Recent studies have indicated that exposure to particulate air pollution could also be associated with acute heart attack. This may be due, in part to a sympathetic stress response, as detected by changes in heart rate variability, the production of cytokines, and an increased vulnerability to plaque rupture. Some responsible pollutants include carbon monoxide, nitrogen dioxide, sulphur dioxide, and small particulate matter (less than 10 microns and less than 2.5 microns).
Short-term particulate exposure contributed to acute coronary events (heart attack) in patients with underlying coronary artery disease. PM1, PM2.5 and PM10 are risk factors of all-cause, cardiovascular, stroke, respiratory, and COPD mortality. PM1 accounts for the vast majority of short-term PM2.5- and PM10-induced mortality. Smaller size fractions of PM have a more toxic mortality impact.
Air pollution is a reality today and has been a subject of much discussion recently. Several studies have demonstrated the association of poor air quality with diseases such as respiratory and heart diseases, making it a major public health problem of concern. Air pollution, and specifically fine particulate matter is associated with increased cardiovascular disease mortality. It has emerged as a potentially modifiable risk factor for the development of CVD. Multiple observational studies have demonstrated an association between fine particulate air pollution (primarily from the use of fossil fuels in automobiles, power plants, and for heating purposes) and cardiovascular and cardiopulmonary mortality as well as an increased risk for the development of acute coronary syndrome.
There is increasing evidence for the role of environment in pathogenesis in many diseases. Children below 5 years of age and adults older than 50 years are most at risk. A global assessment of the burden of disease from environmental risks by the WHO has shown that 23% of global deaths and 26% of deaths among children under five are due to modifiable environmental factors.
Delhi has been experiencing high air pollution levels since the past few days. The air quality is particularly poor in the early morning when pollution is extremely high. This is also the time when many people venture out to exercise or drop their school children. It is imperative to use a mask and also make people aware of the harmful effects of air pollution.”
Some tips
•Walk or cycle for short distance commutes or to the neighborhood market. Plan and combine all your errands in one area or close by areas for one trip. Limit driving and make use of carpool.
•Use public transport as much as possible for longer distances. If you have to use your vehicle keep it well maintained for efficient functioning with regular servicing to reduce harmful exhaust emissions and get pollution check done as required. Follow speed limits. Avoid buying a diesel vehicle.
•Avoid burning candles dhoop or incense sticks at home or workplace.
•Quit smoking.
•Plant more trees. Limit the areas of bare soil by growing grass to reduce the amount of dust. Sprinkle water on exposed soil or construction sites regularly to reduce generation of dust. Wet mop the floors at home or workplace.
•Choose a place with least pollution levels when there is a choice.
(The writer is recipient of Padma Shri award and is past president, Indian Medical Association.)