Air pollution and health.

Over the past three or four decades, there have been important advances in the understanding of the actions, exposure-response characteristics, and mechanisms of action of many common air pollutant

https://www.jstor.org/stable/pdfplus/3431520.pdf

Human Health Effects of Air Pollution

This document presents answers to 24 questions relevant to reviewing European policies on air pollution and to addressing health aspects of these policies. The answers were developed by a large group of scientists engaged in the WHO project “Review of evidence on health aspects of air pollution – REVIHAAP”. The experts reviewed and discussed the newly accumulated scientific evidence on the adverse effects on health of air pollution, formulating science-based answers to the 24 questions. Extensive rationales for the answers, including the list of key references, are provided. The review concludes that a considerable amount of new scientific information on the adverse effects on health of particulate matter, ozone and nitrogen dioxide, observed at levels commonly present in Europe, has been published in recent years. This new evidence supports the scientific conclusions of the WHO air quality guidelines, last updated in 2005, and indicates that the effects in some cases occur at air pollution concentrations lower than those serving to establish these guidelines. It also provides scientific arguments for taking decisive actions to improve air quality and reduce the burden of disease associated with air pollution in Europe. This publication arises from the project REVIHAAP and has been co-funded by the European Union.

Review of evidence on health aspects of air pollution – REVIHAAP Project. Technical Report. World Health Organization Regional Office for Europe 2013

Despite current regulations, which limit the levels of certain air pollutants, there are still a number of adverse health effects that result from exposure to these agents. Numerous epidemiological studies have noted an association between the levels of air pollution and hospital admissions for a variety of different health reasons, including a number of respiratory diseases, as well as increased morbidity and mortality associated with various respiratory conditions and diseases. Because of the large impact respiratory virus infections have on morbidity and even mortality, it is important to understand whether and how exposure to common air pollutants could exacerbate the susceptibility to and severity of respiratory virus infections. This review focuses on current epidemiological and experimental studies, which have examined the association between and effect of air pollutants and respiratory viral infections, as well as potential mechanisms associated with these effects. Examined in this review are U.S. Environmental Protection Agency (EPA) "criteria" pollutants nitrogen dioxide (NO(2)), ozone (O(3)), and particulate matter (PM), as well as indoor pollutants such as environmental tobacco smoke (ETS) and combustion products of biomass fuels. Although a number of studies indicate associations between exposure to air pollutants and increased risk for respiratory virus infections, potential mechanisms mediating these effects are largely unexplored. Therefore, additional studies, both epidemiologic and mechanistic, are necessary to increase our understanding of how exposure to air pollutants could affect respiratory virus infections, especially in populations already at risk of developing significant morbidity/mortality after infections with respiratory viruses.

Air pollution and respiratory viral infection.

The short-term effects of nitrogen dioxide (NO(2)) on total, cardiovascular and respiratory mortality in 30 European cities participating in the Air Pollution on Health: a European Approach (APHEA)-2 project were investigated. The association was examined using hierarchical models implemented in two stages. In the first stage, data from each city were analysed separately, whereas in the second stage, the city-specific air pollution estimates were regressed on city-specific covariates to obtain overall estimates and to explore sources of possible heterogeneity. A significant association of NO(2) with total, cardiovascular and respiratory mortality was found, with stronger effects on cause-specific mortality. There was evidence of confounding in respiratory mortality with black smoke and sulphur dioxide. The effect of NO(2) on total and cardiovascular mortality was observed mainly in western and southern European cities, and was larger when smoking prevalence was lower and household gas consumption was higher. The effect of NO(2) on respiratory mortality was higher in cities with a larger proportion of elderly persons in the population and higher levels of particulate matter with a 50% cut-off aerodynamic diameter of 10 mum. The results of this large study are consistent with an independent effect of nitrogen dioxide on mortality, but the role of nitrogen dioxide as a surrogate of other unmeasured pollutants cannot be completely ruled out.

https://erj.ersjournals.com/content/erj/27/6/1129.full.pdf

Short-term effects of nitrogen dioxide on mortality: an analysis within the APHEA project

Nitrogen dioxide exposure in vivo and human alveolar macrophage inactivation of influenza virus in vitro.

Symptoms and changes in pulmonary function of subjects with chronic obstructive pulmonary disease (COPD) and elderly normal subjects, induced by a 4-h exposure to 0.3 ppm NO2, were investigated using a double-blind, crossover design with purified air. The 5-day experimental protocol required approximately 2 wk with at least a 5-day separation between randomized 4-h exposures to either NO2 or air which included several periods of exercise. Over a 2-yr period, COPD subjects, all with a history of smoking, consisting of 13 men and 7 women (mean age of 60.0 yr) and 20 elderly normal subjects of comparable age and sex were evaluated. During intermittent light exercise, COPD subjects demonstrated progressive decrements in FVC and FEV1 compared with baseline with 0.3 ppm NO2, but not with air. Differences in percent changes from baseline data (air-NO2) showed an equivocal reduction in FVC by repeated measures of analysis of variance and cross-over t tests (p less than 0.10). Subgroup analyses suggested that responsiveness to NO2 decreased with severity of COPD; in elderly normal subjects, NO2-induced reduction in FEV1 was greater among smokers than never-smokers. A comparison of COPD and elderly normal subjects also revealed distinctions in NO2-induced responsiveness.

Pulmonary performance of elderly normal subjects and subjects with chronic obstructive pulmonary disease exposed to 0.3 ppm nitrogen dioxide.

Nitrogen dioxide (NO2) is a pollutant of both outdoor and indoor atmospheres that has the potential to alter alveolar epithelial permeability. In order to assess alterations in the protein content of alveolar lining fluid induced by brief (3-h) exposures to low-level NO2, normal volunteers were exposed sequentially to air and NO2, separated by at least 2 wk, in an environmental chamber. Bronchoalveolar lavage (BAL) was performed after exposure. Four experimental protocols were used: (1) continuous 0.60 ppm NO2 with BAL performed 3.5 h after exposure (n = 8), (2) background 0.05 ppm NO2 with three 15-min peaks of 2.0 ppm followed by BAL 3.5 h after exposure (n = 15), (3) continuous 0.60 ppm NO2 with BAL performed 18 h after exposure (n = 8), and (4) continuous 1.5 ppm NO2 with BAL 3.5 h after exposure (n = 15). No changes in lavage fluid levels of total protein or albumin were observed in response to NO2. However, exposure to continuous 0.60 ppm NO2 was associated with increases in lavage fluid levels of t...

Effects of nitrogen dioxide exposure on bronchoalveolar lavage proteins in humans.

Effects of in vitro exposure to nitrogen dioxide on human alveolar macrophage release of neutrophil chemotactic factor and interleukin-1.

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Nitrogen dioxide exposure in vivo and human alveolar macrophage inactivation of influenza virus in vitro.

Pulmonary performance of elderly normal subjects and subjects with chronic obstructive pulmonary disease exposed to 0.3 ppm nitrogen dioxide.

Effects of nitrogen dioxide exposure on bronchoalveolar lavage proteins in humans.

Effects of in vitro exposure to nitrogen dioxide on human alveolar macrophage release of neutrophil chemotactic factor and interleukin-1.