has a handy tool: the Air Now website. This platform allows residents to quickly gauge air quality by simply entering their zip code, providing real-time data, including PM2.5 levels.

Breast cancer incidence linked to high particulate air pollution • Earth.com

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Mums exposed to air pollution give birth to smaller babies, but living in a greener area may mitigate the risks

Posted on September 8, 2023 by Respro® UK Ltd

Women exposed to air pollution give birth to smaller babies, according to research that will be presented at the European Respiratory Society International Congress in Milan, Italy [1]. The research also shows that women living in greener areas give birth to bigger babies and this may help counteract the effects of pollution. 

There is a strong relationship between birthweight and lung health, with low birthweight children facing a higher risk of asthma and higher rates of chronic obstructive pulmonary diseases (COPD) as they grow older. 

Researchers say there is a need to reduce air pollution and make towns and cities greener to help protect babies and their developing lungs from potential harm. 

The study was based on data from the Respiratory Health in Northern Europe (RHINE) study and presented by Mr Robin Mzati Sinsamala, a researcher in the Department of Global Public Health and Primary Care at the University of Bergen (UiB), Norway. It included 4286 children and their mothers living in five European countries (Denmark, Norway, Sweden, Iceland and Estonia). 

The researchers gauged the greenness of the areas where the women were living during pregnancy by measuring the density of vegetation on satellite images. This vegetation includes forests and farmland as well as parks in urban areas. The researchers also used data on five pollutants: nitrogen dioxide (NO2), ozone, black carbon (BC), and two types of particulate matter (PM2.5 and PM10). The average levels of air pollution were within European Union standards. Researchers compared this information with the babies’ birthweights, taking account of factors that are known to affect birthweight, such as mother’s age, whether the mothers smoked or had any other health conditions. 

They found that higher levels air pollution were linked with lower birthweights, with PM2.5, PM10, NO2 and BC associated with average reductions in birth weight of 56g, 46g, 48g and 48g, respectively. When researchers took greenness into account, the effect of air pollution on birthweight was reduced. Women who lived in greener areas had babies with slightly higher birth weight (27g heavier on average) than mothers living in less green areas. 

Mr Sinsamala said: “The time when babies are growing in the womb is critical for lung development. We know that babies with lower birthweight are susceptible to chest infections, and this can lead on to problems like asthma and COPD later on. 

“Our results suggest that pregnant women exposed to air pollution, even at relatively low levels, give birth to smaller babies. They also suggest that living in a greener area could help counteract this effect. It could be that green areas tend to have lower traffic or that plants help to clear the air of pollution, or green areas may mean it’s easier for pregnant women to be physically active.” 

The study is part of a wider programme of research called Life-GAP (Lifespan and inter-generational respiratory effects of exposures to greenness and air pollution) that is investigating the effects of air pollution and greenness on lung health in generations of Europeans over the long term. 

European Respiratory Society Advocacy Council Chair, Professor Arzu Yorgancioğlu, who was not involved in the research, says: “This study adds to a growing body of evidence on the damage that air pollution is having on our health, especially in vulnerable babies and young children. Women who are pregnant will want to protect their babies from potential harm. However, as individuals, it can be difficult to reduce our exposure to air pollution or make our neighbourhoods greener. 

“As doctors and researchers who care about children’s health, we need to put pressure on governments and policy-makers to lower the levels of pollution in the air we breathe. This study also suggests that we could help to mitigate some of the effects of pollution by making our neighbourhoods greener.”

Mums exposed to air pollution give birth to s | EurekAlert!

https://www.eurekalert.org/news-releases/1000633

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Air pollution greatest global threat to human health, says benchmark study

Posted on August 29, 2023 by Respro® UK Ltd

Air pollution is more dangerous to the health of the average person on planet Earth than smoking or alcohol, with the threat worsening in its global epicenter South Asia even as China fast improves, a study showed Tuesday.

Yet the level of funding set aside to confront the challenge is a fraction of the amount earmarked for fighting infectious diseases, said the research from the Energy Policy Institute at the University of Chicago (EPIC).

Its annual Air Quality Life Index (AQLI) report showed that fine particulate air pollution — which comes from vehicle and industrial emissions, wildfires and more — remains the “greatest external threat to public health.”

If the world were to permanently reduce these pollutants to meet the World Health Organization’s (WHO) guideline limit, the average person would add 2.3 years onto his or her life expectancy, according to the data, which has a 2021 cutoff.

Fine particulate matter is linked to lung disease, heart disease, strokes and cancer.

Tobacco use, by comparison, reduces global life expectancy by 2.2 years while child and maternal malnutrition is responsible for a reduction of 1.6 years.

Asia and Africa bear the greatest burden yet have some of the weakest infrastructure to deliver citizens timely, accurate data. They also receive tiny slices of an already small global philanthropic pie.

For example, the entire continent of Africa receives less than $300,000 to tackle air pollution.

“There is a profound disconnect with where air pollution is the worst and where we, collectively and globally, are deploying resources to fix the problem,” Christa Hasenkopf, director of air quality programs at EPIC, told AFP.

While there is an international financing partnership called the Global Fund that disburses $4 billion annually on HIV/AIDS, malaria and tuberculosis, there is no equivalent for air pollution.

“Yet, air pollution shaves off more years from the average person’s life in the DRC (Democratic Republic of Congo) and Cameroon than HIV/AIDS, malaria, and other health threats,” the report said.

– Bangladesh tops ranking –

Globally, South Asia is the worst impacted region. Bangladesh, India, Nepal and Pakistan are in order the top four most polluted countries in terms of annualized, population-weighted averages of fine particulate matter, which are detected by satellites and defined as particles with a diameter of 2.5 microns or less (PM2.5).

Air pollution concentrations are then fed into the AQLI metric which calculates their impact on life expectancy, based on peer-reviewed methods.

Residents of Bangladesh, where average PM2.5 levels were 74 micrograms per cubic meter, would gain 6.8 years of life if this were brought to WHO guidelines of 5 micrograms per cubic meter.

India’s capital Delhi meanwhile is the “most polluted megacity in the world” with annual average particulate pollution of 126.5 micrograms per cubic meter.

China, on the other hand, “has had remarkable progress in terms of its war on air pollution” which began in 2014, said Hasenkopf.

Its air pollution dropped 42.3 percent between 2013 and 2021. If the improvements are sustained, the average Chinese citizen will be able to live 2.2 years longer.

In the United States, legislative actions like the Clean Air Act helped reduce pollution by 64.9 percent since 1970, helping Americans gain 1.4 years of life expectancy.

But the growing threat of wildfires — linked to hotter temperatures and drier conditions due to climate change —  are causing pollution spikes from the western United States to Latin America and Southeast Asia.

For example, California’s historic wildfire season of 2021 saw Plumas County receive an average concentration of fine particulate matter more than five times over the WHO guideline.

North America’s story of air pollution improvements in recent decades is similar to Europe, but there remain stark differences between western and eastern Europe, with Bosnia the continent’s most polluted country.

Air pollution greatest global threat to human health, says benchmark study

https://uk.news.yahoo.com/air-pollution-greatest-global-threat-040436366.html

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As wildfires multiply, a new era of air pollution

Posted on August 23, 2023 by Respro® UK Ltd

From Quebec to British Columbia to Hawaii, North America is facing an extraordinary wildfire season — and regions both near and far have found themselves increasingly blighted by smoke exposure.

Here’s what you should know about air pollution from these blazes.

What we know

One of the defining aspects of smoke from wildfires is “particulate matter” — toxins that, in their numbers, can make smoke visible.

Particulate matter of 2.5 micron diameter, PM2.5, is “particularly dangerous for human health and emitted in really large quantities,” Rebecca Hornbrook, an atmospheric chemist at the National Center for Atmospheric Research, who flies in planes through smoke for her research, told AFP.

“Typically if you are downwind of a wildfire, that’s the thing that’s causing the majority of the darkening of the sky and the lack of visibility,” she said, such as the shrouded skies seen in New York as a result of fires hundreds of miles away in Quebec earlier this year.

PM2.5 penetrates deep inside the lungs and potentially even the bloodstream.

The average American had already been exposed to 450 micrograms of smoke per cubic meter by early July, worse that the entirety of the years from 2006-2022, economist Marshall Burke at Stanford posted on X recently, citing calculations made by the university’s Environmental Change and Human Outcomes Lab.

Also of concern are invisible substances known as volatile organic compounds such as butane and benzene. These cause eye and throat irritation, while some are known carcinogens.

When VOCs mix with nitrogen oxides — which are produced by wildfires but also are abundant in urban areas from burning fossil fuels — they help form ozone which can exacerbate coughing, asthma, sore throat and difficulty breathing.

– What we don’t know –

Automobile ownership exploded after World War II, and in the decades since scientists have gained insights on how it impacts humans — from the onset of asthma in childhood to increased risk of heart attacks and even dementia later on in life.

That breadth of knowledge is lacking for wildfire smoke, explained Christopher Carlsten, director of the Air Pollution Exposure Laboratory at the University of British Columbia.

Based on the two dozen studies published “there seems to be a greater proportion of respiratory versus cardiovascular effects of smoke as compared to traffic pollution,” he told AFP.

The reason might be that nitric oxides are more prominent in traffic pollution.

Carlsten’s lab has begun conducting human experiments with wood smoke to gain more clarity.

Medical interventions exist, said Carlsten, who is also a physician, including inhaled steroids, non-steroid inflammatories, and air filters — but research is urgently needed to know how best to use them.

Will it spur action?

The warming planet also impacts our psychological wellbeing in myriad ways, Joshua Wertzel, chair of the American Psychiatric Association’s committee on climate change in mental health, told AFP.

One response is distress, “anger, grief, anxiety, in the face of the natural disasters they expect to come,” with these rates far higher in younger people than older.

Another is mental “acclimatization,” a byproduct of evolution that helps us cope with new stressors, but if we’re not careful can inure us to dangers, much like the proverbial frog in boiling water.

For Hornbrook, who is based in Colorado, what eastern North America experienced in 2023 is what the western side of the continent has already been dealing with for many years — and the global picture is only set to worsen given humanity’s appetite for burning fossil fuels.

While historic pollution regulations helped rein in emissions from cars and industry, climate action will be needed to tackle the wildfire scourge, she said.

“It gets frustrating knowing that we’ve been ringing the warning bell for years and years, and we’re now seeing what we’ve been warning about,” she said, but added there was still hope. “Maybe now people are actually starting to notice and we’ll see some change.”

As wildfires multiply, a new era of air pollution

https://www.france24.com/en/live-news/20230822-as-wildfires-multiply-a-new-era-of-air-pollution

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Wildfires and farming activities may be top sources of air pollution linked to increased risk, cases of dementia

Posted on August 15, 2023 by Respro® UK Ltd

Wildfires and farming may pose threats to cognitive health, according to new research from the University of Michigan.

Increasingly, evidence shows exposure to air pollution makes the brain susceptible to dementia. And now the findings of Boya Zhang and Sara Adar, environmental epidemiology researchers in U-M’s School of Public Health, point to a strong likelihood that agriculture and wildfires, with their release of a range of harmful emissions at high concentrations, need to be more closely studied and monitored for their risks to public health, specifically dementia.

“We saw in our research that all airborne particles increased the risk of dementia but those generated by agricultural settings and wildfires seemed to be especially toxic for the brain,” said Adar, associate chair of the Department of Epidemiology in the School of Public Health. She currently leads several large cohort studies on the impacts of exposures on cognitive aging and dementia.

“Our findings indicate that lowering levels of particulate matter air pollution, even in a relatively clean country like the United States, may reduce the number of people developing dementia in late life,” Adar said.

Adar and Zhang’s paper, “Comparison of Particulate Air Pollution From Different Emission Sources and Incident Dementia in the U.S.,” appears in the JAMA Internal Medicine.

Zhang, a research fellow who focuses on the effects of air pollution on cardiopulmonary disease and cognitive aging, said, “This work suggests that particulate matter air pollution from agriculture and wildfires might be more neurotoxic compared with other sources. However, more research is needed to confirm these effects, especially for these two sources which have received less attention in prior research.”

“Given that the development of dementia could take a long time, this study mainly aimed to provide evidence for policymakers to reduce exposures to these sources of emissions,” Zhang said.

The findings come as unusually poor air quality is regularly triggering alerts in the U.S. The alerts are aimed at protecting the public from the unseen, swirling mix of microscopic toxins in air pollution, specifically fine particulate matter or PM2.5. It is one of the most concerning elements of air pollution.

At less than 2.5 microns in size, PM2.5 is less than the width of a human hair. Because it’s so small, it can enter the brain through the nose directly or cross the blood-brain barrier in other ways. PM2.5 is also known to affect the lungs, heart, and in emerging research, the brain and cognitive function.

“These findings are quite timely given the increasing frequency of wildfire smoke in our
communities,” Adar said. “Our data suggest that in addition to some of the more obvious health impacts of wildfire smoke like irritation to our throats and eyes along with breathing difficulties, high smoke days might also be taking a toll on our brains.”

The record number of air quality alerts in the U.S. this year are due in large part to smoke from wildfires burning in Canada since May. The effect of wildfire is not new in the U.S., especially given the fires in the western part of the country.

Adar, a long-time environmental epidemiologist, said that wildfire smoke is becoming a more widespread stressor with many cities experiencing 30-plus days each year impacted by smoke. Given the extremely high levels of exposure to the public, wildfires are thought to contribute up to 25% of fine particulate matter exposures over a year across the U.S. and as much as 50% in some western regions of the country, Adar said.

“While individual wildfires may be short-lived, these events are becoming more frequent in our communities due to warmer temperatures, drier conditions, and longer fire seasons. As we’ve seen, wildfire smoke can also travel very far distances,” Adar said.

Their findings are based on research into the development of dementia among nearly 30,000 adults from across the U.S. over an 18-year period. The data comes from the Health and Retirement Study, a nationally-representative collection of cohorts of older adults who have been followed since 1992. Pollution estimates in Adar and Zhang’s study were based on home addresses of participants. Participants have been interviewed biennially about their cognition, overall health, and health behaviors until death or loss of contact for the survey.

They observed that higher levels of particulate matter air pollution, especially from agriculture and wildfires, were associated with greater risks of dementia. The findings could not be explained by other factors such as individual, neighborhood, socioeconomic status, occupation, or hometown or region of the country.

“With the knowledge of which sources are more toxic than others, it may be possible to design interventions for specific sources as a more effective way to decrease the burden of dementia,” Zhang said.

Dementia is currently the seventh leading cause of death and one of the major causes of disability and dependency for older people, according to the World Health Organization.

The research specifically sought to test the hypothesis that a variation in emission sources could explain which are most toxic, but measuring the emissions with their distinct physical and chemical characteristics is challenging.

Past studies analyzing exposures to source specific fine particulate matter meant researchers mainly investigated relationships with the total mass of fine particulate matter in the air.

“In our study, we used a sophisticated prediction model that includes information about the chemical transformations and dispersion of pollution from different sources to estimate the levels of source-specific particulate matter air pollution at participants’ residential addresses,” Zhang said. “This approach is beneficial because it not only accounts for pollution directly emitted by a source but also pollution generated through reactions with other chemicals in the air.”

Since the average level of exposure to PM2.5 for the people studied was less than the National Ambient Air Quality Standard, this is not just an issue of extreme pollution events, the researchers say, though it’s clear that the air quality from wildfire events is worsening. This research suggests that it’s not just sending people with respiratory ailments to the hospitals but there may also be longer lasting effects to the body. With the changing climate, it’s likely that these threats to health will increase.

via https://medicalxpress.com/news/2023-08-wildfires-farming-sources-air-pollution.html

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Air pollution linked to higher mental health service use by people with dementia

Posted on August 8, 2023 by Respro® UK Ltd

Cutting levels of nitrogen dioxide and particulate matter might reduce demand in urban areas …and help free up resources in overstretched psychiatric services, suggest researchers

Exposure to relatively high levels of air pollution is linked to increased use of community mental health services by people with dementia, finds a large long term study focusing on a large area of London with heavy traffic and published in the open access journal BMJ Mental Health.

Cutting levels of nitrogen dioxide and particulate matter might reduce demand in urban areas and help free up resources in overstretched psychiatric services, suggest the researchers.

An estimated 850,000 people are living with dementia in the UK, with the number projected to increase to 2 million by 2050, in tandem with the ageing of the population. Dementia is already the leading cause of death in the UK, note the researchers.

A good deal of research has focused on the effects of air pollution in older age, including its potential role in the speeding up of cognitive decline and dementia, they add.

But while air pollution has been linked to increased health service use by people with dementia, these studies have largely focused on hospital services, rather than community services, which is where most people with the condition are managed in the UK. 

To plug this knowledge gap, the researchers looked back at community mental health service use over 9 years by 5024 older people (65 and above) living in 4 boroughs of South London following their initial dementia diagnosis between 2008 and 2012. 

Over half (54%, 2718) had been diagnosed with Alzheimer’s disease, which is caused by plaque deposits and tangles in the brain; a fifth (20%,1022) had vascular dementia, which is caused by damage to blood vessels in the brain; and over a quarter (26.5%,1330) had other or unspecified dementia.

Quarterly published estimates of two major air pollutants—nitrogen dioxide (NO2) and particulate matter (PM2.5 and PM10)—covering the area around participants’ homes were linked with their anonymised mental health records for the period 2008-12.

Exposure to all air pollutants was highest in people with vascular dementia and lowest in those with Alzheimer’s disease.

The monitoring period was divided into three time points: up to 12 months; up to 5 years; and up to 9 years after diagnosis.

In the first year of monitoring, higher exposure to all air pollutants was associated with an increase in the use of community mental health services by people with dementia, after accounting for potentially influential factors. 

The higher the level of exposure, the greater the use of these services, particularly for exposure to NO2 . This was especially noticeable among those with vascular dementia.

Compared with those living in areas with the lowest levels of exposure to NO2, those living in areas with the highest level of exposure were 27% more likely to use these services.

And those exposed to the highest levels of very small particulate matter (PM2.5) were 33% more likely to use mental health services.

The associations between PM2.5 and more frequent mental health service use were still evident 5 and 9 years later for people with Alzheimer’s disease and vascular dementia, but were most noticeable for those with vascular dementia. 

During the study period the Mini Mental State Exam (MMSE) was used to measure brain function and the Health of the Nation Outcomes Scale (HoNOS65+) was used to measure physical health and social activity.

At all time points, exposure to NO2 was associated with higher HoNOS65+ scores, indicating poorer health and social functioning, including the capacity for routine activities of daily living, but not poorer cognition. Similar findings emerged for particulate matter.

Air pollution wasn’t associated with brain function as measured by MMSE results over the study period. But exposure to NO2  was associated with higher HoNOS65+ scores at all time points, indicating poorer health and social functioning, including the capacity for routine activities of daily living. Similar findings emerged for PM2.5. 

This is an observational study, and therefore no firm conclusions can be drawn about cause and effect. The researchers also acknowledge that they weren’t able to assess the impact of early life exposure to pollutants or fluctuations in exposure over the 9 years, or changes in exposure due to residential mobility or time away from home.

Nevertheless, based on their findings, they estimate that if the annual PM2.5 exposure in London (11.6 µg/m3 in 2019) fell to 5 µg/m3, as recommended by the World Health Organization, the number of community mental health service contacts by people with dementia could be reduced by 13% a year. 

Similarly, reducing annual levels of NO2 (39 µg/m3 in 2019) to the recommended limit of 10 µg/m3 could reduce annual mental health service contacts by 38%. 

These estimates are likely to apply to other large cities in high income countries with heavy diesel traffic, they suggest.

“Based on the evidence presented, we contend that air pollution could be considered an important population-level target to reduce mental health service use in people with dementia, particularly for those with vascular dementia,” they write. 

They add: “The reduction in air pollution and particularly NO2  through public health interventions such as the expansion of ultra-low emission zones could potentially improve functioning and disease trajectories for people with dementia.

“Reducing pollutant exposure might reduce the use of mental health services in people with dementia, freeing up resources in already considerably stretched psychiatric services.” 

https://www.eurekalert.org/news-releases/997622

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