Air pollution is a complex and ubiquitous mix of pollutants, including particulate matter, chemicals and biological materials. And today it is increasingly recognized that air pollution has widespread and damaging effects on human health and is a major concern for the global community. A number of epidemiological and pathophysiological data confirms the link between air pollution and mortality and morbidity, mainly but not exclusively from respiratory and cardiovascular diseases. These effects occur not only after acute exposure to elevated concentrations of particulate matter and gaseous air pollutants, but even after short-term exposure to relatively low levels of concentrations. The most vulnerable populations, such as the elderly, infants, pregnant women, and people with comorbidities, are most susceptible to the adverse health effects of poor air quality.

Substances causing direct air pollution pose a greater or lesser danger to humans. From a health perspective, the most important components of polluted air are particulate matter (PM - particulate matter) and gaseous pollutants - ozone, nitrogen dioxide (NO2), volatile organic compounds (including benzene), carbon monoxide (CO) and sulfur dioxide (SO2). Primary pollutants, such as soot particles and oxides of nitrogen and sulfur, are emitted directly into the air when fossil fuels are burned. The main sources of NO2 are automobile traffic, power generation, industrial sources, and residential heating. Secondary pollutants are formed in the atmosphere from other components, such as ozone, resulting from photochemical reactions from nitrogen oxides and volatile organic components. All components of air pollution are harmful to human health, but the most serious effects are associated with atmospheric PM, which contain and carry a wide range of toxic substances into the respiratory tract. PM are classified by size into large (diameter < 10 µg/m³; PM10), small (diameter < 2.5 µg/m³; PM2.5) and ultrafine (diameter < 0.1 µg/m³; PM0.1). PM2.5 is contained within the coarse particle fraction and is traced along with it, accounting in total for about 50% of the total PM10 mass. At the same time, small PM are more dangerous than larger ones. When inhaled, large PM are trapped in the nasal cavities and upper airways, whereas small and ultrafine PM can penetrate deeper into the pulmonary alveoli and possibly enter the bloodstream.

Various experimental studies have identified a number of biological mechanisms that demonstrate a link between air pollution and the development of cardiovascular disease. Most studies in different populations link long-term exposure to air pollution with an increased risk of fatal or nonfatal coronary heart disease. An analysis of more than 65,000 postmenopausal U.S. women who participated in the Women's Health Initiative showed a 21% increase in the incidence of fatal and nonfatal coronary heart disease for every 10 µg/m³ increase in PM2.5. In addition, a correlation is confirmed between air pollution associated with traffic and fuel combustion and acute myocardial infarction. Also, long-term exposure to PM and NO2 is associated with incidents of heart failure. For cerebrovascular disease, time-series studies in Korea and Finland show an association between air pollution and stroke mortality.

Studies show that exposure to air pollutants is linked with chronic obstructive pulmonary disease (COPD), acute respiratory infections, lung cancer, and respiratory allergies. And an assessment of the effects of air pollution on children has confirmed detrimental effects on lung function, airway infections, and asthma attacks. In a very large study of heart and lung disease-related hospitalizations in ten U.S. cities, for every 10 µg/m³ increase in PM10 there was a 2.5% increase in COPD hospitalizations. Another U.S. study found that a dramatic increase in PM2.5 was associated with an increased risk of hospitalization with COPD of about 0.9%. There is also growing evidence that air pollution is linked to the risk of developing lung cancer. In a prospective analysis of ESCAPE study data, there was a statistically significant association between lung cancer and PM10 concentrations. Concerns have recently emerged about the possible effects of particulate air pollution on pregnancy and the first period of fetal extrauterine life. In particular, several studies have found an association between exposure to air pollution during pregnancy with low birth weight at term and delayed psychomotor development in childhood.

The WHO 2021 Review of Evidence on the Health Aspects of Air Pollution demonstrates evidence of a possible link between long-term exposure to PM2.5 and neurodevelopment and cognitive function, as well as other chronic diseases, such as diabetes. Air pollution is a major environmental contributor to disease. It is estimated that fine particulate matter PM2.5 in the air is associated with 2.9 million premature deaths in 2017, including from coronary heart disease, stroke, COPD, lung cancer, lower respiratory infections, and type 2 diabetes. In addition, ground-level ozone is estimated to be associated with 472,000 premature deaths from COPD. Estimates of global transport-related mortality range from 165,000 in 2010 to 376,000 in 2005 for PM2.5 and ozone-related mortality. These estimates of premature deaths correspond to 5-10% of global mortality due to PM2.5 and 16% of global mortality due to ozone. The percentage of air pollution-related deaths attributable to transport emissions has been estimated to be significantly higher in some regions than the global average. Studies have shown that ground transportation accounts for 5% of global mortality from PM2.5, but the figure is as high as 20% in Germany and 21% in the United States. Similarly, transport emissions have been shown to contribute 32% and 24% of total mortality from PM2.5 in North America and Europe, respectively, and 20%-26% of total ozone mortality in North America, South America, Europe, the former Soviet Union, and the Middle East.

The air quality in Armenia (air quality index), and especially the air quality in major cities such as Yerevan, is rated as satisfactory, which means that some pollutants may pose a danger to people who are particularly sensitive to the level of air pollution. This is due to the high level of traffic in the city during the day, the geographical location of some of its areas, and the relative dryness of the air. Interactive maps showing the air quality index in different areas show that the main air pollutants in Yerevan are PM2.5 and ozone,. The concentration of PM2.5 exceeds the maximum permissible concentrations (MPC) by 4.5-5 times during the day and amounts to 24.8-27.63 µg/m³. It is worth noting that the effect on mortality is associated with exposure to annual mean PM2.5 concentrations even below 15 µg/m³.

Taking into consideration that 7,700 new cases of cancer are registered in Armenia every year, we consider it important and necessary to focus the attention of the government of the Republic of Armenia on the quality of air in settlements and to implement policies towards recording and regulating the composition of air.

Source:

1. Mannucci P. M. et al. Effects on health of air pollution: a narrative review //Internal and emergency medicine. – 2015. – Т. 10. – С. 657-662.
2. Brunekreef B, Holgate ST (2002) Air pollution and health. Lancet 360:1233–1242.
3. Dockery DW, Pope CA 3rd, Xu X et al (1993) An association between air pollution and mortality in six US cities. N Engl J Med 329:1753–1759.
4. Hoek G, Brunekreef B, Fischer P, van Wijnen J (2001) The association between air pollution and heart failure, arrhythmia, embolism, thrombosis, and other cardiovascular causes of death in a time series study. Epidemiology 12:355–357.
5. Franchini M, Mannucci PM (2011) Thrombogenicity and cardio- vascular effects of ambient air pollution. Blood 118:2405–2412.
6. Franchini M, Guida A, Tufano A, Coppola A (2012) Air pollution, vascular disease and thrombosis: linking clinical data and pathogenic mechanisms. J Thromb Haemost 10:2438–2451.
7. Franchini M, Mannucci PM (2009) Particulate air pollution and cardiovascular risk: short-term and long-term effects. Semin Thromb Hemost 35:665–670.
8. Schwarze PE, Ovreik J, Lag M et al (2006) Particulate matter properties and health effects. Consistency of epidemiological and toxicological studies. Hum Exp Toxicol 25:559–579.
9. Franck U, Odeh S, Wiedensohler A, Wehner B, Herbarth O (2011) The effect of particle size on cardiovascular disorders— the smaller the worse. Sci Total Environ 409:4217–4221.
10. Brown JS, Zeman KL, Bennett WD (2002) Ultrafine particle deposition and clearance in the healthy and obstructed lung. Am J Respir Crit Care Med 166:1240–1247.
11. Franchini M, Mannucci PM (2011) Thrombogenicity and cardio- vascular effects of ambient air pollution. Blood 118:2405–2412.
12. Lanki T, Pekkanen J, Aalto P, Elosua R, Berglind N, D’Ippoliti D et al (2006) Associations of traffic related air pollutants with hospitalisation for first acute myocardial infarction: the HEAPSS study. Occup Environ Med 63:844–851.
13. Atkinson RW, Carey IM, Kent AJ, van Staa TP, Anderson HR, Cook DG (2013) Long-term exposure to outdoor air pollution and incidence of cardiovascular diseases. Epidemiology 24:44–53.
14. Hong YC, Lee JT, Kim H, Ha EH, Schwartz J, Christiani DC (2002) Effects of air pollutants on acute stroke mortality. Environ Health Perspect 110:187–191.
15. Kettunen J, Lanki T, Tittanen P, Aalto PP, Koskentalo T, Kul- mala M et al (2007) Association of fine and ultrafine particulate air pollution with stroke mortality in an area of low air pollution levels. Stroke 38:918–922.
16. Brunekreef B, Holgate ST (2002) Air pollution and health. Lancet 360:1233–1242
17. MacIntyre EA, Gehring U, Mo lter A, Fuertes E, Klu ̈mper C, Kra ̈mer U et al (2014) Air pollution and respiratory infections during early childhood: an analysis of 10 European birth cohorts within the ESCAPE Project. Environ Health Perspect 122:107–113.
18. Zanobetti A, Schwartz J, Dockery DW (2000) Airborne particles are a risk factor for hospital admissions for heart and lung dis- ease. Environ Health Perspect 108:1071–1077.
19. Dominici F, Peng RD, Bell ML, Pham L, McDermott A, Zeger SL et al (2006) Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases. JAMA 295:1127–1134.
20. Raaschou-Nielsen O, Andersen ZJ, Beelen R, Samoli E, Stafog- gia M, Weinmayr G et al (2013) Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European study of cohorts for air pollution effects (ESCAPE). Lancet Oncol 14:813–822.
21. Raaschou-Nielsen O, Andersen ZJ, Beelen R, Samoli E, Stafog- gia M, Weinmayr G et al (2013) Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European study of cohorts for air pollution effects (ESCAPE). Lancet Oncol 14:813–822.
22. Stieb DM, Chen L, Eshoul M, Judek S (2012) Ambient air pollution, birth weight and preterm birth: a systematic review and meta-analysis. Environ Res 117:100–111.
23. Guxens M, Garcia-Esteban R, Giorgis-Allemand L, Forns J, Badaloni C, Ballester F et al (2014) Air pollution during pregnancy and childhood cognitive and psychomotor development: six European birth cohorts. Epidemiology 25:636–647.
24. Stanaway J D et al 2018 Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the global burden of disease study 2017 Lancet.
25. Lelieveld J, Evans J S, Fnais M, Giannadaki D and Pozzer A 2015 The contribution of outdoor air pollution sources to premature mortality on a global scale Nature.
26. Silva R A, Adelman Z, Fry M M and West J J 2016 The impact of individual anthropogenic emissions sectors on the global burden of human mortality due to ambient air pollution Environ. Health Perspect.
27. Lelieveld J, Evans J S, Fnais M, Giannadaki D and Pozzer A 2015 The contribution of outdoor air pollution sources to premature mortality on a global scale Nature.
28. Silva R A, Adelman Z, Fry M M and West J J 2016 The impact of individual anthropogenic emissions sectors on the global burden of human mortality due to ambient air pollution Environ. Health Perspect.
29. https://www.iqair.com/ru/armenia/yerevan
30. Air Quality Index
31. Beelen R, Raaschou-Nielsen O, Stafoggia M et al (2014) Effects of long-term exposure to air pollution on natural-cause mortality: an analysis of 22 European cohorts within the multicentre ESCAPE project. Lancet 383:785–795.
32. https://armeniatoday.news/armenia-ru/579585/