One in six people dying of lung cancer in UK are non-smokers, experts say

Posted on April 26, 2019 by Respro® UK Ltd

Scientists blame rise on car fumes, secondhand smoke and soot from wood-burning stoves

Growing numbers of non-smokers are being diagnosed with lung cancer, many at a stage when it is incurable, experts in the disease have revealed.

They blame the rise on car fumes, secondhand smoke and indoor air pollution, and have urged people to stop using wood-burning stoves because the soot they generate increases risk.

About 6,000 non-smoking Britons a year now die of the disease, more than lose their lives to ovarian or cervical cancer or leukaemia, according to research published on Friday in the Journal of the Royal Society of Medicine.

That is about a sixth of the 36,000 deaths a year from lung cancer.

“If considered as a separate entity, lung cancer in never-smokers is the eighth most common cause of cancer-related death in the UK and the seventh most prevalent cancer in the world,” the authors state.

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A “never-smoker” is classed as someone who has smoked fewer than 100 cigarettes in their lifetime.

The authors include Prof Paul Cosford, Public Health England’s director for health protection and medical director, and Prof Mick Peake, the director of the centre for cancer outcomes at University College London hospitals.

“With declining rates of smoking, the relative proportion of lung cancers in never-smokers is rising,” they said. “In addition, the absolute numbers and rates of lung cancers in never-smokers are increasing.”

Cosford – himself a non-smoker with lung cancer – said: “People will find these numbers very surprising. They rarely think of lung cancer as a non-smoker’s disease. They’re so focused on smoking as the main risk factor that we forget that there are quite a few causes of lung cancer that affect non-smokers.

“From a personal perspective, when I knew I was ill I never thought I would have lung cancer as I wasn’t a smoker. There’s an emerging realisation that this is a health problem we need to get supportive about.”

The difficulty identifying lung cancer means that many non-smokers are diagnosed when it has reached stage three or four, which means that treatment may prolong their life, but they cannot be cured.

Patients are often misdiagnosed, especially by GPs, and have their symptoms mistaken for something else, such as muscular pain, partly because they are similar to those for other ailments.

Breathing in secondhand smoke – for example being brought up in a home where one or both parents smoke – is the single biggest risk factor for a non-smoker getting lung cancer, the paper says. That accounts for 15% of the 6,000 cases.

Exposure to carcinogens in the workplace, such as asbestos, are to blame for 20.5% of lung cancers in non-smoking men and 4.3% in non-smoking women.

Outdoor air pollution is also a key factor, accounting for 8% of cases in non-smokers. It is thought to lead directly to the death of 39,000 Britons every year from a range of medical conditions, including lung cancer.

Wood and coal-burning stoves used indoors are also a risk, added Cosford. “I would like a nice wood-burning stove and used to have one. But we can’t get away from the fact that we are producing air pollution by burning wood and coal in our houses.

“The best thing is not to do it, but if you do do it then use the latest technology stove, use seasoned wood and have good ventilation.”

Richard Steyn, a consultant thoracic surgeon in the NHS and the chair of the UK Lung Cancer Coalition, said: “Apart from avoiding passive smoke, areas of high air pollution and wearing protective breathing apparatus in specific occupations, there is not a great deal that someone who does not smoke can do to avoid the risk.”

Health professionals need to be more aware that a non-smoker could have lung cancer in order to improve earlier diagnosis, he added.

“GPs and hospital doctors working in the NHS need to be more aware of the fact that lung cancer does occur in people who have never smoked and that as a disease in itself is more common than many other cancers that have a much higher profile, such as cancers of the cervix, ovary and the leukaemias.

“Many patients who have never smoked who develop lung cancer have their diagnosis delayed because of this lack of recognition so many of them have very advanced disease by the time they get to specialist care.”

via One in six people dying of lung cancer in UK are non-smokers, experts say | Society | The Guardian

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What are the ten towns with the worst air pollution in France?

Posted on April 26, 2019 by Respro® UK Ltd

Residents of Brittany and Normandy were warned this week that sand particles from the Sahara desert were adding to already high pollution levels in their regions. But where are the ten towns with the worst air pollution in France?
Earlier this week locals in Brittany were ordered to reduce their speed when driving and told that outdoor sporting activities should be avoided by anyone with pre-existing health issues due to the level of pollution which had been exacerbated by sand arriving from the Sahara.

Each year more than 500 French cities exceed the recommended concentration limit of fine particles in the air, with 48,000 deaths in France related to fine-particle air pollution each year, according to the latest report from the country’s Ministry of Ecological Transition and Solidarity.

For PM2.5 particles – basically the particles of air that are the most dangerous to a person’s health – the World Health Organisation (WHO) has set an upper limit of 10 micrograms of dirty air particles. If this was achieved, it would help dramatically cut the number of deaths caused by pollution.

However a total of 500 French cities exceed this concentration limits of fine particles in the air each year.
The main reasons behind this are road traffic and wood fires, with good weather and mild temperatures also playing a role in pollution peaks.
Here are the towns and cities in France that had the worst pollution in 2018, according to a report by air quality information site AirVisual.
1. Saint-Denis (Seine-Saint-Denis), 17,6 μg/m3
2. Saint-Mandé (Val-de-Marne) 16,2 μg/m3
3. Paris 15,6 μg/m3
4. Valenciennes (Nord) 15,3 μg/m3
5. Douai (Nord) 15 μg/m3
6. Roubaix (Nord) 14,9 μg/m3
7. Salaise-sur-Sanne (Isère) 14,7 μg/m3
8. Strasbourg (Bas-Rhin) 14,4 μg/m3
9. Lille (Nord) 14,3 μg/m3
10. Saint-Quentin (Aisne) 14,3 μg/m3
On a more positive note, France’s Ministry of Ecological Transition and Solidarity said that “the implementation of various strategies and action plans led to an overall improvement in air quality” between 2007 and 2017, adding that pollutants are decreasing.

via What are the ten towns with the worst air pollution in France? – The Local

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Air pollution poses risks for childhood cancer survivors

Posted on April 25, 2019 by Respro® UK Ltd

Poor air quality days significantly increase the risk of hospitalizations for respiratory issues in young survivors of cancer, according to a study conducted by researchers at Huntsman Cancer Institute (HCI) at the University of Utah (U of U) and published in the International Journal of Environmental Research and Public Health.

Better treatments — developed through research — have resulted in a dramatic increase in the rates of childhood cancer survival; today, nearly 80 percent of children diagnosed with cancer will survive their disease. However, these survivors may experience long-term detrimental health issues related to their cancer treatment. In this project, HCI researchers sought to better understand what a polluted environment means for the health of cancer survivors who may already be at a higher risk for illness because of the type of cancer treatment they received. The team examined the medical records of nearly 4,000 childhood, adolescent, and young adult cancer survivors diagnosed or treated at Primary Children’s Hospital between 1986 and 2012. They tracked when and how often those survivors required emergency room treatment or were admitted to a hospital in Utah due to respiratory illness. The study was divided into three groups: those who received chemotherapy as part of their cancer treatment, those who didn’t receive chemotherapy, and a cancer-free group. The researchers found the risk for respiratory hospitalization was significantly higher among the survivors who received chemotherapy compared to the cancer-free group.

HCI’s researchers were specifically looking at what happened to survivors on unhealthy air days. The study found the risk for hospitalizations among cancer survivors was significant when air pollution (PM2.5) was below the standard for sensitive groups (35.4 µg/m3), implying that levels below that protective standard may still contribute to respiratory problems for cancer survivors. Of the 3,819 survivors in the study, 185 had a total of 335 respiratory events documented in their medical record. 91 percent of hospitalizations and 75 percent of emergency room visits took place along the Wasatch Front counties of Salt Lake, Davis, Utah and Weber.

This is the first study to report a connection between PM2.5 levels and childhood cancer survivors requiring emergency treatment or hospitalization for respiratory issues. Survivors of childhood cancers may have higher vulnerability to high levels of PM2.5 because of lung damage and potential immunosuppression resulting from cancer and treatment with chemotherapy.

“This study has wide application to cancer survivors in Utah as well as nationwide,” said Judy Ou, PhD, a cancer epidemiologist at HCI and lead author on the study. “There are approximately 17 million cancer survivors in the United States, and statistics show about 40 percent of the U.S. population lives in places that are considered polluted at certain times of the year. This study provides valuable information to the medical community about how air pollution affects young survivors of cancer. We can use this to inform strategies to address this risk.”

Anne Kirchhoff, PhD, HCI cancer researcher and associate professor of pediatrics at the U of U, said, “We really haven’t thought about how environmental exposures may affect long-term healthcare needs and health outcomes. We may need to rethink guidelines, both on air pollution notifications from public health agencies as well as guidelines we’re giving cancer patients.”

Kirchhoff and Ou are working to identify effective strategies for sharing this information with health advocates, air quality organizations, and families affected by childhood cancers. The researchers collaborated with scientists from other departments at the University of Utah and Brigham Young University on this work.

The researchers say the Utah Population Database was vital to their research. They hope to use the resource on a follow-up project that would include a larger sample size to further evaluate the results of this study. They would also like to extend the study to adult cancer survivor populations. “We would like to understand the effects of pollution on a large sample and be able to provide guidance to cancer survivors across the country,” said Ou.

This HCI-led research is supported by the National Cancer Institute grant P30 CA042014, St. Baldrick’s Foundation Childhood Cancer Research Grant, Huntsman Cancer Foundation, and Intermountain Healthcare’s Primary Children’s Hospital.

Story Source:

Materials provided by Huntsman Cancer Institute. Note: Content may be edited for style and length.

via Air pollution poses risks for childhood cancer survivors — ScienceDaily

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‘Landmark’ study links air pollution to unborn baby growth

Posted on April 24, 2019 by Respro® UK Ltd

A new study from scientists at the University of Aberdeen has revealed that exposure to air pollution is linked to babies’ growth during pregnancy

The study analysed over a decade’s worth of research evidence from around the world to establish the extent to which mothers’ exposures to air pollution, diet, alcohol and chemicals affects fetal growth.

While there was surprisingly insufficient evidence that poor diet, alcohol or chemicals were factors, the study found evidence that exposure to nitrogen dioxide resulted in smaller fetal head size, particularly in the last three months of pregnancy.

The nitrogen dioxide referred to in the research is primarily generated by vehicle traffic, but can be present in the home from cigarette smoke, or butane and kerosene heaters and stoves.

Professor Steve Turner, who led the study, said: “What was unique about our review of the literature is that we looked at unborn babies to see if mothers’ exposures to these factors affected fetal development. We used medical literature dating back 13 years, when the first studies linking exposure to fetal measurements was first published.

“The seven studies where air pollution was measured and linked to fetal size were from different geographical areas of the world, including Australia, the USA and several countries in Europe. However in all of the studies the evidence was clear that in the third trimester in particular, exposure to nitrogen dioxide reduced fetal growth.”

Previous research has shown that being small – for gestational age – at birth is associated with increased risk for conditions that include coronary artery disease, type II diabetes and asthma, meaning that a baby subject to air pollution in the womb is more likely to develop one of these later in life.

Professor Turner continued that: “public health measures are urgently required to minimise pregnant mothers’ exposures to nitrogen dioxide.”

via ‘Landmark’ study links air pollution to unborn baby growth – PharmaTimes

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Millions more Americans breathing dirty air as planet warms – report

Posted on April 24, 2019 by Respro® UK Ltd

Forty-three percent of Americans live in places where they’re breathing unsafe air, according to American Lung Association

An increasing number of Americans live in places with unhealthy levels of smog or particulate air pollution – both of which are being made worse by climate change, according to a new report.

Air quality in the US has been improving since the 1970s, but that progress may be backsliding and 43% of Americans are now living in places where they are breathing unsafe air, according to the American Lung Association report.

As temperatures rise, wildfires are getting worse and spewing smoke across the west. And more smog, or ozone, is forming on warmer days.

For the three hottest years on record, 2015 through 2017, about 141 million people lived in US counties that saw unhealthy levels of particle pollution, either in a single 24-hour period or over a year, or unhealthy levels of smog. That is seven million more people than in the group’s last report.

“We’re seeing in this year’s report the impacts of climate change on air quality in really stunning terms,” said Paul Billings, a vice president for the association.

via Millions more Americans breathing dirty air as planet warms – report | Environment | The Guardian

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Air Pollution Is Killing More People Than Smoking—and Fossil Fuels Are Largely to Blame

Posted on April 18, 2019 by Respro® UK Ltd

Air pollution causes up to 8.8 million premature deaths each year around the globe, surpassing worldwide deaths from smoking. A new study, published late last month in the Proceedings of the National Academy of Sciences, finds that about 65 percent of those deaths are caused by emissions from fossil fuel-related activities, and that we can prevent about 3.6 million premature deaths every year if we phase out fossil fuels.

The study’s authors make use of epidemiological studies that follow cohorts of people around the world to model causes of mortality and thereby calculate the role of fossil fuel-caused air pollution. If we reduced the impact of all sources of anthropogenic pollution (including things like agriculture), the researchers calculate, the number of deaths prevented per year would jump to 5.6 million.

“Considering that this is a factor of 3 higher than the mortality rate from other avoidable environmental risks such as unsafe water, sanitation, and hygiene, reducing air pollution is clearly an effective and urgent health intervention,” the authors write. They find that, in particular, rapidly reducing fine particulate matter in the atmosphere could greatly reduce health impacts of exposure to air pollution, which include cardiovascular disease, asthma, and lung cancer.

The study also finds implications for the climate when fossil fuel emissions are ramped down thanks to a decrease in the use of aerosols. “By removing aerosol pollution, we find substantial regional invigoration of the hydrologic cycle,” leading to an increase in precipitation, they write.

This “invigoration” would have an especially significant impact in areas like northern China and Mexico, where record-setting droughts caused by climate change have been devastating agricultural productivity.

While aerosols have interrupted the Earth’s hydrologic cycles, they’ve also had a cooling effect on the planet. Those particles in the atmosphere reflect sunlight back into space, reducing the amount that is absorbed by the oceans and surfaces of Earth.

The study finds that aerosols have masked (that is, dampened the effect of) global warming by about 0.5 degrees Celsius. That effect has been particularly pronounced in areas of North America and northeast Asia, where researchers find that up to two degrees of warming has been masked. While carbon dioxide and other greenhouse gases are warming up the atmosphere, those aerosols have also been forestalling some of the worst impacts.

Aerosols have a shorter lifespan in the atmosphere than carbon dioxide, so “overall, the warming effect dominates,” says lead author Jos Lelieveld of the Max Planck Institute for Chemistry in Germany. “But in some areas which are very polluted, the cooling effect can be quite substantial.”

“The bottom line of this study is that we really need to do something quickly, especially if you want to meet these targets that we have all agreed upon at the Paris Agreement,” Lelieveld says. Signatories to the Paris Agreement have pledged to keep warming below two degrees Celsius by 2100, which, the study’s authors say—optimistically—could be possible.

If “within the next decade or so, say by mid-century,” we stop emitting greenhouse gases, Leliveld says, “it would still be possible to meet the two-degree target.”

via Air Pollution Is Killing More People Than Smoking—and Fossil Fuels Are Largely to Blame – Pacific Standard

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Counties Where Traffic Air Pollution Hurts Children Most

Posted on April 16, 2019 by Respro® UK Ltd

A first-of-its-kind county-by-county heat map details the distribution of childhood asthma due to nitrogen dioxide across the U.S.

IN THE U.S., over 6 million children had ongoing asthma in 2016. Globally, asthma kills around 1,000 people every day – and its prevalence is rising.

This condition has a high economic cost. Each year in the U.S., more than $80 billion is lost because of asthma. This is mainly due to premature deaths, medical payments and missed work and school days. The burden is higher for families with asthmatic children, who, on average, spend $1,700 more on health care than families with healthy children.

One major environmental factor that might contribute to the development of asthma is air pollution from traffic. In our study, published on April 3, our team mapped where in the U.S. children are most at risk for developing asthma from this type of pollution.

Traffic and Asthma

Asthma is likely the most common chronic disease in childhood, according to the World Health Organization.

Asthma presents as episodes of wheezing, coughing and shortness of breath due to the reversible, or partially reversible, obstruction of airflow. Six in 10 of children with asthma worldwide had a form of persistent asthma, meaning that either they were on long-term medication or their condition could not be controlled even with medication.

Traffic pollution contains a mixture of harmful pollutants like nitrogen oxides, carbon monoxide, particulate matter, benzene and sulfur. These pollutants are known to harm health in many ways, causing a number of cardiovascular, respiratory and neurological diseases.

One 2013 review suggested that long-term exposure to common traffic-related air pollutants is linked to the development of asthma in children and adults.

A much larger meta-analysis in 2017, which focused on children and included more recently published studies, found consistent connections between this type of pollution and childhood asthma development. The researchers concluded that there is now sufficient evidence showing a relationship between this type of pollution and the onset of childhood asthma.

Studies from the nonprofit research group Health Effects Institute and the U.S. Environmental Protection Agency have concluded along these lines.

Mapping the Problem

Despite this emerging evidence, the burden of childhood asthma due to traffic-related air pollution is poorly documented. Very few studies explore the geographic and spatial variations.

My research team wanted to quantify the connection between exposure to traffic pollution and the onset of childhood asthma across 48 U.S. states and the District of Columbia. We also wanted to make these data open to the public.

In our analysis, we looked at 70 million kids and conducted all calculations at the census block level, the smallest available geographical unit for census data. We collaborated with researchers from the University of Washington, who modeled the concentrations of nitrogen dioxide, a strong sign of traffic-related air pollution, using satellite imagery combined with environmental ground monitoring data.

We then took data extracted from surveys by the Centers for Disease Control and Prevention, estimating childhood asthma incidence in the U.S. Alongside data from our air pollution models, we used these data to estimate the number of childhood asthma cases caused by exposure to traffic pollution.

We then created a first-of-its-kind, county-by-county interactive heat map and city-by-city table detailing the distribution of childhood asthma due to nitrogen dioxide across the U.S. in both 2000 and 2010. Each county is represented, and users can explore the data to see the findings for a particular county.

A Win for Public Health
Our analysis found that childhood asthma cases attributable to traffic pollution across the U.S. decreased, on average, by 33% between 2000 and 2010. In 2000, we estimated that 209,100 childhood asthma cases could be attributed to traffic pollution, while this number dropped to 141,900 cases in 2010. That’s a major win for public health.
What caused the decline in traffic-related asthma cases? There may be multiple causes, including more fuel-efficient vehicles, more stringent regulation on nitrogen oxide emissions and, potentially, reductions in total vehicle miles traveled due to the recession.
Despite this encouraging decrease in air pollution and its associated health burden, there were 141,900 childhood asthma cases due to traffic-related air pollution in the U.S. That’s 18% of all childhood asthma cases.
Moreover, we found that children living in urban areas had twice the percentage of asthma cases attributable to nitrogen dioxide exposures as compared to children living in rural areas.
Our estimates underline an urgent need to reduce children’s exposure to air pollution. We hope that our analyses and heat maps will better inform policymakers, transportation agencies, medical associations and anyone else interested in learning more about the burden of childhood asthma due to air pollution.

via Counties Where Traffic Air Pollution Hurts Children Most | Healthiest Communities | US News

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High-emission Vehicles to be Restricted from Downtown Seoul

Posted on April 15, 2019 by Respro® UK Ltd

High-emission vehicles will be restricted from the center of Seoul beginning in July this year, as part of the municipal government’s new policy measures to reduce fine dust pollution in the capital, it was announced Monday.

Grade 5 emission vehicles, mostly diesel cars, will be barred from entering Seoul’s Green Transport Promotion Zone, a 16.7-square-kilometer downtown area designated within the Joseon Dynasty fortress walls, the government said.

After a five-month grace period, violators will be fined 250,000 won (US$220), beginning Dec. 1.

The stringent driving restrictions will be applied to the 2.45 million vehicles that are classified by the Ministry of Environment as grade 5 emission cars out of the 23 million vehicles registered in the nation.

Municipal officials said grade 5 emission vehicles will likely be banned from entering the green promotion zone from 6 a.m. to 7 or 9 p.m. in consideration of logistics movement and other factors. At present, about 20,000 to 30,000 grade 5 emission cars are estimated to pass through the zone a day.

All owners of grade 5 emission cars will be individually notified of the Seoul government’s new driving restrictions by mail.

The latest policy measures came after the average concentration of harmful ultra fine particles in the air of Seoul reached the highest level last month since record-keeping began in 2015.

The government of Seoul also said it will cooperate with private businesses to gradually replace about 100,000 delivery motorcycles with eco-friendly electric motorcycles by 2025. Diesel-powered delivery motorcycles are known to emit at least six times more air pollutants than small passenger cars.

This year, it aims to distribute 1,000 electric motorcycles to franchise and delivery companies.

In addition, the municipal government will replace about 450 diesel-powered village buses with electric buses from next year in cooperation with the central government.

The Seoul government will install a total of 2,500 air quality monitors throughout the city by 2022 and put large-scale construction sites, gas stations, printing factories and other heavy emitters of fine dust under special supervision.

Idling police buses and auto repair shops will be regulated more stringently starting this year, it said.

“Fine dust is a pain in people’s lives and a national disaster that threatens the lives of citizens,” Seoul Mayor Park Won-soon said. “Citizens, as both the biggest victims of fine dust and the subjects of policies, should be prepared to accept lifestyle changes.”

via High-emission Vehicles to be Restricted from Downtown Seoul | Be Korea-savvy

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