Air Pollution: A Global Health Problem

In countless cities worldwide and throughout much of the countryside, the air is so polluted that the simple act of breathing can be fatal. In some cases, the harm inflicted by air pollution on the human body is clear and direct; in others, it weakens the body, leaving it susceptible to other ailments. In the United States alone, air pollution kills over 50,000 persons a year-a death toll higher than that of traffic accidents, breast cancer, or AIDS.2 European air pollution levels equal or exceed those of the United States. In China, India, Thailand and other industrializing nations, air pollution is literally palpable.

AIR POLLUTION HEALTH EFFECTS: COUNTRY STUDIES

In Europe, eleven groups of researchers working at ten different centers collected data on air pollution, hospital admissions and mortality in fifteen cities during the 1970s and 1980s. The effort was part of a program called Air Pollution Health Effects: A European Approach. Not surprisingly, the researchers found that as levels of air pollution increased, so did deaths and hospital admissions. Some specific studies include the following:

The Netherlands: When levels of nitrogen dioxide (NO2) rose, children suffered more upper respiratory infections. Infections of the lower respiratory tract followed local increases in black smoke, and coughing rose in step with ozone concentrations. Deaths due to particulate pollution averaged 13 per day. Among primary school children, the temporary decrease in pulmonary function due to particulate air pollution was about 5 percent, while about 700 cases of asthma were aggravated daily.

France: When levels of black smoke and sulfur dioxide rose in 1992 and 1993, so did nighttime coughing and wheezing among asthmatics. Hospital admissions for chronic obstructive pulmonary disease increased when levels of sulfur dioxide rose, while admissions for asthma rose with increases in ambient nitrogen dioxide. The researchers concluded that "relationships between air pollution and mortality and hospital admissions for respiratory causes exist even in a rather low-polluted area and even below what is usually considered as safe levels of pollutants."

Poland: Scientists collected information from more than 500,000 army­induction medical examinations conducted between 1979 and 1981 at 241 centers throughout Poland. Centers with sulfur dioxide-polluted air had four times as much asthma and three times as much bronchitis as centers without the pollution. In Krakow, researchers tracked residents for thirteen years and found that men who lived in the city's polluted areas had losses of lung function "equivalent to the effect of smoking."

Thailand: Doctors at the Bangkok Police Hospital describe how traffic officers develop a sort of "brown lung" disease, with persistent cough, sputum production, abnormal lung function tests and spots on their lungs. These officers are merely an extreme example; roughly one of every nine Bangkok residents have respiratory ailments of some sort. In Thailand's Mae Moh region, where power plants burn high­sulfur coal with no emission controls, 4,000 residents required medical treatment after weather conditions trapped sulfur dioxide pollution over the area in 1992.

The best estimates are that more than a billion people live in urban areas with unhealthful levels of air pollution.3 (See Table 1.) Developing nations harbor some of the worst air pollution problems, due to a combination of swelling populations, economic development, and urbanization. Moreover, the trend in most developing nations is toward much dirtier air.

Although considerable progress has been made in the United States toward reducing air pollutants in recent decades, this progress is partial. In 1995, 33 million American cities failed to meet federal smog regulations.4 In 1996, EPA estimated that 80 million Americans breathed substandard air in 1995, compared to 140 million in 1990.5

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