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The surprising link between air pollution and Alzheimer’s disease

Jan 31st, 2017
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http://www.latimes.com/science/sciencenow/la-sci-sn-air-pollution-alzheimers-20170131-story.html

With environmental regulations expected to come under heavy fire from the Trump administration, new research offers powerful evidence of a link between air pollution and dementia risk.

For older women, breathing air that is heavily polluted by vehicle exhaust and other sources of fine particulates nearly doubles the likelihood of developing dementia, finds a study published Tuesday. And the cognitive effects of air pollution are dramatically more pronounced in women who carry a genetic variant, known as APOE-e4, which puts them at higher risk for developing Alzheimer’s disease.

In a nationwide study that tracked the cognitive health of women between the ages of 65 and 79 for 10 years, those who had the APOE-e4 variant were nearly three times more likely to develop dementia if they were exposed to high levels of air pollution than APOE-e4 carriers who were not.

Among carriers of that gene, older women exposed to heavy air pollution were close to four times likelier than those who breathed mostly clean air to develop “global cognitive decline” — a measurable loss of memory and reasoning skills short of dementia.

While scientists have long tallied the health costs of air pollution in asthma, lung disease and cardiovascular disease, the impact of air pollutants on brain health has only begun to come to light. This study gleans new insights into how, and how powerfully, a key component of urban smog scrambles the aging brain.

Published Tuesday in the journal Translational Psychiatry, the research looks at a large population of American women, at lab mice, and at brain tissue in petri dishes to establish a link between serious cognitive decline and the very fine particles of pollution emitted by motor vehicles, power plants and the burning of biomass products such as wood.

All three of these biomedical research methods suggest that exposure to high levels of fine air pollutants increases both dementia’s classic behavioral signs of disorientation and memory loss as well as its less obvious hallmarks. These include amyloid beta protein clumps in the brain and the die-off of cells in the brain’s hippocampus, a key center for memory formation.

Using air pollution standards set by the U.S. Environmental Protection Agency, researchers found significant differences on all those measures between those who breathed clean air and those exposed to pollution levels deemed unsafe.

In lab mice, breathing air collected over the 10 Freeway in Los Angeles led to brain concentrations of amyloid protein that were more dense and more likely to form dangerous clumps than breathing air that satisfied EPA standards before 2012. When lab mice were bred with a strong predisposition to develop dementia and its hallmarks, the brain differences between pollution-breathing animals and those that breathed clean air were starker.

In 2011, a study in the journal Lancet found that those who lived close to densely trafficked roads were at a far higher risk of stroke and dementia than those who lived farther away. A year later, a team led by Alzheimer’s disease researcher Dr. Samuel Gandy at Mt. Sinai in New York first established that air pollutants induced inflammation, cell death and the buildup of amyloid protein in the brains of mice.

The new study extends those findings.

Authored by geriatric and environmental health specialists at USC, the new study estimates that before the EPA set new air pollution standards in 2012, some 21% of new cases of dementia and of accelerated cognitive decline could likely have been attributed to air pollution.

There is potential legal significance to the researchers’ finding that women (and mice) who carried a genetic predisposition to developing Alzheimer’s disease were far more sensitive to air pollution’s effects. In devising pollution standards, the EPA is currently required to consider their health impact on “vulnerable populations.” The agency is also required to use its regulatory authority to take steps to protect those populations.

Air pollution has been declining steadily since the EPA promulgated new standards in 2012. But Dr. Jiu-Chiuan Chen, an environmental health specialist at USC’s Keck School of Medicine and the study’s senior author, said it’s not clear that even current standards are safe for aging brains, or for brains that are genetically vulnerable to Alzheimer’s.

The Trump administration has signaled it will look to scrap or substantially rewrite Obama administration regulations that tightened emissions from power plants and established tougher fuel efficiency standards for cars in an effort to curb climate change and reduce air pollution.

“If people in the current administration are trying to reduce the cost of treating diseases, including dementia, then they should know that relaxing the Clean Air Act regulations will do the opposite,” Chen said.

Air pollution costs trillions

Dec 4th, 2016
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Premature deaths due to air pollution cause annual global costs of about US$225 billion in lost work days, and more than US$5 trillion in welfare losses, according to a new study.

http://airclim.org/acidnews/air-pollution-costs-trillions

Exposure to air pollution increases the risk of contracting cancers and heart, lung and respiratory diseases. According to the latest available estimates by the World Health Organization (WHO), 5.5 million premature deaths worldwide, or 1 in every 10 deaths, in 2013 were attributable to indoor and outdoor air pollution.

A joint study, entitled “The Cost of Air Pollution: Strengthening the economic case for action”, published by the World Bank and the Institute for Health Metrics and Evaluation, has estimated the costs of premature deaths related to air pollution.

Using the WHO estimates of premature mortality attributable to air pollution, the study valued the economic costs following two different approaches: Firstly a welfare-based approach that monetizes the increased fatality risk from air pollution according to individuals’ willingness to pay, and secondly an income-based approach that equates the financial cost of premature mortality with the present value of forgone lifetime earnings.

In 2013, the cost to the world’s economy of welfare losses due to exposure to ambient and household air pollution amounted to some US$5.11 trillion. In terms of magnitude, welfare losses in South Asia and East Asia and the Pacific were the equivalent of about 7.5 per cent of the regional gross domestic product (GDP), while in Europe and North America they were equal to respectively 5.1 and 2.8 per cent of GDP. At the low end, losses were still equal to 2.2 per cent of GDP in the Middle East and North Africa.

It is pointed out that the full costs of air pollution to society are even greater than is reported in the study. Examples of other costs not included in this report are the costs of illnesses (e.g. hospital care, medication), reduced output of agricultural crops, damage to natural ecosystems and cultural heritage, and lowered economic competitiveness of growing cities.

On top of being a major health risk, air pollution is also a drag on development. By causing illness and premature death, air pollution reduces the quality of life. By causing a loss of productive labour, it also reduces productivity and incomes.

According to the study, annual labour income losses cost the equivalent of 0.83 per cent of the gross domestic product (GDP) in South Asia. In East Asia and the Pacific, where the population is ageing, labour income losses represent 0.25 per cent of GDP, while in Sub-Saharan Africa, where air pollution impairs the earning potential of younger populations, annual labour income losses represent 0.61 per cent of GDP.

“Air pollution is a challenge that threatens basic human welfare, damages natural and physical capital, and constrains economic growth. We hope this study will translate the cost of premature deaths into an economic language that resonates with policy makers so that more resources will be devoted to improving air quality. By supporting healthier cities and investments in cleaner sources of energy, we can reduce dangerous emissions, slow climate change, and most importantly save lives,” said Laura Tuck, Vice President for Sustainable Development at the World Bank.

Christer Ågren

The report: https://openknowledge.worldbank.org/handle/10986/25013

World Bank press release, 8 September 2016: http://www.worldbank.org/en/news/press-release/2016/09/08/air-pollution-…

Hongkongers could benefit from new air pollution mask that’s six times more effective than rivals

Dec 1st, 2016
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After months of development, a successful Kickstarter crowdfunding campaign and many pre-orders, a Swedish start-up has launched the Airinum Urban Breathing Mask to meet growing global demand

http://www.scmp.com/lifestyle/health-beauty/article/2050738/hongkongers-could-benefit-new-air-pollution-mask-thats-six?cx_tag=recommend_desktop#cxrecs_s

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When Alexander Hjertstrom moved from his native Sweden to the western Indian city of Ahmedabad in the autumn of 2014, he suffered the return of an old fiend: asthma.

The intense air pollution in the city had caused his long-gone respiratory condition to return.

Hjertstrom, then a master’s student on a six-month exchange at the Indian Institute of Management, found that wearing an anti-pollution breathing mask was the most effective way to protect himself. However, he found most masks on the market were primitive and far from perfect in design and construction. They were certainly not appealing to wear every day.

Upon his return to Sweden after finishing a research project on air pollution while in India, Hjertstrom discussed the problem with three friends. Living in Sweden, the clean Scandinavian air was something all four had taken for granted.

“Given how acute the problem of air pollution was and the poor product offerings we could find, we decided to do something about it,” says Fredrik Kempe, a childhood friend of Hjertstrom.

They came up with the Airinum Urban Breathing Mask, which its founders term a “next generation anti-pollution mask”. In tests it has been shown to protect wearers up to six times better than other widely available masks.

After months of development, a very successful Kickstarter crowdfunding campaign and large number of pre-orders, the company opened their online shop for worldwide sales on December 1.

“Compared to all other civilian masks that we’ve found, purchased and tested, our mask really works,” says Kempe, Airinum’s co-founder and chief marketing officer, who has a master’s degree in innovation management.

“Many masks out there today either lack proper filter technology, or they have a poor fit, resulting in leakage and poor filtration. Our mask uses high-quality filters tested here in Sweden in collaboration with Camfil, a global leader in the air filter industry. The construction of the mask has been developed, tested and iterated over the past year to achieve the perfect fit.”

Anti-pollution masks are big business, particularly in smoggy China, where face masks even feature on fashion show catwalks. Sales of masks in China reached 1.7 billion units in 2014, a 20 per cent increase year on year, according to Chinese market research firm Daxue Consulting.

Airinum looks similar to other high-end masks on the market, such as Vogmask, currently the leading face mask in China, and Cambridge Mask. But Kempe says Airinum’s Urban Breathing Mask is “completely different”. For one thing it has a unique changeable filter system, while Vogmask’s filter is permanently sewn into the mask and does not have reusable exhalation valves. So once Vogmask’s filter reaches the end of its useful life (hundreds of hours), or starts to leak, a new mask has to be bought.

Airinum’s mask has proprietary changeable filters that use a three-layer, hi-tech filter technology which protects against up to 99 per cent of viruses, bacteria, allergens and smog. External tests have shown the mask to have better filtration efficiency than the N95 filter mask requirements set forth by the US National Institute for Occupational Safety and Health. For easy breathing, the mask has two custom-made exhalation valves – essential to let warm, moist air out of the mask.

For the perfect fit, the mask uses stretchable material that fits the contours of the wearer’s face. Adjustable ear loops and an elastic binding surrounding the mask ensure a tight seal around the face. The mask comes in five sizes to suit both children and adults.

For some aesthetic flair, the founders sought the expertise of renowned Scandinavian creative minds – Mattias Wiklund, the menswear pattern maker at Swedish fast fashion chain H&M, and Kemal Alidzikovic, who works with Swedish fashion/function brands such as Acne and Haglofs.

The Kickstarter campaign, which ran for five weeks in November and December 2015, gathered up €70,743 (HK$581,522) from 1,386 backers in more than 30 markets, including Hong Kong. Airinum also received funding from the Swedish government, business angels and an accelerator programme in Stockholm.

The Urban Breathing Mask costs US$75 and the price includes the mask and two filters, which last up to 200 hours. The company plans to offer a long-term subscription service for filters.

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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OECD warns of rising costs of air pollution

Oct 3rd, 2016
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Outdoor air pollution could cause up to nine million premature deaths a year by 2060 and cost US$ 3.3 trillion annually as a result of sick days, healthcare expenditure and reduced agricultural output, unless action is taken.

http://airclim.org/acidnews/oecd-warns-rising-costs-air-pollution

In 2010, outdoor air pollution caused more than three million premature deaths worldwide, with elderly people and children most vulnerable. New projections presented in an OECD report “The Economic Consequences of Outdoor Air Pollution” imply a doubling, or even tripling, of premature deaths from particulate matter (PM2.5) and ozone (O3) – or one premature death every four or five seconds – by 2060.

The projected increase in concentrations of PM2.5 and ozone will result in significant economic costs to society. The direct market impact of air pollution in terms of lower worker productivity due to illness, higher spending on health care, and lower crop yields, could exceed US$ 3,000 billion annually by 2060, equal to one per cent of GDP. For example, between now and 2060, the number of annual work days lost to air-pollution-related illness is expected to jump from 1.2 to 3.7 billion.

These estimates of economic market impacts do not however reflect the true costs of air pollution because shortening of people’s lives and pain and suffering from respiratory and cardiovascular diseases do not really have a market price. The OECD has therefore also estimated the non-market welfare costs by using economic studies on how people value their health and how much they would be prepared to pay to reduce the health risks, i.e. by introducing policies and measures that would cut air pollutant emissions.

Based on this data, the current (2015) annual global welfare costs of mortality and morbidity from outdoor air pollution are estimated at US$ 3,440 billion, and by 2060 they would amount to between US$ 20,000 and 27,000 billion a year (see table).

Table: Total global welfare costs of air pollution (billions US$)

global-welfare-costs

It should be noted that air pollution damage to ecosystems, biodiversity and our cultural heritage has not been assigned any monetary value and is therefore not included in these economic estimates.

According to the projections, the biggest rises in air pollution mortality rates are expected in India, China, Korea and Central Asian countries, where rising populations and congested cities mean more people are exposed to high levels of pollution. The premature death rates are forecast to be up to three times higher in 2060 than in 2010 in China and up to four times higher in India. Mortality rates are however seen to be stabilising in the United States and falling in much of Western Europe thanks in part to efforts to move to cleaner energy and transport.

Projected GDP losses will be biggest in China, Russia, India, Korea and countries in Eastern Europe and the Caspian region, as health costs and lower labour productivity hit output.

“The number of lives cut short by air pollution is already terrible and the potential rise in the next few decades is terrifying,” said OECD Environment Director Simon Upton. “If this is not motivation enough to act, this report shows there will also be a heavy economic cost to not taking action. We must prevent these projections from becoming reality.”

“It is time for governments to stop fussing about the costs of efforts to limit air pollution and start worrying about the much larger costs of allowing it to continue unchecked. Their citizens’ lives are in their hands,” concluded Simon Upton.

Christer Ågren

Something in the air: Is Hong Kong’s pollution problem worsening?

Sep 21st, 2016
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https://www.timeout.com/hong-kong/blog/something-in-the-air-is-hong-kongs-pollution-problem-worsening-092116

The government is trumpeting recent figures that show air pollution is significantly decreasing but is the news as good as it sounds? And what other forms of pollution should Hongkongers worry about?

Christie Tse and Joyce Au find out

“See the people walking by right now? Leisurely walking past, enjoying life, breathing the fresh air?” asks Dr Bob Tsui, vicechairman of NGO Clear The Air, as he points out his office window overlooking the streets of Jordan. You are being ‘attacked through your eyes, your cornea, your nostrils, your mouth and your skin” all the time, he follows up. As you’re reading this, tiny deadly pollution particles called magnetites are slowly moving up your nostrils, penetrating your brain tissue, nervous system and lungs. In a crowded, polluted city like Hong Kong, your body is constantly under attack, every second of every day according to Dr Tsui.

According to government statistics, though, air pollution has been decreasing for several years now. The Environmental Protection Department reckons that between 2011 and 2015, average concentrations of PM10, PM2.5, nitrogen dioxide and sulphur dioxide at roadside monitoring stations fell by 26 percent, 21 percent, 19 percent and 33 percent, respectively. The figures sound impressive and the government has been running adverts on TV trumpeting its success at clearing the air.

However, all is not rosy. Recent studies conducted by scientists in Mexico City have discovered a correlation between 100 and 200 nanometer magnetites released through the exhaust pipes of taxis and buses and the development of Alzheimer’s disease. This new information has sparked concern in the local scientific community since roadside pollution remains one of the leading causes of air pollution in our jam-packed city. “In the past 20 years, Hong Kong has not once met its own Air Quality Index standard or that of the World Health Organisation’s,” exclaims Patrick Fung, CEO of NGO Clean Air Network. Paul Zimmerman, Southern District councillor, believes this is unforgiveable, as ‘it’s almost like violence is around you the whole time’, he tells us.

And that’s not the half of it. You may think you can avoid pollution by simply turning recluse and staying at home, but you’d be very wrong.

Studies conducted at the University of Hong Kong reveal that our own kitchens discharge carcinogenic particles into the air every time food is made with vegetable oil. Dr Tsui states that vegetable oil is ‘the most dangerous oil you can use’ since it contributes to air pollution. Clear The Air has published an article that details the process by which vegetable oil, when subjected to high temperatures, oxidises into cancer causing chemicals. “People wonder how they get sick because they eat well all their lives,” Dr Tsui remarks, “but they don’t realise they’re constantly surrounded by these cancerous particles.”

The worst part of all of this is that the toxic kitchen discharge is completely preventable. According to Dr Tsui, the government has the ability and resources to go into restaurants and check their deep friers for dangerous particles.

“It’s a simple test strip and they can do it very easily,” he tells us. “But I have made this announcement for years and the government has not taken any action!” By placing steam jet filters in the kitchen stove, the carcinogenic particles could be released into water. This wouldn’t contaminate the water, according to Dr Tsui, because by the time the dangerous particles pass through the filter and hit the water, many things happen chemically to make the particles no longer harmful.

And cooking oil and air pollution are not the only worries we need have in Hong Kong. After the waves of rubbish that washed up on our beaches over the summer, Hongkongers should be acutely aware of the problem of landfill. Around 30 percent of landfill is made of Styrofoam and in 500 years, that same Styrofoam will still not have decomposed. What’s worse, Styrofoam is mainly composed of styrene, an extremely dangerous chemical that has been linked to cancer, vision and hearing loss, impaired memory and concentration, damage to the nervous systems and depression. “Styrene is dangerous,” Dr Tsui declares. “Styrene is vicious. Styrene should not exist in the food chain and yet, every restaurant [in Hong Kong] today still uses Styrofoam takeout boxes.” Worryingly, when we eat hot food or drink hot liquid from Styrofoam plates, boxes or cups, it’s possible for us to consume the styrene that leaches out of the hazardous material.

Once we’ve ingested these dangerous chemicals, they can swim into our bloodstreams, penetrate our organs and cause irrevocable damage to our bodies. Even Styrofoam that’s out in the ocean can ultimately affect us since when marine life, such as fish, consume it, styrene enters the food chain and eventually, Dr Tsui believes, ‘we’ll eat the darn thing’.

Dr Tsui asks: “How can the government be so blind and be so idiotic to allow this to go on?” Just as toxic kitchen discharges are preventable, so too is the use of Styrofoam. Not just in the food industry but all industries. Instead of using Styrofoam boxes for takeaway meals, companies should start using biodegradable containers, Clear The Air advocates. This minor innovation is also very much within the grasp of companies’ capabilities. Fibre generated from corn can be made to make the boxes and then coated in honey wax. Best of all, these resources are biodegradable.

Another solution that the government and corporations can consider implementing, according to Clear The Air, is changing the original chemical composition used to make Styrofoam. The government could order corporations to put titanium dioxide polymers in the Styrofoam so that once the material is dumped on landfill or into the ocean and exposed to UV light, the Styrofoam will disintegrate into carbon dioxide and water, which equates to less harmful pollution.

There are many little things we can do to contribute to a more environmentally friendly society, such as switching off the lights when we leave a room, turning off the air conditioner when we leave the house, adding insulated panels to our windows and attaching solar panels to our roofs. The list is endless. But while every little helps, these changes are too-little-too-late because, ultimately, it is up to our local authority to enact the kind of legislative reform required to make a real difference. As Dr Tsui so clearly puts it: “No matter how rich or how poor you are, you are subjected to this kind of invisible attack. The government needs to stop with the [political games] and start working on practical solutions to eradicate pollution-induced cancer.”

Unfortunately, when it comes to asking the government for help, every issue seems like an urgent matter. Compared to global threats such as deadly diseases like the zika virus or even more mundane local issues like affordable housing, the largely invisible problem of pollution is all too often pushed to the bottom of the list of priorities.

The public, not just the government, underestimate the drastic consequences of air contamination since the effects are not as apparent as many other similarly pressing matters. But pollution is an urgent problem because it surrounds us all. It’s in the air we breathe, the places we walk and the supposedly safe confines of our own homes. We live and breathe pollution whether we like it or not, so it’s about time we paid attention.

For more information visit cleartheair.org.hk.

Alzheimer’s could be caused by toxic air pollution particles found in brain tissue

Sep 6th, 2016
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Abundance of magnetite in brains of people from Mexico City and Manchester described as “dreadfully shocking”

http://www.independent.co.uk/life-style/health-and-families/health-news/alzheimers-toxic-air-pollution-particles-brain-tissue-magnetite-barbara-maher-a7227891.html

Minute magnetic particles typically found in air pollution have been detected in “abundant” quantities in human brain tissue for the first time.

The tiny particles of iron oxide, known as magnetite, are toxic and it has been suggested they could play a role in causing or hastening the onset of Alzheimer’s disease.

The study, in which brain tissue samples from 37 people were collected from those who had lived in Mexico City and in Manchester in the UK, is the first to prove magnetite particles found in air pollution have made their way into the brain.

Magnetite naturally occurs in angular formations in the brain. But for every one natural angular particle, researchers found as many as 100 smooth, spherical particles.

The smooth shape of the observed magnetite particles is characteristic of high temperature formation, such as from vehicle (particularly diesel) engines, power stations or open fires, researchers said.

The toxic magnetite particles disrupt normal cellular functions in the brain by causing oxidative stress, and by the creation of unstable free radicals – particles which damage essential structures in brain cells.

Though no definite link between magnetite and Alzheimer’s has been established, previous studies have found a correlation between high quantities of the compound and the disease in the brains of Alzheimer’s sufferers.

The study was led by scientists at Lancaster University and published in the Proceedings of the National Academy of Sciences (PNAS).

The World Health Organisation warned as many as three million premature deaths every year were the result of air pollution.

In the UK it is thought as many as 50,000 people die each year due to air pollution. A further 520,000 are affected by Alzheimer’s, a common form of dementia.

Physicist Barbara Maher, co-director of the Centre for Environmental Magnetism and Paleomagnetism at Lancaster University said in a statement: “Our results indicate that magnetite nanoparticles in the atmosphere can enter the human brain, where they might pose a risk to human health, including conditions such as Alzheimer’s disease.

“The particles we found are strikingly similar to the magnetite nanospheres that are abundant in the airborne pollution found in urban settings, especially next to busy roads, and which are formed by combustion or frictional heating from vehicle engines or brakes.”

Speaking to the BBC she added: “It’s dreadfully shocking. When you study the tissue you see the particles distributed between the cells and when you do a magnetic extraction there are millions of particles, millions in a single gram of brain tissue – that’s a million opportunities to do damage.”

Professor David Allsop, a specialist in Alzheimer’s at the University of Lancaster and co-author of the study, said: “This finding opens up a whole new avenue for research into a possible environmental risk factor for a range of different brain diseases.”

Geophysicist Joe Kirschvink at California Institute of Technology in Pasadena, who first detected naturally formed magnetite particles in the brain 25 years ago, told the journal Science, he believes the presence of the particle in the brain is “disturbing”.

He said: “Once you start getting larger volumes of [environmental] magnetite, the chemical reactivity goes way up.

“That nanoparticles of industrially generated magnetite are able to make their way into the brain tissues is disturbing.”

Dr David Reynolds, chief scientific officer at Alzheimer’s Research UK, told the Press Association: “Little is known about the role of magnetite nanoparticles in the brain and whether their magnetic properties influence brain function.

“It’s interesting to see further research investigating the presence of this mineral in the brain, but it’s too early to conclude that it may have a causal role in Alzheimer’s disease or any other brain disease.

“We know that air pollution can have a negative impact on certain aspects of human health, but we can’t conclude from this study that magnetite nanoparticles carried in air pollution are harmful to brain health.”

Policymakers should take note of the results, Professor Maher told Science.

“It’s an unfortunately plausible risk factor, and it’s worth taking precautions. Policymakers have tried to account for this in their environmental regulations, but maybe those need to be revised,” she said.

Air pollution causes wrinkles and premature ageing, new research shows

Jul 15th, 2016
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Toxic fumes may be the primary cause of skin ageing in polluted cities such as London, New York and Beijing, scientists say

https://www.theguardian.com/environment/2016/jul/15/air-pollution-causes-wrinkles-and-premature-ageing-new-research-shows

Air pollution is prematurely ageing the faces of city dwellers by accelerating wrinkles and age spots, according to emerging scientific research.

The effects of toxic fumes on skin are being seen in both western cities, such as London and New York, as well as in more visibly polluted Asian cities and in some cases may be the primary cause of ageing. The pollution is also being linked to worsening skin conditions such as eczema and hives.

The scientific discoveries are now driving the world’s biggest cosmetics companies to search for solutions, including medicine-like compounds that directly block the biological damage. But doctors warn that some common skin care routines, such as scrubs, make the damage from air pollution even worse.

Poisonous air is already known to cause millions of early deaths from lung and heart diseases and has been linked to diabetes and mental health problems. But perhaps its most visible impact, the damage caused to skin, is just beginning to be understood.

“With traffic pollution emerging as the single most toxic substance for skin, the dream of perfect skin is over for those living and working in traffic-polluted areas unless they take steps to protect their skin right now,” said Dr Mervyn Patterson, a cosmetic doctor at Woodford Medical clinics in the UK.

“Unless people do more they will end up wearing the pollution on their faces in 10 years’ time. It is definitely something people now need to take seriously.”

Prof Jean Krutmann, director at the Leibniz Research Institute for Environmental Medicine in Germany, said: “UV [damage from the sun] was really the topic in skin protection for the last 20-30 years. Now I think air pollution has the potential to keep us busy for the next few decades.”

Air pollution in urban areas, much of which comes from traffic, includes tiny particles called PMs, nitrogen dioxide (NO2) and chemicals such as polycyclic aromatic hydrocarbons (PAHs). “What is very clear is that PMs are a problem for skin,” said Krutmann, whose work has shown PMs increase age spots and wrinkles.

But one of the his newest studies showed NO2 also increases ageing. They studied people in both Germany and China and discovered that age spots on their cheeks increased by 25% with a relatively small increase in pollution, 10 microgrammes of NO2 per cubic metre. Many parts of the UK have illegally high levels of NO2, with London breaking its annual limit in the first week of 2016, with levels reaching over 200 microgrammes of NO2 per cubic metre.

Krutmann said other factors, such as UV exposure, nutrition and smoking contribute to ageing: “But what we can say is that, at least for the pigment spots on the cheeks, it seems air pollution is the major driver.”

“It is not a problem that is limited to China or India – we have it in Paris, in London, wherever you have larger urban agglomerations you have it,” he said. “In Europe everywhere is so densely populated and the particles are being distributed by the wind, so it is very difficult to escape from the problem.”

The accelerated skin ageing was seen in relatively young people and Patterson said: “If you are seeing these changes in middle age, these are worrying trends.”

Other recent research is summed up in a review paper in the journal Frontiers in Environmental Science, which concluded: “Prolonged or repetitive exposure to high levels of these [air] pollutants may have profound negative effects on the skin.”

Understanding exactly how air pollution causes the skin damage is at an early stage, according to Krutmann: “We are just now dipping into the mechanisms.” But many of the pollutants are known to pass easily through the skin and cause a variety of impacts.

“These agents have a very irritating effect and once they get into the skin, they activate multiple pathways of inflammation,” said Patterson. “Some pathways ignite the melanocytes, which create far too much pigment and end up giving you unwanted sun spots.”

“Other pathways ignite messengers that make blood vessels grow, that’s what results in increased redness and potentially rosacea,” he said. “Also, if you damage skin, it goes into repair mode and excites enzymes which re-adsorb damaged collagen. When you have too much chronic inflammation, these enzymes remove more collagen than your skin can create. This produces skin laxity and that’s where fine lines and wrinkles come in.”

Dr Debra Jaliman, a skin expert based in New York City, says her patients are now worrying about the impact of air pollution on their skin, which she said can cause darkening of the skin and acne-like eruptions, as well as ageing.

“At the moment, there are not many products for prevention [of air pollution damage], however it may be a trend in the coming years as it becomes a much bigger issue,” she said.

Major beauty companies have begun their own research and are launching the first products formulated to battle skin damage from toxic air. Dr Frauke Neuser, senior scientist for Olay, a Procter and Gamble brand, has run studies showing significantly lower skin hydration in people living in polluted areas and lab studies showing that diesel fumes and PMs cause inflammation in skin cells.

Her team then screened for ingredients that could counteract some of the damaging effects. “We found niacinamide – vitamin B3 – to be particularly effective,” she said. “We have recently increased its level in several products by as much as 40%.”

Frauke’s work has also shown direct correlations between spikes in PM air pollution in Beijing and an increase in hospital visits by people with skin conditions including hives. “This indicates that not only skin ageing but also skin health are affected by air pollution,” she said.

L’Oreal, another cosmetics giant, published a medical study in 2015 showing that eczema and hives were more common in people in Mexico exposed to higher levels of air pollution, a conclusion supported by separate research in Canada. “The next step is to understand more deeply the environment-induced damages, in order to develop skin ageing prevention routines and products,” said Dr Steve Shiel, scientific director at L’Oreal.

Clinique, a big makeup brand, has already launched a sonic face cleansing brush it claims better removes pollution. “This [air pollution] is not going to go away. This is not a problem that is easily fixed,” said Janet Pardo at Clinique.

However, researchers are now working on medicine-like compounds that block the damage from air pollution from occurring in the first place. Krutmann’s lab helped Symrise, one of the world’s biggest suppliers of cosmetics ingredients, identify one, though the lab has no commercial stake in the product, which is called SymUrban.

“We found one molecule that can do the job,” he said, and it is now being registered as cosmetic ingredient. “In a few years from now I expect we will see cosmetic products that can specifically protect against skin ageing from air pollution.”

Patterson said it is possible for people to give themselves some protection now. “You don’t have to sit back passively and put up with it. You can take sensible, easy steps that will make a difference.”

“If your skin is really healthy, it is quite a good barrier,” he said, explaining that the top layer is like a roof – flattened cells like tiles separated by protective lipids.

“Certain skin care products are very disruptive to the surface of the skin,” he warned. “So a darling of the industry is retinoids, but these have a very profound negative effect on barrier function. Another darling of the industry is glycolic acid, but it is also very disruptive to the external skin barrier. People think these are good skin care, making the skin look smoother, but they are not helpful for the overall health of the skin barrier.”

Patterson is also dismissive of face scrubs: “The skin is trying its damnedest to make this wonderful defence mechanism and what do women and men do? They scrub the hell out of it. It just doesn’t make sense.” He said products that help repair the skin barrier, by delivering the pre-cursor lipids the cells need, are beneficial, as are ones that tackle inflammation.

“You can also put on a very nice physical shield in the form of good quality mineral makeup,” he said. “That produces an effect like a protective mesh and probably has some trapping effect, protecting against the initial penetration of particles. But you also need always to try to remove that shield in the evening, washing the slate clean every night.”

Air pollution—crossing borders

Jul 8th, 2016
by Editor.
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http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31019-4/fulltext

A silent killer responsible for more deaths than the number from HIV/AIDS, tuberculosis, and road injuries combined. A killer indifferent to political agendas and that cannot be contained by borders. Air pollution is associated with around 6·5 million deaths each year globally. While premature deaths from household air pollution are projected to decline from 3·5 million today to 3 million by 2040, premature deaths from outdoor pollution are set to rise from 3 million to 4·5 million in the same period. Transformative action is needed to mitigate this death toll.

There is a dearth of information available on the health effects and economic impact of environmental pollution. Proven solutions are available, but implementation remains a challenge that requires coordinated efforts across sectors and nations. A report by the World Wildlife Fund’s European Policy Office, Climate Action Network Europe, the Health and Environment Alliance, and Sandbag has, for the first time, quantified the cross-border health effects of air pollution from coal use in electricity generation in the European Union (EU), estimating total associated economic costs of up to €62·3 billion. The report aims to promote debate on the rapid phase-out of coal-burning power generation and calls for action at the national and EU level. Toxic particles created by burning coal can be carried beyond the borders of the countries where the power plants are situated. In France, where coal burning is low, 1200 premature deaths a year are caused by air pollution from the Czech Republic, Germany, Poland, Spain, and the UK. The cross border nature of coal pollution highlights the need for governments to work together to urgently phase out coal burning.

The need for cooperation is reiterated in a special report on Energy and Air Pollution from the International Energy Agency (IEA), which campaigns for global action to overcome the negative environmental effects of energy use. The report cites energy production as the most important source of air pollution coming from human activity and presents strategies to tackle energy poverty in developing countries, reduce pollutant emissions through post-combustion control technologies, and promote clean forms of energy.

The Clean Air Scenario presented by IEA uses benchmarks for air quality goals, such as WHO guideline levels, to set long-term targets. Strategies outlined for the energy sector are adapted to different national and regional settings. In developing countries in Asia and sub-Saharan Africa, a notable health impact arises from smoky environments caused by use of wood and other solid fuels for cooking; whereas power plants, industrial facilities, and vehicle emissions are the main causes of outdoor pollution in many high-income countries. Cities in particular are susceptible to becoming pollution hotspots due to concentrated populations, energy use, and traffic.

Although the report takes important steps in tailoring policies to local and national conditions, the proposals are not ambitious enough. For example, the report sets out a scenario in which the number of people being exposed to fine particulate matter levels above the WHO guideline in the EU will be less than 10% by 2040. Yet in the USA, average air pollution limits are already below national limits, having declined by 70% since 1970 despite growth in population levels and energy consumption. Setting half-hearted goals as far ahead as 2040 will only widen the gap between the USA and the rest of the world. The report recognises the need for clearly defined responsibilities, reliable data, and a focus on compliance and policy improvement to keep strategies on course. However, long-term goals can be easy to forget or conveniently ignore, particularly if the issue is allowed to slip down the political agenda. Now is not a time to become complacent, but to match the strides being made by the USA in improving air quality.

The Lancet, the Global Alliance on Health and Pollution (GAHP), and the Icahn School of Medicine at Mount Sinai, with coordination from the UN Environment Programme and the World Bank, have united to produce a Commission on Pollution, Health, and Development. The aim of the Commission is to inform key decision makers globally of pollution’s severe and under-reported contribution to the global burden of disease and to present available pollution control strategies and solutions, dispelling the myth of pollution’s inevitability and combating apathy. In a turbulent political climate, environmental pollution must not be allowed to fall by the wayside. Policies should take centre stage and nations must come together in a spirit of mutual cooperation to tackle air pollution.

Air pollution becomes leading risk factor for stroke worldwide

Jun 13th, 2016
by Editor.
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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.

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