Air Pollution and Lung Health: A Significant Public Health Challenge in Resource Poor Countries
DOI:
https://doi.org/10.71637/tnhj.v25i1.918Keywords:
Air pollution, low-middle-income country, system strengthening, lung healthAbstract
Background: The majority of the inhabitants of today's world live in financially deprived countries with well-established high levels of air pollution. Air pollution is one of the biggest environmental threats as well as health challenges ravaging the century and is yet to be eliminated. This is particularly worse in low-middle-income countries where polluted air continues to remain a well-known menace to lung health. This paper describes the increasing effects of air pollution on the general well-being and lung health of inhabitants residing in low-middle-income countries and propose solutions and recommendations for ameliorating this significant health challenge.
Methods: A scoping review to evaluate published studies on the Air pollution and Lung Health in resource poor countries. The search was conducted on electronic databases: PubMed and Google scholar until April 2024, using the following keywords: “Air pollution”, “Lung Health”, “Public Health challenges”, “resource poor countries”. Included studies addressed the effects of air pollution on lung health in resource poor countries.
Conclusion: The prevalence of lung diseases such as pneumonia, asthma, chronic obstructive lung disease, and lung cancer is directly proportional to the burden of air pollution, resulting in high morbidity and mortality every year in resource-poor settings. This has been noted to be a far greater contributor to the burden of lung diseases even more than tobacco smoke. This problem can be combated through proper air quality monitoring, enforcement of air pollution guidelines, policy framework, and regulations, provision, and utilisation of cleaner fuel, planned urbanisation, and through health systems strengthening.
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References
1. Ghorani‑Azam A, Balali‑Mood M. Effects of air pollution on human health and practical measures for prevention in Iran. J Res Med Sci. 2016;21(65).
2. WHO global air quality guidelines: particulate matter (PM2.5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide. Bonn, Germany: WHO European Centre for Environment and Health; 2021. (accessed Feb 21, 2024)
3. Fowler D, Brimblecombe P, Burrows J, Heal MR, Grennfelt P, Stevenson DS, et al. A chronology of global air quality. Philos Transact A Math Phys Eng Sci. 2020 Oct 30;378(2183):20190314.
4. Fowler D, Brimblecombe P, Burrows J, Heal MR, Grennfelt P, Stevenson DS, et al. Correction to “A chronology of global air quality.” Philos Transact A Math Phys Eng Sci. 2021 Jul 12;379(2201):20210113.
5. World Health Organisation. World Health Organization; Ambient air pollution data. 2021. Available from: http://www.who.int/data/gho/data/themes/air-pollution/ambient-air-. (accessed Feb 21, 2024)
6. World Health Organization (WHO). Ambient (outdoor) air pollution. World Health Organization (WHO); 2022. Available from: http://www.who.int/news-room/fact-sheets/details/ambient-(outdoor)-air-quality-and-health (accessed Feb 26, 2024)
7. Hajat A, Hsia C, O’Neill MS. Socioeconomic Disparities and Air Pollution Exposure: a Global Review. Curr Environ Health Rep. 2015 Dec;2(4):440–50.
8. Tran VV, Park D, Lee YC. Indoor Air Pollution, Related Human Diseases, and Recent Trends in the Control and Improvement of Indoor Air Quality. Int J Environ Res Public Health. 2020 Apr 23;17(8):2927.
9. Mannucci PM, Franchini M. Health Effects of Ambient Air Pollution in Developing Countries. Int J Environ Res Public Health. 2017 Sep 12;14(9):1048.
10. Bonzini M, Tripodi A, Artoni A, Tarantini L, Marinelli B, Bertazzi PA, et al. Effects of inhalable particulate matter on blood coagulation. J Thromb Haemost. 2010 Apr;8(4):662–8.
11. Schwarze PE, Øvrevik J, Låg M, Refsnes M, Nafstad P, Hetland RB, et al. Particulate matter properties and health effects: consistency of epidemiological and toxicological studies. Hum Exp Toxicol. 2006 Oct;25(10):559–79.
12. US EPA (US Environmental Protection Agency) (2023). Available from: Available online at: https://www.epa.gov/pm-pollution/particulate-matter-pm-basics (accessed Feb 20, 2024)
13. Bentayeb M, Simoni M, Norback D, Baldacci S, Maio S, Viegi G. Indoor air pollution and respiratory health in the elderly. J Env Sci Health Tox Hazard Subst Env Eng. 2013;48(14):1783–9.
14. Kurmi OP, Lam KBH, Ayres JG. Indoor air pollution and the lung in low- and medium-income countries. Eur Respir J 2012;(40):239–54.
15. Bruce N, McCracken J, Albalak R, Schield M, Smith K, Lopez Victorina. Impact of improved stoves, house construction and child location on levels of indoor air pollution exposure in young Guatemalan Children. J Expo Sci Environ Epidemiol. 2004;14(1):S26–33.
16. Yu W, Ye T, Zhang Y, Xu R, Lei Y, Chen Z, et al. Global estimates of daily ambient fine particulate matter concentrations and unequal spatiotemporal distribution of population exposure: a machine learning modelling study. Lancet Planet Health. 2023 Mar;7(3):e209–18.
17. Fuller R, Landrigan PJ, Balakrishnan K, Bathan G, Bose-O’Reilly S, Brauer M, et al. Pollution and health: a progress update. Lancet Planet Health. 2022 Jun;6(6):e535–47.
18. Abdul Jabbar S, Tul Qadar L, Ghafoor S, Rasheed L, Sarfraz Z, Sarfraz A, et al. Air Quality, Pollution and Sustainability Trends in South Asia: A Population-Based Study. Int J Environ Res Public Health. 2022 Jun 20;19(12):7534.
19. Rentschler J, Leonova N. Global air pollution exposure and poverty. Nat Commun. 2023 Jul 22;14(1):4432.
20. Meghji J, Mortimer K, Agusti A, Allwood BW, Asher I, Bateman ED, et al. Improving lung health in low-income and middle-income countries: from challenges to solutions. The Lancet. 2021 Mar;397(10277):928–40.
21. Ibrahim MF, Hod R, Nawi AM, Sahani M. Association between ambient air pollution and childhood respiratory diseases in low- and middle-income Asian countries: A systematic review. Atmos Environ. 2021 Jul;256:118422.
22. Shang Y, Sun Z, Cao J, Wang X, Zhong L, Bi X, et al. Systematic review of Chinese studies of short-term exposure to air pollution and daily mortality. Environ Int. 2013 Apr;54:100–11.
23. Romieu I, Gouveia N, Cifuentes LA, de Leon AP, Junger W, Vera J, et al. Multicity study of air pollution and mortality in Latin America (the ESCALA study). Res Rep Health Eff Inst. 2012 Oct;(171):5–86.
24. Achakulwisut P, Brauer M, Hystad P, Anenberg SC. Global, national, and urban burdens of paediatric asthma incidence attributable to ambient NO2 pollution: estimates from global datasets. Lancet Planet Health. 2019 Apr;3(4):e166–78.
25. UNICEF NIGERIA. Air pollution, especially in the home, biggest driver of child deaths from pneumonia in Nigeria. Available from: https://www.unicef.org/nigeria/press-releases/nigeria-has-highest-number-air-pollution-related-child-pneumonia-deaths-world (accessed Feb 21, 2024)
26. Blanco I, Diego I, Bueno P, Casas-Maldonado F, Miravitlles M. Geographic distribution of COPD prevalence in the world displayed by Geographic Information System maps. Eur Respir J. 2019 Jul;54(1):1900610.
27. Colbeck I, Nasir ZA, Ali Z. The state of indoor air quality in Pakistan—a review. Environ Sci Pollut Res. 2010 Jul;17(6):1187–96.
28. Carvalho H. The air we breathe: differentials in global air quality monitoring. Lancet Respir Med. 2016 Aug];4(8):603–5.
29. Climate and clean air coalition initiative (CCAC. In a World Full of Dirty Air, Regional Agreements on Air Pollution Offer a Glimmer of Hope by CCAC Secretariat -. UN Environment Programme. 2023 Sep 6; Available from: https://www.ccacoalition.org/news/world-full-dirty-air-regional-agreements-air-pollution-offer-glimmer-hope (accessed Mar 24, 2024)
30. Abir AH. Role of Laws to Control Brick Manufacturing and Kiln Establishment in Bangladesh: Scope of Alternative Bricks. VNU J Sci Earth Environ Sci. 2019 Mar 28];35(1).
31. United Nation Environmental Programme. New UN report details environmental impacts of export of used vehicles to developing world. United Nation Environmental Programme. 2020 Oct 26; Available from: https://www.unep.org/news-and-stories/press-release/new-un-report-details-environmental-impacts-export-used-vehicles#:~:text=Nairobi%2C%2026%20October%202020%20%2D%20Millions,report%20by%20the%20UN%20Environment (accessed Mar 28, 2024)
32. Kalagbor IA, Dibofori-Orji AN, Ekpete OA. Exposure to Heavy Metals in Soot Samples and Cancer Risk Assessment in Port Harcourt, Nigeria. J Health Pollut. 2019 Dec;9(24):191211.
33. Yakubu O. Particle (Soot) Pollution in Port Harcourt Rivers State, Nigeria—Double Air Pollution Burden? Understanding and Tackling Potential Environmental Public Health Impacts. Environments. 2017 Dec 24;5(1):2.
34. Ekhator OC, Orish FC, Nnadi EO, Ogaji DS, Isuman S, Orisakwe OE. impact of black soot emissions on public health in Niger Delta, Nigeria:understanding the severity of the problem. Inhal Toxicol. 2023;1–13.
35. Worldbank. Poverty and Inequality Platform. World Bank. Available from: http:/pip.worldbank.org/home (accessed Mar 23, 2024)
36. Wang Y, Duong M, Brauer M, Rangarajan S, Dans A, Lanas F, et al. Household Air Pollution and Adult Lung Function Change, Respiratory Disease, and Mortality across Eleven Low- and Middle-Income Countries from the PURE Study. Environ Health Perspect. 2023 Apr;131(4):047015.
37. THE WORLD BANK IBRD.IDA. Middle Income Countries Overview: Development news, research. Available from: http://worldbank.org/en/country/mic/overview (accessed Mar 29, 2024)
38. United Nations. UN DESA Policy Brief No.140: A World of 8 Billion. Department of Economic and Social Affairs, United Nations. Available from: http://www.un.org/development/desa/dpad/wp-content/uploads/sites/45/publication/PB_140.pdf (accessed Mar 28, 2024)
39. Rahaman MA, Kalam A, Al-Mamun M. Unplanned urbanization and health risks of Dhaka City in Bangladesh: uncovering the associations between urban environment and public health. Front Public Health. 2023;11:1269362.
40. Prüss-Ustün A, van Deventer E, Mudu P, Campbell-Lendrum D, Vickers C, Ivanov I, et al. Environmental risks and non-communicable diseases. BMJ. 2019 Jan 28;364:l265.
41. United Nations Environmental Programme. Air. Available from: https://www.unep.org/beatpollution/forms-pollution/air (accessed Feb 22, 2024)
42. Schraufnagel DE, Balmes JR, Cowl CT, De Matteis S, Jung SH, Mortimer K, et al. Air Pollution and Noncommunicable Diseases. Chest. 2019 Feb;155(2):417–26.
43. Bourdrel T, Bind MA, Béjot Y, Morel O, Argacha JF. Cardiovascular effects of air pollution. Arch Cardiovasc Dis. 2017 Nov;110(11):634–42.
44. Miller MR, Shaw CA, Langrish JP. From particles to patients: oxidative stress and the cardiovascular effects of air pollution. Future Cardiol. 2012 Jul;8(4):577–602.
45. Chen R, Jiang Y, Hu J, Chen H, Li H, Meng X, et al. Hourly Air Pollutants and Acute Coronary Syndrome Onset in 1.29 Million Patients. Circulation. 2022 Jun 14;145(24):1749–60.
46. Fongsodsri K, Chamnanchanunt S, Desakorn V, Thanachartwet V, Sahassananda D, Rojnuckarin P, et al. Particulate Matter 2.5 and Hematological Disorders From Dust to Diseases: A Systematic Review of Available Evidence. Front Med. 2021 Jul 14;8:692008.
47. Malik VS, Singh M, Pradhan P, Singal K, Agarwal A, Chauhan A, et al. Role of environmental lead in the occurrence of anemia in Indian children: a systematic review and meta-analysis. Environ Sci Pollut Res. 2022 May;29(25):37556–64.
48. Lee KK, Miller MR, Shah ASV. Air Pollution and Stroke. J Stroke. 2018 Jan;20(1):2–11.
49. Adami G, Pontalti M, Cattani G, Rossini M, Viapiana O, Orsolini G, et al. Association between long-term exposure to air pollution and immune-mediated diseases: a population-based cohort study. RMD Open. 2022 Feb;8(1):e002055.
50. Faustini A, Renzi M, Kirchmayer U, Balducci M, Davoli M, Forastiere F. Short-term exposure to air pollution might exacerbate autoimmune diseases. Environ Epidemiol. 2018 Sep;2(3):e025.
51. United Nations Environmental Programme. Pollution Action Note – Data you need to know. 2021. Available from: https://www.unep.org/interactives/air-pollution-note/ (accessed Feb 23, 2024)
52. Darbre PD. Overview of air pollution and endocrine disorders. Int J Gen Med. 2018;11:191–207.
53. Liu W, Pan X, Vierkötter A, Guo Q, Wang X, Wang Q, et al. A Time-Series Study of the Effect of Air Pollution on Outpatient Visits for Acne Vulgaris in Beijing. Skin Pharmacol Physiol. 2018];31(2):107–13.
54. Vargas Buonfiglio LG, Comellas AP. Mechanism of ambient particulate matter and respiratory infections. J Thorac Dis. 2020 Mar;12(3):134–6.
55. Vargas Buonfiglio LG, Mudunkotuwa IA, Abou Alaiwa MH, Vanegas Calderón OG, Borcherding JA, Gerke AK, et al. Effects of Coal Fly Ash Particulate Matter on the Antimicrobial Activity of Airway Surface Liquid. Environ Health Perspect. 2017 Jul 24;125(7):077003.
56. Liu J, Chen X, Dou M, He H, Ju M, Ji S, et al. Particulate matter disrupts airway epithelial barrier via oxidative stress to promote Pseudomonas aeruginosa infection. J Thorac Dis. 2019 Jun;11(6):2617–27.
57. Liu H, Zhang X, Zhang H, Yao X, Zhou M, Wang J, et al. Effect of air pollution on the total bacteria and pathogenic bacteria in different sizes of particulate matter. Environ Pollut. 2018 Feb;233:483–93.
58. Van Der Vliet A, Eiserich JP, Cross CE. Nitric oxide: a pro-inflammatory mediator in lung disease? Respir Res. 2000 Aug;1(2):1.
59. Groves AM, Gow AJ, Massa CB, Laskin JD, Laskin DL. Prolonged injury and altered lung function after ozone inhalation in mice with chronic lung inflammation. Am J Respir Cell Mol Biol. 2012 Dec;47(6):776–83.
60. Yoon HI, Hong YC, Cho SH, Kim H, Kim YH, Sohn JR, et al. Exposure to volatile organic compounds and loss of pulmonary function in the elderly. Eur Respir J. 2010 Dec 1;36(6):1270–6.
61. Garçon G, Dagher Z, Zerimech F, Ledoux F, Courcot D, Aboukais A, et al. Dunkerque City air pollution particulate matter-induced cytotoxicity, oxidative stress and inflammation in human epithelial lung cells (L132) in culture. Toxicol In Vitro. 2006 Jun;20(4):519–28.
62. Boskabady M, Marefati N, Farkhondeh T, Shakeri F, Farshbaf A, Boskabady MH. The effect of environmental lead exposure on human health and the contribution of inflammatory mechanisms, a review. Environ Int. 2018 Nov;120:404–20.
63. Wigenstam E, Elfsmark L, Bucht A, Jonasson S. Inhaled sulfur dioxide causes pulmonary and systemic inflammation leading to fibrotic respiratory disease in a rat model of chemical-induced lung injury. Toxicology. 2016 Aug ;368–369:28–36.
64. Ryter SW, Ma KC, Choi AMK. Carbon monoxide in lung cell physiology and disease. Am J Physiol-Cell Physiol. 2018 Feb 1;314(2):C211–27.
65. Wang X, Ding H, Ryan L, Xu X. Association between air pollution and low birth weight: a community-based study. Environ Health Perspect. 1997 May;105(5):514–20.
66. Salam MT, Millstein J, Li YF, Lurmann FW, Margolis HG, Gilliland FD. Birth outcomes and prenatal exposure to ozone, carbon monoxide, and particulate matter: results from the Children’s Health Study. Environ Health Perspect. 2005 Nov;113(11):1638–44.
67. Mölter A, Agius RM, de Vocht F, Lindley S, Gerrard W, Lowe L, et al. Long-term exposure to PM10 and NO2 in association with lung volume and airway resistance in the MAAS birth cohort. Environ Health Perspect. 2013 Oct;121(10):1232–8.
68. Rice MB, Ljungman PL, Wilker EH, Gold DR, Schwartz JD, Koutrakis P, et al. Short-Term Exposure to Air Pollution and Lung Function in the Framingham Heart Study. Am J Respir Crit Care Med. 2013 Dec 1;188(11):1351–7.
69. Adam M, Schikowski T, Carsin AE, Cai Y, Jacquemin B, Sanchez M, et al. Adult lung function and long-term air pollution exposure. ESCAPE: a multicentre cohort study and meta-analysis. Eur Respir J. 2015 Jan;45(1):38–50.
70. Zhou X, Guo M, Li Z, Yu X, Huang G, Li Z, et al. Associations between air pollutant and pneumonia and asthma requiring hospitalization among children aged under 5 years in Ningbo, 2015-2017. Front Public Health. 2022;10:1017105.
71. Rajak R, Chattopadhyay A. Short and Long Term Exposure to Ambient Air Pollution and Impact on Health in India: A Systematic Review. Int J Environ Health Res. 2020 Dec;30(6):593–617.
72. Berg CD, Schiller JH, Boffetta P, Cai J, Connolly C, Kerpel-Fronius A, et al. Air Pollution and Lung Cancer: A Review by International Association for the Study of Lung Cancer Early Detection and Screening Committee. J Thorac Oncol. 2023 Oct;18(10):1277–89.
73. Shetty BSP, D’Souza G, Padukudru Anand M. Effect of Indoor Air Pollution on Chronic Obstructive Pulmonary Disease (COPD) Deaths in Southern Asia-A Systematic Review and Meta-Analysis. Toxics. 2021 Apr 16;9(4):85.
74. Ephraim-Emmanuel BC, Enembe O, Ordinioha B. Respiratory Health Effects of Pollution Due to Artisanal Crude-Oil Refining in Bayelsa, Nigeria. Ann Glob Health. 2023;89(1):74.
75. World Health Organisation. AirQ+: software tool for health risk assessment of air pollution. Httpswwwwhointeuropetools--Toolkitsairq---Softw-Tool--Health-Risk-Assess--Air-Pollut. Available from: https://www.who.int/europe/tools-and-toolkits/airq---software-tool-for-health-risk-assessment-of-air-pollution (accessed Feb 29, 2024)
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