Respiratory Diseases: A History

The existing awareness of the ill effects of air pollution started during the middle of the twentieth century when the so-called "killer fog" and the "London smog of 1952" wreaked havoc on the health of the citizens in Donora, Pensyvania and London, respectively. There were about 4000 documented deaths in London at the time. Their untimely demise points to the prevalent use of "dirty fuels." These events acted as catalysts for government attention regarding urban air pollution. (Rahman, et. al., 2001)

According to Rahman and company, the main culprit is the combustion of fossil fuels-producing sulfur dioxide, carbon monoxide (usually from vehicle exhausts), suspended particulate matter, ground-level ozone, nitrogen dioxide and lead. Many nations since then have established "ambient air quality standards" to protect the public from these hazardous chemicals. (2001)

Many industrialized nations have already significantly decreased the amount of air pollutants is their cities. However, even with safety guidelines in place, the same is not true for poorer developing countries. In fact according to the World Bank, an estimated 2-5% of all the deaths in urban areas in developing countries are linked to exposure to these pollutants--existing beyond the set World Heath Organization standards. People in these areas suffered diseases spanning from "a wide range of severity from coughing and bronchitis to heart disease and lung cancer" (Rahman, et. al., 2001). Some of these urban cities include the megacities of Beijing, Delhi, Jakarta, and Mexico City.

Most susceptible to the ill effects of these pollutants are "infants, the elderly, and those suffering from chronic respiratory conditions including asthma, bronchitis, or emphysema." (Rahman, et. al., 2001)

A study by Estrella, et. al. correlates exposure to traffic congestion to acute respiratory diseases in school children in Ecuador. They argue that during these circumstances children are exposed to highly concentrated levels of carbon monoxide-the main motor vehicle emission. (2005)

Previous literature shows that mortality in infants and early childhood are high in places with elevated ambient particle concentration-such as the case in Brazil, Taiwan, the Czech Republic, the United States, and Mexico. (Hertz-Picciotto, et. al. 2007)

Ambient air pollution is composed of smoke from manufacturing, motor vehicles, cigarette smoke and many polycyclic aromatic hydrocarbons or PAHs. A major finding in the Hertz-Piccioto and colleagues' study (2007) is a clear demonstration that PAHs were chiefly associated with physician-diagnosed Lower Respiratory Infections (LRIs) in two-year-old preschool children. Of all the LRIs, bronchitis was the usual diagnosis.

The study also showed that temperature and air pollution are linked with each other in causing LRIs. During colder months, the burning of fossil fuels is more prevalent causing more pollutants in the atmosphere. However, the exposure to PAHs still contributes to developing bronchitis even at varying temperatures. According to their data, "PAHs were significant in all 25 models fit to the data on two to four-and-a-half year olds, and in 21 out of 25 models in the younger age group." (Hertz-Picciotto, et. al. 2007)

A study conducted by Zhang, et. al. showed that in certain cities of China and in many parts of the world, the death of schoolchildren due to respiratory ailments is attributable to "certain personal, residential, and family factors." (2002)

Some of the causes for respiratory diseases suffered by school children in the eight districts of the "Four Chinese Cities Study" were linked to living conditions. These conditions are characterized by sharing personal items, sharing bedrooms, sharing beds, the children's rooms being smoky during cooking time, and exposure to parental cigarette smoke. On a more genetic perspective, most parents had histories of asthma which may contribute to the children's vulnerability to respiratory diseases. (Zhang, et. al., 2002)

The obvious solutions to these problems are better household ventilation, altering cooking methods (so that the smoke does not stay inside the house) and discipline on the side of parents to either quit smoking or to smoke away from their children.

In adults, aside from ambient air pollution, respiratory diseases may be brought about by occupational exposures to hazardous chemicals. Perhaps the most serious of all occupational lung diseases is pneumoconiosis. This is caused by the inhalation of coal dust. The graveness of the effect depends on the type of dust exposure, the characteristics of the dust particles (such as fineness, concentration, and extent of exposure) and the victim's health prior to the exposure. Other occupational respiratory diseases include silicosis (caused by the inhalation of dust with free silica or silicon dioxide), mesothelioma (caused by the inhalation of asbestos fibers), byssinosis (caused by inhalation of cotton dust during processing), bagassosis (caused by the inhalation of dust from bagasse or sugar cane waste), and tuberculosis (caused by exposure to great amounts of dusts from quarries, mines, textiles, and other industries) (Rahman, et. al., 2001). Unfortunately, because of poverty, many people are willing to work in places with high-risk exposure to various harmful chemicals despite knowing the plausible health consequences.

Rahman and collegues recognize the challenge of understanding the relevance of socio-economic and genetic factors in the researches regarding respiratory diseases. A greater understanding might be achieved by combining these factors with laboratory, epidemiologic, and clinical data. (2007)

Public health authorities should consider reducing the encumbrance of respiratory diseases as a public heath challenge. Simple ways that may help are managing indoor and outdoor pollution, lowering the contact of people to active and passive tobacco and cigarette smoke, elevating the living standards of people (providing well-ventilated housing facilities), convalescing the dietetic and nutritional condition of the populace, and general education about the causes and treatment of various respiratory diseases.

References

Estrella, B., Estrella, R., Oviedo, J., Narvaez, X., Reyes, M. T., Gutierrez, M., et al. (2005). Acute Respiratory Diseases and Carboxyhemoglobin Status in School Children of Quito, Ecuador. Environmental Health Perspectives, 113(5), 607+. Retrieved April 22, 2008, from Questia database:

Hertz-Picciotto, I., Baker, R. J., Yap, P., Dostal, M., Joad, J. P., Lipsett, M., et al. (2007). Early Childhood Lower Respiratory Illness and Air Pollution. Environmental Health Perspectives, 115(10), 1510+. Retrieved April 22, 2008, from Questia database:

Rahman, Q., Nettesheim, P., Smith, K. R., Seth, P. K., & Selkirk, J. (2001). International Conference on Environmental and Occupational Lung Diseases. Environmental Health Perspectives, 109(4), 425. Retrieved April 22, 2008, from Questia database:

Zhang, J., Hu, W., Wei, F., Wu, G., Korn, L. R., & Chapman, R. S. (2002). Children's Respiratory Morbidity Prevalence in Relation to Air Pollution in Four Chinese Cities. Environmental Health Perspectives, 110(9), 961+. Retrieved April 22, 2008, from Questia database: