Clinical Effects of Air Pollution on the Central Nervous System

1. CLINICAL EFFECTS OF AIR POLLUTION ON THE
CENTRAL NERVOUS SYSTEM
ADE WIJAYA, MD – APRIL 2020

2. AIR POLLUTION
 Mixture of gases and particulate matter released into the surrounding air by stationary (industrial and
household etc.) and mobile (vehicles, trains, ships etc.) sources.
 Gases:
- Carbon Monoxide (CO)
- Ozone (O3)
- Nitrogen dioxide (NO2)
- Sulfur dioxide (SO2)
 Particulate matter <250 nm (PM2.5) as a principal antagonist due to small aerodynamic diameter and ability
to traverse the alveolar region of the respiratory system
Krzyzanowski M, Cohen A. Update of WHO air quality guidelines. Air Quality, Atmosphere & Health. 2008; 1:7–13.
Harrison RM, Yin J. Particulate matter in the atmosphere: which particle properties are important for its effects on health? The Science of the total environment. 2000;

3. AIR POLLUTION AND CENTRAL NERVOUS SYSTEM
Cognitive
White
Matter
Stroke
Babadjouni RM, Hodis DM, Radwanski R, Durazo R, Patel A, Liu Q, Mack WJ. Clinical effects of air pollution on the central nervous system; a review. Journal of Clinical Neuroscience. 2017 Sep 1;43:16-24.

4. AIR POLLUTION AND COGNITIVE FUNCTION
WHITE MATTER INJURY

6. MECHANISM
 Air pollution causes neuroinflammation and accumulation of AB42 and alpha-synuclein in the brain,
providing a potential mechanism for neurodegeneration
 PM2.5 exposure is associated with smaller white matter volumes in the subcortical areas of the external
capsule, extreme capsule, and calcarine cortex
Babadjouni RM, Hodis DM, Radwanski R, Durazo R, Patel A, Liu Q, Mack WJ. Clinical effects of air pollution on the central nervous system; a review. Journal of Clinical Neuroscience. 2017 Sep 1;43:16-24.

7. Calderón-Garcidueñas L, Torres-Jardón R, Kulesza RJ, Park SB, D’Angiulli A. Air pollution and detrimental effects on children’s brain. The need for a multidisciplinary approach to the issue complexity and challenges. Frontiers in human
neuroscience. 2014 Aug 12;8:613.

8. AIR POLLUTION AND STROKE

9.  The Global Burden of Disease Study 2013 found 29.2% of the global stroke burden was attributable to
air pollution
 A recent study suggests that PM2.5 increases stroke mortality rate, number of hospital admission days,
and related healthcare costs
 Air pollution is associated with increased carotid intima-media thickness (CIMT).
Feigin VL, Roth GA, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, et al. Global burden of stroke and risk factors in 188 countries, during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet Neurology.
2016; 15:913–24
Kunzli N, Jerrett M, Garcia-Esteban R, Basagana X, Beckermann B, Gilliland F, et al. Ambient air pollution and the progression of atherosclerosis in adults. PloS one. 2010;
5:e9096.

11. SUMMARY
 Clinical and epidemiological studies have established adverse effects of air pollution on the central
nervous system.
 Air pollution is associated with cognitive dysfunction, Alzheimer’s Disease and Parkinson’s disease.
 Air pollution is associated with structural brain effects and white matter injury.
 Adverse outcomes in stroke and carotid artery disease are associated with air pollution.

12. THANK YOU