We spoke to Maria Rosaria Gualano, Associate Professor of General and Applied Hygiene at UniCamillus University.
When we talk about pollution, it is difficult to really understand what we are talking about. It is a subject that–wrongly–seems almost intangible, so used are we to the air we breathe in our cities and to unpleasant news. It seems to be a very distant issue that does not affect us. Instead, we breathe it in–literally!–every time we inhale air: the effects of environmental pollution are now one of the greatest challenges of our time, with devastating consequences for human health, ecosystems and the global economy.
Rapid industrialisation, the intensive use of pesticides and chemical fertilisers, increasing urbanisation, the use of fossil fuels and poor waste management have all contributed to a dramatic increase in pollution of the air, land and water.
However, air pollution is the leading cause and most dangerous environmental threat to human health. Every year, millions of people die prematurely from respiratory, cardiovascular and other diseases directly linked to exposure to air pollution. Particularly in developing countries, the poorest communities suffer the most from the effects of pollution because they have no access to adequate protection or effective health care.
Speaking of numbers, a study on the relationship between pollution and health was published in The Lancet on 17th May 2022, reporting that air pollution caused up to 9 million premature deaths in 2015.
Exposure to lead, another dangerous pollutant, has had devastating effects on the mental and physical health of millions of people. A study published in September 2023 showed that lead exposure, especially in children, leads to severe delays in cognitive development, with a global loss of about 765 million IQ points each year.
But that is not all. In addition to the serious health consequences, pollution is also a heavy economic burden: the World Bank Group‘s website reports that the global cost of air pollution will exceed $8 trillion in 2019–that is about 6% of the global GDP.
Air pollution and climate change: a vicious circle
Air pollution is closely linked to climate change: greenhouse gas emissions, together with black carbon and methane pollution, accelerate global warming and intensify extreme weather events. At the same time, climate change increases pollution, creating a vicious circle that threatens food security, the availability of drinking water and the stability of infrastructure.
Contamination of soil and water resources also threatens natural ecosystems and biodiversity, not to mention forest fires (whether deliberate or not), which make matters worse by releasing huge amounts of carbon dioxide and other pollutants into the atmosphere.
It all seems a lot worse than it is, and it probably is. But we must not forget that we are part of this process, just as we can be part of the change. In what way? We asked Maria Rosaria Gualano, Associate Professor of General and Applied Hygiene at UniCamillus University.
What daily practices can help reduce exposure to air pollution?
It is certainly important to reduce exposure to air pollution as much as possible to protect our own health and that of our loved ones, and there are a number of strategies that can be used to do this. However, there is one important variable that draws a line in the sand, and that is where you live, as there are certainly important differences between rural and densely populated urban areas, as well as between places where there are factories and/or other possible sources of emissions that exacerbate pollution. For example, if you live in an urban area, it is important to consider going outdoors at times when there is less traffic (e.g. outside peak hours, generally in the morning when offices open and in the late afternoon) and therefore walking either in the early morning or in the evening. At the same time, it is also advisable to freshen the air in our homes: where possible, especially for those who live in more polluted areas, air purifiers with HEPA filters can be useful to reduce fine particles (PM2.5) and other indoor pollutants. If possible, go to green areas: parks are the lungs of our cities, and in some places (Barcelona, for example) urban planning is being redesigned to increase the number of trees in the streets, also to reduce the heat, including the heat linked to the asphalt, which is becoming increasingly stifling, especially in summer. We should also take advantage of clear days, when there is a lot of wind and the air is cleaner, as well as after a ‘cleansing’ rain.
As far as materials are concerned, I would also like to mention the new generation of paints that have been specially developed to absorb pollutants not only indoors but also outdoors: in Rome, for example, in the Ostiense district, there is the largest ‘ecological’ wall painting in Europe, created using these techniques to absorb smog. It is certainly a beautiful example of an innovative combination of urban planning, art, architecture and sustainability. It is also interesting to mention that today we have digital tools such as weather or other specific apps that allow us to monitor pollution levels and therefore encourage us to act accordingly, depending on the moment. If we want reliable data, it is always advisable to follow what sources such as the Italian Regional Environmental Protection Agency (ARPA), the European Environment Agency (EEA) and the World Health Organisation (WHO) say.
What are the warning signs we should look out for to see if pollution is affecting our health?
If you live in areas that are more at risk, i.e. more polluted ones, you should be aware of certain signs and symptoms, taking into account variability due to individual factors such as age, previous illnesses and medical conditions. For example, if you have symptoms such as a dry, persistent cough, this could also be a sign of a condition related to chronic exposure to environmental stressors such as particulate matter or irritant gases. Obviously, people who already have underlying conditions such as asthma and COPD may experience a worsening of their symptoms. Other symptoms to look out for include a burning sensation and irritation of the throat, nose and eyes, skin irritation, headaches and difficulty concentrating. It is best to consult your GP, especially if you are experiencing persistent or disabling symptoms that can be attributed to such situations, so your condition can be better investigated and, if possible, the source of pollution can be removed or moved away–or at least protective measures can be put in place. For example, people who work in highly polluted environments wear appropriate personal protective equipment (PPE).
Are there foods or drinks that can help neutralise the effects of pollution on our bodies?
We now know how much a healthy lifestyle and diet can improve our health. Certainly, a Mediterranean diet and, above all, a varied diet can have a protective effect against various agents, including air pollutants. In fact, by eating antioxidant foods rich in omega-3s, vitamins and fibre, we can provide our body with the nutrients it needs to fight inflammation and cellular damage. For example, we must not forget the role of such an essential vitamin as vitamin D, which falls to alarming levels in the absence of sunlight. On the contrary, I would advise you to take a dose of vitamin D and possibly, in consultation with your GP, to take supplements or at least to improve your intake through diet and lifestyle.
Are there categories of people who are more vulnerable to pollution?
Yes, there are categories of people who need more attention, who are ‘fragile’ and therefore more vulnerable to the harmful effects of air pollution. In particular, extreme age groups (children and the elderly) and people with pre-existing conditions (such as respiratory and/or cardiovascular diseases) or weakened immune systems may suffer much more from these exposures, which are harmful to a healthy organism and even more so to a vulnerable one.
Particular attention should also be paid to pregnant women, who should definitely not be exposed to pollution. Recommendations for these categories include those already mentioned, which should be reinforced and strongly reiterated: be careful when going out in areas and at times when particulate levels are higher due to traffic and other sources of urban pollution; refresh the air frequently or use indoor air purifiers; and avoid passive smoking. In extreme cases, the use of masks should also be considered when people have to wait in polluted areas. Whenever possible, go outdoors to places away from smog and away from cities.
In addition to individual contributions, are there actions that would be useful to take on the global and international level?
We live in an extremely difficult time in history in many ways, and one of the greatest challenges is the healthy survival of our planet. Sometimes we forget that we are not the only inhabitants of Earth and that interaction with all other living species and with all parts of the environment greatly affects our existence. Think of the Amazon forest: we all studied it in school, but then most of us forget its importance. This historic period requires a two-fold approach: on the one hand, raising awareness of individuals, who can do so much on their own and together with everyone else to tackle pollution and climate change by choosing a sustainable lifestyle; on the other, there is an urgent need to strengthen global policies, national and supranational approaches–because this is a challenge that affects us all. Nobody wins alone. It is therefore essential (in the light of all the climate agreements, such as the Paris Agreement) that all countries in the world respect the agreed strategies and commit themselves to the common good. I think we have to be optimistic, and this optimism has a reason: never before have we had such incredible technological and non-technological tools at our disposal, allowing us to monitor events and intervene with effective equipment. Technological and scientific innovation will be able to make an important contribution to reducing polluting emissions and helping us to improve the health of the planet, and therefore our own!
What are the most common diseases linked to pollution?
Since the time of the father of medicine, Hippocrates, people have been studying the relationship between environmental elements (such as air, water and soil) and human health. Today we know that pollution makes us sick and kills us. The underlying causes have been studied and we now know how air pollution can lead to not only respiratory and allergic conditions, but also cardiovascular, cerebrovascular and neurodegenerative diseases. In addition, air pollution has been classified as a human carcinogen by the WHO. Finally, the effects of these pollutants on male and female reproductive health are being studied, both as a potential factor in infertility and as a risk to the health of the unborn child. It is therefore clear that reducing air pollution and improving air quality must be a key objective on the global public health agenda.