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300 million children breathe heavily toxic air: UNICEF

Oct 31st, 2016
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Some 300 million children live with outdoor air so polluted it can cause serious physical damage, including harming their developing brains, the United Nations said in a study released Monday.

Nearly one child in seven around the globe breathes outdoor air that is at least six times dirtier than international guidelines, according to the study by the UN Children’s Fund, which called air pollution a leading factor in child mortality.

UNICEF published the study, “Clear the Air for Children,” a week before the annual UN climate-change talks, with the upcoming round to be hosted by Morocco on November 7-18.

The agency, which promotes the rights and well-being of children, is pushing for world leaders to take urgent action to reduce air pollution in their countries.

“Air pollution is a major contributing factor in the deaths of around 600,000 children under five every year, and it threatens the lives and futures of millions more every day,” said Anthony Lake, executive director of UNICEF.

“Pollutants don’t only harm children’s developing lungs. They can actually cross the blood-brain barrier and permanently damage their developing brains and, thus, their futures. No society can afford to ignore air pollution,” Lake said.

Toxic air is a drag on economies and societies, and already costs as much as 0.3 percent of global gross domestic product, the broad measure of economic activity, UNICEF said.

Those costs are expected to increase to about one percent of GDP by 2060, it said, as air pollution in many parts of the world worsens.

UNICEF points to satellite imagery which it says confirms that about two billion children live in areas where outdoor air pollution exceeds minimum air-quality guidelines set by the World Health Organization.

The air is poisoned by vehicle emissions, fossil fuels, dust, burning waste and other airborne pollutants, it said.

South Asia has the largest number of children living in such areas at about 620 million, followed by Africa with 520 million and the East Asia and Pacific region with 450 million.

The study also looked at indoor air pollution, typically caused by burning coal and wood for cooking and heating.

Together, outdoor and indoor air pollution are directly linked to pneumonia and other respiratory diseases that account for almost one death in 10 in children under the age of five, or nearly 600,000 children, making air pollution a leading danger to children’s health, UNICEF said.

The agency noted that children are more susceptible than adults to indoor and outdoor air pollution because their lungs, brains and immune systems are still developing and their respiratory tracts are more permeable.

Children breathe twice as quickly as adults and take in more air relative to their body weight.

The most vulnerable to illnesses caused by air pollution are children living in poverty, who tend to have poorer health and little access to health services.

– Better protect children –

To combat these noxious effects, UNICEF will call on the world’s leaders at the UN’s 22nd meeting on climate change in Marrakesh, known as COP22, to take urgent action to better protect children.

“Reducing air pollution is one of the most important things we can do for children,” UNICEF said in its report.

At the government level, UNICEF said steps should be taken to reduce fossil-fuel emissions and increase investments in sustainable energy and low-carbon development.

The agency, noting that air quality can fluctuate rapidly, also called for better monitoring of air pollution to help people minimize their exposure.

Children’s access to good-quality healthcare needs to be improved and breastfeeding in the child’s first six months should be encouraged to help prevent pneumonia.

Policymakers should “develop and build consensus on children’s environmental health indicators,” the report urged.

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Air pollution becomes leading risk factor for stroke worldwide

Jun 13th, 2016
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http://www.news-medical.net/news/20160613/Air-pollution-becomes-leading-risk-factor-for-stroke-worldwide.aspx

Three quarters of strokes worldwide could be prevented by addressing behavioural risk factors such as smoking, poor diet and low physical activity

Air pollution – including environmental and household air pollution – has emerged as a leading risk factor for stroke worldwide, associated with about a third of the global burden of stroke in 2013, according to a new study published in The Lancet Neurology journal.

The findings, from an analysis of global trends of risk factors for stroke between 1990-2013, also show that over 90% of the global burden of stroke is linked to modifiable risk factors, most of which (74%) are behavioural risk factors such as smoking, poor diet and low physical activity. The authors estimate that control of these risk factors could prevent about three-quarters of all strokes.

The study is the first to analyse the global risk factors for stroke in such detail, especially in relation to stroke burden on global, regional and national levels. The researchers used data from the Global Burden of Disease Study to estimate the disease burden of stroke associated with 17 risk factors in 188 countries. They estimated the population-attributable fraction (PAF) of stroke-related disability-adjusted life years (DALYs) – ie. the estimated proportion of disease burden in a population that would be avoided if exposure to a risk factor were eliminated.

Every year, approximately 15 million people worldwide suffer a stroke – of these, nearly six million die and five million are left with permanent disability. Disability may include loss of vision and/or speech, paralysis and confusion.

Globally, the ten leading risk factors for stroke were high blood pressure, diet low in fruit, high body mass index (BMI), diet high in sodium, smoking, diet low in vegetables, environmental air pollution, household pollution from solid fuels, diet low in whole grains, and high blood sugar (figure 2). About a third (29.2%) of global disability associated with stroke is linked to air pollution (including environmental air pollution and household air pollution). This is especially high in developing countries (33.7% vs 10.2% in developed countries).

In 2013, 16.9% of the global stroke burden was attributed to environmental air pollution (as measured by ambient particle matter [PM] pollution of aerodynamic diameter smaller than 2·5 μm) – almost as much as that from smoking (20.7%) (paper, table). From 1990 to 2013, stroke burden associated with environmental air pollution (PM25) has increased by over 33% (Appendix, table 4).

“A striking finding of our study is the unexpectedly high proportion of stroke burden attributable to environmental air pollution, especially in developing countries. Smoking, poor diet and low physical activity are some of the major risk factors for stroke worldwide, suggesting that stroke is largely a disease caused by lifestyle risk factors. Controlling these risk factors could prevent about three-quarters of strokes worldwide.” says lead author Professor Valery L Feigin, of Auckland University of Technology, New Zealand.

“Our findings are important for helping national governments and international agencies to develop and prioritise public health programmes and policies. Governments have the power and responsibility to influence these risk factors through legislation and taxation of tobacco, alcohol, salt, sugar or saturated fat content, while health service providers have the responsibility to check and treat risk factors such as high blood pressure,” he says.

“Taxation has been proven to be the most effective strategy in reducing exposure to smoking and excessive intake of salt, sugar and alcohol. If these risks take a toll on our health, and taxation is the best way to reduce exposure to these risks, it logically follows that governments should introduce such taxation and reinvest the resulting revenue back into the health of the population by funding much needed preventative programmes and research in primary prevention and health. All it takes is recognition of the urgent need to improve primary prevention, and the good will of the governments to act,” says Professor Feigin.

The relative importance of risk factors varied depending on age group, country and region:

  • Household air pollution was a more important risk factor for stroke in central, eastern, and western sub-Saharan Africa and south Asia (ranked 3rd), compared to North America, central, eastern and western Europe (where it was not in the top 10 risk factors) (paper, figure 2)
  • Low physical activity was a much greater risk factor for stroke among adults over 70 than among adults aged 15-69 (Appx, table 2)
  • Globally, the risk factor that was most reduced between 1990 and 2013 was second-hand smoke (31% reduction in stroke-related DALYs). The greatest reduction was in developed countries (Appx, table 4), but the contribution of second-hand smoke to global stroke burden still remains noticeable at 3.1% for 15-49 year olds, especially in developing countries where it reaches 3.2% (Appx, table 2).
  • The risk factor that was most increased was a diet high in sugar-sweetened beverages (63.1% increase in stroke-related DALYs). The greatest increase was in developed countries (Appx, table 4) but the contribution to stroke burden remains low at 1.6% for 15-49 year olds (Appx, table 2).
  • Air pollution, environmental risks, tobacco smoke, high blood pressure and dietary risks were more important risk factors for stroke in developing countries compared to developed countries.
  • Low physical activity was a more important risk factor for stroke in developed countries compared to developing countries.

The authors say that because of a lack of data, they could not include some important risk factors for stroke such as atrial fibrillation, substance abuse or other health conditions. They were also unable to account for patterns of some risk factors such as levels of smoking, BMI level or underlying genetic risk factors. The data does not differentiate between ischaemic and haemorrhagic strokes but the authors say that while the risk factors for different types of stroke may vary slightly at the individual level, global, regional and national policies tend to look at the overall risk of stroke.

The study also provides information on the contribution of all 17 risk factors for stroke for 188 countries, for example the top 5 risk factors for stroke in the following countries were:

  • UK & USA: high blood pressure, high BMI, diet low in fruit, diet low in vegetables, smoking (Appx, table 7 and 8).
  • India: high blood pressure, diet low in fruit, household air pollution, diet low in vegetables, diet high in sodium (Appx, table 7 and 8).
  • China: high blood pressure, diet low in fruit, diet high in sodium, smoking, environmental air pollution (Appx, table 7 and 8).

Writing in a linked Comment, Professor Vladimir Hachinski, University of Western Ontario, London, Canada and Dr Mahmoud Reza Azarpazhooh, Mashhad University of Medical Sciences, Mashhad, Iran, say:

The most alarming finding was that about a third of the burden of stroke is attributable to air pollution. Although air pollution is known to damage the lungs, heart, and brain, the extent of this threat seems to have been underestimated. Air pollution is not just a problem in big cities, but is also a global problem. With the ceaseless air streams across oceans and continents, what happens in Beijing matters in Berlin. Air pollution is one aspect of the fossil fuel and global warming problem, which is itself partly a result of westernisation and urbanisation, especially in India and China. In 1900, only about 15% of the world’s population lived in cities; now more than half the world’s population does. In cities, particularly in megacities (>10 million inhabitants), getting unhealthy food is easy and getting exercise is hard, emphasising the difficulty of achieving a healthy lifestyle in an unhealthy environment.

EU nations refuse to back limited licence for potentially cancercausing weedkiller

Jun 7th, 2016
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Scores of potentially carcinogenic weedkillers remain for sale across UK and Europe despite European Union nations refusing to back a limited extension of pesticide glyphosate’s licence for use.

A compromise proposal to renew the licence for glyphosate for 12-18 months yesterday failed to win support at the EU executive. Support of 65% was required, but reports said seven states abstained, 20 backed the proposal and one voted against.

Two earlier meetings in 2016 failed to extend the licence for up to 15 years, which led to the compromise and much shorter period being offered.

There are contradictory findings on the carcinogenic risks of glyphosate, which is a component of weedkillers commonly sold by UK and European retailers, which has placed it amid the scrutiny of EU and US politicians, regulators, researchers and consumer groups.

The EU executive hopes a pending study by the EU’s Agency for Chemical Products will allay concerns. European commissioners are due to disucss the matter again today.

The current EU licence for glyphosate expires 30 June.

In the absence of a majority decision, the EU executive could submit its proposal to an appeal committee of political representatives from member states within a month.

If there was again no verdict reached, the European Commission could adopt its own proposal.

Researchers find shared molecular response to tobacco smoke and indoor air pollution

Jan 11th, 2016
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http://medicalxpress.com/news/2016-01-molecular-response-tobacco-indoor-air.html

Exposure to certain household air pollutants may cause some of the same molecular changes as smoking cigarettes.

A study in the journal Carcinogenesis reports non-smoking women living in rural China who burn smoky (bituminous) coal for heating and cooking had gene expression patterns in buccal (cheek) epithelial cells similar to those present in the cheek cells of active cigarette smokers. The study, conducted by investigators at Boston University School of Medicine (BUSM), the U.S. National Cancer Institute (NCI), and others, is the first to identify genomic alterations that result from exposure to smoky coal.

Approximately three billion people in the world use coal and biomass (charcoal, wood, animal dung and crop waste) for cooking and heating. “Lung cancer rates among non-smoking women in China’s rural counties, where smoky coal is used extensively, are among the highest in the world,” noted Qing Lan, MD, PhD, MPH, senior investigator at the NCI, and co-senior author of the study.

Avrum Spira, MD, MS, professor of medicine, pathology and laboratory medicine at BUSM and co-senior and co-corresponding author of the study, has previously shown that tobacco smoke induces gene expression changes throughout the epithelium of the respiratory tract. Since smoky coal is also an established risk factor for lung cancer and other non-malignant respiratory diseases, the researchers were interested to examine whether smoky coal had a similar effect on the respiratory tract.

“While lung cancer in this population has been linked to the usage of smoky coal, as compared to smokeless (anthracite) coal, the molecular changes experienced by those exposed to these indoor air pollutants remained unclear,” said Nathaniel Rothman, MD, MPH, MHS, senior investigator at the NCI, and a co-author of the study.

To understand the physiologic effects of this exposure Spira and his collaborators at NCI analyzed buccal epithelial cells collected from healthy, non-smoking female residents of Xuanwei and Fuyuan county who burned smoky and smokeless coal. Genome-wide gene-expression profiles were examined and changes associated with coal type were compared. The researchers identified 282 genes as differentially expressed in the buccal epithelium of women exposed to smoky versus smokeless coal.

“We then compared our smoky coal gene-expression signature to gene-expression changes observed in tobacco users and found that smoky coal emissions elicited similar physiologic effects. These results shed new light on the molecular mechanisms associated with smoky coal exposure and may provide a biological basis for the increased risk of lung cancer,” explained Spira, who is also director of the Boston University Cancer Center and a pulmonologist at Boston Medical Center. “We hope genomic profiling of the biologic response to solid fuel emissions will ultimately lead to the development of clinically relevant biomarkers,” he added.

“Ultimately, this and other studies of the health effects from indoor air pollution due to smoky combustion highlight the importance of switching to cleaner fuels,” concluded Lan.