Air pollution and public health

Unit 2:
Air and health of the public
By:
Nabin Lamichhane
Assistant Professor, Purbanchal
University
Gothgaun

2
A Lecture notes Preapared by Mr. Nabin
Lamichhane

Healthful Air
• Air that has, appears to have or helps to
produce good health.
• The degree of air quality which is suitable or
cleans enough for humans, animals or plants
to remains healthy.
• Air, water, Soil etc are the natural resources
that we cannot live without.
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Healthful Air…
• To understand that human beings (as well as
other animals) perform the respiration
process because we need air to breathe and
because oxygen is ultimately the fuel that
allows our cells to produce energy from the
food we eat.
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Healthful Air
• Air is a mixture of various gases like nitrogen,
oxygen and carbon dioxide, and others in
traces; along with water vapor perceptible as
humidity and suspended solids in particulate
form.
• Hippocrates: “About, air water and location”
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Healthful Air
• Pure air is the first food and the first
therapeutic drugs.
• Per day: We eat
– 3 kg water and 15 kg Air (equivalent to 3 kg
oxygen)
– 22000 times breaths per day.
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Properties of Healthful Air
• Physical Properties
– Odorless
– Tasteless
– Takes some space
– Warm air rises and cool air
fall
– Not have fixed shape, Has
Volume, expands and
compresses.
– Weight and pressure on earth
(Atmospheric Pressure)
– Resistant for motion
– Generally Colorless
(Transparent)
– Gas at room temperature.
• Chemical Properties
– Carbon dioxide, Oxygen,
Nitrogen, and trace elements.
– Oxygen is highly a reducing
gas.
– Rusting
– Combustibility
– Flammability
– Slightly soluble in water
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Properties of Healthful Air
• Gaseous Properties
• Air is not a single gas. It’s a
mixtures of gases.
• A breathing gas must Have:
– Sufficient oxygen to support life,
consciousness and work rate of the
breather.
– Must not contain harmful
gases. Carbon
monoxide and carbon dioxide are
common poisons which may
contaminate breathing gases. There
are many other possibilities.
– Must not become toxic when being
breathed at high pressure such as
when underwater. Oxygen
and nitrogen are examples of gases
that become toxic under pressure.
• Biological Properties
– Oxygen (O2) must be present in
every Healthful air.
– Oxygen binding capacity
– Can help in the production of
Energy
– Animal Excretes CO2 and many
others substance in breathing
– Green plant use CO2 gas for
photosynthesis.
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Air Quality
• The term "air quality" means the state of the air
around us. Good air quality refers to clean, clear,
unpolluted air. Clean air is essential to maintaining the
delicate balance of life on this planet - not just for
humans, but wildlife, vegetation, water and soil. Poor
air quality is a result of a number of factors, including
emissions from various sources, both natural and
"human-caused." Poor air quality occurs when
pollutants reach high enough concentrations to
endanger human health and/or the environment. Our
everyday choices, such as driving cars and burning
wood, can have a significant impact on air quality.
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Need for healthful air for healthful living
• The human body uses air in several ways.
Without it we wouldn't be able to live.
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Physical Needs
• Breathing in Oxygen
• Exhaling Waste: O2 is primarily combined with carbon in our
bodies to produce CO2 which is exhaled.
• Plant :
• Use CO2 (together with sunlight and water) to produce energy
and give out Oxygen as a by-product. This oxygen is what
almost all animals need to survive.
• Regulating Temperature :
• The air around us helps to keep us warm.
• In the absence of any heat in the air, our bodies lose
heat quickly. If we are working hard or exercising we
generate excess heat. The air provides some cooling to
help the body maintain an ideal temperature of 37
degree C. 12
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Physical Needs
• Transmitting sound : Our sense of hearing relies on sound energy being
transmitted through the air. Without air, no sound would reach our ears.
• Transmitting light : If all of the air was suddenly removed from the room
you would still be able to see for the few last brief moments of your life.
But consider that the air might be replaced with something else that is
breathable but not transparent. If the air were not transparent, you'd have
trouble using your eyes.
• Fresh air is good for digestion: Fresh air helps you to digest food more
effectively. That is why it’s great to take a small walk outside after you eat.
From all the health benefits of fresh air, this one is really important if you
are trying to lose weight.
• Improves blood pressure and heart rate: If you have a problem with blood
pressure, you should avoid polluted environments and try to stay in
surroundings that have a good supply of fresh air. Dirty environment
forces the body to work harder, to get the amount of oxygen it needs.
• Strengthens your immune system: White blood cells kill and fight bacteria
and germs. They need enough oxygen to work and function properly.
• Fresh air cleans your lungs: Fresh air helps the airways of your lungs to
dilate more fully and improves the cleansing action of your lungs. When
you exhale and breathe out through your lungs, you release airborne
toxins from your body.
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Mental
• Feelings of freshness
• Cool air give sense of happiness with joy.
• The smells in fresh air bust stress and increase happiness.
• More oxygen supply in prevents from brain hemorrhage, MI
etc.
• Fresh air makes you happier because the amount of
serotonin is affected by the amount of oxygen you inhale.
Serotonin can significantly lighten your mood and promote
a sense of happiness and well-being. Fresh air will leave
you feeling more refreshed and relaxed.
• Healthy air will bring more energy and sharper mind
• Fresh air helps to think better and increases energy level.
Brain needs twenty percent of body’s oxygen.
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Social
• Healthy surrounding –Healthy air
• Wide space is good path of communication air-
Good housing- Good Social status
• Every people wants to live in cool weather, clean
environment with healthy water, healthy society.
• Health Air helps to make a healthy society
• House with good ventilation and wide space
around gives a sense of prestige among the
society.
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Importance of Healthy Air on Human
Health
• Healthy air reduces the burden of disease
from stroke, heart disease, lung cancer, and
both chronic and acute respiratory diseases,
including asthma.
• Better the air quality , better the
cardiovascular and respiratory health of the
population will be, both long- and short-term.
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Mechanism of contribution of healthy
air to human health
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Basic Mechanisms
• Air Travels:
Nose- Lungs- Alveoli- Blood- cells- energy
yielding
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Mechanisms
• Respiration is the release of energy from glucose in the muscles.
• When the body is at rest this is aerobic respiration. As you exercise
you breathe harder and deeper and the heart beats faster to get
oxygen to the muscles.
– Glucose + oxygen → energy + water + carbon dioxide
• When exercising very hard, the heart cannot get enough oxygen to
the muscles. Respiration then becomes anaerobic.
– Glucose → energy + lactic acid
• Oxygen is by far the most important necessity of human life. ...
Energy is life and the production of energy in the body depends
upon oxygen. The second important function of oxygen is to
combine with metabolic waste products to allow their elimination
from the body. This process is called the oxidation reduction cycle.
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Ways of promoting and maintaining healthful air
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• Green belts
– Trees help in removing carbon dioxide and other
pollutants from air and by release of oxygen into the air
thereby improving air quality. A green belt
development can also help in removing particulate
matter from the air by trapping such particulate matter.
– Green belt land has become the key in protection of
natural and semi-natural environment as well as a
retreat for wildlife.
– Access to an open space provides a number of
recreational and educational opportunities, while the
physical barrier between urban areas and the
countryside improves air quality in urban centers.
• Ventilation, Doors and Windows.
• Bio-gass Promotion
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• Making home as a smoking free
• Proper housing environment
• Concept of Cycle cities
• Proper use of fans and coolers
• Regular cleaning (Vacuum Cleaners)
• Air conditioning: Air conditioners are beneficial in so much
as they help circulate and filter indoor air. Almost all air
conditioners contain a filter that will remove allergens and
other pollutants as it pulls air from inside the room.
• Adequate Spacing
• Educational Approaches
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Measurement of healthful air quality
• Clean air is considered to be a basic
requirement of human health and well-being
• Intended to inform policy-makers and to
provide appropriate targets for a broad range
of policy options for air quality management.
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• The "WHO Air quality guidelines" provide an assessment
of health effects of air pollution and thresholds for
health-harmful pollution levels.
• Policies and investments supporting cleaner transport,
energy-efficient housing, power generation, industry and
better municipal waste management would reduce key
sources of urban outdoor air pollution.
• The 2005 "WHO Air quality guidelines" offer global
guidance on thresholds and limits for key air pollutants
that pose health risks. The Guidelines indicate that by
reducing particulate matter (PM10) pollution from 70 to
20 micrograms per cubic metre (μg/m), we can cut air
pollution-related deaths by around 15%.
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• Setting the healthy level of air quality.
• Ensuring that the air quality standard are met.
• Ensuring healthy sources of Air.
• Evaluating the effectiveness of the ambient air
quality monitoring.
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How can you say that our surrounding’s air is
healthful?
• International Level:
– International Regulations
– Campaigns
– Collaborations
• National Level:
– Creating and enforcing regulations
– Appropriate plans, policies, laws, acts and their Implementation.
– National Air Quality Policy
– Small installation’s emissions regulated
– Criteria setup
– Vehicle emission limit
– Emission regulations for industries
– Level of morbidity and mortality etc
– Coordination Mechanism
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How can you say that our surrounding’s air is healthful?
• Community Level:
– Commitment
– Solid waste management practices etc.
– Coordination with stakeholders
– Community Actions
• Household Level:
– Proper use of Ventilation, doors and Windows
– Physical Infrastructure
– Location
– Wide yard
– Proper disposal of Waste and smoke
– Solid waste management policies
– Socio-economic status
• Individual Level:
– Level of Awareness etc.
– Income
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• OSHA (Occupational Safety and Health Administration) and
NIOSH (National Institute for Occupational Safety and Health)
define an oxygen deficient atmosphere as any atmosphere
containing oxygen at a concentration below 19.5% at sea
level, which includes a safety factor. At concentrations below
16%, decreased mental effectiveness, visual acuity, and
muscular coordination occur.
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Some indicators for Measuring
Healthful Air
• Air Temperature
• Air Temperature and
Humidity
• Cooling Power (Kata
Thermometer)
• Effective Temperature
• Corrected Effective
Temperature
• McCARDLE’S Maximum
allowable sweet rate
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Air Quality Index
• The AQI is an index for reporting daily air
quality. It tells you how clean or polluted
your air is, and what associated health
effects might be a concern for you. The AQI
focuses on health effects you may
experience within a few hours or days after
breathing polluted air.
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• CHEMICAL CHANGES: The air becomes progressively contaminated by
carbon dioxide and the oxygen content decreases due to metabolic
processes.
• PHYSICAL CHANGES:
– Rise in temperature
– Increase of humidity
– Decrease in air movement
– Body odours
– Bacterial pollution
• Unless the vitiated air is replaced by fresh air, it may adversely affect the
comfort. health and efficiency of the occupants. It is known that a
feeling of suffocation or discomfort is experienced by the occupants in
insufficiently ventilated rooms and also complaints of headache,
drowsiness and inability to concentrate. There is also the risk of droplet
infection and lowered resistance to disease (on prolonged exposure).
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Characteristics of Unhealthy
(Polluted air)?
• Air contamination- Polluted air—Unhealthy
Air.
• A air is said to be unhealthy when there is
excessive presence or concentration of
foreign materials in the air, which adversely
affect the well being of the individuals and
causes damage to the property. (American
Medical Association)
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Characteristics of Unhealthy (Polluted) air?
• Presence in the outer atmosphere of substances
or contaminants put there by man, in quantities
and concentrations and of a duration as to cause
any, discomfort to a substantial number of
inhabitants of an area which are injurious to
public health or to human, plant or animal life or
property or which interfere with the reasonable
comfortable enjoyment of life and property
throughout the state or through out the
territories or areas of state.
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Characteristics of Unhealthy (Polluted) Air
• Generally Man-made
• Disease agents may be conveyed by air
• The characteristics can be observed in:
– Effects of Air Pollution on Human
– Effects of Air Pollution in Vegetation
– Effects of Air Pollution on materials etc.
• Unhealthy Air causes the increased incidence of respiratory
diseases, cardiovascular diseases and many mores (eg Eye irritation,
increased mucous production, cough and shortness of breath etc.)
• Unhealthy air---Water Pollution (taste of water is altered)
• Unhealthy Air- Unhygienic Food- different health problems
• Unhealthy Air results:
– Climate Change and global warming
– Acid rain
– Altered Agricultural Production
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Characteristics of Unhealthy (Polluted) Air
• The quality of air is being reduced by industrial modernization. Cement factories,
mines, steel manufacturers and thermal-power plants are among some of the
leading producers of air pollution.
• The effects of air pollution can be felt thousands of miles from its original source.
China's industrial pollution can be felt in Western parts of the United States. Aerial
transport has also caused pesticides from farms in South America to arrive in
Antarctica.
• The internal combustion engines of cars and other vehicles produce carbon
monoxide, which is a highly poisonous gas. According to the American Heart
Association, breathing this form of air pollution over a long period of time can
cause serious respiratory problems.
• Sulfur dioxide, nitrogen oxide and other air pollutants can enter the pores of
developing plants and break down the waxy coating that protects them from
disease and excess water loss.
• Volcanic activity can be one of the most significant natural sources of air pollution.
When volcanoes erupt, they spew large amounts of ash and toxic chemicals into
the air.
• Desert areas create dust storms that contribute to particulate matter in the
atmosphere. Forest and grass fires also produce smoke that causes chemical
pollutants to enter the air. 41
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Sources/Causes of Unhealthy Air
• Based on Mode of Generation:
– Natural Sources: Forest fires, Volcanic eruption, Dust
storms, Pollen grains.
– Manmade: Domestic, Industrial, Vehicular etc.
• Based on the shape of entry of pollution:
– Point source (single source: Volcano), Line source
(Aero planes), Area/volume sources.
• Based on Origin:
– Primary: Smoke release from burning coal
– Secondary: Formed by Primary pollutants.
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Sources/Causes of Unhealthy Air
• Based on Chemical composition:
– Organic: Proxy Acetyl Nitrate, Hydrocarbons
– Inorganic: CO2, SO2, NOx
• Based on state of Matter:
– Particulate matter:
• Finely divided solid and liquid particles
• Size: 5000 to0.0002 micron)
• Highly reactive
• Mostly carried through the smoke, dust etc.
– Gaseous: CO2, SO2
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Measurement of Unhealthy Air
• Estimating the adverse effects of Air Pollution
• Monitoring the level of Air Pollutants
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Adverse effects of Air Pollution
• Immediate
– Respiratory system: Acute Bronchitis, Suffocation
and Death.(eg Black Hole of Kolkata)
• Delayed:
– Chronic Bronchitis, Lung Cancer, Bronchial
Asthma, emphysema and respiratory allergies.
• Lead: Loss of IQ
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Social and Economic Aspects
• Deduction of Plant and Animal life
• Corrosions of Metals
• Damage to building
• Cost of cleaning and maintenance and repairs.
• Reduces the visibility in towns
• Damage soil and clotings
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Other measurable effects
• Ozone layer depletion
• Phtotchemical smog
• Acid Rain
• Global Warming
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Monitoring unhealthy air
• Level of Sulphur dioxide (major pollutant)
• Smoke or Soiling Index
• Grit and Dust measurement
• Coefficient of haze
• Air Pollution Index
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Air related Human Behaviors
Encouraged
• Banned Smoking, Smoking Zones
• Plastic related disposal should be
recycled
• Masking
• construction site should be sealed.
• Tree plantation
• Adequate Housing, proper ventilation,
Adequate spacing
• Solar power, Biogas
• Checking Air filters of the vehicle
• Use Dustbin
• Clean the carbon deposit from silencer.
• Improved version of ‘Chulo’
• Implementation of Legal provisions
• Open ventilation and windows
Discouraged
• Smoking (Great exposure to
CO)
• Plastic related waste
shouldn’t be burnt
• Coal combustion, Petrol
engines, diesel engine
• Chemical releasing the
fumes
• Heaters
• Unnecessary wood fire
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Encouraged
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Discouraged
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Ways of preventing air from becoming
unhealthy (Polluted)
WHO Recommendation
• Containment (Enclosure, ventilation, air cleaning)
• Replacement: ( electricity, solar, natural gas, deleaded
petrol)
• Dilution: Vegetation, Green belts
• Legislations: Clean air acts, powers to local authority,
smokeless zones, punishments etc.
• International Actions:
– International Network for laboratories for the monitoring and
study of air pollution
• 2 International centers at Washington and London
• 3 centers at Moscow, Nagpur and Tokyo.
• 20 labs in different countries
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• Zoning: Zoning of industries on the basis of types
• Air Pollution control at source:
– Raw material substitution: Low suplure fuels can be
used in place of high sulfure fuels in order to control
air pollution.
– Modification of Process: For eg: The use of exhaust
hoods and ducts over several types of industrial ovens
allow the recovery of various solvents that could have
become air pollutants
– Equipment Alterations
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• Controlling Air pollution by Devices
– Cyclone Separator
– Wet Collector
– Fabric Filters etc.
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Overview of national policy, strategies, and programs
focused on air and health
• Constitution of Nepal 2072
– Part III: Fundamental Rights and duties
• Article : 30 : Right regarding clean environment
– Right to live in healthy and clean environment
– Right to compensation for the victim of environment pollution
– Legal provisions
• Article 35: Right to health (including access to safe
drinking water and sanitation)
• Article 36: Right to food
• Article 37: Rights to housing
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• Environmental Protection Act 2053.
• Environment Protection Rules, 2054 (1997).
– No specific law to address air pollution; Environment
Protection Act (1997) and Environment Protection
Rules (1999) are umbrella legislation.
• Nepal ranked 177th out of 178 for air quality in
2014 Environmental Performance Index.

Overview of National Plans and
Policies
• National Ambiant
Air Quality
Standard (NAAQS)
was introduced in
2003 and updated
in 2012.
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Overview of National Plans and Policies
• Nepal Vehicle Mass Emission Standard (NVMES) was
introduced in 2000 and revised in 2012. Now all vehicles
except for heavy equipment vehicles imported to Nepal
require compliance with EURO III emission standard.
• Euro III Standard Fuel: Nepal Oil Standard started
supplying EURO III standard of fuel since 2010.
• Emission standards for in-use and new diesel generators
(DG) sets, industrial boilers, cement industries and crusher
industries were introduced in 2012. However,
implementation of the standards and its compliance has
not been effective yet. The government has also
introduced brick kiln stack emission standard in 2008.
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• Climate Change Policy 2011 has aimed at moving
in low carbon development path, which provide
co-benefits for reducing the air pollution.
• Ambient Air Quality Monitoring System: MoSTE
started monitoring ambient air quality through
six monitoring stations in 2002. The equipment
however stopped functioning in 2007 and in
2013, the Ministry has resumed air quality
monitoring in three of the stations: in Bhaktapur,
Machhegaun and Putalisadak by measuring PM10
levels on a daily basis.
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• Vehicle Inspection and Emission Testing: Nepal initiated activities for
monitoring of exhaust emissions in the valley in 1993 and issuance of
Green Sticker system was enforced since December 1999. The
vehicle emission testing is only limited within Kathmandu valley and
is applicable only to three and four wheelers. However, the
inspection and emission testing system has not been effectively
implemented.
• Ban on polluting vehicles: The government banned the operation of
heavily polluting diesel three wheelers and import of new two-stroke
and second hand vehicles in 1999, in an effort to combat air pollution
in Kathmandu Valley. This initiative prompted the scaling up of
electric vehicles (Safa tempo) for public transportation.
• Ban on the heavily polluting Movable Bull Trench Kiln: In 2003, old
polluting brick kilns in Kathmandu Valley were banned by the
government following significant protests from the local people. This
was followed by the introduction of less polluting technologies,
mainly Fixed Chimney & Vertical Shaft Brick Kilns (VSBK).
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Overview of national policy, strategies, and
programs focused on air and health
• Restriction on used car importation: vehicles older than 5 years are
banned
• Incentives for clean production and installation of pollution
prevention technologies: old brick kiln technology within
Kathmandu Valley, and introduction of the cleaner Vertical shaft
Brick Kiln technology which provides energy cost savings, better
quality and less pollution; Industrial Enterprises Act grants 50%
reduction in taxable income for companies that invest in industry
process / equipment that controls pollution for 3 years
• National Indoor air pollution guidelines- 2009
• Air Quality Management Action Plan for Kathmandu Valley
• At present, 3 monitoring stations 2 in Kathmandu valley and 1 in
Dulikhel.
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• Pollution tax on fuel: The government started to collect
pollution tax of NRs. 0.5 from each liter of petrol and diesel
sold in the Kathmandu Valley in 2007. However the
provision to deposit the pollution tax to Environment
Protection Fund as decided in Financial Act 2002/03 has
not been implemented yet and the amount collected has
remained unspent.
• Road improvement, footpaths and cycle lanes: The
government has initiated road expansion campaign to
improve the traffic flow, and has built sidewalks and cycle
tracks to promote walking and cycling. Under Kathmandu
Sustainable Urban Transport Project, the government is
improving the public transport system and pedestrianizing
the urban core areas.
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Overview of Plans and
Policies
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•Day Celebration (June 5, WED)
•Awareness Programs
•Private Sectors role
•NGOs, INGOs:
Clean Energy Nepal, Environmental Public Health
organization, Clean Air Network, International
Center for Integrated mountain Development,
LEADERS Nepal.
International organizations and developmental
agencies have played key role in supporting
government for improving the air quality such as
establishment of air quality monitoring stations by
DANIDA, promotion of electric vehicles by USAID,
introduction of Vertical Shaft Brick Kiln
(VSBK) technology projects
supported by Asian Development Bank.

International Campaigns
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• WHO Responses:
– Air quality guidelines have been published by WHO in 1987 and they
were revised in 1997.
– Given the wealth of new studies on the health effects of air pollution
that have been published in the scientific literature since the
completion of the second edition of the Air quality Guidelines for
Europe, including important new research from low-and middle-income
countries where air pollution levels are at their highest, WHO has
undertaken to review the accumulated scientific evidence and to
consider its implications for its air quality guidelines.
– New indoor air quality guidelines for household fuel combustion
– Household energy database
– Research and programme evaluation
– Leadership and advocacy in the health, energy and climate community
– Global Alliance for Clean Cook stoves and the Climate Clean Air
Coalition.
• UNFCCC, Kyoto Protocol, Montreal Protocol, COPs, Paris Agreement
etc.

Roles and Responsibilities
• As a Policy maker
• Policy, law and regulation analysis : Recommendation
• Project Design
• Control Strategy formulation
• Identification and Assessment
• As a Program Initiator, Manager
• Identification of Public health Emergency
• Monitoring, Implementation of Programs
• EIA
• As an Advocator
• As a Police Inspector of Environment.
• As a Researcher
• Report Preparation and Dissemination
• As a Environmental Health Educator
…………………………….???????
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References
• A text book of Preventive and social medicine,
K Park (24th edition)
• WHO website
• References were tried to put in the respective
slides.
( Note: This PPT is only created for the Teaching
learning purpose)
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Thank You!!
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