Diversity in Health and Care 2010;7:5–7
# 2010 Radcliffe Publishing
Guest editorial
Indoor air pollution: a poorly recognised hazard Kin Bong Hubert Lam BSc MPhil PhD
Lecturer in Environmental and Occupational Epidemiology
Om P Kurmi BSc MSc
Research Fellow
Jon G Ayres BSc MBBS MD FRCP FRCPE FFOM FRCPSG
Professor of Environmental and Respiratory Medicine
Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston,
Birmingham, UK
Air is essential for life, and its quality has long been recognised as being linked to health and well-being. As early as the 13th century, the then king of England,
Edward I, alerted by the pungent smoke over London, forbade the burning of coal and ordered
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Although the source is admittedly different, these levels are very much higher than those found in outdoor urban background sites in the UK (around 15 g/m3).
Both epidemiological and experimental studies have shown that indoor air pollution has serious consequences for health, especially in women and children.
Conditions such as acute lower respiratory infection, particularly pneumonia in children, chronic obstructive pulmonary disease (COPD), lung cancer and cataract are the major illnesses associated with or caused by indoor air pollution (World Health Organization,
2002). Exposure to smoke from solid fuel increases the risk of COPD by approximately threefold in adults, and the risk is much higher in women who do the cooking (Kurmi et al, 2010). Worldwide, indoor air pollution accounts for 2 million deaths annually
(United Nations Development Programme, 2009) and
2.7% of the loss of disability-adjusted life years (DALYs;
World Health Organization, 2002). In developing countries, 44% of these deaths occur in children, and 60% of the adult deaths occur in women (United
Nations Development Programme, 2009).
Apart from the local health effects, the burning of solid fuels can also have a much wider impact on the environment. Although
This source features a report by Jill U. Adams on the dangers, and current regulations of air pollution and climate change. Holding a Ph.D. in pharmacology from Emory University, the author primarily writes a health column for the Washington Post. She has also been featured in the magazines Audubon, Scientific American and Science. Because this article covers climate change, there is an inherent liberal bias. However, this bias coincides with irrefutable scientific data proving the existence of climate change. The audience for this article is anyone effected by air pollution and climate change; just about everyone. This source upholds my speculation that human beings have a significant effect on the climate. Before reading this article, I wasn’t aware that 55 million people a year died from air pollution. I found this source on CQ Researcher while searching for ‘pollution.’
Pollution continues to pose an enormous threat to residents of urban cities worldwide. In the August 2008 Monthly Update, it is stated that approximately 800,000 deaths each year can be attributed to outdoor air pollution, making pollution the single most harmful environmental hazard to human health in urban areas (Kallman). The fact that pollution kills hundreds of thousands of people each year alone portrays just how dangerous living in these conditions can be. Kallman writes about a study which proves an increase in upper respiratory diseases, cardiovascular mortality, respiratory mortality, and low birth weights when exposed to air pollutants (August 2008: Monthly Update). These can be very serious diseases and complications which, when contracted, can lead to death or very serious illnesses. There
The author begins the article by discussing the death percentage related to air pollution and what causes the elevated levels of air pollution. Huth continues the article by pointing out that different areas have different problems related to air pollution. Finally, Huth draws attention to the fact that different countries have different solutions to the air pollution. Though this piece was written for the entire United States, the fact that air pollution can be deadly to humans is universally applicable. Though Huth is a reporter and not an environmental scientist, Huth does cite reports made by credible institutions. Though this article talks only about how air pollution is deadly and does not expand the idea to talk about other health complications, the fact that air pollution is dangerous to human health does support my claim that a reduction in air pollution will lead to a better quality of
Respiratory disorder, mostly affect the upper or lower respiratory tract, however bacterial or viral infection are the causative agent and the disease is common in all ages. In addition, the lungs and the bronchi can also be affected, causing inflammation and obstruction of the airflow resulting in wheezing, chest tightness, stridor, low grade fever, cough, and hemoptysis due severe damage to the lung tissues. Most common diseases of the respiratory system include; pneumonia, croup, asthma, bronchitis, laryngitis, and tuberculosis, affected disease location determines the signs and symptoms. Hereditary and environmental factors such as allergens and other irritants can be a contributory factor, especially in children. However, respiratory compromise occur as a result of incomplete airway development among this vulnerable population predisposing them to chronic asthma (Huether & McCance, 2012).
Poor air quality is associated with some health issues from the short-term problems to severe
Patients with lung disease might be another subgroup of individuals helpless to the wellbeing effects of air contamination, since exposures after finding
Air quality depends on the presence of chemical, physical or biological agents which influence the natural composition of the atmosphere. Wood smoke contains irritants, systemic toxins and carcinogens. Burning of wood for heating, cooking, and lightening results in exposure to such pollutants as fine particles and carbon monoxide (http://www.who.int/). It was also found that high amounts of polycyclic aromatic hydrocarbons present in wood smoke, produce high levels of free radicals, DNA damage as well as inflammatory and oxidative stress response gene expression (Danielsen et al. 2011). There is consistent evidence that both ambient (outdoor) and household (indoor) air pollution cause upper (laryngitis, sinusitis) and lower (bronchitis, asthma, chronic obstructive pulmonary disease) respiratory diseases and other conditions, which can even be fatal. All family members are exposed to adverse effects of wood smoke, but the highest risk occur to women and young children, who spend the most time near the domestic hearth. It was
Starting in the year 2004, the air pollution has reached an alarming level in the city o Toronto. Dr Barbara Yaffe, the acting medical officer of health of Toronto Public health, has released a report in July 2004 saying that the “air pollution [in the city] has contributed to over 1700 premature deaths and 6000 hospitalization admission in Toronto each year” (Yaffe, 2004, p.i). According to this report, pollutants such as ozone, nitrogen dioxide, sulphur dioxide, and carbon monoxide have increased within the air of the city; these pollutants are tiny particles that are 2.5 micron in diameter or less and can affect people’s respiratory system and cause cardiovascular and respiratory problems such as “asthma, bronchitis in children, adult chronic bronchitis, and heart problem” (TPH, 2007, figure 1). Although it
Air pollution can be undoubtedly harmful to pregnancy. Substances such as carbon monoxide, ozone, nitrogen dioxide, benzene, emissions from solid biomass, and nitroarenes all contribute to air pollution. Studies done in North Carolina, California, and East India all conclude the same thing; air pollutants do affect the health of babies during pregnancy. The most severe affects from these toxins include cancer, short-and-long-term morbidity, and stillbirth. Still damaging, yet less traumatizing effects include low birth weight, small for gestational age, and preterm birth. PM2.5 is particulate matter in the air. One study shows it reduces birth weight by 3.1 g (Gray, 2013). Because most of air
2012, 268). Today clinical studies have proven air pollution causes lower birth weight, growth retardation and malformations, particularly in soft tissue (Connell et al. 2012, 268). Many women in urban centres would have spent long times in areas of higher air pollution especially due to the low ventilation in houses and rooms, such as the kitchen. These occupation and living conditions can have substantial effects on health and by taking a wider socio-cultural, environmental and historical context (Swales 2013, 319-320) the link between these and health can be examined.
Air, is one of the most substantial source to mankind and our planet. While it exists, so does everything else along. However, in today’s epidemic, there has been certain factors that have increased in understanding whether the air we breathe today is healthy or not? Is it doing more harm than we thought? In other words, the health risks against air pollution have risen in the past few decades; all from what you may ask? Well, it could be for various factors and evaluations; either environmental or materialistic. Pollution is a major public health crisis in the world. (Friis, 2012). This is one of the conflicts that contribute to various aspects of an individual’s life, whether they may realize it or not. In this paper will include the sources that cause pollution with the effects it cause as well as policies on the regulation of air pollution.
It is always common that air that we breather within various indoor environments have different particles and gaseous contaminants. Upon these contaminants affecting human health and performance they change to be known as indoor pollutants, for example school setting commonly experience this environment. Health and performance in school is also affected by indoor temperature and relative humidity on influence of the airborne level of molds as well as bacteria.
Schools’ children do spend in their classrooms almost double the time they do in their rooms at homes (WHO, 2007). This gives the extra importance of having good indoor air quality at schools which helps to pertain an improved learning environment, increased productivity and better health for students and school staff. Having poor indoor air qualities would have severe consequences on health, behaviors, perception, development and learning disabilities (WHO, 2007).
Nearly 3 billion people in the developing world are exposed to indoor air pollution (IAP) through smoke from traditional cook stoves and open fires used for cooking and heating purposes (Cleancookstoves.org, 2014). Women as head of household are often in charge of preparing and cooking meals, and as such are exposed to the smoke from these duties multiple times daily over the life course. Use of these open fires and inefficient cook stoves that burn solid fuels (wood, dung, agriculture) and coal not only poses gender-specific health hazards, but also have salient consequences for quality of life, education, income generation and environmental sustainability. IAP itself is a complex mixture of particles in smoke from cooking that overwhelms poorly ventilated households, which breach the acceptable levels for air polluting particles 100-fold (Who.int, 2014). Once respired, these particles lodge deep within the lungs and cannot be dislodged, leading on to cause a range of non-communicable diseases, most notably: acute and chronic respiratory/lung disease, COPD, lung cancer and bronchitis, as well as accounting for 4.3 million premature deaths (Who.int, 2014). It is through the combustion of solid fuels and biomass that these particles are released into the air, and as such those in living in resource constrained settings are highly vulnerable to lung diseases from household pollution, as they do not have access to clean energy and fuels.
Airborne particle matter small enough to penetrate human respiratory tracts are referred to as air pollutants; environmental teratogens. “The bulk of all air pollution research target reproductive health has been conducted only in the past decade. Recently this research has begun to focus on one specific source of modern-day air pollution- traffic exhaust.” (Ritz, B) Since the early 1990’s researchers are becoming more aware of the teratogenic effect of air pollution. Although the study of air pollutions impact on prenatal development is still an area of science that is developing, the proof is that exposer puts pregnancies and children at higher risks of complications to their health. Research suggests that infants living in areas with high levels of air pollution have greater risks of