Air pollution – our biggest killer?
At present, the world is clearly in crisis over the coronavirus pandemic. In reality, this has affected a significant number of people around the globe, with around 100 million cases and close to 50,000 deaths. Many parts of the world have gone into serious lockdowns and restrictions with a virus that in reality causes a mild illness in around 80% of cases but has been associated with a high case fatality rate in Italy (11%) but a low fatality rate in Australia (at present just below 0.5%).
There is, however, no doubt that a much greater concern and much bigger killer is that of air-pollution. It is estimated that 8.8 million deaths per year are directly related to air-pollution with more than half being related to indoor pollution, such as cooking over coal, wood and biomass stoves and the remainder, outdoor pollution with a degree of overlap. Although you would expect that air-pollution targets the lungs, it is estimated that around 43% of cardiovascular deaths have a strong contribution from air-pollution.
How bad is air pollution?
Cigarette smoke is directly related to 7.2 million deaths annually, HIV-AIDS 1 million deaths, parasites and insects, such as malaria, 600,000 deaths and violence including wars 530,000 deaths.
Air-pollution kills 45 times more people every year than alcohol, 60 times more people than drug abuse. The highest mortality from air-pollution is in Asia and Africa but there is also contribution to disease in Europe and the Americas. It is estimated that Australia has the lowest air-pollution death rates with only 1.5% of the deaths in Australia being related to air-pollution because of the Australian air quality standards which are the strictest of all countries.
It is also estimated that 2/3 of the deaths from air-pollution are completely avoidable if we had better regulations around indoor and outdoor pollution. The diseases related to air-pollution are legion and include the following:
- Cardiovascular disease – a number of studies show the more significant exposure to air pollution, the much higher rate of heart attack and stroke. There is also a link between high blood pressure and abnormal blood fats with higher exposure to air-pollution. Diabetes and chronic kidney disease are higher in people with high exposure as well.
- Chronic lung disease – being exposed to a significant amount of air-pollution for 10 years is linked to the same degree of lung disease as smoking a packet of cigarettes per day for 30 years. There is a definite link between asthma and air-pollution with greater exposure, the worse the asthma.
- The brain is not spared from air-pollution. Exposure to air-pollution as a one year old is linked to deleterious brain changes at age 12. Many mental health disorders such as bipolar depression, teenage psychoses and autism are linked to exposure to air-pollution during the first 10 years of life. There is also a link between anxiety disorders and air-pollution. At the other end of the spectrum, a study of 1000 women aged between 73 to 87 showed a 40% increased risk for Alzheimer’s disease with higher levels of exposure to air-pollution.
- A study from India showed a link between air-pollution and osteoporosis.
- Air-pollution can also affect an unborn child with high rates of congenital abnormalities and preterm births.
- A 30 year study showed that premature death in 24 countries was again linked to air-pollution.
- Interestingly there also appears to be a link with hair loss and air-pollution and it has been suggested that multivitamins do decrease the health risks from air-pollution.
Although the ongoing debate around climate change has been put aside whilst we deal with this acute crisis from coronavirus, a central theme from either air-pollution or where we are seeing the greatest effects of the coronavirus is over-population. It is the concentrated areas of population such as China, northern Italy and New York to name three clear examples where coronavirus has caused most havoc. It is my belief that there is a strong link between the over concentration of population, air-pollution and a variety of health disorders including the coronavirus.
At some stage, the coronavirus will subside and life hopefully will return to some degree of normality. But, unless we make some significant long-term changes we are left with the ongoing carnage from over-population and air-pollution. In my view this is the true crisis in the world and as a global society we need urgent and long-term strategies to reverse the obvious and devastating mortality from what we, as human beings, are doing to the world.
Providing stress echocardiography heart health services for more than 25 years, Dr Walker is an expert in the field of preventative cardiology and has published seven best-selling books about the subject. Dr Walker is a member of the Miskawaan Health Group medical advisory board.
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