Air Pollution and its Effects on Health – Case Studies India
Health – Case Studies India Air pollution in Indian cities. Critical [PM ... Type of study : Cross sectional with matched controls.
Air pollution and its effects on health – Case studies India
Air pollution and its effects on health – Case studies India To investigate the health impact of vehicular pollution of Kolkata (former Calcutta)
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energy resource and environmental pollution have been found to be responsible Forest resources : Use and over-exploitation deforestation
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Air Pollution and its Effects on Health – Case Studies India
urban air pollution on the respiratory and systemic health of the residence of Kolkata (former Calcutta) • To investigate the underlying mechanism of air pollution-related health impairments at the cellular and subcellular levels for better understanding and management of the problem •
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- A total number of 932 non-smoking adult males, aged 25-58 years, median age 44 years, who were residents of Kolkata for the past 10 years or more were enrolled as subjects exposed to urban air pollution mostly from vehicular sources.
Air Pollution and its Effects on
Health - Case Studies, India
Manas Ranjan Ray & Twisha Lahiri
Chittaranjan National Cancer Institute, Kolkata
Air pollution in Indian cities
Critical [PM
10 > 90 g/m 3 Guwahati, Patna, Raipur, Delhi, Faridabad, Dhanbad, Nagpur, Bhopal, Indore, Jalandhar, Ludhiana, Jaipur, Howrah, KolkataHigh [PM
1061 - 90
g/m 3 Hyderabad, Chandigarh, Ahmedabad, Panjim, Shimla, Bangalore,Mumbai, Pune, Bhubanshwar
Moderate [PM
1031 - 60
g/m 3Kochi, Shillong, Chennai
Low [PM
10 up to 30 g/m 3Aizwal
CPCB, 2009
Particulate pollutant levels in past
10 years were far above NAAQS
Vehicular emission contributes
to70% of pollution load
Air Pollution in Kolkata
Objectives
!To prepare a database on the impact of chronic exposure to urban air pollution on the respiratory and systemic health of the residence of Kolkata (formerCalcutta)
!To investigate the underlying mechanism of air pollution-related health impairments at the cellular and subcellular levels for better understanding and management of the problem •!Type of study : Cross sectional with matched controls !Area: Kolkata & Rural West Bengal !Participant :932 urban male, median age : 44 yr (25 - 58 yr)
!812 rural control, median age : 43 yr (24 - 57 yr) !Urban, occupationally exposed (n = 460):Traffic policemen - 56
!Road-side hawker - 188 !Auto-rickshaw driver - 82 !Bus driver - 78 !Motor mechanic - 56Urban, with office job (n = 472)
Study protocol
932 urban male, median age : 44 yr (25 - 58 yr)
812 rural control, median age : 43 yr (24 - 57 yr)
Urban, occupationally exposed (n = 460):
Air pollution
Increases prevalence of upper respiratory symptomsAir pollution
Increases prevalence of upper respiratory symptoms ...Seasonal impact on LRS
SES Dry cough Wet cough
High 1 1
Medium 2.31* 1.72*
Low 3.34* 2.20*
Inverse correlation with SES
Epidemiological study on
health hazards of air pollution is in progressQuestionnaire survey for
respiratory symptoms and neurobehavioral problemsPulmonary function test by spirometry
Parameters measured
FVC, FEV
1 , FEV 1 / FVC, PEFR, FEF25-75%
0 2 40255075100125150175200225250
No. of individuals
FVC (L)
MeasuredPredicted
0 2 40255075100125150175200225250
No. of individuals
FEV1 (L/s)
MeasuredPredicted
Lung function of urban group
Air pollution adversely affects lung function
Reduced lung function
Air pollution and COPD
Elastase
PMNAM (MMP12)
PMNFate of airborne pollutants
after inhalationAlveolar macrophages engulf inhaled PM
Rural Urban
Alveolar Macrophage with engulfed carbonaceous PM
Phagocytosis of ultrafine particles by AM
10 micrometer
Air pollution and pulmonary
inflammationAdverse cellular lung reaction
Airway infection & inflammation
Air pollution and inflammatory cytokines
1. !Interleukin-6, 2. Interleukin-8, 3. Interleukin-10, 4. Interleukin-12, 5 . TNF-alphaIron in AM
Does air pollution affect
the immunity?CD4+ cells
CD8+ cells
CD19+ cells
CD16+56+
cells CD4+ CD8+Rural Urban
Immune alterations
CD4 (FL2)
48%CD8 (FL1) 53%
Rural Urban
Immune alterations ...
1. !CD11b neutrophil, 2. CD11b monocyte, 3. CD18 neutrophil, 4. CD18 monocyteImmune alterations ...
Does air pollution affect
the cardiovascular system? It is not just the lungs and lower respiratory tract, the cardiovascular system is also affected by air pollutionDr. Alfred Munzer
Former President, American Lung Association
Air pollution increases heart diseases
Air pollution increases prevalence of hypertensionGiant platelets
Air pollution activates blood platelets
2-fold rise in aggregation & ATP-release
Platelet activation - cardiovascular risk
Neutrophil-platelet aggregates
Monocyte-platelet aggregates
MFI of CD11b/CD18 on leukocytes
increased by 48% !Inflammation and activation of coagulation cascadeIncreased formation of leukocyte-
platelet aggregates !Thrombotic disorders Control Kolkata Platelet- leukocyte aggregates cardiovascular riskOxidized low-density lipoprotein in blood
Anti-cardiolipin antibodies in serum
Air pollution and the heart
PM 2.5 , UFPCoagulation factor,
CRP, IL-6
ox LDL LiverThrombosis
Plaque formation
Rupture
CVDFoam cell
ROSPlatelet activation
Does air pollution damage
the chromosomes and the DNA?Micronucleus formation
DNA damage, comet assay
Excess comet formation suggests increase in DNA damageComet assay in PBL
Comet assay in epithelial cells
a b c dAir pollution
and risk of lung cancerExcess AgNOR in buccal epithelial cells
indicates increase in ribosome biosynthesisAgNOR, ribosome biosynthesis
Up-regulation of Akt signal transduction
a b c dMetaplasia, dysplasia, cancer risk
a b c d e fMechanism of air pollution
induced health impairment : oxidative stressGeneration of oxidative stress
Does air pollution affect
mental health?Neurobehavioral symptoms
1. !Burning sensation in extremities, 2. Blurred vision, 3. Drunken feeling,4. Forgetfulness
Depression
Depression (BDI-II score
! 14) PM 10 g / m 360 120 180
Air pollution alters blood neurotransmitter levels E: Epinephrine; NE: Nor-epinephrine; DA: Dopamine; 5-HT: SerotoninSummary
Chronic exposure to urban air pollution affects lung function, increases the risk of CVD and lung cancer, alters immunity, induces DNA and chromosomal damage and increases the prevalence of depression and neurobehavioral symptoms
The changes were positively associated with PM
10 and PM 2.5 in ambient air after controlling potential confounders by multivariate logistic regression analysis PM perhaps mediated these changes via generation of ROS and depletion of antioxidant defenseLet us join hands
To curb Air Pollution
For aBetter Tomorrow
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