Air Quality: Who Suffers Most And Why?

The Air Quality Index (AQI) is a tool used by the EPA to communicate about outdoor air quality and health. The AQI runs from 0 to 500 and is divided into six categories, each corresponding to a different level of health concern. When AQI values are above 100, air quality is considered unhealthy for members of sensitive groups, who are at greater risk of experiencing health effects due to their medical conditions, exposure conditions, or innate susceptibility. These groups include people with heart and lung disease, older adults, children, people with diabetes, pregnant women, and people of lower socioeconomic status.

People with pre-existing conditions

One of the most significant ways air pollution impacts those with pre-existing conditions is by exacerbating their existing health issues. Fine particulate matter (PM2.5) and other pollutants can infiltrate the body's organs and systems, causing complications and worsening pre-existing conditions. This is especially true for individuals with respiratory and cardiovascular diseases, who are at an increased risk of experiencing health issues when air quality deteriorates.

The susceptibility to air pollution increases with age. Older adults, particularly those over 65, are more susceptible to environmental hazards due to a higher prevalence of pre-existing respiratory and cardiovascular diseases. Additionally, the gradual decline in physiological defences that occurs with ageing makes them more vulnerable to the effects of air pollution.

Children and adolescents are also vulnerable to air pollution due to their developing bodies, organs, and immune systems. Exposure to air pollution during childhood can increase the risk of developing diseases later in life. Unfortunately, children have limited agency in protecting themselves or influencing air quality policies, making them a vulnerable group.

Socioeconomic factors also play a role in vulnerability to air pollution. People in low-income neighbourhoods and communities may be more vulnerable due to various factors, including proximity to industrial sources of pollution, underlying health problems, poor nutrition, and stress. In Europe, for example, lower-income individuals are more likely to live closer to busy roads or industrial areas, resulting in higher exposure to air pollution.

It is crucial for individuals with pre-existing conditions to be aware of daily air quality levels, which can be found in weather forecasts, on websites, or through notifications via email or apps. By staying informed, they can take necessary precautions to reduce their exposure and potential health risks associated with poor air quality.

The elderly

As people age, their bodies become less able to compensate for the effects of environmental hazards. Older people are more susceptible to the adverse effects of air pollution, and this susceptibility is expected to differ widely between individuals and over time. Outdoor air pollution is a major environmental health problem, with 3.7 million premature deaths worldwide in 2012 attributable to it. Exposure to air pollutants may even be fatal for the elderly, especially in cases of comorbidity.

The major health problems associated with air pollution for the elderly are cardiovascular and respiratory diseases. Poor air quality is a harmful factor for the health of older adults, particularly during physical activities. Air pollution can aggravate heart disease and stroke, lung diseases such as chronic obstructive pulmonary disease and asthma, and diabetes. Fine particle pollution (PM2.5) has been linked to premature death, cardiac arrhythmias and heart attacks, asthma attacks, and the development of chronic bronchitis. Ozone (O3), even at low levels, can exacerbate respiratory diseases. Other pollutants that present health risks include nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO).

Despite the number of studies published on the effects of air pollution on the health of older adults, the results are often divergent, and more research is needed to produce conclusive knowledge. However, it is clear that air pollution has a negative impact on the health of older adults, and it is important for this sensitive group to be informed about environmental health risks and take steps to reduce those risks.

Children and infants

Several factors contribute to children's increased sensitivity to air pollution. Firstly, children have a higher breathing rate than adults, inhaling more air per unit of body mass. They also tend to be "mouth breathers," which increases their exposure to pollutants. Physiological factors, such as the rapid development and growth of their respiratory systems, make them more susceptible to the harmful effects of air pollution.

Breastfeeding infants are particularly vulnerable as they spend more time indoors in close proximity to their mothers, increasing their exposure to indoor air pollution. This is especially true in households with poor ventilation, where fine particle matter can reach levels far exceeding WHO air quality guidelines. Additionally, children may engage in household chores like cooking or collecting firewood, exposing them to harmful smoke and fuel.

The risk of adverse health outcomes from air pollution varies depending on geographical region, the source of pollution, duration of exposure, and concentration levels. In developing countries, the magnitude of risk is much higher for children due to factors such as lower air quality standards and limited access to healthcare.

To protect children's health, it is crucial to minimize their exposure to air pollution. This can be achieved through measures such as improving indoor ventilation, reducing outdoor physical activity during high pollution periods, and utilizing services like EnviroFlash, which provides notifications about air quality and suggested safety measures. By proactively addressing this issue, we can safeguard children's respiratory health and overall well-being.

Pregnant women

Air pollution is a serious issue that affects everyone, but some groups are more vulnerable to its harmful effects than others. These groups are considered "sensitive" to air pollution and may experience adverse health impacts even when air quality is considered acceptable for the general population. One such sensitive group is pregnant women.

Numerous studies have investigated the impact of air pollution on pregnancy outcomes. Research has consistently linked high levels of air pollutants to adverse health effects in pregnant women, including maternal hypertensive disorders, postpartum depression, and placental abruption, and even pregnancy loss. One study found that exposure to particulate matter less than 2.5 μm (PM2.5) and ozone (O3) throughout pregnancy was associated with an increased risk of pregnancy loss, particularly after 8 weeks of gestation. Another study, focusing on women in New England who conceived through assisted reproduction, revealed a correlation between higher average exposure to nitrogen dioxide (NO2) during pregnancy and a higher risk of pregnancy loss after 30 days of a positive pregnancy test.

Furthermore, air pollution has been associated with various negative outcomes for newborns. These include low birth weight, preterm birth, and infant mortality. The World Health Organization (WHO) has reported that 99% of the world's population breathes air that exceeds its recommended limits for air quality. This alarming statistic underscores the urgency of addressing air pollution and protecting vulnerable populations, including pregnant women and their infants.

To protect themselves and their unborn children, pregnant women should be aware of the air quality in their local areas and take appropriate precautions. They can sign up for notifications about air quality through services like EnviroFlash, which provides alerts when the Air Quality Index (AQI) reaches unhealthy levels. By staying informed and taking necessary precautions, pregnant women can reduce their exposure to harmful pollutants and potentially mitigate the associated health risks for themselves and their babies.

People who work outdoors

Outdoor workers, such as farm workers, are at a higher risk of respiratory hazards, especially when exposed to smoke from wildfires. Wildfire smoke contains chemicals, gases, and fine particles that can be harmful to respiratory health. The smallest particulate matter, PM2.5, which includes solid particles and liquid droplets with a diameter of 2.5 micrometers or less, poses the greatest hazard to respiratory health. It can worsen existing respiratory and cardiovascular conditions, such as asthma, heart disease, and lung disease, and cause coughing, wheezing, and difficulty breathing.

To protect outdoor workers, employers should regularly monitor the Air Quality Index (AQI) and PM2.5 levels, especially when smoke from wildfires is present. When the AQI for PM2.5 is 151 or higher, employers are required to implement measures to safeguard their employees' health. This includes providing enclosed structures or vehicles with filtered air for workers, changing work locations or schedules, and supplying proper respiratory protection equipment, such as disposable filtering facepiece respirators (dust masks) or full-facepiece respirators.

Additionally, outdoor workers themselves can take proactive steps to reduce their exposure to air pollution. Signing up for notifications about air quality, such as through the EnviroFlash service, can help them stay informed about the AQI levels in their area. By receiving alerts when the AQI reaches unhealthy levels, they can take appropriate actions to limit their exposure and reduce their risk of experiencing health effects associated with air pollution.

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