Blog # 9

Air Pollution

Particle pollution consists of a mixture of solids and liquid droplets.Particle pollution levels can be very unhealthy and even hazardous during events such as forest fires. Particle levels can be elevated indoors, especially when outdoor particle levels are high.

Sensitive groups for particle pollution include people with heart or lung disease (including heart failure and coronary artery disease, or asthma and chronic obstructive pulmonary disease), older adults (who may have undiagnosed heart or lung disease), and children. The risk of heart attacks, and thus the risk from particle pollution, may begin as early as the mid-40s for men and mid-50s for women.

Ozone affects the lungs and respiratory system in many ways. It can:

• Irritate the respiratory system
• Reduce lung function
• Inflame and damage the cells that line the lungs
• Make the lungs more susceptible to infection
• Aggravate asthma
• Aggravate other chronic lung diseases such as emphysema and bronchitis
• Cause permanent lung damage

Carbon monoxide is an odorless, colorless gas. It forms when the carbon in fuels does not completely burn.Carbon monoxide enters the bloodstream through the lungs and binds to hemoglobin, the substance in blood that carries oxygen to cells. It reduces the amount of oxygen reaching the body’s organs and tissues.

• People with cardiovascular disease, such as coronary artery disease, are most at risk. They may experience chest pain and other cardiovascular symptoms if they are exposed to carbon monoxide, particularly while exercising.
• People with marginal or compromised cardiovascular and respiratory systems (for example, individuals with congestive heart failure, cerebrovascular disease, anemia, or chronic obstructive lung disease), and possibly young infants and fetuses, also may be at greater risk from carbon monoxide pollution.
• In healthy individuals, exposure to higher levels of carbon monoxide can affect mental alertness and vision.

Sulfur dioxide, a colorless, reactive gas, is produced when sulfur-containing fuels such as coal and oil are burned. Generally, the highest levels of sulfur dioxide are found near large industrial complexes. Major sources include power plants, refineries, and industrial boilers.

• People with asthma who are physically active outdoors are most likely to experience the health effects of sulfur dioxide. The main effect, even with very brief exposure (minutes), is a narrowing of the airways (called bronchoconstriction). This may be accompanied by wheezing, chest tightness, and shortness of breath, which may require use of medication that opens the airways. Symptoms increase as sulfur dioxide levels or breathing rate increases. When exposure to sulfur dioxide ceases,lung function typically returns to normal within an hour,even without medication.
• At very high levels, sulfur dioxide may cause wheezing, chest tightness, and shortness of breath even in healthy people who do not have asthma.
• Long-term exposure to sulfur dioxide may cause respiratory symptoms and illness, and aggravate asthma. People with asthma are the most susceptible to sulfur dioxide. However, people with other chronic lung diseases or cardiovascular disease, as well as children and older adults, may also be susceptible to these effects.

A key tool in this effort is the Air Quality Index, or AQI. EPA and local officials use the AQI to provide simple information about your local air quality, how unhealthy air may affect you, and how you can protect your health.

I read about impact of air pollution on immune system. Negative health effects from the chronic inhalation of polluted air are well known to cause cardio-respiratory disease. It can be particularly damaging to seniors, children, and people with asthma. According to a study from Ohio State University, breathing polluted air can also cause widespread inflammation by triggering the release of white blood cells from bone marrow into the blood stream. The influx of white blood cells can alter the integrity of the blood vessels. The white blood cells are then absorbed into fat tissues where chemicals are released that cause inflammation.

To reduce my impact on air quality, I can:

• Choose a cleaner commute — car pool, using public transportation, bike or walk when possible.
• Follow manufacturers' recommendations for use and properly seal cleaners, paints, and other chemicals to prevent evaporation into the air
• Educate my community to monitor the local Air Quality Index (AQI) daily and follow the necessary precautions based on the level of AQI eg. When AQI values are between 101 and 150, members of sensitive groups may experience health effects, but the general public is unlikely to be affected. So The following groups should reduce prolonged or heavy outdoor exertion:The following groups should reduce prolonged or heavy outdoor exertion:
     - People with lung disease, such as asthma
     - Children and older adults
     - People who are active outdoors

Local particulate Air pollution (PM2.5) in San Mateo, CA  was 7.2 (μg/m3), AQI : 28.8, and health category was good by utilizing air assessment tool. Since 1955, the Air District has worked to improve air quality in the Bay area. The first regulation aimed at reducing air pollution banning open burning at dumps and wrecking yards is adopted in 1957.

The journal articles were not associated to my current practice. However, a article was very interesting to me.

Pesticide-Poisoned Patients: Can They Be Used as Potential Organ Donors?

 The gap between the number of patients on transplant waiting lists and patients receiving transplants is growing. Use of organs from donors who have died following pesticide exposure remains controversial. Overall survival with good function was 96%, 71%, 83%, and 67% for kidneys, livers, corneas and hearts respectively.Review of the published literature suggests that solid organ donation following exposure to a pesticide is associated with good short-to-medium-term graft organ function following transplantation, particularly for transplanted kidneys and corneas.

The best strategy for me to help patients and reducing the effect of air pollution on them is education. Providing information to patients, their families, and parents of pediatric patients about impacts of various pollutants on health, aggravating cardiovascular, respiratory, kidney, and other diseases, how to help to clean the air, and how to monitor air quality index can be very helpful.

Blog # 10

Indoor Air Quality

It has been estimated that people spend about 90% of their time in both private and public indoor environments, such as homes, gyms, schools, work places, transportation vehicles, etc.; thus, IAQ has a significant impact on health and quality of life in general. For many people, the health risks from exposure to indoor air pollution may be greater than those related to outdoor pollution. In particular, poor indoor air quality can be harmful to vulnerable groups such as children, young adults, the elderly, or those suffering chronic respiratory and/or cardiovascular diseases.

Most indoor air pollution originates from sources that release gases or particles into the air. Candles, air fresheners, cleaning products and other household items can be potential culprits of air pollutants in your home.

In my home, whenever is possible I open the doors and windows for having fresh air and better ventilation. For home hygiene, I also clean the surfaces with diluted vinegar. But, since we have yard and garden, we expose to pollen and allergens which trigger my husband's allergy symptoms especially in spring.

The floor of my house is covered by carpets. So I am concerning about the impacts of carpet and formaldehyde on our health.

New carpeting is a primary source of volatile organic compounds (VOCs), which can include highly toxic chemicals such as formaldehyde and acetaldehyde. The largest release of VOCs from new carpeting will occur in the first 72 hours after installation. 

New carpet installation is associated with wheezing and coughing in babies during their first year of life.

Consider carpeting and rugs made from natural materials like wool, which will (typically) not contain flame-retardants or stain-resistant chemicals and will naturally repel insects.

Make sure you regularly ventilate your home by opening windows on opposite sides of the house so the toxic fumes can be exchanged for outside air.

Patients and their family need to know about indoor air quality, cooking risks and ensuring air flow. Thus, I educate them about these important issues.

NEWS

Feb 19, 2019

Plastic threatens our health from before production to long after it’s thrown away: Report

"Every stage of the plastic lifecycle poses significant risks to human health, and the majority of people worldwide are exposed to plastic at multiple stages of this lifecycle."

Brian Bienkowski

The report cites shocking statistics on plastic production, including data that shows plastic

production has increased from 2 million metric tons in 1950 to 380 million metric tons in 2015.

Currently about 42 percent of plastic is designed for packaging, which is especially troubling

because most plastic packaging is designed for single-use.

And the tons of plastic already produced is not going anywhere— "roughly two thirds of all

plastic ever produced has been released into the environment and remain there in some form—

as debris in the oceans, as micro- or nanoparticles in air and agricultural soils, as microfibers in

water supplies, or as microparticles in the human body," the authors wrote.

"Companies cannot continue hiding behind waste-management solutions like recycling, when

none of that will be enough unless they also dramatically reduce plastic use by using 

alternatives to single-use plastics," she added.

Two-thirds of all plastic ever produced remains in the environment