By Avinash Prabhakar

New Delhi, Oct 23 (IANS): As a major environmental risk factor, air pollution has evolved as a serious problem in recent decades with high toxicological impact on human health ranging from lungs to other organs and leading to 7 million premature deaths annually across the globe.

Air pollution does not affect only the respiratory realm of the body but it has long-term health effects which include heart disease, lung cancer, brain stroke, autoimmune diseases and premature birth, fetal growth restriction among others.

Air pollution is a major contributor to lung disease, but a study shows that it can damage most other organ systems of the body. The environmental factors have also been linked with the pathogenesis of autoimmune diseases and it has now been established that the environmental exposures of particles like trichloroethene (TCE), silica, mercury, pristane etc are linked with the higher risk of autoimmune diseases.

"The autoimmune diseases like autoimmune hepatitis, rheumatoid arthritis, and systemic sclerosis (SSc), are chronic and potentially life-threatening inflammatory disorders, but it is evident that such diseases are influenced by genetic, hormonal and environmental factors", said Dr Uma Kumar - Prof & Head, Department of Rheumatology, All India Institute of Medical Sciences.

"Study has established that there is a relation between the environmental factors and the autoimmune diseases. In a study, we had observed that the inflammatory levels of the patients with rheumatoid arthritis rose when exposed to the PM2.5", said Kumar.

"In a study conducted in the Delhi NCR some year back, it was observed that more than two thirds of the population had the inflammatory markers and occupational stress markers positive. And, out of total, 18 per cent have an autoimmune antibody positive that suggests that subclinical autoimmunity was being developed in them", Kumar added.

From smog enveloping the cities to smoke inside the home, air pollution poses a major risk. The outdoor air pollution in both cities and rural areas is causing fine particulate matter which results in strokes, heart diseases, lung cancer and acute and chronic respiratory diseases. According to the World Health Organisation, around 2.4 billion people are exposed to dangerous levels of household air pollution, while using polluting open fires or simple stoves for cooking fuelled by kerosene, biomass (wood, animal dung and crop waste) and coal. The combined effects of ambient air pollution and household air pollution is associated with 7 million premature deaths annually.

The increase in the particles in the air is implicated in allergic skin conditions such as atopic dermatitis and eczema. The pollutants like ultraviolet radiation, organic compounds, oxides, particulate matter, affect the skin, said Dr Manish Jangra, Dermatologist at RML Delhi. "The exposure of the skin to air pollutants has been associated with skin aging and inflammatory or allergic skin conditions such as eczema, psoriasis or acne and atopic. Air pollutants damage the skin by inducing oxidative stress. Dermatitis while skin cancer is among the most serious effects of it", said Jangra.

While talking about the exposure to air pollution during pregnancy, Fertility Expert Dr Archana Dhawan Bajaj said that the pollutants can increase the risk of premature birth and low birth weight and even stillbirth. Premature birth happens before 37 weeks of pregnancy while low birth weight is when a baby is born weighing less than 5 pounds, 8 ounces. Stillbirth is when a baby dies in the womb after 20 weeks of pregnancy.

"The rising air pollutants are causing stillbirth and premature death among those women living in polluted ambience", added Bajaj.

"Along with causing detrimental effects on the respiratory diseases, the air pollution may lead to lower immunity in pregnancy with worsening complications like fetal growth restriction. Vulnerable age groups like babies, children, adolescents, pregnant women are most vulnerable to air pollution. Vehicular emissions and outdoor pollution along with indoor pollution like dust, viruses, bacteria contribute to adverse outcomes. Small particulate matter are transmitted in maternal lungs and get carried to the foetus through placental circulation. This leads to preterm labour, miscarriages and low birth weight", said Obstretician & Gynaecologist, Dr Rinku Sengupta Dhar.