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Air pollution and the risk of emphysema

KOLKATA, INDIA - 22 Oct 2016: Boys play soccer on the Maidan on October 22, 2016 in Kolkata (Calcutta), India
A group of boys play soccer in the smog on a maidan in Kolkata. 

Long-term exposure to air pollution ups the risk of developing emphysema in a similar way to smoking, according to a recent study. 

The research – carried out by the National Institute of Environmental Health Sciences (NIEHS) and the National Heart, Lung, and Blood Institute (NHLBI), both part of the US National Institutes of Health – linked an increase in emphysema levels between 2000 and 2018, particularly amongst non-smokers. Emphysema is typically associated with tobacco use, but senior author Dr R Graham Barr stated that exposure to pollutants carries a similar risk of developing emphysema as smoking a pack of cigarettes each day for 29 years as well as three years of ageing. 

The study measured the effect of “multiple air pollutants – ozone, fine particles known as PM2.5, nitrogen oxides, and black carbon” on lung health, according to NIEHS scientific program director Dr Bonnie Joubert, utilising lung function tests and CT scans for lung imaging. “With the study’s long-running duration, repeated CT scans allowed analysis of changes in emphysema over time,” said Dr Joubert. The study’s findings, according to the director of NIEHS’s Division of Cardiovascular Sciences  Dr David Goff, reflect a “need to assess the effectiveness of strategies to control air pollutants in our efforts to improve heart and lung health.” 

Emphysema is part of a group of conditions known as chronic obstructive pulmonary disease (COPD). Emphysema is characterised by damage to the alveoli (air sacs in the lungs), with the most notable symptom being shortness of breath. 

The findings are a cause for concern for India, where COPD is responsible for a million deaths in India each year. Pollution is considered the main driver of this crisis. This is unsurprising, given that India is home to seven of the ten most polluted cities in the world. As such, even short-term exposure to the pollution in India’s cities is damaging to lung health – carrying dire implications for those who live there and are exposed to such pollution over an extended period of time. Rural areas, meanwhile, are far from immune to India’s pollution crisis. 75 percent of pollution-related deaths in India occur in rural areas – driven in part by indoor pollution, caused by the use of unsafe biofuels for cooking. 

India is considered the worst country in the world in terms of environmental health. Air pollution is the main cause of this, being described by the Economic Performance Index as “the leading environmental threat to public health.” Indeed, pollution killed 1.2 million people in India in 2017 and, by 2050, pollution-related deaths are expected to triple unless meaningful action is taken. Rising rates of lung disease such as emphysema will play a major role in this, with this latest piece of research yet another reminder of the public health crisis in India’s skies.

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