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Lecture 6

Week 6 Reading.docx

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Grace Barakat

Week 6 Reading- Air Pollution and Children’s Health Abstract -children’s exposure to air pollution is a special concern because their immune system and lungs are not fully developed raising the possibility of different responses than seen in adults -air pollution exacerbates minor acute illness -air pollution, particularly traffic related pollution, is associated with infant mortality and the development of asthma and atopy -other studies have associated particulate air pollution with acute bronchitis in children -children have been shown to be at particular risk for other effects of air pollution, as detailed below Background -the lung is not well formed at birth, and development of full functionality does not occur until approximately 6 years of age -children also have a larger lung surface area per kg of body weight than adults -there is a critical exposure time when air pollution may have lasting effects on respiratory health -immune system, immature at birth, is also beginning to develop -another major factor that influences the relative impact of air pollution on children versus adults is exposure. -Children spend more time outdoors than adults, particularly in the summer and in the late afternoon. Some of that time is spent in activities that increase ventilation rates. -this can increase the exposure to air pollutants compared with adults, as indoor concentrations of air pollutants of outdoor origin are usually lower Pre- and perinatal effects of air pollution -prenatal exposure of populations to prevailing levels of air pollution is associated with early fetal losses, preterm delivery, and lower birth weight -environmental tobacco smoke was associated with adverse birth outcomes -the mechanisms are unknown -recently, a number of studies have reported that air pollution is associated with a child’s death -the great air pollution episode of London established causality -PM 10s associated with higher death rates in the next 11 months of life after birth. This excess risk seemed to be principally from respiratory illness, although sudden death syndrome deaths were also elevated -death from respiratory disease was associated with air pollution, particularly from traffic Acute effects of air pollution exposure Exposure issues -ozone levels are very low indoors -ozone has a distinct temporal pattern. Because it is not directly emitted from polluting sources but produced by photochemical reactions in the atmosphere, it shows strong seasonal and diurnal variations. It is high in the summer and afternoon and low in the night, early morning, and winter -children tend to be outdoors in the afternoon and in the summer, which results in much higher exposure for children than adults, who are protected by their indoor environment Health effects -wheezing, coughing, etc. correlated with air pollution, also significant associations have been reported with PM ,10nd associations with ozone -a strong association was found between particle pollution and peak flow decrements in children with asthma symptoms -air pollution is related to serious asthma exacerbation and to pneumonia exacerbation -ozone to be associated with altered macrophage function and epithelial injury, which could plausibly modify infectivity -other evidence points to a role for pollution in increasing lung inflammation in children, particularly those with asthma -excellent evidence that changing pollution in the short term produces immediate reductions in asthma exacerbations Effects of long-term exposure to air pollution - found significant decrements in lung function associated with exposure -ozone exposure during childhood associated with reduction in lung function -chronic bronchitis and chest illness in children were associated with exposure to particulate air pollution -no association was seen with asthma or wheezing -moving from areas with higher PM to a10as with lower rates resulted in increased lung function. Also reduction in pollution results in reduced rates of chronic cough and bronchitis in children. -exposure to diesel exhaust varies greatly with distance from major roadways -in areas without heavy industry, almost all NO is2attributable to traffic. -although both gasoline and diesel engines produce NO , die2el engines produce more -a strong association between asthma prevalence and NO levels 2 -the NO 2easurements outside each child’s home were significant predictors of hay fever; symptoms of allergic rhinitis; wheezing and sensitization against pollen, house dust mites, or cats -this indicates that traffic pollution but probably not NO f2om traffic is associated with atopy and wheezing. If NO p2r se is not the relevant exposure, than diesel particles or some component of the those particles may be the most important etiologic component -both traffic and industry release NO b2t different particles are attached to their NO rele2se Reading #2: Does chronic exposure to air pollution in childhood impact long-term respiratory health? (BARKAT) -the health consequences of acute episodes of air pollution are well documented such as the Meuse Valley fog of 1930 (Belgium) and the London fog of 1952 -although pollution abatement initiatives reduced acute air pollution episodes over the last half-century, air pollution still occupies a central focus in global environmental issues -cohort studies
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