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It is estimated that ambient or outdoor air pollution in cities and rural areas has caused 4.2 million premature deaths worldwide each year in 2016.
According to a World Health Organization (WHO) report published on May 2, 2018, this mortality is linked to exposure to small particles of 2.5 microns or less in diameter (P2.5) , responsible for cardiovascular and respiratory diseases and cancers.
Premature death is a death occurring before the average age of death in a given population.
"He [premature death] is a definition that varies between population and group, "said Heather Adair-Rohani, an expert in health and household pollution at WHO.
"We tend to think that this is a risk, you basically have an increased risk of contracting this disease. And this often leads to an earlier death than one would expect if your environment was very healthy and stable, "said Adair-Rohani.
A girl begs alms of a group of people wearing face masks to fight pollution in New Delhi, India on Thursday, November 9, 2017. A thick, gray haze wrapped the Indian capital then that air pollution was reaching dangerous levels, pushing local authorities to close schools. (AP Photo / Manish Swarup)
People living in low- and middle-income countries are disproportionately burdened by outdoor air pollution, with 91% of the 4.2 million premature deaths occurring in these countries.
The WHO estimates that 58% of premature deaths from outdoor air pollution were due to ischemic heart disease and stroke in 2016. Eighteen percent of deaths were due to chronic obstructive pulmonary disease and acute lower respiratory tract infections, and 6% to the lungs. cancer, according to the WHO report.
Some deaths can be attributed to more than one risk factor at the same time. For example, smoking and ambient air pollution affect lung cancer. Some lung cancer deaths could have been prevented by improving the quality of the air or by reducing smoking.
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WHO has confidence in the risk estimates provided by the public.
"The WHO explains very precisely what are the results of the disease that we actually estimate in terms of attributed death or disability attributed," Adair-Rohani said. "That's why we do not necessarily count for all the diseases potentially related to air pollution."
For example, despite the large amount of new evidence suggesting that an early onset of diabetes is due to exposure to air pollution, WHO does not publicly count the number of cases of diabetes. Epidemiological evidence is not yet robust enough to allow WHO to establish risk estimates.
"We need to have a solid foundation for the use of these numbers and how we performed the calculations," Adair-Rohani said. "We are confident in the risk estimates we provide because we believe they are based on a consensus of extensive scientific evidence as well as expert contributions. "
A woman wears a mask when she looks at her smartphone while she was walking down a Beijing street on Tuesday, November 21, 2017. Authorities issued a blue alert in case of heavy pollution of the city. air in the Chinese capital. (AP Photo / Mark Schiefelbein)
Over the past 40 years, a very large number of epidemiological studies have been conducted on the link between exposure to air pollution and premature death. Many researchers in the scientific community have conducted these studies, including researchers from the United States Environmental Protection Agency (EPA).
Air pollution studies focus on the major pollutants, including particulate matter, ozone, sulfur dioxide, nitrogen dioxide and carbon monoxide, according to Jason Sacks, senior epidemiologist at the Office of the research and development of the EPA.
These studies examine whether daily or annual changes in air pollution are associated with premature mortality.
"By evaluating each of the studies conducted in different geographical locations and within diverse populations, it is then possible to examine all of the evidence, taking into account data from experimental studies, to draw conclusions about the existence of a link between exposure to air pollution and premature death, "Sacks said.
The EPA has developed a publicly available software program, the Environmental Benefit Mapping and Analysis Program – Community Edition (BenMAP – CE), which assesses the effects of air quality on the environment. health. Other research groups and international organizations have developed similar tools.
These tools use simple algebraic equations that rely on the results of epidemiological studies, as well as on population and health impact data, to calculate the impacts of quality of life. Current air or changes in air quality.
The combination of experimental studies and epidemiological studies shows that a short-term or long-term exposure to an air pollutant could lead to a range of health problems in the body, such as changes in the heart or lung function.
The exposure could eventually result in more overt health effects, which would require hospitalization or premature death, according to Sacks.
Cars at rush hour crossing a thick smog. (Getty / E + / plherrera)
Decades of research have shown that each of the major pollutants can cause different health responses, detailed in the EPA's integrated science assessments for each of the major pollutants.
In addition, many health factors that play a role in the impact of air pollution on health have been examined in the ISA standards for each of the common pollutants.
Although health factors that may increase health risk present varying risks depending on the pollutants, it has been shown that the stage of life, as in children and adults over 65, and the diseases Pre-existing cardiac and pulmonary conditions contributed to the increased risk.
The relationship between time of exposure to air pollution and increasing risks to health will vary depending on the underlying health condition of an individual.
"If air pollution concentrations are extremely high, for example during a fire, many people may experience respiratory symptoms, such as irritation of the airways," Sacks said.
It has also been shown that poor air quality can have a negative impact on lung development in children growing up in cities with high levels of air pollution.
However, with the improvement of air quality, studies have shown that measurable improvements have been made to improvements in health.
For example, children's lung function improves and life expectancy generally increases as they move to cleaner cities.
Access to health care and socio-economic status are also factors associated with exposure to air pollution and the consequences of the disease, Adair-Rohani said.
"We are seeing very high levels of air pollution in low- and middle-income countries, but many of the studies come from high-income countries," said Adair-Rohani. "WHO encourages more research in high-income and low- and middle-income countries."
There are fewer regulations in low- and middle-income countries, such as in South-East Asia. At the same time, many Western countries have adapted their policies and regulations to manage air pollution levels.
According to Sacks, some measures can be taken at the individual level to reduce the amount of pollutants from the outside air in the house, for example by using air purifiers and filters.
"Using central air conditioning or even window air conditioning units instead of opening windows can also reduce the amount of outdoor air pollution that can get inside," Sacks said. .
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