Pollution's Impact On Asian Health: Understanding The Dangers

Air pollution is a pressing issue in Asia, with the region displaying some of the highest recorded levels of air pollution in the world. This is a major concern as air pollution has been linked to a range of illnesses, including respiratory and cardiovascular diseases, lung cancer, asthma, and more. In 2021, about 35% of global deaths from outdoor air pollution occurred in East Asia and the Pacific, with South Asia accounting for about 33%. The high levels of air pollution in Asia are largely due to the burning of fossil fuels and biomass for power generation, industry, transport, and home cooking, as well as dust storms and wildfires. As a result, billions of people in Asia are exposed to health-damaging levels of air pollution, causing millions of premature deaths each year.

Asthma and other respiratory illnesses

Air pollution is a pressing environmental health crisis, causing 6.5 million deaths annually, with 70% of these occurring in the Asia-Pacific region. The main sources of air pollution are the burning of fossil fuels and biomass, industrial emissions, transportation, and household sources. These pollutants include particulate matter (PM10 and PM2.5), nitrogen dioxide, carbon monoxide, and sulfur dioxide, which can penetrate deep into the lungs and bloodstream, causing serious health issues.

One of the most vulnerable groups affected by air pollution in Asia is children. In 2021, 100 children under five died every day in the East Asia and Pacific region due to air pollution-linked causes. Children exposed to high levels of air pollution are at risk of developing respiratory problems later in life, including asthma and bronchitis. UNICEF reports that more than 35 million children in the region live in countries that primarily use solid fuels for cooking and heating, exposing them to dangerous indoor air pollutants.

Asthma is a chronic respiratory disease characterised by variable airflow obstruction, bronchial hyperresponsiveness, and airway inflammation. Air pollution has been linked to negative asthma outcomes, with outdoor pollutants such as nitrogen dioxide, sulfur dioxide, and particulate matter (especially PM2.5) exacerbating symptoms and decreasing lung function. Studies have found a positive association between exposure to air pollution and the development of asthma in children, with prenatal and postnatal exposures increasing the risk.

In addition to asthma, air pollution is a contributing factor to other respiratory illnesses. It can trigger and escalate respiratory conditions, leading to increased hospital admissions for respiratory tract infections such as pneumonia. The interaction between climate change and air pollution further exacerbates these health issues, with rising temperatures increasing the levels of air pollutants and vulnerable populations, including children, being disproportionately affected.

The impact of air pollution on respiratory health has led to initiatives such as the Asia-Pacific Clean Air Partnership, which aims to tackle air pollution through knowledge-sharing and collaborative solutions. There is also a growing focus on increasing public awareness, implementing policy changes, and developing targeted health risk assessments and interventions to protect respiratory health and enhance public health outcomes.

Heart and lung disease

Air pollution is a pressing environmental health crisis, causing more than 6.5 million deaths annually, with the majority of these (70%) occurring in the Asia-Pacific region. The burning of fossil fuels and biomass is the principal source of air pollution in Asia's urban and rural areas.

Air pollution has been linked to heart and lung disease in Asia. Short-term exposure to air pollution can increase the risk of heart attack, stroke, arrhythmias and heart failure in susceptible people, such as the elderly or those with pre-existing medical conditions. The risk of death is greater with long-term exposure. Research shows that long-term exposure to particulate pollution is linked to an increased risk of heart attacks and other forms of heart disease.

Particulate matter (PM) is made up of particles (tiny pieces) of solids or liquids in the air. PM10 particles are deposited in the nasal cavities and upper airways, whereas PM2.5 and PM0.1 particles may penetrate the lung alveoli and enter into the bloodstream, thereby exerting adverse health effects. PM2.5 particles can be inhaled deeply into the lungs and have been linked to an increased risk of lung cancer and cardiovascular death.

In 2020, all countries in the East Asia and Pacific region had PM2.5 pollution levels that exceeded World Health Organization (WHO) air quality levels. In 2021, one hundred children under 5 died every single day in the region due to air pollution-linked causes.

The World Health Organization (WHO) reported that ambient air pollution was responsible for 3.7 million deaths in 2012, representing 6.7% of total deaths worldwide, and was the cause of 11% of chronic obstructive pulmonary disease-related deaths and 29% of heart disease and stroke deaths.

Cancer

Air pollution is a pressing environmental health crisis that is responsible for millions of deaths annually, with Asia-Pacific bearing the brunt of it. According to the World Health Organization (WHO), 99% of the world's population breathes unhealthy air, and air pollution is now estimated to cause around seven million deaths per year.

In Asia, air pollution is linked to an alarming increase in cancers of the lung, head, and neck, which are on the rise in the region. The risk factors associated with air pollution are similar to those caused by smoking tobacco. Fine particulate matter, known as PM2.5, is a mix of solid particles and liquid droplets that can penetrate deep into the lungs and even enter the bloodstream, causing DNA damage and protein adducts, which have been linked to cancer.

Several large-scale studies in the US and Europe have shown a positive association between air pollution and lung cancer mortality, with one study in California finding an increased risk of developing lung cancer among non-smoking adults. While rigorous scientific studies on the association between air pollution and cancer incidence have not been conducted in Asian countries, an alarming surge in lung cancer cases among non-smoking women in India has been observed, likely due to the country's worsening air pollution problem.

In addition to lung cancer, air pollution is linked to cancers of the upper aerodigestive tract, which includes the head and neck, and nasopharyngeal cancers. These cancers have typically been linked to smoking, but the increase in these cancer cases in Asia suggests a need to focus on reducing air pollution, promoting clean energy, and investigating the carcinogenic effects of air pollution.

Furthermore, air pollution can interfere with cancer treatments, reducing the effectiveness of chemotherapy drugs, increasing surgical complications, and potentially interacting with targeted therapies and immunotherapies. As such, the benefits of reducing exposure to air pollution are far-reaching and can help prevent cancer cases and deaths.

Diabetes

Air pollution is a pressing environmental health crisis that is responsible for more than 6.5 million deaths annually, with Asia-Pacific accounting for 70% of these deaths. The burning of fossil fuels and biomass is the principal source of air pollution in Asia, with other sources including dust storms, industrial emissions, and wildfires.

In recent years, the prevalence of diabetes has increased in both developed and developing nations. Studies have found that air pollution is linked to an increased risk of type 2 diabetes mellitus (T2DM), with air pollutants associated with impaired glucose metabolism, insulin resistance, and T2DM.

In South Korea, for example, the rapid industrialization of the country and surrounding East Asian areas has led to increased air pollution, which is a major environmental problem. A study conducted in South Korea assessed the changes in fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) associated with exposures to particulate matter (PM10), fine particulate matter (PM2.5), and nitrogen dioxide (NO2). The analysis found that exposure to air pollution was reported to affect glucose metabolism, increasing the risk of diabetes mellitus.

Additionally, a study by Chen and colleagues found that lung-specific inflammation caused by air pollution is sufficient to increase circulating levels of TNFα and IL-6, adipocyte expression of IL-6 mRNA and Tnfα, aortic endothelial dysfunction, and systemic IR. These factors can lead to abnormal glucose tolerance, fat metabolism disorder, and an increased risk of diabetes.

Furthermore, PM2.5, a fine particulate matter that is the most dangerous type of pollutant, may target the lung and liver, activating macrophages, ERS, and UPR. This can stimulate lipogenesis, lipid deposition, and adipocyte differentiation, as well as visceral fat inflammation, IR, brown fat mitochondrial fat changes, and ERS in the liver, eventually leading to diabetes.

The Asia-Pacific Clean Air Partnership, established in 2015, is a platform for policymakers and stakeholders to share knowledge, tools, and innovative solutions to tackle air pollution in the region. It is crucial to prioritize initiatives that aim to reduce air pollution and mitigate the associated health risks, including the increasing incidence of diabetes.

Cognitive impairment in children

Air pollution is a severe and growing problem in Asia, with a range of harmful pollutants exceeding safe levels in many countries. The impact of this pollution on human health is significant, and one of the most vulnerable groups is children. Cognitive impairment in children due to pollution is an emerging area of concern and extensive research.

Multiple studies

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