Air Pollution's Victims In California: Who Suffers?

California has some of the worst air quality in the United States, with over 90% of its residents breathing unhealthy levels of air pollutants. The state's large population, significant port industry, and growing economy create significant emissions from traffic, diesel trucks, construction, agriculture, and domestic sources. Vulnerable groups such as children, the elderly, and those with pre-existing health conditions are particularly at risk of adverse health effects, including respiratory issues, cardiovascular problems, and even premature death. As California continues to battle wildfires and the impacts of climate change, improving air quality and protecting the health of its residents remain crucial priorities.

Children and the elderly

Children are at greater risk from inhaled pollutants than adults due to their unique activity patterns and behaviours. They often play on the ground, amidst dirt and dust that may carry toxicants, and they frequently put their hands, toys, and other items into their mouths, ingesting harmful substances. They also tend to spend more time outdoors and are more physically active than adults, increasing their exposure to air pollution. Relative to their body size, children eat, breathe, and drink more than adults, and their biological defences and filters, such as nasal passages, are less developed, making them more susceptible to pollutants. Additionally, children are particularly vulnerable during developmental stages such as fetal development, early childhood, and puberty, where environmental exposures can have a significant impact on their growth.

The elderly are also at high risk due to their decreased ability to compensate for the effects of environmental hazards as they age. Air pollution can aggravate existing health conditions, such as heart disease, stroke, lung diseases like COPD and asthma, and diabetes. Fine particle pollution (PM2.5) and ozone (O3) are of particular concern for older adults, as they have been linked to premature death, cardiac issues, asthma attacks, and the development of chronic bronchitis.

The California Air Resources Board (CARB) has established health-based ambient air quality standards to protect these vulnerable groups, and they continue to work towards reducing emissions and improving air quality in the state.

People with asthma

Air pollution is a well-documented trigger for asthmatics, and it can cause measurable lung damage in children aged 10-18. The California Air Resources Board (CARB) has found that children who play multiple outdoor sports and live in communities with high ozone levels are more likely to develop asthma. Additionally, children living near busy roads have an increased risk of asthma, and asthmatic children exposed to higher levels of air pollution are more likely to develop symptoms of bronchitis.

Air pollution can also worsen asthma symptoms, with higher air pollution levels increasing the risk of adverse health effects. Breathing air pollution can be fatal, and certain pollutants may cause serious, long-term effects, such as cancer, even at low levels.

Furthermore, climate change poses additional risks to public health, as it leads to extreme high temperatures, increased allergens, and elevated disease-carrying mosquitoes and pests. These factors can trigger worsened allergies and elevate the risk of heat-related sickness and death.

People with heart disease

Air pollution is a significant public health concern in California, with over 90% of its residents exposed to unhealthy levels of air pollutants annually. People with heart disease are particularly vulnerable to the harmful effects of air pollution, and the state's poor air quality poses a serious risk to their health. Here is some detailed information on how air pollution affects individuals with heart disease in California:

Impact on Cardiovascular Health

Fine particulate matter (PM2.5) and ozone are two of the most concerning pollutants in California from a public health perspective. These pollutants are released into the atmosphere through various industrial processes, vehicle emissions, and wood combustion. Exposure to these pollutants has been linked to adverse effects on heart health.

Research, such as the Multi-Ethnic Study of Atherosclerosis Air Pollution Study (MESA Air), has found a direct correlation between air pollution and atherosclerosis, a condition characterized by the buildup of plaque in the coronary artery. This buildup can restrict blood flow to the heart and other major blood vessels, increasing the likelihood of heart attacks and strokes.

Symptoms and Risks

For people with chronic heart disease, exposure to fine particulate matter can lead to symptoms such as chest tightness or pain in the chest, neck, or shoulder. Additionally, air pollution has been associated with an increased risk of cardiovascular events, including heart attacks, arrhythmias, and heart failure, especially in susceptible individuals with pre-existing heart conditions.

Precautions and Recommendations

Air Quality in California

California's air quality is heavily influenced by its large population, significant port industry, and thriving economy, which contribute to emissions from traffic, diesel trucks, construction, agriculture, and domestic sources. The state's environmental conditions, including frequent wildfires and mountainous terrain that traps pollution, further exacerbate the air quality issues. As a result, California leads the nation in cities with the worst air pollution, with Los Angeles, Bakersfield, Fresno, and San Jose among the top-ranked cities.

People with respiratory diseases

Air pollution can cause and exacerbate respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis. It can also trigger asthma attacks and COPD episodes requiring hospitalization. The pollutants of greatest concern from a public health perspective are fine particulate matter (PM2.5 and PM10) and ozone, which are formed from the combustion of fuels and emissions from motor vehicles. Exposure to these pollutants has been linked to increased asthma prevalence, new-onset asthma, risk of bronchitis and wheezing, deficits in lung function growth, and airway inflammation.

Children with respiratory diseases are especially susceptible to the harmful effects of air pollution due to their developing lungs and immune systems. Research has shown that exposure to air pollution is associated with increased asthma prevalence and incidence, as well as a higher risk of chronic and acute respiratory symptoms for children with asthma.

Air pollution can also impact the lung function of individuals with respiratory diseases. Studies have found that exposure to pollutants such as nitrogen dioxide (NO2), particulate matter (PM2.5 and PM10), and ground-level ozone (O3) is associated with deficits in the growth of forced expiratory volume and forced vital capacity.

Additionally, air pollution can cause increased oxidative stress, which is linked to various diseases, including cancer, and aging. It can also lead to DNA damage and has been identified as the ninth leading risk factor for the global disease burden.

The impact of air pollution on respiratory diseases is particularly pronounced in low-income and minority communities in California. Policies and industrialization have historically relegated these communities to areas closer to industrial plants, resulting in higher exposure to air pollution. Neighborhoods with higher percentages of people of color in the San Francisco Bay Area, for example, have double the rate of pollution-related childhood asthma compared to predominantly white neighborhoods.

Overall, air pollution poses a significant risk to individuals with respiratory diseases in California, and targeted interventions and policy changes are needed to mitigate these health risks and achieve health equity.

People with cancer

Air pollution can also negatively impact the quality of life of people living with cancer by exacerbating respiratory symptoms, increasing fatigue, reducing physical activity, and worsening treatment side effects. It may also interfere with cancer treatments by reducing the effectiveness of chemotherapy drugs, increasing surgical complications, and potentially interacting with targeted therapies and immunotherapies.

In California, air pollution is a significant public health concern, with over 90% of Californians breathing unhealthy levels of one or more air pollutants during some part of the year. The state's large population, significant port industry, and growing economy create significant emissions from traffic, diesel trucks, construction, agriculture, and domestic emissions.

The California Air Resources Board (CARB) has set standards for eight "traditional pollutants," such as ozone and particulate matter. In addition, CARB identifies other air pollutants as toxic air contaminants (TACs) - pollutants that may cause serious, long-term effects, such as cancer, even at low levels. Most air toxics have no known safe levels, and some may accumulate in the body from repeated exposures.

Recommendations for People with Cancer in California

• Stay informed about the air quality in your area and follow health recommendations when air quality levels exceed “good” standards.
• Consider using air purifiers at home, especially if you live in an area with poor air quality.
• If possible, avoid spending prolonged periods outdoors in areas with high levels of air pollution.
• Advocate for policies and interventions that aim to reduce air pollution, such as the transition to cleaner energy sources and the promotion of active transportation (walking and cycling).

Frequently asked questions