Date post: | 21-Jul-2015 |
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Health & Medicine |
Upload: | wisconsin-clean-cities |
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Asthma and pollution
Mitchell Grayson, MD
Director
Fight Asthma Milwaukee (FAM) Allies
Asthma is a problem
Every day in America:40,000 people miss school or work due
to asthma
30,000 people have an asthma attack
5,000 people visit the emergency room due to asthma
1,000 people are admitted to the hospital due to asthma
11 people die from asthma
• An immune response in the small airways of the lungs, characterized by
– Inflammation and edema (swelling)
– Mucus production (snot)
– Bronchospasm (muscle tightness)
What is Asthma?
Drawings from M. Tsutsumi
Asthma triggers
• Asthma can be triggered by many airborne factors:
– Pollen (trees, grasses, ragweed)
– Mold spores
– Air pollution
• Exhaust from vehicles– School buses, trucks
– Small engines (eg, lawn mowers)
– Boats and cars
• Factory smoke / exhaust
Air Pollution
• Ozone (O3)
– An invisible gas formed through chemical reactions of nitrous oxides and volatile organic compounds
– Able to chemically react with lung tissue leading to tissue damage
• Particle Pollution
– A mix of airborne solids and liquids
– Comes from burning fossil fuels in factories, power plants, steel mills, smelters, diesel/gasoline, wood (even from residential fireplaces).
– May trigger asthma possibly leading to hospitalization and death
Particle Size
• Size matters
– > 10 µm impact in the nose and mouth
– < 5 µm can impact in the lungs
bronchioles and alveoli
bronchioles (small airways)
trachea (large airways)
nose and mouth
3
From: Heyder J. Proc Am Thorac Soc. 2004;1:315.
Why worry about emissions?
Health Impact of Diesel Emissions
Data from 2010 Clean Air Task Force
Does exhaust really matter to people with asthma?
To reduce traffic for the games:• Around-the-clock public transportation was provided• 1,000 buses added to the existing fleet• Downtown city streets were closed to private cars • Downtown delivery schedules altered to ease morning rush hour • Allowed flexible work schedules and telecommuting
These changes resulted in marked declines in ozone and other air pollutants known to trigger asthma exacerbations.
A study examined the 1996 summer Olympic games in Atlanta
Friedman MS, et al. JAMA. 2001;285:897-905
Results for people with asthma
• When compared to pre-Olympics data, the frequency of asthma events (emergency room and/or hospitalizations) decreased by
– 42% (Georgia Medicaid claims)
– 44% (Health Maintenance Organization data)
– 11% (data from two Pediatric Emergency Depts)
– 19% (data from the Georgia Hospital Discharge Database)
• So, reducing pollutants and ozone reduced the burden of asthma!
Friedman MS, et al. JAMA. 2001;285:897-905
Recommendations
• Check Air Quality Daily:
– 1-866-DAILY AIR
– (1-866-324-5924)
– www.epa.gov/airnow
– Orange level means air quality is bad for sensitive groups including older adults, all children, and people with respiratory illness.
• On bad air quality days:
– Stay indoors
– Do not exercise outside
Thank You!