Study
Air pollution stunting children’s lungs, study finds
A six-year study finds children living in highly polluted parts of cities have up to 10 per cent less lung capacity than normal, with warnings the damage could be permanent
http://www.telegraph.co.uk/journalists/laura-donnelly/11953613/Air-pollution-stunting-childrens-lungs-study-finds.html
High levels of air pollution are stunting the growth of children’s lungs, a major study has found.
Eight and nine-year-olds living in cities with high levels of fumes from diesel cars have up to 10 per cent les lung capacity than normal, the research suggests.
Over six years, researchers examined the lung function of 2,400 children at 25 schools across east London, and found a direct correlation between air pollutant exposure and reduced lung growth.
Such children have an increased risk of disease such as asthma and bronchitis and, and the prospect of a permanent reduction in lung capacity.
The tests checked the volume of air each child could breathe, as well as levels of inflammation in their lungs, with urine tests to check for heavy metals, which are produced by vehicles.
Overall, those living in areas with high levels of particulates and nitrogen dioxide had up to 10 per cent reduced lung capacity the study led by Prof Chris Griffiths, principal investigator at the Medical Research Council and Asthma UK Centre in Allergic Mechanisms of Asthma.
“The data shows that traffic pollution stops children’s lungs growing properly,” Ian Mudway, a respiratory toxicologist at King’s College London told the Sunday Times.
“The evidence suggests that by 8-9 years old, children from the most polluted areas have 5 to 10 per cent less lung capacity and they may never get that back.”
The study was designed to assess the impact of London’s Low Emission Zone (LEZ) which since 2008 has discouraged larger diesel vehicles such as lorries from entering the capital.
The research found the measure had made no difference.
“It is very disappointing that the LEZ, which was specifically designed as a major public health intervention, has so far brought about no change,” said Prof Griffiths.
“This raises questions over the government’s current consultation on air quality, which is based around the idea of creating similar low emission zones in up to 30 other polluted urban areas. There appears to be no evidence that these low emission zones can reduce pollution or improve health.”
Other studies have shown diesel pollutants causing lung inflammation, researchers said, with tests showing black carbon from diesel exhaust emissions inside children’s lung cells.
Earlier this year research suggested that air pollution could increase the risk of brain damage and small strokes which are linked to dementia.
Environmental groups say diesel cars could be phased out as part of Government efforts to address pollution.
Nearly 9,500 people die early in a single year as a result of air pollution in London, study finds
http://www.independent.co.uk/news/uk/home-news/nearly-9500-people-die-early-in-a-single-year-in-london-as-a-result-of-air-pollution-study-finds-10390729.html
Researchers find the number of premature deaths caused by air pollution was higher than previously thought
James Rush
Wednesday 15 July 2015
Nearly 9,500 people died early in a single year as a result of long-term exposure to air pollution in London, according to new research.
Researchers from King’s College London found the number of premature deaths caused by air pollution was higher than previously thought after taking into account the effects of both airborne particles, also known as PM2.5, and nitrogen dioxide (NO2), a toxic gas which is largely a by-product of diesel engines.
It is believed to be the first time an attempt has been made to quantify the health and economic impacts of NO2, with previous studies focusing only on PM2.5.
The researchers estimated the number of premature deaths associated with PM2.5 in 2010 was 3,537, while the number of deaths associated with NO2 was believed to be 5,879 – creating a total of 9,416 premature deaths attributed to air pollution.
In January this year it was reported that NO2 levels in Oxford Street had exceeded the legal limit for the whole of 2015 in the space of just four days – while the limit was also breached in Putney High Street a day later.
Meanwhile in April the Supreme Court ordered the government to take action to bring UK air pollution within legal limits after a case was brought by environmental law group ClientEarth.
The new report, put together for the Greater London Authority, has found that most of the deaths caused by NO2 were linked to road transport and other sources from within the city, while health issues caused by PM2.5 were predominantly from particles created outside of London, including emissions transported from Europe.
The Mayor of London Boris Johnson has now called for the UK government and the EU to take further action to improve air quality across Europe in the wake of the latest research.
Simon Birkett, founder and director of Clean Air In London, applauded Mr Johnson “for leading the world by publishing the first estimates for the number of deaths attributable to nitrogen dioxide (NO2) as he famously did for particles in 2010” but also called for a ban on diesel from the most polluted areas by 2018.
He said: “These estimates will send shockwaves around the world. We were expecting bad news given scientists say many roads in central London will tend to have the highest concentrations of NO2 in the world and levels in Oxford Street are well over three times the legal limit that have been in legislation since 1999 to be met by 2010. But these numbers are much worse than the 7,500 total deaths attributable to long-term exposure to air pollution that we estimated from the Mayor’s Ultra Low Emission Zone consultation documents late last year.”
The Mayor of London’s office has said due to the fact the data is five years old, it will not include the impact of measures implemented since 2010. These include the tightening of Low Emission Zone standards, the delivery of more than 1,300 hybrid buses and the introduction of age limits for taxis.
The Mayor has also confirmed the introduction of the Ultra Low Emission Zone in London from 2020.
Campaigners however have said the government must do more to prevent premature deaths caused by air pollution.
Alan Andrews, a lawyer at ClientEarth, said: “This new research piles more pressure on the government to come up with a clear and credible plan to cut pollution from diesel vehicles.”
He went on to say: “Nitrogen dioxide is produced mainly by diesel vehicles. We need to get the worst polluting of these out of our towns and cities, away from our schools and hospitals. That requires action from the government on a national scale.”
Philip Insall, health director at charity Sustrans, said: “The evidence of damage caused by air pollution is so damning that the Government can’t afford not to act, and act now.
“By reducing our reliance on motor vehicles and putting serious investment into walking and cycling we can slash pollution, and at the same time we will benefit from lower obesity, reduced traffic congestion and more pleasant urban environments.”
Dr Penny Woods, Chief Executive of the British Lung Foundation, said: “Exposure to air pollution increases the risk of lung cancer, impairs child lung development and increases the risk of hospitalisation among people with a pre-existing lung condition. It is time we stop talking and take immediate action to prevent more people being needlessly killed by the air that they breathe.”
Mr Johnson said: “I’ve been criticised for cleaning up taxis, upgrading bus fleets and my plans for the world’s first Ultra-Low Emission Zone in 2020, but this study shows imperatively why these bold measures are required. I need the help and strong support of the Government and the EU to effectively win London’s pollution battle and target the enormous amount of toxic air transported into our great capital internationally.”
The government’s scientific advisors are set to warn this year that air pollution across the UK may be to blame for as many as 60,000 early deaths in Britain each year.
In November The Sunday Times reported that the Committee on the Medical Effects of Air Pollutants, an official advisory body, was expected to publish a report this year showing that the premature death toll caused by road traffic pollution is around twice as high as originally thought.
Combined effects of prenatal polycyclic aromatic hydrocarbons and material hardship on child IQ
http://www.sciencedirect.com/science/article/pii/S0892036215000380
Highlights
•PAH–DNA adducts in cord blood provided an individual measure of prenatal exposure.
•Material hardship in pregnancy and child’s early life proxied economic deprivation.
•Adverse effects on child IQ at age 7 were seen only among mothers with hardship.
•Interaction between high adducts and hardship on working memory was significant.
•These results indicate the need for a multifaceted approach to prevention.
Abstract
Importance
Polycyclic aromatic hydrocarbons are common carcinogenic and neurotoxic urban air pollutants. Toxic exposures, including air pollution, are disproportionately high in communities of color and frequently co-occur with chronic economic deprivation.
Objectives
We examined whether the association between child IQ and prenatal exposure to polycyclic aromatic hydrocarbons differed between groups of children whose mothers reported high vs. low material hardship during their pregnancy and through child age 5. We tested statistical interactions between hardships and polycyclic aromatic hydrocarbons, as measured by DNA adducts in cord blood, to determine whether material hardship exacerbated the association between adducts and IQ scores.
Design
Prospective cohort. Participants were recruited from 1998 to 2006 and followed from gestation through age 7 years.
Setting
Urban community (New York City)
Participants
A community-based sample of 276 minority urban youth
Exposure measure
Polycyclic aromatic hydrocarbon–DNA adducts in cord blood as an individual biomarker of prenatal polycyclic aromatic hydrocarbon exposure. Maternal material hardship self-reported prenatally and at multiple timepoints through early childhood.
Main outcome measure
Child IQ at 7 years assessed using the Wechsler Intelligence Scale for Children.
Results
Significant inverse effects of high cord PAH–DNA adducts on full scale IQ, perceptual reasoning and working memory scores were observed in the groups whose mothers reported a high level of material hardship during pregnancy or recurring high hardship into the child’s early years, and not in those without reported high hardship. Significant interactions were observed between high cord adducts and prenatal hardship on working memory scores (β = − 8.07, 95% CI (− 14.48, − 1.66)) and between high cord adducts and recurrent material hardship (β = − 9.82, 95% CI (− 16.22, − 3.42)).
Conclusion
The findings add to other evidence that socioeconomic disadvantage can increase the adverse effects of toxic physical “stressors” like air pollutants. Observed associations between high cord adducts and reduced IQ were significant only among the group of children whose mothers reported high material hardship. These results indicate the need for a multifaceted approach to prevention.
Air pollution costs European economies US$ 1.6 trillion a year in diseases and deaths, new WHO study says
A staggering US$ 1.6 trillion is the economic cost of the approximate 600 000 premature deaths and of the diseases caused by air pollution in the WHO European Region in 2010, according to the first-ever study of these costs conducted for the Region. The amount is nearly equivalent to one tenth of the gross domestic product (GDP) of the entire European Union in 2013.
The new study was published today by the WHO Regional Office for Europe and the Organisation for Economic Co-operation and Development (OECD) as a 3-day high-level meeting on environment and health in Europe opens. Over 200 representatives from European countries and international and nongovernmental organizations gather in Haifa, Israel, on 28–30 April 2015 to look at achievements, gaps and challenges and set future priorities.
“Curbing the health effects of air pollution pays dividends. The evidence we have provides decision-makers across the whole of government with a compelling reason to act. If different sectors come together on this, we not only save more lives but also achieve results that are worth astounding amounts of money,” says Dr Zsuzsanna Jakab, WHO Regional Director for Europe. “Cross-sectoral work is the backbone of the environment and health process, which was initiated 26 years ago, and it is even more relevant today in the discussions taking place at this meeting in Haifa.”
A ground-breaking report: economic cost of the health impact of air pollution in Europe
Economic cost of the health impact of air pollution in Europe is the first assessment of the economic burden of deaths and diseases resulting from outdoor and indoor air pollution in the 53 countries of the Region.
The economic cost of deaths alone accounts for over US$ 1.4 trillion. Adding another 10% to this, as the cost of diseases from air pollution, results in a total of almost US$ 1.6 trillion. In no less than 10 of the 53 countries of the Region, this cost is at or above 20% of national GDP (see Annex for data by country). The study uses the methodology applied in a 2014 report by OECD and makes the calculations based on the most recent economic estimates of the health impacts of air pollution.
The economic value of deaths and diseases due to air pollution – US$ 1 600 000 000 000 – corresponds to the amount societies are willing to pay to avoid these deaths and diseases with necessary interventions. In these calculations, a value is attached to each death and disease, independent of the age of the person and which varies according to the national economic context.
Air pollution: the single largest environmental health risk
Over 90% of citizens in the Region are exposed to annual levels of outdoor fine particulate matter that are above WHO’s air quality guidelines. This accounted for 482 000 premature deaths in 2012 from heart and respiratory diseases, blood vessel conditions and strokes, and lung cancer. In the same year, indoor air pollution resulted in an additional 117 200 premature deaths, five times more in low- and middle-income countries than in high-income countries.
“Reducing air pollution has become a top political priority. Air quality will be a key theme at the next Environment for Europe Ministerial Conference in Georgia in 2016”, says Mr Christian Friis Bach, Executive Secretary of the United Nations Economic Commission for Europe (UNECE). “Fifty-one countries are today finding joint solutions in the framework of the UNECE Convention on Long-range Transboundary Air Pollution. This work must be strengthened to reduce air pollution even further and extended to more countries and to other regions.”
“About 2500 people are estimated to die in Israel annually as a result of exposure to air pollutants. The main source of air pollution is transportation, mainly in major city centres,” says Mr Ofir Akunis, Deputy Minister of Environmental Protection and Member of Knesset (Parliament) for Israel. “Since 2011, the Ministry of Environmental Protection’s Clean Air Law regulates pollutants from major sources such as transport, industry and energy in accordance with the most stringent standards. The Ministry aims to use all available resources to reduce air pollution, as this means saving the lives of thousands of people, as well as billions to the Israeli economy”.
Improving environment and health in Europe: how far have we gotten?
The cost of the health impacts of air pollution is only one of many studies that will provide evidence on the environmental impacts on health to be released at the Haifa meeting.
Another new report, Improving environment and health in Europe: how far have we gotten? jointly published by WHO and UNECE, informs that one in four Europeans still falls sick or dies prematurely from environmental pollution. Data from several surveys in priority thematic areas such as water and sanitation, air quality, the day-to-day surroundings of children’s lives, chemicals and asbestos, climate change and health inequalities all show that while progress has been remarkable, it has been uneven (see Fact Sheet on the report).
Air pollution , stroke, and anxiety
Particulate air pollution is an emerging risk factor for an increasing number of common conditions
The effects of air pollution on the lungs and heart are now widely appreciated, with expanding evidence for an important role in cardiac disease.1 The Global Burden of Disease Study identified fine particulate matter (PM2.5) in outdoor air and household air pollution from use of solid fuels as the ninth and fourth leading risk factors, respectively, for disease worldwide,2 and the World Health Organization attributes one in every eight deaths to air pollution.3 The effects of air pollution are not limited to cardiopulmonary diseases. Recent evidence suggests a role in diverse outcomes, including diabetes,4 low birth weight, and preterm birth.5 This research stems from improved understanding of the role of air pollution in initiating systemic inflammation, a response that may affect multiple organ systems. Two linked studies (doi:10.1136/bmj.h1295, doi:10.1136/bmj.h1111) add to growing evidence that air pollution is an important risk factor for an increasing number of common diseases.6 7
In the first of the two papers, Shah and colleagues6 systematically reviewed and meta-analysed 103 studies conducted in 28 countries and including 6.2 million events to assess the role of short term fluctuations in air pollution as a trigger for stroke. Although evidence from several cohort studies of long term exposure to particulate matter indicates associations with stroke mortality, such findings are not universal.8
The role of air pollution as a possible trigger for stroke has important implications for disease burden, especially in China where air pollution and the incidence of (especially haemorrhagic) stroke are high. In their analysis, Shah and colleagues found that increases in each of the common gaseous and particulate air pollutants were significantly associated with admission to hospital for stroke or stroke related mortality, with associations strongest for strokes on the same day as exposure; increased ozone was only weakly associated with cerebrovascular events.
Air pollution remained significantly associated with stroke in sensitivity analyses that adjusted for potential biases related to quality of outcome ascertainment, assessment of exposure, and adjustment for confounders. This analysis supports a role for air pollution as a modifiable risk factor for stroke, although associations with air pollution were less precise for haemorrhagic stroke than for ischaemic stroke. The impact of chronic exposure to air pollution on development of carotid atherosclerosis (a precursor for stroke) remains unclear. Although this is not covered in the analysis, evidence of an association is growing.9
Since air pollution causes systemic inflammation, it is reasonable that researchers have now turned to the arena of mental health, a leading priority for research given the relative absence of known modifiable risk factors and a high and growing disease burden.10 In the second linked paper, Power and colleagues exploit rich data in the Nurse’s Health Study cohort to assess the role of particulate pollution on prevalent anxiety symptoms.7 They found an exposure dependent association between higher levels of PM2.5 and increased symptoms of anxiety, and indications that associations were stronger for exposures in the month immediately preceding the scoring of anxiety.
These observations were supported by several sensitivity analyses, which indicated that associations were robust to broad geographical region, health status (to control for the possibility of anxiety as a sequela of cardiopulmonary effects of air pollution), and demographic characteristics, although the study was limited to older women. Power and colleagues’ findings add to a growing literature on the mental health effects of air pollution, including a small but intriguing body of research linking short term variability in air pollution to suicide.11
Power and colleagues used spatiotemporal exposure estimates and reported stronger effects for more recent exposures, reducing confounding by spatially varying factors correlated with air pollution. Since effects were observed over all time periods, spatial variation seems to have had an important influence on effect estimates. Furthermore, although effects were observed in all geographical regions, the investigators did not examine other potentially adverse (for example, noise, barometric pressure, solar intensity) or healthy (for example, natural spaces) environmental exposures that may operate at different scales. Indeed, evidence is accumulating that natural spaces may have beneficial effects on stress and social cohesion, both of which deserve further study in relation to mental health.12
As with any observational study, questions remain, as the authors acknowledge, and the findings should be replicated in other populations and with other study designs. Moreover, although these observations are biologically plausible, given links between inflammation and anxiety there is a need for greater mechanistic supporting evidence, of the type that now exists for associations between particulate matter and pulmonary, cardiac, and circulatory disease.
The findings of these two studies support a sharper focus on air pollution as a leading global health concern. They also suggest opportunities for reducing the prevalence of two debilitating and common diseases. One of the unique features of air pollution as a risk factor for disease is that exposure to air pollution is almost universal. While this is a primary reason for the large disease burden attributable to outdoor air pollution, it also follows that even modest reductions in pollution could have widespread benefits throughout populations. The two linked papers in this issue confirm the urgent need to manage air pollution globally as a cause of ill health and offer the promise that reducing pollution could be a cost effective way to reduce the large burden of disease from both stroke and poor mental health.
Notes
Cite this as: BMJ 2015;350:h1510
Footnotes
Research, doi:10.1136/bmj.h1295
Research, doi:10.1136/bmj.h1111
Competing interests: I have read and understood the BMJ policy on declaration of interests and declare the following: none.
Provenance and peer review: Commissioned; not externally peer reviewed.
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‘Cover up’ claim as incinerator study postponed
http://www.airqualitynews.com/2014/02/03/cover-up-claim-as-incinerator-study-postponed/
Research into effects of waste incineration on human health will be postponed after data had to be ‘manually’ entered
A study aiming to establish whether there is a link between modern municipal waste incinerator emissions and health defects has been postponed until 2015, in what the Breathe Clean Air Group has labelled a government ‘cover-up’.
The research, which was due to be published in March 2014, was approved by the Health Protection Agency in January last year to extend the evidence base and provide further information to the public.
The study involves examining areas of up to 15km around 22 incinerators across England, including Grundon’s Lakeside energy-from-waste facility, the SELCHP plant in Lewisham, the London Waste Edmonton incinerator and SITA UK’s Tees Valley plant in Billingham.
Scientists hope to determine if there is a potential link between incinerator emissions and health outcomes, such as low birth weight, still births and infant deaths.
In addition, a Dundee-based incinerator has also been included in the study, with working relating to the plant funded by a grant from the Scottish Government.
But Public Health England, which is funding King’s College London and Imperial College London to carry out the study, today revealed the preliminary results would not be available until 2015 due to the ‘unanticipated complexity in gathering data’ – caused by having to enter emissions data into an electronic format manually before statistical analysis could begin.
Consequences
Commenting on the postponement, Pete Kilvert, chairman of the anti-incinerator Breathe Clean Air Group – said he feared the government would instruct the research teams to take ‘an average’ sample around each incinerator rather than look at the consequences on people living ‘downwind’ of each facility.
He said: “The Government is hell bent on burning the country’s waste and telling us that it won’t do us any harm. When waste such as plastics, metals and organic material are burnt at low temperatures, then new chemicals such as dioxins and heavy metals will settle out into our community.”
Public Health England today said it continues to stand by its position that well run and regulated municipal waste incinerators are not a significant risk to public health.
Commenting on the delay, Dr Simon Bouffler, deputy director of Public Health England’s Centre for Radiation, Chemical and Environmental Hazards, said: “It was originally envisaged that preliminary results for this study would be available by March 2014 but because of the unanticipated complexity in gathering data this has been delayed.
“A paper with preliminary results is now expected to be prepared for submission to a peer-reviewed journal around the end of 2014, with publication in 2015.”
He added: “Some of the data on emissions from MWIs were unexpectedly held in paper format rather than in electronic files, and had to be entered manually onto computer before the statistical analysis could begin. There was a delay while this process took place.”