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PHAR 303 > L16. Air Pollution > Flashcards

L16. Air Pollution Flashcards

1
Q

What are 2 of the big leading risk factors for disease?

A
  1. Air pollution:
    - major cause of global death
  2. Tobacco
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2
Q

What 2 factors cause disability adjusted life years (the number of years lost due to ill-health, disability or early death)? where?

A
  • Smoking: significant in north America and various parts of the developed world
  • Air pollution: India and China
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3
Q

Where is Death due to outdoor air pollution bad?

A

Really bad in Beijing, and any of the cities in China

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4
Q

Give a time lapse of smog-related events starting from 2003 in montreal.

A

2003- people were astounded to see smog and it made headlines

2007- smog was getting a bit worse

2008 - smog kills 3000 Canadians a year and causing >20000 chronic diseases.

2009 - ban the installation of new fireplaces and wood stoves, smog alerts were happening all the time.

2013- whole city is full of smog

2017- kids with asthma and people with heart disease are told to stay indoors on certain days, environment Canada is monitoring the levels all the time to give these people the appropriate alerts

2018- smog alert

2021- smog warnings

2022- january first, 1st day of year, there was a smog warning and people needed to stay indoors if they had respiratory ailments

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5
Q

What has been done in canada due to the prevalence of smog?

A

Over the years, air quality monitoring systems have been installed all over Canada.

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6
Q

What is the “smog city”?

A

Windsor, Ontario

Always full of huge trucks with diesel engines (very polluting) to transport between Canada and the US. So Windsor is full of air pollution all year round.

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7
Q

TRUE OR FALSE? car accidents kills more humans than smog?

A

False. smog kills more

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8
Q

Describe the bronchus (two large tubes that carry air from your windpipe to your lungs. You have a left and right main bronchus in each lung.) (cellular structure).

A

Outer layer: epithelium. then muscle layer then cartilage layer.
Ciliated cells line it. Cilia beat and propel the mucus along to continually clean the airways. There are also muscle cells further down and goblet cells that release mucus.

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9
Q

What is a bronchiole?

A

Smaller airways than bronchus, much less muscle. Have cells that have CYP450s for metabolism.

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10
Q

Describe how alveoli facilitate exchange between lungs and the body. What is a consequence?

A

There is only one endothelial cell between a capillary and an alveolus. So it is beautifully designed for the exchange of gases. Due to this, they can take in other things you inhale. We can absorb drugs this way as well as toxins. Particles that are not removed from the alveolus can cause direct problems in the lung

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11
Q

How do the lungs defend against pollution? Is it fool proof?

A
  1. Cilia: Beat and propel the mucus layer upward toward the trachea toward the back of the throat where you swallow it.
  2. Macrophages: Phagocytose ingested small particles in the lung periphery (alveoli). the macrophages then ride up on mucociliary escalator and are also swallowed.

A good built in system but not perfect so when exposed to air pollution we do end up with problems.

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12
Q

What does the size of particles you inhale dictate? Be specific.

A

The size of the particle dictates where it will end up:

Larger >2.5 microns: stuck in mucus in the larger airways which are then removed.

The smaller the particles (PM < or = 2.5 microns) the further it gets and the more likely they will stay. PM = particulate matter.

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13
Q

What are some sources of particulate matter? who is vulnerable?

A

Some sources of particulate matter :

  • Can be natural or not
  • Smoking
  • Dust storms

Everyone is vulnerable to particles and volatile organic chemicals in air pollution but the most vulnerable are babies.

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14
Q

What are the effects of inhaled pollutants?

A
  1. Multiple effects on organ systems
  2. Lungs – first area of attack, then things get out of lungs and into other organ systems.
  3. Brain
  4. Heart
  5. Kidney
  6. Etc.
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15
Q

What is one of the dirtiest things you can use as a source of energy? Bitch.

A

Coal

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16
Q

What significant event happened in London in the 1950s?

A

in 1952, within a few days, more than 4000 people were killed.
-They called it the “London Fog” but it wasn’t fog, it was smog.
- It Was inside AND outside.
Couldn’t see down the hallway in the hospital.

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17
Q

What caused the london fog?

A

Sulphur dioxide which is a major constituent of air pollution and burning coal, and the smoke level were correlated with the death rate.

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18
Q

What did London do in response to the London Fog? the world?

A

This woke up England and London to act:

  • They put in clean air laws
  • Banned the use of coal within the city
  • Had to heat the house with electricity
  • Pollution levels dropped

It was also a wake up call for the world regarding air pollution and other places started to measure their air pollution for example, montreal.

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19
Q

What sources can air pollution come from?

A
  1. Natural: for ex volcanoes erupting, lightning, wildfires, forests.
  2. Manufactured: human activity by burning fossil fuels in industry or automobiles.
    - > mobile: Cars, trucks, buses, motorcycles, airplanes.
    - > Stationary: Industry, power plants, sewage treatment
    - > Area: Cities, livestock, fertilizer.
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20
Q

What are the sources of death from air pollution in USA vs in India?

A

USA:
Major: burning fossil fuels to generate electricity, traffic (gasoline), & agriculture

India:
Major: Residential energy– burning things in their homes to cook and heat

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21
Q

What are the major ways that air pollution will kill you? Rank from highest to lowest.

A
  1. The major problem is cardiovascular. So the pollutants you are breathing in are entering the circulation through the intimate connection between the capillaries and alveoli. Getting into the blood stream and going to the heart and brain which are particularly vulnerable.
  2. COPD (chronic obstructive pulmonary disease)
  3. Lung cancer
  4. Lung respiratory infections: Children are very vulnerable to lung infections if heavily exposed to polluted air.
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22
Q

What are the categories of indoor air pollutants?

A
  1. Pathogenic microorganisms: Molds, bacteria, viruses
  2. Allergenic microorganisms: Molds, bacteria
  3. Respirable Particles: Smoke, dust, pet hairs, dust mites, etc.
  4. Volatile organic compounds: Formaldehyde, cooking products, hair sprays, pesticides
  5. Radon and radon decay products
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23
Q

What is the average air filtration in well insulated houses?

A

1 air change per hour.

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24
Q

What are sources of indoor air pollution?

A

Fireplaces, Cleaning agents, Gas stoves, Tobacco, Mould, Radon, etc.

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25
Q

What is radon?

A
  • Decay product of uranium
  • Small particle that can rise up through the ground, get into well water, and then into your house
  • If you breathe it in it increases your risk of lung cancer
  • Montreal is not in a region that has a big problem with this
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26
Q

Does Canada still use coal?

A

Canada has stopped burning AND mining coal. other countries like china are still burning a lot of it.

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27
Q

Why is burning coal bad? what is released?

A
  • When you burn coal there are a lot of sulphur based materials that are released into the air (sulfuric acid) which are dangerous to breathe in.
  • Sulfuric acid comes down in rain and corrodes metals, monuments, bridges, everything.
  • It is worse in the winter with temperature inversions where the pollution stays in one place.
28
Q

What causes acid rain?

A

Burning fossil fuels leads to the formation of sulfuric and nitric acids (So2, NO2). This comes down in rainwater and harms everything in its path.

29
Q

What is the cycle of Acid rain?

A
  1. Car emissions (NO)
  2. Sulfur dioxide and NO from burning coal
  3. The sulfur and nitrogen compounds turn into sulfuric acid and nitric acid in the atmosphere.
  4. everything from steps 1,2,3 are carried by the wind (can travel far) and then come down in the rainwater.
  5. What happens when they come down depends on where they land:
    - In a shallow lake: makes the whole lake acidic destroying the fish and other creatures
    - In a deep lake: have limestone at the base which tends to neutralize it (safer)
    - in soil: depends on what’s being grown. Ex: Farmers growing potatoes need to spread lime on their crops so that the pH of the crops balance out when it rains acid.
30
Q

What did the term smog come from? what are you seeing when you see smog? what is the biggest culprit?

A

The term smog came from a combination of Smoke + fog

What you see is a photochemical reaction

The biggest culprit is auto-exhaust which is worse in the summer.

31
Q

How does north america monitor the air for smog?

A

The USEPA has air quality standards for the separate ingredients in smog:

  1. Ozone
  2. Particulate matter (<2.5 microns)
  3. Sulfur dioxide
  4. Nitrogen dioxide
  5. Carbon monoxide: you can’t transport oxygen if you have carboxyhemoglobin due to high CO exposure.
  6. Lead: used to be high in north America because it was added to gasoline.
    - >Incredibly dangerous to children (development of NS and IQ)
    - >Now banned in north America
32
Q

What is ozone? What catalyzes the reaction to make ozone and where is it most prevalent?

A
  • Most extensively studied air pollutant
  • Ground level ozone is a combination of: nitric oxide + another oxygen gives nitrogen dioxide + visible sunlight which gives another oxygen atom = ozone (O3).
  • The reaction to make ozone is catalyzed by sunlight, so ozone is highest in the northern hemisphere in the summer (june-august).
33
Q

What are the effects of ozone?

A
  1. Eye irritation
  2. Irritation to epithelial cells lining entire airway and free radical production which damages all nearby cells:
    - >Nose irritation
    - >Sore throat
    - >Cough
    - >Increased infection due to damage of epithelial cells which help protect you from infection
  3. Chronic lung diseases:
    - >Asthma
    - >Bronchitis
    - >Pain
  4. Emphysema gets worse
  5. Lung damage
    - >Edema
    - >Inflammation: the injury and inflammation caused by ozone impairs the defense mechanisms in lungs.
34
Q

How are the symptoms of inflammation due to ozone described?

A 
The symptoms of the inflammation that occurs at the different parts of the airways are described by adding "itis" at the end of the word.
Ex:
1. Rhinitis --> nose 
2. Pharyngitis 
3. Laryngitis --> ex: inflammation in the larynx 
4. Tracheitis 
5. Bronchitis 
6. Bronchiolitis 
7. Bronchopneumonia
35
Q

How can lung function be measured? How can this be useful in relation to ozone?

A

Ozone exposure decreases lung function.

Can measure this with a standard lung function test: Spirometry.

36
Q

What is anthropogenic air pollution? How many deaths does it cause per year?

A

Air pollution that humans cause (not natural air pollution from volcanoes for example)

Annual deaths due to anthropogenic air pollution is around 7 million.

37
Q

What are the sources of the different types of particulate matter?

A
  1. Course (2.5-10 uM) particles:
    - Traffic and construction
    - Tire dust
    - WIND BLOWN SOIL
  2. Fine (<2.5 uM) particles:
    - BURNING FOSSIL FUELS
    - Industrial emission
    - Biomass burning
    - Coal burning
    - Construction dust
    - Urban fugitive dust
    - Soil dust
38
Q

What happens when you breathe in fine particles?

A

Some of the particles get exhaled

Some of them damage the lung tissue itself

Others get into the circulation and go elsewhere

39
Q

What happens once the particulate matter (small vs large) are in the airway (@nose or alveoli)?

A
  1. Bigger/medium particles:
    - Taken out by mucociloary escalator and the macrophages that ride along it then you swallow them
    - Out through GI tract
  2. Some small ones:
    - Can go through the olfactory bulbs in the nose and go into the brain.
    - Can go all the way to alveoli
40
Q

What is the mortality of air pollution directly correlated with?

A

The mortality to air pollution is directly correlated to the content of the PM <2.5.

This is because they get into the rest of the body and cause: Bronchitis, cancer, cardiovascular disease. It can also damage brain.

41
Q

How do particulate matter pollutants get into the brain? What can this cause?

A

small particles can go through the olfactory bulbs in the nose and go into the brain. Consequences:
1. Neuroinflammation

  1. Damage/loss of neurons
  2. Microglia activation and damage which can cause a vicious circle where neurons are destroyed.
  3. BBB damage/dysfunction:
    - >The small particles can damage the tight junctions or even the endothelial cells
    - >Cause changes in transporter proteins
    - >Inflammation
    - >All of this lets the particles get into the brain to then interact with neurons, microglia, astrocytes, etc.
  4. Oxidative stress
  5. Cerebrovascular damage
  6. Neurodegeneration
  7. Etc. Leads to CNS disease
  8. The biggest concern is cognitive impairment in children because their brains are still growing, and their BBB is not yet fully formed
  9. Is exposure to fine particles related to strokes, MS, Parkinson’s?
42
Q

What happens when particulate matter get into the alveoli?

A
  1. Enter capillaries
  2. Get into pulmonary veins
  3. Go to the heart and get spread to the rest of body
  4. They can also enter the lymphatics draining the lungs
43
Q

What is SO2 gas? What causes its production? why is it bad?

A
  • SO2 is found in smog. It is produced from Coal producing sulfur dioxide (SO2) and sulfuric acid & burning for electricity.
  • It is a water soluble irritant gas that is absorbed in upper airways and causes irritation. It also causes bronchoconstriction and mucous secretion (Cell injury and proliferation of goblet cells due to the increased mucous secretion).
  • SO2 leads to bronchitis: inflammation of bronchi which can be acute or chronic.
44
Q

What is NO2? Why is it bad?

A
  • It is found in smog
  • It is produced from gas heaters, stoves, farmers (silage), side stream tobacco smoke.
  • It causes airway injury similar to ozone (O3) -> injuring the epithelial cells down the airway.
45
Q

What are the main ingredients of smog?

A
  • CO
  • Volatile organic compounds
  • Ozone (main ingredient in smog)
  • Particulate matter
  • NO2 (nitrogen dioxide)
  • Sulfur dioxide (SO2)
46
Q

What is diesel exhaust?

A
  • Trucks have diesel engines that burn diesel fuel.
  • The exhaust on these trucks release ultrafine particles of 0.1 microns which is the most dangerous type of exhaust you can inhale. it goes straight into the blood, heart, and brain from the alveoli.

It also causes the carbon monoxide effect: carboxyhemoglobin.

47
Q

how is a risk assessment done on air pollution?

A
  1. epidemiology
  2. clinical study (look at humans with different exposures)
  3. laboratory tests on animals and plants
48
Q

What are the questions that come with doing an air pollution risk assessment?

A
  • The problem is to find the difference between intermittent exposure or chronic
  • Humans vs other species (not only humans are affected by air pollution)
  • Interactions between exposures to different types of pollution
  • We don’t know the mechanisms
  • Is there a certain amount of tolerance that develops when you are exposed to things
49
Q

What is happening currently with smog in canada?

A
  • Air quality index is monitored all over Canada
  • Air quality agreement between Canada and US
  • Fighting acid rain: Levels have come down because we are burning less coal
  • Little change in ozone and PM < 2.5 levels
  • Ozone high along the border of Canada and US because of the industries and bigger population
50
Q

What is happening with smog in fraser valley (canada)?

A

Big smog problem due to the temperature inversion of the rocky mountains

High pollution risk due to geography

51
Q

What is significant about Canada’s weather in relation to smog?

A

In the winter we must be careful about temperature inversions:

  • Normally, the pollutants would go up to the cooler air and then be blown away (because the temp goes from warm air to cool air to cooler air – from ground level to sky)
  • But with thermal inversions, particularly in the winter (cool air, warm inversion layer air, cool air) the pollutants stay in our breathing air lower to the ground. Pollution is trapped.
52
Q

What was the impact of covid on air quality in Canada?

A

Air quality improved

Everything went way down during the lock down

Shows how the air quality is dependent on cars etc.

53
Q

What was the biggest source of particulate matter in canada?

A

Residential wood heating was the biggest source of particulate matter:

  • Montreal Banned wood stoves in 2009
  • Montreal Banned fireplace wood burning
54
Q

Why does the summer have less PM than the winter in Canada?

A

Summer has less PM than in winter due to the burning of fossil fuels when it is cold.

55
Q

Who is smog the biggest risk for?

A
  1. Kids playing outdoors (MAJOR)
  2. Adults active outdoors
  3. People with respiratory diseases
  4. Particularly sensitive individuals
56
Q

What is the biggest source of indoor air pollution?

A

Smoking

57
Q

What is COPD? What are the side effects?

A

Chronic obstructive pulmonary disease.

Side effects: spasms, inflammation, and mucus.

58
Q

What are the variants of COPD?

A
  1. Bronchitis
  2. Emphysema
  3. Asthma
59
Q

What is COPD caused by?

A

smoking cigarettes & e-cigarettes (vaping)

60
Q

Why is vaping a problem?

A
  1. Advertised as green, healthy, wonderful
  2. Ads aimed at kids
  3. Ads also claim that they are safe:
    - >“Zero chemicals” LIE
    - >They are made up of chemicals
  4. Cheaper so kids can afford them
61
Q

What is vaping? What are you inhaling?

A

What is it?
- Heating the fluid to a very high temperature and Drawing it into the lungs. The liquid is filled with a bunch of chemicals.

What are you taking in?

  1. Nanoparticles
  2. Formaldehydes
  3. Nitrosamines
  4. Metals
  5. Carbonyls
  6. Volatile organic compounds
  7. Polycyclic aromatic hydrocarbons
  8. NICOTINE
62
Q

What does vaping do to cultured cells from human lungs?

A

In cultured cells from human lungs such as fibroblasts and epithelial cells we see that some flavours of e-cigarettes release inflammatory mediators.

63
Q

What does e-cigarettes show in animal models compared to controls?

A

Mice exposed to e-cigarettes twice a day (total 3 hours) for 2 weeks close to human exposure levels.

Results compared to controls (exposure to clean air):

  • the mice are more susceptible to infections due to lung damage
  • Number of macrophages is much higher
  • Altered cytokines in lung fluid
  • More vulnerable to influenza
  • More viruses in lung
  • Weight loss
  • More death
64
Q

What do studies on e-cigarettes show about human vulnerability? **this is a summary slide that is important to remember

A
  1. Much more vulnerable to streptococcal pneumonia
  2. Altered inflammatory cells in lungs
  3. More bacteria in lungs
  4. Impaired phagocytosis
  5. Macrophages impaired
  6. People who smoke E-cigarettes are more likely to smoke
  7. May be fewer compounds in E-cigarettes than in cigarettes but still not safe
65
Q

What is a consequence of all of the studies on e-cigarettes?

A

Smoking and vaping are now both prohibited indoors.

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