Environmental and Workplace Lung Disease- NOT DONE SLIDE 9

major atmospheric pollutants

carbon monoxide, nitrogen oxides, sulphur oxides, heavy metals, hydrocarbons, photochemical oxidants, particulate matter

carbon monoxide pollutant

largest pollutant by weight; produced by incomplete combustion of carbon in fuels, mainly cars

binds to hemoglobin, with 200x greater affinity than O2

commuter using a busy urban road may have 5-10% of their Hb bound to CO

evidence that it impairs mental skills, reduced by catalytic converters

nitrogen oxides

produced when fossil fuels burned at high temps in power stations and cars

cause inflammation of eyes and upper respiratory tract during smoggy conditions

high concentration can cause acute tracheitis, acute bronchitis, and pulmonary edema

sulphur oxide pollutant

corrosive, poisonous gases produced when sulphur containing fuels are burned, mainly by power stations

cause inflammation of mucous membranes, eyes, upper respiratory tract, and bronchial mucosa

short term exposure to high concs can cause edema

hydrocarbon pollutant

product of unburned fuel waste

not usually toxic at concentrations found in atmosphere, but can sunlight triggers conversion into photochemical oxidants

photochemical oxidants pollutant

ozone, peroxyacyl nitrates, aldehydes, and acrolein

produced by actions of sunlight on hydrocarbons and nitrogen oxides

cause inflammation of eyes and respiratory tract

high concentration ozone causes pulmonary edema

particulate matter pollutant

particles with range of sizes, up to visible smoke and soot

sources are power stations, industrial plants

although air pollution can occur due to natural causes such as volcanoes,

increased combustion of fossil fuels is the largest culprit for the deterioration of our planet’s air

effects of climate change

increased temp, increased cardio-respiratory attacks, changes in frequency of respiratory disease, altered distribution of allergens and infectious disease vectors, increased wildfires, increased drought conditions

effects of climate change- increased temperature

increased number of deaths and acute morbidity, especially among respiratory patients, due to heat waves

for every 1 degree C rise, the risk of premature death among respiratory patients is up to 6 times higher than in the rest of the population

effects of climate change- increased cardio-respiratory attacks

due to higher concentrations of ground-level ozone

effects of climate change- changes in frequency of respiratory disease

due to transboundary long-range air pollution

effects of climate change- altered distribution of allergens/infectious disease vectors

e.g. more pollen due to rapid growth of plants, longer pollen seasons, and high allergen content during thunderstorms

effects of climate change- increased wildfires

this activity is increasing with climate change

decreased air quality, smoke can travel great distances

at risk population include adults 65+, children, pregnant woman and developing fetuses, pre-existing lung disease (asthma, COPD)

one recent worldwide estimate is that 339,000 deaths annually may be attributed to landscape fire smoke

effects of climate change- increased drought conditions

multiple health challenges: in dry conditions, more pollen, dust, particulates (and wildfire smoke) which can irritate respiratory epithelium, exacerbate chronic respiratory illnesses, and asthma, and increase risks for acute respiratory infection

components of fire smoke that cause issues

vary depending on fuel tupe, landscape, meteorological conditions, etc

include asphyxiants, respiratory irritants, systemic toxins

wildfire components- asphyxiants

produce hypoxia by displacing oxygen, e.g. CO2, CO, and methane

wildfire components- respiratory irritants

produce hypoxia by causing tracheobronchitis, upper airway obstruction, pneumonia

e.g. ammonia, acrolein/aldehyde, sulphur dioxide

wildfire components- systemic toxins

cause inhalation injury

e.g. particulate matter- depends on particle size, concentration, respiratory rate, pre-existing conditions, time exposure

of all the things the components of wildfires can cause, what does this ultimately result in?

decreased lung function, exacerbation of asthma and COPD, increased respiratory infections which means increased ER units and hospitalizations

effects of air pollutants on upper airway disease

epidemiological studies have shown that these aggravate airway diseases including asthma, COPD, bronchitis, as well as these type of diseases such as allergic and non-allergic rhinitis, sinusitis, and otitis media

diesel exhaust particles, nitrogen dioxide and cigarette smoke, photochemical pollutants/ozone are worst offenders

young children and obese most vulnerable

more studies needed on long term effects of lower dose exposures

many pollutants trigger the generation of

ROS, which induce apoptosis and increase inflammation and mucin production

ozone effects

exposure impairs lung function, even in healthy individuals, where it causes reductions in vital capacity, FEV1, and resistance

effects of exposure increase with physical exercise

patients with respiratory diseases are more susceptible to its effects, e.g. it can cause difficulty of breathing (e.g. shortness of breath and pain when taking a deep breath)

long term exposure implicated in asthma development and under conditions of oxidizing air pollution (such as summer), exposure may lead to asthma exacerbations

exposure likely to cause premature deaths

children seem at increased risk from exposure, as they have a relatively higher dose per body mass and their lungs are still developing