Impact of Nanoparticulates from Traffic Emissions on Viral Lung Infection

Nanoparticle exposure reactivates latent herpesvirus and restores a signature of acute infection (19 page pdf, Christine Sattler, Franco Moritz, Shanze Chen, Beatrix Steer, David Kutschke, Martin Irmler, Johannes Beckers, Oliver Eickelberg, Philippe Schmitt-Kopplin, Heiko Adler and Tobias Stoeger, Particle and Fibre Toxicology, Jan. 10, 2017)

Also discussed here: Nanoparticle exposure can awaken dormant viruses in the lungs (ScienceDaily, Jan. 17, 2017)

Today we review a lab experiment on cells in mice that examined the impact of exposure to nanoparticles (NP). Results indicate that these nanoparticles can “reawaken” latent herpes viruses in the lung by weakening the immune system and allowing viruses to invade the host cell. The researchers would like to examine if these results can be transferred to humans and if so, if exposure to emissions from combustion  and  traffic-
related emissions suggest another serious impact.
 
  Key Quotes:

"From previous model studies we already knew that the inhalation of nanoparticles has an inflammatory effect and alters the immune system,.. an exposure to nanoparticles can reactivate latent herpes viruses in the lung."

“There are several publications providing evidence that the presence of carbon-based NP has an influence on virus infection in mice or in cells.”

 “If the immune system becomes weakened or if certain conditions change, the viruses become active again, begin to proliferate and destroy the host cell.” “further experiments with human cells demonstrated that Epstein-Barr viruses are also 'awakened' when they come into contact with the nanoparticles.”

“They detected a significant increase in viral proteins, which are only produced with active virus proliferation …Metabolic and gene expression analyses also revealed patterns resembling acute infection,"

 “we show that exposure of latently infected cells or tissues to NP leads to reactivation of latent virus accompanied by an increase in viral proteins and metabolome- and transcriptome-signatures that can also be found in acute virus infection.”

“Many people carry herpes viruses, and patients with idiopathic pulmonary fibrosis are particularly affected…If the results are confirmed in humans, it would be important to investigate the molecular process of the reactivation of latent herpes viruses induced by particle inhalation. Then we could try to influence this pathway therapeutically."

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How Do Air Pollution Alerts Affect Public Health Use?

Effects of an air pollution personal alert system on health service usage in a high-risk general population: a quasi-experimental study using linked data (7 page pdf, R A Lyons, S E Rodgers, S Thomas, R Bailey, H Brunt, D Thayer, J Bidmead, B A Evans, P Harold, M Hooper, H Snooks, J Epidemiol Community Health, May 23, 2016)

Today we review an analysis of the reaction of an “intervention” group of patients with air pollution- related illnesses (cardio-respiratory and COPD) to alerts produced by the UK’s airAware alert system over a two year period, as measured by visits to hospital emergency departments, compared to a control group which were not similarly afflicted. Results indicate a doubling of emergency admissions and four times the number of respiratory conditions for the intervention group compared to the control group. The authors conclude that some health interventions or alerts beyond a certain distribution level are harmful in terms of health service utilisation.

 .  

Key Quotes:

“The airAware system was a novel development because it integrated near real-time data rather than forecasting. Its design facilitated early identification of local air pollution problems and issued timely warnings of air pollution episodes reflecting levels of particulate matter (measured as particulate matter 10 μm or less in diameter”

“The number of messages per day was limited to three; on any single day no more than three alerts could be issued. Only one alert was issued for the day unless a higher pollution trigger level was met during the daily alerting period.”

“The intervention group experienced a doubling of emergency admissions for all relevant conditions and a fourfold admissions increase for respiratory conditions”

 “Our findings raise questions about the trade off between harms and benefits of air pollution alerting services. .. There is a growing evidence base demonstrating some public health interventions are harmful. Wider roll-out of such systems does not appear to be warranted given the current evidence base.“

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What are Countries Doing to Protect Human Health and Ecosystems?

Global Metrics for the Environment, 2016 REPORT, Environmental Performance Index (12 page pdf, Yale University, Jan. 24, 2016)

Also discussed here: U.S. Could Do Much More To Protect The Environment, Report Finds (Huffington Post, Jan. 27, 2016)

And here:Environmental Performance Index- Air Quality (Yale University, Jan. 24, 2016)

Today we review the 2016 Environmental Performance Index, prepared by Yale University which ranks the performance of countries in two areas: protection of human health and protection of Ecosystems. While improvements were seen in most categories, air quality is becoming worse mainly as a result of increased concentrations of fine particulate matter, especially in urban areas. While only 2% of global deaths (1.24 million) are caused by unsafe drinking water (and that is due to 80% of waste water not being treated), poor air quality caused 10% of global deaths (5.52 deaths). Overall, Finland tops the list in all categories with policy commitments made to achieve carbon neutral status by 2050. Other Scandinavian countries are near the top while North American countries such as Canada (ranked overall at #16) or the USA (ranked 26) are not achieving as much. This also applies to air quality where Canada at #26 and USA at #36.  

Key Quotes:

 “The Environmental Performance Index (EPI) ranks countries’ performance on high-priority environmental issues in two areas: protection of human health and protection of ecosystems.”

“Finland has taken the top spot, followed by Iceland, Sweden, Denmark, and Slovenia. Finland’s top ranking stems from its societal commitment to achieve a carbon-neutral society that does not exceed nature’s carrying capacity by 2050,”

“The Index’s bottom third, comprised mostly of African countries with a smattering of South and East Asian nations, is a list of troubled states whose problems extend beyond their inability to sustain environmental and human health”

“In 2013, unsafe water was responsible for 2 percent of global deaths (~1.24 million), while poor air quality was responsible for 10 percent of all global deaths (~5.52 million).”

 “More than 3.5 billion people - half of the world’s population - live in nations with unsafe air quality.” “34 percent of global fish stocks are overexploited or collapsed.”

 “More than 80 percent of the world’s discharged wastewater is untreated when it’s released into the environment.”

 “Around one-third of countries scored on Climate and Energy are reducing their carbon intensity” “Environmental regulations in the country [USA] are less stringent than regulations in some European countries, according to the International Union for Conservation of Nature. And congressional Republicans have repeatedly tried to weaken regulations the Environmental Protection Agency has put into place”

 "While many environmental problems are the result of industrialization, our findings show that both poor and wealthy nations suffer from serious air pollution,"

 "With the very survival of the planet at stake, we hope leaders will be inspired to act -- especially in urban areas where an increasing majority of the world's population lives.”

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Preterm Births and Exposure to Urban Air Pollution

Exposure to airborne particulate matter during pregnancy is associated with preterm birth: a population-based cohort study ( 8 page pdf, Emily DeFranco, William Moravec, Fan Xu, Eric Hall, Monir Hossain, Erin N. Haynes, Louis Muglia and Aimin Chen, Environmental Health, Jan. 15 2016)

Also discussed here: Exposure to high levels of air pollution associated with higher risk of preterm birth (ScienceDaily. Jan. 26, 206)

Today we review research into the link between preterm births and exposure during pregnancy to Particuate Matter (PM2.5) in an urban environment. Results indicate a 19% overall increased risk with the greatest risk during the 3rd trimester of pregnancy (prior to the 37th week) Dropping PM2.5 levels to below the EPA standard of 15μg/m3 could result in a 17% improvement in the frequency of preterm births.

   

Key Quotes:

“The study… identified a 19 percent increased risk, with the greatest risk when high exposure occurred during the third trimester of pregnancy.”

"Although the risk increase is modest, the potential impact is robust, as all pregnant women are potentially at risk,"

"We estimate that decreasing the amount of particulate matter in the air below the EPA's standard threshold could decrease preterm birth in women exposed to high levels of small particulates by about 17 percent, which corresponds to a 2.22 percent decrease in the preterm birth rate in the population as a whole."

“Preterm birth rates were higher among mothers exposed to high levels of airborne particle pollution above the EPA standard, as well as among mothers 40 or older, black mothers, and women with no prenatal care or with lower education level.”

Related articles

• Air Pollution Linked to Risk of Preterm Birth
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What are the Public Health Considerations when Mitigating Climate Change in Cities?

Building-related health impacts in European and Chinese cities: a scalable assessment method (13 page pdf, Jouni T. Tuomisto, Marjo Niittynen, Erkki Pärjälä, Arja Asikainen, Laura Perez, Stephan Trüeb, Matti Jantunen, Nino Künzli and Clive E. Sabel , Environmental Health, Dec. 14, 2015)

Today we review an assessment of the impact of various climate mitigation changes on health, an aspect not often considered in trying to achieve the main objective of reduced carbon emissions by reducing energy requirements for buildings for example.. In the European cities examined the health benefits were minimal (but positive) largely because the existing power sources were already clean. Care needs to be taken when reducing heating needs by adding insulation which may cause a worsening of indoor air quality. The advantages of having such a model are clear as more cities undertake mitigation by redesigning buildings.

   

Key Quotes:

“Active climate mitigation policies will also, aside of their long term global impacts, have short term local impacts, both positive and negative, on public health.”

“Our main objective was to develop a generic open impact model to estimate health impacts of emissions due to heat and power consumption of buildings.”

“The assessed policies were replacement of peat with wood chips in co-generation of district heat and power, and improved energy efficiency of buildings achieved by renovations”

“Kuopio has a climate objective to reduce GHG emissions by 40 % between 1990 and 2020. This is a major challenge but it seems to be achievable if large fuel changes from peat to wood-based fuels are done in the district heating.”

“levels of indoor pollutants are affected by ventilation and there is a risk that energy savings by decreasing ventilation may cause higher exposures and increase harmful health effects.”

 “The main study areas included heat and power generation, traffic, buildings and their effect on health and well-being.”

“The assessed local public health benefits of the fuel change and energy conservation – buildings renovation – policies, compared to the BAU, are 9 disability-adjusted life years (DALY) per year in Kuopio and 15 DALY/year in Basel in 2030”

“Stuttgart demonstrated that small scale wood pellet combustion for residential heating generates only 1 % of the required heat, but from 2010 to 2025 the burden of disease could be decreased via its banning in the city centre by 15 DALY/year or be increased by its current growing trend by 200 DALY/year.”

“In the assessed cases, all considered decision options had minimal health impacts of PM2 emissions as the current district heating systems are already clean.”

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How is Europe Dealing with Air Pollution from Agriculture?

Clean Air from our Farms (4 page pdf, European Environmental Bureau Position Paper, Apr. 28, 2015)

Also discussed here : Infographic: How agricultural emissions affect our health (European Environmental Bureau, Apr. 28, 2015)

Today we review a note from the European Environmental Bureau which focuses on emissions and pollutants from agriculture which makes up 10% of all greenhouse gas emissions and 40% of the methane from the EU, and impacts both the air(acid rain), soil and human health. A National Emissions Ceilings Directive, issued in 2013, set new targets for ammonia, PM2.5 and methane among other pollutants, with a focus on livestock and manure management as well as croplands and the use of fertilizers and pesticides.

   

Key Quotes :

 « Agricultural emissions in Europe contribute to several environmental problems such as plant damage, eutrophication, acidification, acid rains(that damage plants, lakes and biodiversity), greenhouse gas emissions and ozone formation. However, these emissions also lead to health issues, such as respiratory diseases and result in a shorter life expectancy for humans.”

 “more than 90% of EU ammonia emissions (2011) come from Agriculture and around 40% of the total EU emissions from agriculture in 2012 are methane emissions. The agricultural sector was responsible for over 10% of EU total greenhouse gas emissions in 2012”

“The NECD revision [National Emissions Ceilings Directive, 2013] proposal sets new targets for the four initial pollutants, including ammonia (NH3). And it also for the first time includes limits for PM2.5 and methane (CH4)”

 “the new measures should focus on livestock, soils (50% of EU total agricultural emissions) and manure management(one sixth of the EU total agricultural emissions). In addition, croplands, which occupy more than half the territory of the EU, emit large amounts of volatile pollutants due to fertilizers and pesticides’ use"

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Do Cholesterol Pills Reduce the Risk of Cardiovascular Disease from Exposure to Particulate Matter?

Statins: Widely used drugs may protect people from air pollution (Brian Bienkowski, Environmental Health News, Nov. 24, 2014)  

 Also discussed here: Chronic PM2.5 exposure and inflammation: determining sensitive subgroups in mid-life women.(Abstract, Ostro B, Malig B, Broadwin R, Basu R, Gold EB, Bromberger JT, Derby C, Feinstein S, Greendale GA, Jackson EA, Kravitz HM, Matthews KA, Sternfeld B, Tomey K, Green RR, Green R, Wnviron Res., May 8, 2014)  

Today we review research into the ways that the drugs taken to reduce cholesterol interact with C-reactive protein to reduce the inflammation that normally is caused by exposure to fine particulate matter. This is important since 1 in 4 adults over 45 take statins (including Lipitor, Zocor and other brand names) and over 800,000 deaths world-wide are caused by fine particles.  

Key Quotes:

“Health impacts from spikes in particulates in the air are substantial. Statins seem to protect not only lungs from these impacts but the heart, too,”

 “a 10 µg/m(3) increase in annual PM2.5 more than doubled the risk of CRP [C-reactive protein ] greater than 3mg/l in older diabetics, smokers and the unmarried.”

 “people who take statins have fewer proteins in their blood that indicate inflammation of tissues… This inflammation may aggravate respiratory and cardiovascular diseases.”

“There are some specific groups [such as diabetics] that seem to have higher levels of inflammation after long-term exposure….On the converse side, we found that people on statins seem to be protected from the inflammatory effects of PM2.5.”

“Health impacts from spikes in particulates in the air are substantial. Statins seem to protect not only lungs from these impacts but the heart, too.”

“The older thinking was that plaque in coronary arteries caused heart attacks….Now the thinking is that it’s also due to some living tissue under plague that gets inflamed and that disrupts the plaque. We already knew statins ameliorate heart disease, and always thought it was through lipids, but here’s a new pathway.”

“Larger effects were also observed among those with low income, high blood pressure, or who were using hormone therapy, with indications of a protective effects for those using statins or consuming moderate amounts of alcohol.”

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When Do you Become “Old”

Population ageing: the timebomb that isn’t? (5 page pdf, Jeroen Spijker and John MacInnes, BMJ(British Medical Journal), Nov. 12, 2013)

Today we review a paper about aging and the implications of using a fixed age, such as 65, to indicate when to worry about “old age” diseases, particularly those such as heart and lung diseases that are aggravated by air pollution. The authors contend that the important statistic to use is the years of remaining life expectancy when the average life expectancy in the UK has increased by 34 years, thus moving the yard stick from the pension age of 65 to later. Over time improvements in medical technology and, indirectly in air quality in some places, seniors are living longer which has increased the size of the older generation, while growing obesity has resulted in earlier occurrence of diabetes with negative impacts on life expectancy. It is clear that the dynamics that affect health of the elderly has changed.

  

Key Quotes:

“For the first time, there are now more people over the age of 65 in the United Kingdom than there are children under 15 years. Over the past century, the proportion of over 65s has grown from about one in 20 to around one in six.”

“the old age dependency ratio. It takes the number of people who have reached the state pension age and divides it by the number of working age (16-64 years) adults in order to estimate the proportion of older people relative to those who pay for them.”

 “Since the main factor behind the ageing population is increasing life expectancy, age is a poor measure of its burden…We can best capture this changing importance of age by realising that the age of a population comprises two components: the years lived of its members (their ages) and their years left (remaining life expectancies).”

“In aggregate terms, the population of 2009, despite being much older as measured by years lived, was nevertheless younger than that of 1900 in terms of years left.[39 more years]”

“if we define the dependent older population as people with a remaining life expectancy of ≤15 years, the trend is different…from the late 1970s improvements in old age mortality have reversed the rise in the proportion of the population with low life expectancies.”

“We should not assume that population ageing itself will strain health and social care systems. Demand for services will rise but continue to be driven by other factors, chiefly progress in medical knowledge and technology, but also the increasing complexity of comorbid age related conditions.”

 “Ageing related diseases like osteoarthritis are predicted to increase and start at a younger age. This may not only result in an increased risk of cardiovascular and other chronic diseases, it also suggests that the ageing process can speed up as well as slow down, with obvious implications for public health policy.

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How Polluted are the World’s Cities?

Ambient (outdoor) air pollution database, by country and city (Excel data base, World Health Organization, May 7, 2014)

Also discussed here: Ambient (outdoor) air pollution in cities database 2014 (World Health Organization, May 7, 2014)

And here: Air quality deteriorating in many of the world’s cities (Press Release, World Health Organization, May 7, 2014)

And here: Ambient (outdoor) air quality and health (World Health Organization, Fact sheet N°313, Updated March 2014)

And here: Top 20 most polluted cities in the world (Madison Park, CNN, May 8, 2014)

Today we review a report from the World Health Organization that presents the state of air quality in 1600 cities world-wide in an Excel data base that is easy to manipulate. Only 1/8th of the cities surveyed meet WHO guidelines for fine particulate matter (PM). Those that do better (examples Bogota, Colombia and Copenhagen, Denmark) do it by actively promoting cycling and walking. 88% of the 3.7 million premature deaths/ year because of air pollution occur in low and middle income countries and most of these are in the Western Pacific and Southeast Asia. 7 out of the 10 most polluted cities with the highest levels of particulate matter (PM10) are in Pakistan (Pakistan: Peshwar, Rawalindi and Karachi) or India (Gwalior, Ahvaz, Raipur and Delhi) while all 10 of the least polluted cities are in the USA (mainly in the southwest). Even in regions such as Europe, where WHO guidelines are generally met, lives are shortened by 8.6 months because of exposure to PM

.

PM10: Fine particulate matter of 10 microns or less; Amr: America, Afr: Africa; Emr: Eastern Mediterranean, Sear: South-East Asia, Wpr: Western Pacific; LMI: Low- and middle-income; HI: high-income. PM10 values are regional urban population-weighted.  

Key Quotes:

 “The database contains results of ambient (outdoor) air pollution monitoring from almost 1600 cities in 91 countries. Air quality is represented by annual mean concentration of fine particulate matter …The database covers the period from 2008 to 2013, with the majority of values for the years 2011 and 2012.”

“Only 12% of the people living in cities reporting on air quality reside in cities where this complies with WHO air quality guideline levels. About half of the urban population being monitored is exposed to air pollution that is at least 2.5 times higher than the levels WHO recommends - putting those people at additional risk of serious, long-term health problems.” “Guideline values: PM_2.5 10 μg/m³ annual mean, PM₁₀ 20 μg/m³ annual mean”

“Too many urban centres today are so enveloped in dirty air that their skylines are invisible…Not surprisingly, this air is dangerous to breathe. So a growing number of cities and communities worldwide are striving to better meet the needs of their residents - in particular children and the elderly."

“even in the European Union, where PM concentrations in many cities do comply with Guideline levels, it is estimated that average life expectancy is 8.6 months lower than it would otherwise be, due to PM exposures from human sources.”

 “No Chinese cities ranked in the top 20 most polluted cities, despite thick, gray smog filling its cities and millions of residents commuting behind surgical masks.”

“Effective policies and strategies are well understood, but they need to be implemented at sufficient scale. Cities such as Copenhagen and Bogotà, for example, have improved air quality by promoting ‘active transport’ and prioritizing dedicated networks of urban public transport, walking and cycling.”

“Half of the top 20 cities in the world with the highest levels of PM2.5 were in India…Other cities with high levels were located in Pakistan and Bangladesh.”

 “Ambient (outdoor air pollution) in both cities and rural areas was estimated to cause 3.7 million premature deaths worldwide in 2012….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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