Presentation: Farmer-led climate adaptation - Project launch and overview by ...
Air Pollution on Human Health
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LATE PROF NILAY CHOUDHARY MEMORIAL LECTURE
21.12.2013
DR.AMITA ATHAVALE
PROFESSOR & HEAD
DEPT.OF CHEST MEDICINE & ENVIRONMENTAL POLLUTION RESEARCH
CENTRE,KEM HOSPITAL & SETH G.S.MEDICAL
COLLEGE,PAREL,MUMBAI,INDIA.
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WORK HOME
23 hours indoors: home or work, transit
US EPA ranked American home 4th in list of serious health hazard
CHANGING CLIMATE…
CHANGING ENVIRONMENT
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Do you feel sick in office or home
environment ?
• ETS
• Dust mites- 1 mcg – 10 mcg
• Mould- visible mould damage,odour
• Radon- 200-400bq/m3
• VOC’S
• Asbestos
• Man made mineral fibers
• SPM
• CO2
• SICK BUILDING SYNDROME
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August 2005
2
1
2 2 2
3
6
1
9
3
2 2
11
2
6
4
7
4
5
11
4
2
0
1
2
3
4
5
6
7
8
9
JAN
FEB
M
A
R
A
PR
M
A
Y
JUN
JUL
A
U
G
SEPT
O
C
T
N
O
V
D
EC
ASTHMA ADMISSIONS
2001
2005
n=39
n=34
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March 2012
• Ghatkopar residents say pigeons
are killing them
• Say several of them have
contracted respiratory diseases
due to allergens in the bird
droppings and feathers. Doctor
says four residents have died so
far due to the disease and 12
others have been diagnosed with
it; local Kabutar Khana blamed
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Gorai Dumping Ground Survey
Following concerns raised by the residents of BSES Society and Navlai Society,Gorai a questionnaire survey was
conducted by EPRC, K.E.M Hospital between 7/9/2011 to 28/9/2011.
Gautam Nagar – Deonar
Following the complaint from residents of Gautam Nagar, Opp. Deonar Police Station, Govandi, visit to
area was undertaken on 18-11-2011. This was followed by census and questionnaire survey from
EPRC, K.E.M. Hospital from 23/11/2011 to 25/11/2011.
In the population surveyed 7.6% complained of cough, 17% complained of breathlessness 16% had complained of eye irritation
and 34.9% had complained frequent sneezing. Considering the problem reported by the citizens exposure to cement dust, the
respiratory morbidity observed in this area is significant.
In the population studied 14.5%
complained breathlessness 13.7% had
complained eye irritation and 31.5%
frequent sneezing considering the
problem reported by the citizen regarding
exposure to cement dust, respiratory
morbidity observed in this area is
significant.
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Study of the long term effect of
Indoor biomass smoke on lung
Exposure to long term biomass smoke
is associated with structural and functional
changes in lung.
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Occupation related
Traffic police survey
Obstructive
Restricitve
Mixed
SAO
Normal
Obstructive
Restricitve
Mixed
SAO
Normal
PFT in traffic police in Smokers PFT in traffic police in non-smokers
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• 52/M
• Non-smoker
• Worked in a bakery for > 30 years
• C/O
• Productive cough and exertional
breathlessness since 2 years
• Treated with AKT on multiple occassions
due to Xray changes with no relief
• No h/o HT/DM/IHD
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Urban outdoor air pollution is estimated to cause 1.3 million
deaths worldwide per year. Those living in middle-income
countries disproportionately experience this burden.
…. Air Quality and Health, WHO Fact Sheet NO -313, Sept. 2011
Deaths and DALYs attributable to five environmental risks,
and to all five risks combined by region, 2004
Source : Global Health Risks, WHO, 2009
India Falls under Low and Middle Income Category
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Carcinogenic potential of PAHs is estimated with equivalent of
Benzo (a) pyrene. On the basis of BaPE calculation, residential
site has the maximum values of 18.8 and 13.6 for ambient and
indoor sampling location respectively.
Colaba Dadar Khar Mahul
BaPE Out 3.5 3.8 18.8 7.9
In 6.4 9.7 13.6 4.5
Lung Cancer Cases
/Yr.
Predicted
(2007)
1 3 16 8
Actual (2007) 8 7 10 13
Sum of PAHs
Identified ng/m3
Out 35.7 42.96 175.7
6
90.78
In 75.10 79.28 134.1
8
46.94
Carcinogenic Potential of PAHs-Mumbai City
SOURCE:NEERI MUMBAI
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Conclusions
INDOORS
Ratio at control sites (>1) indicates that there is a strong indoor
source for fine particles. At kerbsite I/0 ratio was 1.02 ± 0.14, close
to 1 indicating equal indoor and outdoor levels.
Theoretical I/O ratio and RCS model supports that indoor air
particles are derived from outdoor air at kerb and residential sites.
Highest BaPE was also observed at residential site indoors.
Though I/O ratio is less than one at residential site toxic pollution
characteristics of fine particles is greater. High indoor toxic
pollution affects personal exposure.
Control systems are primarily:
Creation of Ventilation Systems
AC premises: proper HVAC system
Indoor material selections
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Indoor
Air
Indoor air affects
vulnerable
population as they
spend maximum
time indoors.
Controlling indoor
air pollution will
help to achieve
millennium
development goal
4 and 5 related to
mortality and
morbidity of
women and
children.
Use of clean fuel like LPG
Ventilation standards and building codes for
Indian condition
Adoption of Leadership in Energy &
Environmental Design (LEED) Standards for
indoor air improvement in residential and
commercial places.
Indoor air quality surveillance by corporation
and pollution control boards at regular
interval/on request due to health effects
Manufacturing standards for Indoor air
quality products eg paints, cleaners etc.
Recommendations
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4522.96 million Rupees…..50
microgram rise particulates
• Monetary burden of health impacts of air
pollution in Mumbai, India
• Public Health. 2011 Mar;125(3):157-64.
• Monetary burden of health impacts of air
pollution in Mumbai, India: Implications for
public health policy.
• Patankar AM, Trivedi PL. K.J. Somaiya Institute
of Management Studies and Research,
Vidyavihar (East), Mumbai 400077, India.
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Vector borne diseases & Lung
• P. Vivax malaria – Thrombocytopenia , acute
lung injury, ARDS
• Dengue- ARDS
• Leptospirosis Water scarcity
Construction
Water logging
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Survival of the fittest
• Susceptible population at greatest risk
Genetically susceptible
Geographically susceptible
? Economically susceptible
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Environ Health Perspect. 2008 November; 116(11): A478–A485.
PMCID: PMC2592293
Linking TB and the Environment: An Overlooked Mitigation
Strategy
Charles W. Schmidt
“But doing that won’t be easy. Social and environmental interventions aren’t usually
delivered or funded by the health sector, so that means we all have to work with
other sectors, in particular housing, energy, and education, to
move them forward.”
TB control strategies adopted by the WHO and other organizations emphasize clinical
solutions in the form of drugs, vaccines, and access to health care. But despite the
success of these programs, TB incidence and mortality aren’t falling rapidly enough to
meet WHO targets, and in some areas, particularly in parts of Asia and throughout sub-
Saharan Africa, they continue to climb
“Better treatment is essential, but if we want to affect longer-term trends in the
epidemic we will also have to deal with risk factors,” asserts Eva Rehfuess, a scientist
with the WHO Department of Public Health and Environment
