Based on money and Materials Our modern life became a big illusion. The Real life and happiness needs 1- Security 2- Health 3- Life essentials (food – shelter etc). The Real life and happiness lie behind a natural life in a clean environment. We are sinking in different types of pollution. The consequences of pollution include: 1- Climate change the Heat melts ice, worsens weather and expands oceans. 2- Human health effects a- Climate changes b- Pollutants. 3- Plants and animals Natural habitats become hostile. Pollution is a Global Problem with no but a Single must be a Global Solution that is Go Green, Reduce CO2 and Stop Pollution.

1. Dr. Fathi Neana, MD
Chief of Orthopaedics
Dr. Fakhry & Dr. A. Al-Garzaie Hospital
Saudi Arabia
September, 21 - 2017

2. ‫الن‬ ‫ِي‬‫د‬ْ‫ي‬َ‫أ‬ ْ‫ت‬َ‫ب‬َ‫س‬َ‫ك‬ ‫ا‬َ‫م‬ِ‫ب‬ ِ‫ر‬ْ‫ح‬َ‫ب‬ْ‫ل‬‫ا‬َ‫و‬ ِ‫ر‬َ‫ب‬ْ‫ل‬‫ا‬ ‫ي‬ِ‫ف‬ ُ‫د‬‫ا‬َ‫س‬َ‫ف‬ْ‫ل‬‫ا‬ َ‫ر‬َ‫ه‬َ‫ظ‬ِ‫اس‬‫م‬ُ‫ه‬َ‫ق‬‫ِي‬‫ذ‬ُ‫ي‬ِ‫ل‬‫ل‬َ‫ع‬َ‫ل‬ ‫وا‬ُ‫ل‬ِ‫َم‬‫ع‬ ‫ِي‬‫ذ‬‫ال‬ َ‫ض‬ْ‫ع‬َ‫ب‬ْ‫م‬ُ‫ه‬
َ‫ون‬ُ‫ع‬ ِ‫ج‬ْ‫ر‬َ‫ي‬(41)‫الروم‬
Mischief has appeared on land and sea because of (the meed) that the hands of men have earned, that
(Allah) may give them a taste of some of their deeds: in order that they may turn back (from Evil).
(Quran 30:41)

3.  The rate at which the man has made progress in
terms of technology and industrialization is in
direct proportion with the increase of an evil we
know as pollution
 Millions of deaths occur all around the world due
to various types of pollution.
 Nearly 50% of deaths per year world over occur
due to pollution.
 The harmful effects of pollution take the life very
slowly (silent killer).
 Air pollution is one of the most dangerous types of
pollution
 Global warming the biggest natural threat ever
Pollution the silent killer

4. The Consequences of
Pollution
Physical effects of pollution
 Ecosystem dysfunction
 Environment, greenhouse phenomena
 Climate change, global warming vs. dimming
 Infrastructure and Development
Biological effects of pollution
 People
 Animals
 Plants

5. Health
As defined by World Health Organization (WHO). Health
is a "State of complete physical, mental, and social well
being, and not merely the absence of disease or
infirmity."
Health is a dynamic condition resulting from a body's constant
adjustment and adaptation in response to stresses and changes in
the environment for maintaining an inner equilibrium called
homeostasis.
Read more: http://www.businessdictionary.com/definition/health.html

6. Human Health
Disease
Acute
chronic
Pathogen
Bacteria
viruses
PollutionRisks
Obesity
smoke
Chemicals
Types
Neurotoxines
Carcinogenes
Teratogenes
Endocrine diruptors
Allergens
Dose – response Duration
Bioaccumulation
Biomagnification
Stockholm convention
LD50

7. Bioaccumulation
•Bioaccumulation is the accumulation of harmful substances like pesticides, organic
chemicals in an organism.
•Bioaccumulation happens when an organism absorbs substances that are toxic at a
greater rate than at which the substance is lost.
•The longer the half-life of the substance the greater is the risk of poisoning though
levels of toxins are not very high in the environment.
•Bioconcentration is the uptake and accumulation of toxic substances from water
alone.
Biomagnification
•Biomagnification is also known biological magnification or bioamplification.
•Biomagnification is a process where substances like pesticides or heavy metals
move up the food chain.
•When chemicals or pesticides are let into rivers or lakes they are consumed by
aquatic organisms like fish, which in turn are consumed by large birds, animals or
humans.
•These harmful substances become concentrated in tissues, internal organs as it
moves up the food chain.
•These are substances that increase in concentration in living organisms as they are
taken in due to contaminated air, water or food as these substances are metabolized
or excreted very slowly.
What is the meaning of
Bioaccumulation and Biomagnification

8. Bioaccumulation
and
Biomagnification

9. We are sinking in different types of
pollution
 Water Pollution.
 Land pollution (Soil contamination by
lead, heavy metals).
 Air Pollution.
 Noise Pollution.
 Littering (spilling of oils in oceans).
 Radioactive contamination.
Ionized radiation.
Non ionized radiation (EMFs – Wi-Fi).
 Visual Pollution.
 Thermal pollution.
 Drugs, Alcohol, Smoke.
 Mental pollution.

10. 1- Climate change
a- global warming
b- global dimming
2- Human health effects
a- Climate change
b- Pollutants
3- Plants and animals
Natural habitats become hostile
The Consequences of Pollution

11. Climate change
Greenhouse phenomenon
Global warming
El Niño
Heavy rains & flooding in new sites (Cities)
Desertification of original sites (Africa ..)
Tropical cyclones
Methane clathrate emission
Earthquakes
Volcano eruptions
Global Dimming
Human, agricultural, animal effect

13. Human health effects
1- Climate change 2- Pollutants

14. Human health effects
1- Climate change 2- Pollutants

15. Human health effects
Top 45 diseases caused by pollution
Air pollution
1. Asthma attacks - chronic
obstructive pulmonary disease –
COPD
2. Weakening of lung function
3. Pulmonary cancer
4. Mesothelioma
5. Pneumonia
6. Bronchitis
7. Emphysema
8. Leukemia
9. Birth defects and immune
system defects
10. Cardiovascular problems
11. Neurobehavioral disorders
12. Liver and other types of cancer
13. Premature death
14. Autism
Water pollution
15. Typhoid
16. Giardiasis
17. Amoebiasis
18. Ascariasis
19. Hookworm
20. Gastroenteritis
21. Diarrhea
22. Encephalitis
23. Stomach cramps and aches
24. Vomiting
25. Hepatitis
26. Respiratory infections
27. Liver damage and even cancer
28. Kidney damage
29. Neurological problems
30. Weak sexual power
31. Thyroid system disorders
32. Malaria
33. Rashes on skin
34. Ear aches
35. Pink eyes
Soil pollution
36. Cancer
37. Brain and Nerve Damage
38. Kidney and Liver Disease
Noise pollution
39. Efficiency decrease of people
40. Lack of concentration
41. Fatigue
42. Abortion
43. Blood Pressure
44. Temporary or permanent deafness
45. Anxiety
Light Pollution
Melatonin
Radioactive contamination
Ionized radiation.
Non ionized radiation (EMFs – Wi-Fi).
Thermal pollution
Drugs, Alcohol, Smoke
Mental - psychological

16. Air Pollution

17. Air pollution
1. Asthma attacks - chronic
obstructive pulmonary disease –
COPD
2. Weakening of lung function
3. Pulmonary cancer
4. Mesothelioma
5. Pneumonia
6. Bronchitis
7. Emphysema
8. Leukemia
9. Birth defects and immune
system defects
10. Cardiovascular problems
11. Neurobehavioral disorders
12. Liver and other types of cancer
13. Premature death
14. Autism
Human health effects
Top 45 diseases caused by pollution

19. Not only respiratory and cardiovascular system disorders
Musculoskeletal system disorders too
(Bone is a specialized connective tissue - minerals, Collagen)
1- Arthritis
systemic chronic inflammatory diseases such as rheumatoid arthritis.
2- Osteoporosis
more than 8.9 million fractures annually worldwide
3- Vitamin D deficiency Osteomalacia , UVB rays
4- Lead poisoning and growth
5- Fluorosis
6- 2nd to systemic disorders ( ex: Glycation of collagen - Hypoxia)
Air pollution
Musculoskeletal system disorders
How to limit the impact
1- Drink sufficient water to get rid of the pollutants accumulation
2- Consuming liver-friendly foods such as carrots, lemons and bitter greens
3- Fight inflammation , Cinnamon, ginger and turmeric .
4- Ensure sufficient intake of Vit D and Calcium especially in post partum and post menopausal
women
5- Sun light daily
6- Regular exercise strengthen muscles and bones

20. Effects of air pollution in general
– The air we breathe 26000 times per day contains nitrogen, oxygen, CO2,
water, argon, other trace gases, and a volume of 14,000 liters
– Vegetation is effected when absorbed through pores, soil, and water
– Wildlife and animals can get affected
– Deposition on water bodies affecting its quality, and organisms in water
– Severity and symptoms experienced depend on the pollutant, its
concentration in air, length of exposure and individual sensitivity
– Organic nature of particulate matter (PM) could vary
– Health effects in general
• Healthy individuals may not notice effects from air pollution, except when the
pollution is very high.
• Individuals who have asthma, heart conditions or lung diseases, may
experience distress and other health effects, even at lower levels of
pollution.

21. History
• The Great Smog of London, or Great Smog
of 1952
• December 4th 1952, → fog;
• Smog lasted for 5 days & led to 4000 more
deaths than usual.
• The deaths were attributed to the increase
in air pollution during the period, with 7
fold ↑ in SO2, and 3-fold ↑ in smoke than
before
• The peak in the number of deaths coincided
with the peak in both smoke and SO2
pollution levels.

22. Health effects: London smog 1952
Respiratory effects
• Large number of deaths occurred due to influenza
• Exacerbation in Asthma, Bronchitis, Tuberculosis
• Short term decrease in breathing ability
• Increase in chest pains
• Inflammation of the lungs and damage to
respiratory cells
• Permanent lung damage & reduced life quality due
to ozone.
• Increased number of asthma attacks due to
nitrogen dioxide.
Cardiovascular effects
• Heart failure
• A lack of oxygen in the blood stream in those with
heart disease due to carbon monoxide.
Figure 1
SO2 & SMOKE LEVELS BY DEATH RATE

23. Air Pollution Kills > 5 million people around the World Every Year
Justin Worland, Feb 12, 2016
(Compared with >3.7 million in 2012)

24. Poor quality air blamed for > 6 million deaths a year

25. Number of deaths caused by urban air pollution (UAP) per 1,000 people

26. Traffic emissions and death
Near-road group had:
 Almost double the death rate
from heart and lung disease
 1.4 times higher overall death
rate
Hoek, G., et al. “Association between Mortality and Indicators of Traffic-related Air Pollution in the
Netherlands: A Cohort Study”
Lancet 360 (2002) 1203

27. Diesel exhaust permanently changes
immune response
 More Asthmatic and Allergic
responses
 Polycyclic aromatic hydrocarbons
(PAH) are the culprits
 Diesel and vehicle exhaust and
coal smoke
Nel, A.E., et al., J of Allergy and Clinical Immunology, 2001

28. Air pollution is contamination of the
indoor or outdoor environment
By any chemical, physical or biological
agent that modifies the natural
characteristics of the atmosphere
Air Pollution

29. Sources of air pollution
Man made (Outdoor - Indoor)
• Traffic motor vehicles
• Factories, industrial facilities
• Power stations
• Airplanes
• Household combustion devices
• Domestic coal, wood, biomass, rice husk, etc
• Lack of ventilation (AC)
Natural
• Forest fires
• Gases and ash from volcanoes, windborne dust, grit and pollen
• Human body is designed to cope with some of natural pollutants
• Air passages produce mucus to trap particles from dust and grit from nose
to lower bronchioles; mechanism of sneezing and cough are further
extremes

30. Sources of air pollution

31. Indoor pollution deaths per million
population

34. Some or all of the following health effects
characterize poor indoor air quality:
Sick Building Syndrome (SBS) and Multiple
Chemical Sensitivity (MCS).
1- Headaches
2- Blurred vision
3- Irritations of the eyes, nose and throat
4- Difficulty concentrating
5- Fatigue
6- Nausea
7- Shortness of breath, wheezing
8- Sinus congestion
9- Occupational allergies
Poor indoor air quality

35. Pollutants
• Particulate matter
(PM) especially PM
2.5
• Carbon monoxide
• Ozone, nitrogen
dioxide
• Sulfur dioxide
• Mercury

36. Particulate Matter PM2 level
Most PM particles form in the atmosphere as a result
of chemical reactions between pollutants.
Particulate matter (PM), also known as particle
pollution, is a complex mixture of extremely small
particles and liquid droplets that get into the air.
Once inhaled, these particles can affect the heart and
lungs and cause serious health effects.
On April 28, 2017 - The U.S. Environmental
Protection Agency completes determinations of
attainment for 10 nonattainment areas for the 2006
24-hour fine particle standards.

37. Particulate Matter pathophysiology
 Penetrate deeply into lungs to alveoli,
Irritate lung linings-more asthma,
Stimulate immune system inflammatory
proteins
 Short term exposure to particulates
(PM2.5) increases the incidence of heart
attacks for one day following exposure
 As air pollution goes up the risk of heart
attack goes up
Increased Particulate Air Pollution and the Triggering of Myocardial Infarction
Peters, et al.; Circulation, June 12, 2001, vol. 103

38. Blood
• Altered rheology
• Increased
coagulability
• Translocated particles
• Peripheral thrombosis
• Reduced oxygen
saturationSystemic Inflammation
Oxidative Stress
• Increased CRP
• Proinflammatory mediators
• Leukocyte & platelet activation
PM Inhalation
Brain
• Increased
cerebrovascular ischemia
Heart
• Altered cardiac
autonomic function
• Increased dysrhythmic
susceptibility
• Altered cardiac
repolarization
•Increased myocardial
ischemia
Vasculature
• Atherosclerosis,
accelerated progression of and
destabilization of plaques
• Endothelial dysfunction
• Vasoconstriction and Hypertension
Lungs
• Inflammation
• Oxidative stress
• Accelerated progression
and exacerbation of COPD
• Increased respiratory
symptoms
• Effected pulmonary reflexes
• Reduced lung function
There are multiple mechanistic pathways have complex interactions and interdependencies
Figure 2

39. Carbon Monoxide (CO)
• HB binds with CO to form carboxy-hemoglobin (COHB)
• Prevents O2 transport to tissues → hypoxia
• Binding affinity of CO to HB is 250 times > O2
• Brain, heart, & muscles are sensitive to hypoxia;
– 80% of COHB levels lead to death
– 60% to loss of consciousness
– 40% to confusion and collapse upon exercise
– 30% to headache, fatigue, and impaired judgment
– 5-20% to ↓ visual perception, manual dexterity, learning, complex tasks
– 2.9-4.5%--decreased exercise capacity in healthy men
• Importance for those vulnerable to cardiac conditions (e.g. angina)
• Other nervous system effects are disturbances in hand eye coordination
• Reported to cause Low Birth Weight

40. • Volatile organic compounds (VOC) react with sunlight to form NO2; a by-product of high
temperature & automobile combustion
• organic chemicals like gasoline; vaporize easily
Short term effects
• Breathing difficulty during outdoor activities
• Shortness of breath
• Headaches
• Nausea
• Throat and lung irritation
Long-term effects
• Premature aging of the lungs
• Decreased lung function
• Worsened symptoms of asthma, emphysema, and other lung diseases
• Inflammation and damage of the lining of the lungs
Other Effects
• Allergy symptoms
• Respiratory infections
• Ear infections
• Emphysema attacks
• Overall death rates
Oxidant air pollutants : Ozone, NO, and NO2

42. The difference depends on which layer of the earth's atmosphere the ozone is
found.
Good ozone, or Stratospheric ozone
The Stratospheric layer 10 – 31 miles above the earth's surface
Within this layer, good ozone is made and destroyed naturally all of the time.
Stratospheric ozone varies in thickness
Stratospheric ozone acts as a filter and absorbs the sun's harmful ultraviolet rays
Bad ozone, or ground-level ozone, or Tropospheric ozone
The Tropospheric layer, from the ground up to 10 miles (also known as ambient air).
Composed of natural atmospheric gases, volatile organic compounds (VOCs), nitrogen
oxides, and sunlight
Ground-level ozone levels are usually higher on hot, sunny days
Cars produce most of the nitrogen oxides and VOCs (increased vehicle use also increases
the amount of ozone in the troposphere)
Ground-level ozone is one of the "criteria pollutants," those that are most prevalent in the
ambient air.
What is the difference between good ozone
and bad ozone?

43. Good ozone or Stratospheric ozone

44. Bad ozone, or Ground-level ozone, or
Tropospheric ozone

45. Sulphur Dioxide
• Sulphur dioxide (SO2) is a water soluble,
colorless, gas with a sharp odor; that reacts
with airborne solid particles
• Irritates the eyes and air passages.
• The most common source is burning of
fossil & fuel, combustion, smelting,
manufacture of . acid, conversion of wood
pulp to paper, incineration of refuse and
production of elemental sulphur.
• Coal burning accounts for about 50% of
annual global emissions, with oil burning
accounting for a further 25-30%.
• The natural source is volcanoes.

47. Consequences of air pollution
Health effects
• Effects on cardiovascular
health
• Effects on breathing
(asthma).
• Links to cancer
• Effects on children
• Health effects in relatively
"clean" areas
Who is at Risk?
 Children
 Elderly
 Prior heart or lung disease
patients
 Diabetics
 Persons who work/exercise
outdoors
 Otherwise healthy adults and
children

48. TYPE SOURCES HEALTH EFFECTS
NO2 Vehicles
Domestic
airway irritation; respiratory infection &
impaired lung function
PM Traffic, industry
Biomass
Respiratory, Cardiovascular
Long-term effects? IMR, LBW?
CO Traffic, fuel, industry COHB, Headaches, nausea, dizziness
SO2 Coal & heavy oil
combustion
Breathing difficulties, irritation of eyes, nose,
throat and lungs. Asthmatics
Lead Petrol, paints
industry
Intellectual development, poisoning
Benzene/
Butadiene
Petrol, deisel
Rubber tyre
Cancer (long term effect)
Ozone Photochemical
pollutant
Short term respiratory symptoms; irritant effect
on lungs & airway inflammation
Types of air pollutants and health effects
IMR, Ischemic Mitral Regurgitation. LBW, low birth weight. COHB, Carboxy haemoglobin

49. Pyramid of effects
lung function changes, immunecell responses,
heart rateor heart ratevariability responses
Asthmaattacks, medication use,
symptoms
Doctor visits
Hospital
Admissions
Death

50. • Maintaining a healthy distance between the industrial and
residential areas.
• The chimneys should be constructed tall in size so that the
emissions must be released higher up in the environment
• The sulphur must be removed after burning.
• The gasoline must have anti knocking agents.
• The mining area should be planted with trees.
• The coal fuel should be replaced with gas fuel to control the air
pollution.
How to control air
pollution?

51. • The wastes must be removed
and recycled in the industrial
plants and refineries.
• Plants like pine and ribes need to
be planted to metabolize the
nitrogen oxides and other
pollutants.
How to control air
pollution?

52. • The automobiles must be
designed with emission control
system.
• Timely servicing of the car helps
to keep it in a good condition, and
also minimizes fuel exhaustion
• Using public transportation
helps to prevent the air pollution
How to control air pollution?

53. • Using alternative energy
sources like
Solar energy
Hydroelectric energy
Wind energy
Electric energy
How to control air pollution?

54. How to control air pollution?
Re balance between emission
and dispersion
1- Plant trees
2- alternative energy sources
like Solar energy, Hydroelectric
energy, and Wind energy

55. Final points about air pollution
• Health and economic issue
• Prioritize air quality improvement in decision
making
• Over half the problem is traffic
• Massive hidden health costs in transportation
and power pollution
• Imposed risk on all population groups,
especially our children and elderly