Air Pollution and Primordial Prevention of Chronic Non-Communicable Diseases

Abstract

Air pollution is a global health issue with serious public health implications particularly for children. Studying the effects of environmental factors on the early stages of atherosclerosis can serve for future studies and offer strategies for primary prevention of chronic disease. Usually respiratory effects of air pollutants are being considered, this chapter highlights the importance of non-respiratory health hazards from early life. In addition to short-term effects, exposure to criteria air pollutants from early life might be associated with low birth weight, increase in stress oxidative and endothelial dysfunction which in turn might have long-term effects on chronic non-communicable diseases. The independent association of air pollutants with surrogate markers of endothelial dysfunction and a possible pro-coagulant state is underscored. Similar independent associations are documented for air pollutants and hematologic parameters as well as a possible pro-inflammatory state. The presence of these associations with PM10 (larger than PM2.5 usually considered as harmful) and in a moderate air quality (which is commonly considered with few or no health effect for the general population) highlights the need to reexamine environmental health policies and standards for the pediatric age group. Atherosclerosis begins in early life, and the role of platelets is well-documented from its early stages. The concern of medical literature on atherosclerotic cardiovascular diseases is mostly about some specific inflammatory diseases, and the role of environmental factors, as air pollution is overlooked in many studies. Many studies have documented that disturbance of the inflammatory and the coagulation systems after exposure to air pollution might be a factor in endothelial dysfunction and the progression of cardiovascular diseases. The increase in platelets number and aggregation may be a surrogate marker of early hematologic and hemostatic changes due to air pollutants. The systemic pro-inflammatory and pro-coagulant response to inhalation of fine and ultrafine particulate matters suggest a role for platelet activation in this process. Facilities should be provided for families to become aware of the quality of the air yearround and to check daily air-quality levels and air-pollution forecasts by mass media, local weather reports and other available public information sources. This is especially important for smog levels during hot weather. Protective measures should be taken into account for children and pregnant women to reduce their exposure to air pollutants, e.g. children and pregnant women should avoid congested streets and rush hour traffic, moreover families