Network Updates / Worldwide / 2021-12-01

Doctors should check patients’ exposure to air pollution:

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Air pollution is the biggest environmental threat for premature death. Every year, more than 7 million people die from air pollution factors— that’s more than the deaths from AIDS, tuberculosis and malaria combined.

Air pollution is the contamination of indoor or outdoor air by any chemical, physical or biological agent, including household cooking devices, motor vehicles, industrial facilities and forest fires.

It is now proven that exposure to air pollution can lead to cardiovascular disease,  which is the world’s leading cause of disability and death, responsible for an estimated 18.6 million deaths globally in 2019.

Now, leading American physicians have published an article in the New England Journal of Medicine, calling on doctors to begin screening patients for exposure to indoor and outdoor air pollution in relation to cardiovascular disease, and recommend interventions in order to limit exposure.

“Until now, pollution reduction has received scant attention in programmes for cardiovascular disease control and has been largely absent from guidelines regarding the prevention of cardiovascular diseases,” write authors Philip Landrigan, director of the Global Public Health at Boston College and Sanjay Rajagopalan, director of the Cardiovascular Research Institute at Cape Western Reserve University. “This is an important omission, since incorporation of pollution reduction into cardiovascular disease prevention could save millions of lives.”

Apart from looking at nutrition, diet, smoking and exercise, the co-authors say doctors who treat heart health should help patients recognize their risk factors for exposure to air pollutants and recommend evidence-based strategies in response.

“The first step in preventing pollution-related cardiovascular disease is to overcome neglect of pollution in disease prevention programs, medical education, and clinical practice and acknowledge that pollution is a major, potentially preventable risk factor for cardiovascular disease,” Landrigan and Rajagopalan write.

In addition to obtaining patient histories of pollution exposure, doctors can provide guidance on pollution avoidance. They might recommend minimizing exercise on “bad air” days for example or avoiding exposure on the job, and evading the use of pollution-emitting devices—from fireplaces to incense sticks. Preventative recommendations could include the use of facemasks, in-home air cleaners, and air conditioning, they add.

Governments too, have a responsibility to push through legistlation on the adoption of renewable energy so as to prevent pollution-related cardiovascular disease that will also contribute to combating climate change. This could mean creating incentives and tax structures that favour renewable energy; ending current massive, taxpayer-supported subsidies for the fossil-fuel industry; and taxing pollutant emissions through application of the “polluter pays” principle.