AIR & HUMAN HEALTH Department of Public Health Faculty of Medicine - Padjadjaran University Bandung.
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Transcript of AIR & HUMAN HEALTH Department of Public Health Faculty of Medicine - Padjadjaran University Bandung.
AIR & HUMAN HEALTH
Department of Public HealthFaculty of Medicine - Padjadjaran
UniversityBandung
Learning Objective To describe the importance of air
quality as a determinant of health To describe the nature & extent of air
pollution-related diseases To list the major sources of air pollution To describe how air quality criteria are
developed To discuss the various approaches to
prevention of air-related environmental health problems
Anthropogenic emissions of air pollutant(Source: UNEP, 1992)
0 20 40 60 80 100 120 140 160 180 200
OECD countries Rest of world
CO
SPM
NOx
SOx
1970
1980
1990
1970
1980
1990
1970
1980
1990
1970
1980
1990
Emissions (million tons/year)
The accumulation of active compounds in atmosphere
Affected by: Land features
- valleys- nearby mountain ranges- the lack of open space
Atmospheric movements (e.g. stagnant air)
View of Bandung (from North) - 1
View of Bandung (from North) - 2
Aerosols Small solid or liquid particles (fine drops or
droplets) that are suspended in air form a mixture
Dust: particles in the solid phase Up in the air: suspended particulate matter (SPM)Smoke: particles in both solid & sometimes liquid phase &
the associated gases that result from combustionAsh: the solid phase of smoke, particularly after it settles
into a fine dustFumes: polydispersed fine aerosols consisting of solid
particles that often aggregate togetherFibers: longer & thinner particlesDroplets: liquid-phase particlesMist: a cloud or dense collection of droplets
The most important characteristics
Aerosols: Size (& shape) CompositionGases: Water solubility Chemical reactivity
0.00050.001
0.0050.01
0.050.1
0.51
510
50100
5001000
Oil smoke Fly ash
Tobacco smoke
Pollens
Bacteria
TobaccoMosaicvirus
Insecticide dusts Plant spores
Pulverized coal
Cement dust
Sulfuric acid mist
Flour mill dust
Foundry dustAmmonium chloride fumes
Smelter dust & fumes
Metallurgical dust & fumes
Particle size (m)
Type
s of
Par
ticle
Dep
osite
d
Range of particle diameters from airborne dusts & fumes
Aerodynamic diameter the diameter of a sphere w/ a density of 1
100 m
20 m
10 m
2.5 m
0.1 m
inhalable fraction
thoracic fraction
coarse particles
fine particles
ultrafine particles
nasal cavity
trachea
respirable range
The degree to which particles enter the blood, are circulated & delivered to the body’s tissues depends on:
The concentration inhaled Duration of exposure Solubility in blood & tissue Reactivity of the compound Respiratory rate
Asphyxiants
Simple asphyxiants Substances that dilute or displace the oxygen in air
without any other effect
e.g. carbon dioxide, nitrous oxide, nitrogen, hydrocarbons
Chemical asphyxiants Substances that block the transfer of oxygen to the
tissues or the utilization of oxygen once it reaches the tissues
e.g. carbon monoxide, hydrogen cyanide
Common conditions to which air pollution exposure may contribute
Disease or condition How air pollution may affect condition Associated factors/comments
Acute bronchitisDirect irritative effects of SO2, soot, & petrochemical pollution
Cigarette smoking may have a more than additive interaction
Acute respiratory infections Increased risk in young children Poverty, malnutrition, exposure to infectious agents
Asthma Aggravation from respiratory irritation, possibly on reflex basis
Usually pre-existing respiratory allergy or airway hyperreactivity
Chronic bronchitisAggravation (increase in frequency or severity) of cough or sputum associated with any sort of pollution
Cigarette smoking, occupation
Deaths Fine particulate increases mortality in heart & lung disease; mechanism is unknown Pre-existing hearth & lung disease
Eye irritation
Specific effect of photochemical oxidants, possibly aldehydes, or peroxyacetyl nitrates, particulate matter (fly ash) acts as a foreign body
Susceptibility differs
Headache Carbon monoxide sufficient to lead to more than 10% carboxyhemoglobin
Smoking may also increase carboxyhemoglobin, but not enough to lead to headache
Lead toxicity Adds to body burden Close proximity to lead source, exposure at home
Health effects of specific pollutants
Ozone Highly reactive & unstable compound Symptoms of exposure: nasal discharge, throat
irritation, cough, wheeze, chest pain, headache, fatigue Short period: effects are cumulative After several days: people become tolerant, their
breathing becomes more normal, but persons with asthma may still develop airflow obstruction. Persons whose asthma is triggered by allergies more susceptible to the allergen.
Sulfur Dioxide Major components of the London Fog Main effect: bronchoconstriction Persons with asthma: susceptible & suffer more than
the general public Capable of froming acid, causing acid rain Can be deeply deposited in the distal lung & air space Combine with ozone: appear to provoke airways
responses in an additive or synergistic manner
Oxides of Nitrogen NO: produced by combustion NO2: created by the oxidation of NO under conditions of
sunlight, or formed directly by higher temperature combustion in power plants or indoors from gas stoves
The full effects of NO2 not known In animals: cancerous metastases from the lung much
more likely to appear elsewhere in the body, although NO2 itself does not cause cancer
Potential human effects of nitrogen dioxide
Health effect Mechanism
Increased incidence of respiratory infection
Reduced effectiveness of lung defenses
Increased severity of respiratory infections
Reduced effectiveness of lung defenses
Respiratory symptoms Airways injury & bronchospasm
Reduced lung function Airways & possible alveolar injury
Worsening of the clinical status of persons w/ asthma, COPD, or other chronic respiratory conditions
Airways injury & reduced effectiveness of host defences
Particles Assoc. w/ an elevated risk of mortality & morbidity, esp. among
asthmatic & elderly Larger particles included in PM10 consist mostly of carbon-
containing material & produced from combustion, some produced by wind blowing soil into the air. The larger particulates: not seem to have as much effect on human health as the smaller particulates
Particulates in the fraction PM2.5 contain a proportionately larger amount of water & acid-forming chemicals
PM2.5, CO, sulfate & ozone cannot be easily separated b/c they tend to occur together in urban air pollution. PM2.5 & sulfate (& probably ozone): assoc. w/ an increase higher rates of deaths from & complaints about lung & heart diseases, but not yet known which is the predominant factor
Carbon monoxide Produced mainly by the incomplete burning of fossil fuels Odorless, colorless, & slightly heavier than air, tends to
collect in confined spaces As CO concentrations go up, the oxygen-carrying
capacity of the blood goes down. The CO molecule’s bond to hemoglobin is 200-300 times stronger than the hemoglobin-oxygen bond
Normal amounts in the blood: + 1%. Smokers: + 3 - 5% Low levels of exposure: fatigue, headaches, dizziness; 3-
5%: impaired vision, disturbed coordination, nausea, or death
Human health effects assoc. w/ low-level CO exposure: lowest observed adverse effect levels
COHb Concentration (%) Effects
2.3 – 4.3 Statistically significant decrease (3 – 7%) in the relation b/w work time & exhaustion in exercising young, healthy men
2.9 – 4.5Statistically significant decrease in exercise capacity (i.e., shortened duration of exercise before onset of pain) in patients w/ angina & increase in duration of angina attacks
5 – 5.5 Statistically significant decrease in maximal oxygen consumption & exercise time in young, healthy men during strenuous exercise
< 5.0 No statistically significant vigilance decrements after exposure to carbon monoxide
5.0 – 7.6 Statistically significant impairment of vigilance tasks in healthy experimental subjects
5.0 – 17.0 Statistically significant diminution of visual perception, manual dexterity, ability to learn, or performance in complex sensorimotor tasks (e.g., driving)
7.0 – 20.0 Statistically significant decrease in maximal oxygen consumption during strenuous exercise in young, healthy men
Maximum permitted CO exposure(WHO, 1987)
100 mg/m3 for < 15 min 60 mg/m3 (50 ppm) for < 30 min 30 mg/m3 (25 ppm) for < 60 min 10 mg/m3 (9 ppm) for 8 hr
Volatile Organic Compounds (VOC)
Among other compounds, include benzene, chloroform, methanol, carbon tetrachloride, & formaldehyde
May originate from household products, e.g. painting supplies, dry cleaning establishments, refineries, gasoline stations
Can cause irritation to the respiratory tract, headaches & other non-specific complaints
At high concentrations: toxic effects
Industrial Air PollutionTypes: Reducing air pollution
Caused by the emissions of SO2 & particulates, substances that are chemical reducing agents in the atmosphere
Photochemical air pollutionResults from complicated chemical reactions in the atmosphere that are driven by the energy in sunlight
Point-source emissionsAffects the immediate vicinity of the plant but does not usually involve atmospheric reactions to any great extent
Effective control of industrial & urban air pollution requires: Identifying & measuring the pollutants
that are most responsible for the problem Reducing or preventing their emissions at
the source
To set targets for the control of air pollution
to set standards or guidelines
Standard: a set of laws or regulations that limit allowable emissions or that do not permit degradation (deterioration) of air quality beyond a certain limit
Standards may take form as: Ambient air quality standards
Levels of general air quality in the region that the jurisdiction responsible cannot allow to be exceeded
Emissions standardsSet the amount of pollution that is allowed to come from a particular source
Air Quality Standards, US, 1989
Pollutant
Primary Standards
Average Time Health Effects
CO9 ppm (10 mg/m3)35 ppm (40 mg/m3)
8 hr1 hr
Aggravation of coronary artery disease
Lead 1.5 g/m3 Quarterly average Development effects on children
NO2 0.053 ppm (100 g/m3) Annual (arithmetic mean Increased respiratory infections, risk of acute lung disease
Ozone 0.12 ppm (235 g/m3) 1 hr Decrements in lung function, possibly chronic lung disease
PM10
150 g/m3
50 g/m3
24 hrAnnual (arithmetic mean)
Chronic respiratory disease, altered lung function in children, increased mortality
SO2
0.14 ppm (365 g/m3)0.03 ppm (80 g/m3)
24 hrAnnual (arithmetic mean)
Exacerbation of asthma
WHO Air Quality Guidelines for Europe (Revised 1999)
Compound Guideline Value Averaging Time
CO
100 mg/m3
60 mg/m3
30 mg/m3
10 mg/m3
(90 ppm)(50 ppm)(25 ppm)(10 ppm)
15 min30 min1 hr8 hr
Lead 0.5 g/m3 n.a 1 year
NO2
200 g/m3
40 mg/m3
(0.11 ppm)(0.021 ppm)
1 hrAnnual
Ozone 120 g/m3 (0.06 ppm) 8 hr
Particulate Matter n.a n.a n.a
SO2
500 g/m3
125 g/m3
50 g/m3
(0.174 ppm)(0.044 ppm)0.017 ppm)
10 min24 hrAnnual
n.a. : not applicable
Control of ambient air pollution
Control of emissions Transportation policy Energy policy Policy on placement of facilities
INDOOR AIR POLLUTION Rural people in developing countries may
receive + 2/3 of the global exposure to particulates (women & children: the greatest)
Source: inefficient & smoky fuels burned for cooking & heating
Contaminants: tobacco smoke, radon decay products, formaldehyde, asbestos fibres, combustion products (e.g. NOx, SOx, CO, CO2, & PAHs) & other household chemicals, molds, fungi, viruses, bacteria, algae, pollen, spores, & their derivatives
Sick building syndrome
UDARA DAN KESEHATAN MANUSIA
Definisi : Polutan / PencemaranAdalah sesuatu yang berpengaruh
jelekterhadap lingkungan sehingga
lingkunganmengalami penyimpangan akibatpencemaran
Pencemaran UdaraPencemaran Udara dalam jumlah kecil tidak terasaPencemaran udara dalam jumlah besar,
Lama Manusia akan merasa akibatnya
Biasa untuk mengatasi akibat pencemaran mahal 70% dari udara yang ada di bumi dihasilkan dari proses Foto sintesa, setiap kali manusia bernafas dan menghabiskan 1 Kg O2
BENTUK POLUSI UDARA1. Polusi udara yang berhubungan
dengan setiap orang (Personal Air Polution) Merokok
2. Polusi Udara akibat Pekerjaan (Occupational Air Polution) misal pengaruh uap dan gas
3. Polusi Udara di tempat umum (Community Air Polution) polusi ini paling komplek akibat menyangkut dari berbagai sumber
Beberapa zat kimia dapat menyebabkan polusi udara antara lain :
SO2, H2S, HF, HCl, CO2, NO, NO2, O3 Debu-debu logam : Seng, timah, Arsen,
Silica Debu-debu kapas : debu asbes Tepunsari dan spora tumbuhan Mahkluk hidup : Virus, Bakteri
Sumber Polusi Udara1. Sumber Polusi Udara alamiah
Atmosfer tercemar secara alamiah misal oleh karena
Debu ditiup angin Asap Mikro organisme Kabut Gas dan Bau yang berasal dari rawa-
rawa
Jenis Polutan dari sumber pencemar alamiah antara lain :
SO2 : Gunung apiH2S : Gunung api, reaksi biologis didaerah
rawaCO : Kebakaran hutanNO, NO2 : Reaksi bakteri-bakteri di tanahCH2 : Proses biologisCO2 dan O3 (Ozon)
2. Sumber polusi buatan karena ulah manusia terutama adalah transportasi. 60% dari polutan yang dihasilkan adalah CO. 15% adalah Hidrokarbon
BERBAGAI JENIS POLUTAN YANG PENTING
Polutan udara primer adalah polutan yang
mencakup 90% dari jumlah polutan udara
seluruhnya
TERDAPAT LIMA KELOMPOK POLUTAN PRIMER:
1. Karbonmonoksida (CO)2. Nitrogen Oksida (NOx)3. Hidrocarbon (HC)4. Sulfur Dioxida (SOx)5. Partikel
Toksitas Relatif Polutan
Polutan Toksitas Relatif
COHCSOxNOx
Partikel
1,002.0728,077,8106,7
Konsentrasi COHb - Kesehatan
Konsentrasi COHb dalam darah (%)
Pengaruh Terhadap Kesehatan
<1,0
1.0 – 2,0
2,0 – 5,0
≥ 5
10 - 80
Tidak ada pengaruh
Penampilan agak tidak normal
Pengaruhnya terhadap sistem syaraf sentral reaksi pancaindra tidak normal benda terlihat agak kabur
Perubahan fungsi jantung dan pulmo
Kepala pening, mual, berkunang-kunang, pingsan, sukar bernafas, kematian
Partikel dikelompokan menjadi :1. Debu yang menyebabkan fibrosis
didalam paru-paru ( Silica, Asbes)2. Debu karbon3. Debu yang menimbulkan reaksi
alergis (debu biji-bijian dan debu kayu)
4. Debu yang bersifat iritan : asam alkali
Partikel
Pengaruh partikel / debu pada manusia
Pneumoconiosis, adalah segolongan penyakit kelainan paru-paru yang berupa penimbunan debu
Pengaruh partikel / debu pada manusia
Pneumoconiosis di bagi :1. Silicosis : debu oleh SO2 bebas2. Asbesiosis : debu oleh debu
asbes3. Berryliosis : debu Berrylium4. Byssinosis : debu kapas5. Stanosis : debu biji timah6. Siderosis : debu Fe2O37. Anthracosis : debu Anthrasit
Secara klinis pneumoconiosis tidak dapat dibedakan hanya dapat dilakukan secara radilogi dan pemiriksaan patalogi anatomis