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European Journal of Applied Sciences – Vol. 12, No. 4

Publication Date: August 25, 2024

DOI:10.14738/aivp.124.17324

González, A. A. (2024). Pollution, Climate Change, and their MPACT in Cardiovascular and Respiratory Diseases. European

Journal of Applied Sciences, Vol - 12(4). 364-385.

Services for Science and Education – United Kingdom

Pollution, Climate Change, and their MPACT in Cardiovascular

and Respiratory Diseases

Alcibey Alvarado González

Internal Medicine and Neumology. Clínica de Diagnóstico Médico.

San José, Costa Rica and Metropolitano Research Institute. San José, Costa Rica

ABSTRACT

The effects of climate change and pollution are widespread and rapidly

intensifying and are largely driven by greenhouse-gas (GHG) emissions from

burning fossil fuels. Global mean temperatures have already increased by 1.1°C

since 1900, and given the current policies and actions, a warming of 2.5°C to 2.9°C

or more by the end of this century is expected. Most of the change having occurred

in the past 50 years. The climate change is happening faster than expected and

that the window to act is quickly closing. The severe injuries induced by pollution

and climate change affect the morbidity and mortality of the planet and the

species that inhabit it. The human species has the tools and knowledge to reduce

this injury and safeguard the future of a habitable planet. One of the great

stumbling blocks to achieve this end are the political and economic interests of a

sector of the same species that has enough power and control to stop the healthy

tools that could solve a problem that is planetary. This document concisely

discusses climate change and pollution as etiologies of diseases, giving special

emphasis to cardiovascular and respiratory diseases, which constitute a

significant example of them but are obviously not the only ones.

Keywords: climate change, pollution, greenhouse emissions (GHG), cardiovascular

diseases, respiratory diseases.

INTRODUCTION

In 1974, Nobel Laureates Sherwood Rowland and Mario Molina predicted that the increasing

use of chlorofluorocarbons (CFCs) in foam insulation, refrigeration, and aerosols including

metered-dose inhalers for asthma and chronic obstructive pulmonary disease (COPD) would

exponentially increase stratospheric chlorine loading and catalytically destroy the

stratospheric ozone layer, our primary protection against ultraviolet (UV) light. More than a

decade later, the proof came along in the form of a large hole in the Antarctic ozone layer. The

atmosphere is a mixture of gases that surround any celestial body that has sufficient

gravitational force to prevent the gases from escaping from their environment. The earth's

atmosphere can be divided into several layers. The lower layer or troposphere is the layer

where the clouds that we see are and can reach up to the first 16 kilometers (Km) in tropical

countries. The ozone in this layer is an air pollutant generated by the combustion of fossil

fuels (see later). Then follows the stratosphere, which reaches up to 50 km, tends to maintain

a constant temperature like that of the Earth's surface and is what contains ozone that filters

ultraviolet (UV) light. This ozone is what is destroyed by chlorine, bromine, NO (nitrogen

oxide) and the superoxide radical. One chlorine radical can destroy up to 10,000 ozone

molecules. This ozone is what protects the planet and the species that inhabit it from UV light

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365

González, A. A. (2024). Pollution, Climate Change, and their MPACT in Cardiovascular and Respiratory Diseases. European Journal of Applied

Sciences, Vol - 12(4). 364-385.

URL: http://dx.doi.org/10.14738/aivp.124.17324

(O3 + hv = O+O2). These reactions prevent or avoid virtually all UV radiation of wavelength C

(240-290 nm) and much of UV B radiation (290-320 nm. 1 nm=1x10-9 m). The layer that

includes 50-80 km is the mesosphere and has a marked reduction in temperature, and then

follows the ionosphere that reaches up to 640 km. The outer sheet is the exosphere that

extends up to 9,600 km, the outer limit of the atmosphere. By 1987, Margaret Thatcher

(British Prime Minister) and Ronald Reagan (USA President) signing of the Montreal Protocol

(1). If the attempt to control the climate change began in this way. According to WHO data,

almost the entire global population (99%) is exposed to air pollution levels that are higher

than recommended levels (2). Pollution and climate change interact to injurie the species that

inhabit the planet and the planet itself, since both have the same origin, namely, basically

emissions from burning fossil fuels. Each year, an estimated 9 to 12 million people die

worldwide because of fossil-fuel–generated particulate air pollution and the total number of

deaths attributable to climate change is not even known (3). Air pollution and climate change

also cause and exacerbate myriad health conditions, including heat-related illnesses,

cardiovascular and respiratory disease, allergic conditions, vector-borne disease, pregnancy

complications, and mental health disorders, to name a few examples (see later) (4). In the past

20 years, there has been a 54% increase in heat-related mortality among persons older than

65 years of age, and more than one third of all global warm-season heat-related deaths are

attributable to climate change (5,6). The harms of climate change are happening here and

now, affecting health directly and indirectly, disrupting health care delivery, and creating and

exacerbating inequities. Thus, one goal of communication with patients and the public should

be to increase understanding of the connections between climate change and health, making

them more real and relevant to the audience (7). For example, a third of Americans are

functionally innumerate, lacking the basic math skills needed to make effective health

decisions based on the statistics they typically encounter (8). A further goal might be to

promote understanding of actions people can take to protect their health and address the root

causes of the problem.

THE PROBLEMS

It is unequivocal that humans are changing the planet, including the atmosphere, oceans, and

biosphere, and that these changes are affecting population health and well-being. The GHG

and pollution have three common elements, at least for this monograph. They have similar

origins and harm both the planet and the species that inhabit it.

The Greenhouse Effect

The combustion of fossil fuels (coal, petroleum [oil], and natural gas) is the major source of

both air pollution and the GHG driving climate change. The U.S. Environmental Protection

Agency (EPA) issued an official determination in 2009 that GHGs (including carbon dioxide,

methane, nitrous oxide, hydrofluorocarbons, perfluorocarbons, and sulfur hexafluoride) are

endangering public health and welfare (9). Unlike conventional air pollutants such as

particulate matter or sulfur dioxide, GHG emissions have effects that are not location specific.

According to the EPA, the two largest contributors are transportation (27%) and electricity

production (25%). Industrial sources contribute 24% of GHG emissions, commercial and

residential uses 13%, and land use and agriculture 11% (10). Human activities, particularly

burning of fossil fuels and deforestation, are increasing the concentrations of GHGs in the

atmosphere, which in turn are altering weather patterns worldwide (11). This effect is caused

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European Journal of Applied Sciences (EJAS) Vol. 12, Issue 4, August-2024

by the presence of gases in the atmosphere that allow sunlight to reach the planet but block

the output of infrared radiant energy when it is reflected from the Earth's surface into space.

In other words, the gases that cause this effect are permeable to visible light, which conducts

much of the energy in sunlight, but they are very efficient at absorbing the energy from the

earth to space (which has an infrared wavelength) and prevent them from escaping into

space. In normal concentrations, these gases should maintain a global average temperature on

earth around 150C (600F), but if there is an excess or increase of them, the planet overheats,

preventing these infrared waves from escaping into space, which is what is happening

dramatically right now.

Carbon dioxide (CO2) is the main GHG of concern; other contributors include methane (e.g.,

from livestock, rice cultivation, and biomass burning) and nitrous oxide from nitrogen

fertilizers. Methane reduces the atmospheric volume of hydroxyl ions, decreasing the

atmosphere's ability to "clean itself". Particles also play important roles in altering warming,

such as black carbon (increases warming) and sulfates (cooling effect). To get an idea of the

increasing magnitude of the problem, in 2019, atmospheric CO2 concentrations were higher

than at any time in at least 2 million years. Atmospheric CO2 was more than 419 ppm in

February 2022; preindustrial concentrations were about 280 ppm, and human activities

added about 2500 billion tons of CO2 (GtCO2) to the atmosphere since 1850 (12). The global

mean surface temperature is now about 1.1°C above preindustrial temperatures, with larger

increases over land (1.6°C) than oceans. Furthermore, because warmer air holds more water,

these temperature changes are affecting the hydrologic cycle. The number of heavy rain

events is increasing, resulting in more flooding in some regions. At the same time, droughts

are increasing because warmer air draws more moisture from the soil. Overall, average

precipitation over land likely increased since 1950 (11). Along with changes in the mean of

temperature and precipitation, extremes are increasing, with heat waves, flooding, and

drought becoming more frequent and intense. Compound extreme events also are increasing,

such as back-to-back heat waves, or heat waves and drought or wildfires; low soil moisture is

contributing to wildfire risk. A long list of adverse health effects have been firmly linked to

climate change, including asthma, respiratory and airway diseases, cancer (due to increased

exposure to and intensity of ultraviolet radiation), cardiovascular disease and stroke,

foodborne diseases, heat-related illness and death, interference with prenatal and early

childhood development (due to malnutrition caused by crop failures or exposure to toxic

contaminants linked to extreme weather events and increased pesticide use as the range of

pests expands with increases in temperatures), mental health and stress-related disorders,

neurologic diseases and disorders, and vector-borne, zoonotic, and waterborne diseases (13).

Pollution

Air Pollution:

Although exposure to air pollution has records that date back more than 20 centuries ago,

until the well-known episodes of a sudden increase in pollutants that occurred in the Meuse

Valley (Belgium, 1930), in Donora (Pennsylvania, USA, 1948), and above all in London (United

Kingdom, 1952), studies on the effects of exposure to air pollutants were restricted to work

environments and to exposure to toxic agents used in wars (14). It was only from the mid- 20th century onward that the subject began to be studied more and more, with the first

document on the effects of air pollution on health, prepared by the WHO and published in

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González, A. A. (2024). Pollution, Climate Change, and their MPACT in Cardiovascular and Respiratory Diseases. European Journal of Applied

Sciences, Vol - 12(4). 364-385.

URL: http://dx.doi.org/10.14738/aivp.124.17324

1958, recommending that pollutant levels be reduced for health protection (15).

Environmental and household air pollution jointly rank fifth among the five leading risk

factors for death worldwide (16).

Air pollution is a mix of hazardous substances from both human-made and natural sources.

Air pollution is a familiar environmental health hazard. Vehicle emissions, fuel oils and

natural gas to heat homes, by-products of manufacturing and power generation, particularly

coal-fueled power plants, and fumes from chemical production are the primary sources of

human-made air pollution. Nature releases hazardous substances into the air, such as smoke

from wildfires, which are often caused by people; ash and gases from volcanic eruptions; and

gases, like methane, which are emitted from decomposing organic matter in soils (17). Traffic- Related Air Pollution (TRAP), a mixture of gasses and particles, has most of the elements of

human-made air pollution: ground-level ozone, various forms of carbon, nitrogen oxides,

sulfur oxides, volatile organic compounds (VOC), polycyclic aromatic hydrocarbons (PAH),

and fine particulate matter. Ozone (O3) a trophospheric gas, is often called smog when at

ground level. It is created when pollutants (nitrogen oxides) emitted by cars, power plants,

industrial boilers, refineries, and other sources chemically, and VOC react in the presence of

sunlight (18). Noxious gases, which include carbon dioxide, carbon monoxide, nitrogen oxides

(NOx), and sulfur oxides (SOx), are components of motor vehicle emissions and byproducts of

industrial processes. Particulate matter (PM) is the most thoroughly studied component of air

pollution and is strongly linked to multiple health effects and mortality (19, 20). PM is a

mixture of solid particles and liquid droplets that are suspended in ambient air. PM is

categorized into coarse particles (aerodynamic-mass median diameter, <10 μm [PM10]), fine

particles (<2.5 μm [PM2.5]), and ultrafine particles (<0.1 μm [PM0.1]). Coarse particles

(PM<10) can include wind-blown dust, ash, pollen, and smoke. Fine particles (PM<2.5) are

most often a by-product of burning wood or fossil fuels. The tiniest are called ultrafine

particles (PM<0.1), which are also produced by combustion. PM<2.5 comes mainly from forest

fires. (PM) is composed of chemicals such as sulfates, nitrates, carbon, or mineral dusts.

Vehicle and industrial emissions from fossil fuel combustion, cigarette smoke, and burning

organic matter, such as wildfires, all contain PM. A subset of PM, fine particulate matter (PM

2.5) is 30 times thinner than a human hair. It can be inhaled deeply into lung tissue and

contribute to serious health problems (21).

VOC (benzene, toluene, xylene, 1,3-butadiene, and PAH) vaporize at or near room

temperature—hence, the designation volatile. They are called organic because they contain

carbon. VOCs are given off by paints, cleaning supplies, pesticides, some furnishings, and even

craft materials like glue. Gasoline and natural gas are major sources of VOCs, which are

released during combustion (22). PAH are organic compounds containing carbon and

hydrogen. Of more than 100 PAHs known to be widespread in the environment, 15 are listed

in the Report on Carcinogens. In addition to combustion, many industrial processes, such as

iron, steel, and rubber product manufacturing, as well as power generation, also produce

PAHs as a by-product. PAHs are also found in particulate matter.

Toxic Metal Pollutants:

Lead, mercury, arsenic, and cadmium have long been implicated in the causation of cancer,

neurobehavioral disorders, renal and cardiovascular disease (23). Lead is estimated to have