Air Pollution and Disease

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

With the debate on the contribution of man-made greenhouse gases and their contribution to global climate change and warming, the subject of air pollution has again garnered a wide concern. In the past, air pollution was a concern for the general population due to the proof of adverse health effects and disease, especially respiratory disease and skin cancer rise due to ozone depletion. In the United States, the Clean Air Act and amendments of 1970, 1977, and 1990 achieved much to protect the population from serious and growing health problems, but as research continues we see that these protections were inadequate. Overlooked in the debate over harmful effects of air pollution was the enormous impact on cardiovascular disease, the rise of COPD, and the effects of airborne heavy metal toxins on the nervous system as the incidence of neurodegenerative disease explodes. With world industrialization, increased energy needs, and increased use of motor vehicles, as well as the vast population migration to urban environments and rise of mega-cities, the health threat from air pollution obviously continues to rise for the population of the whole world, as air circulates globally. When such a problem as air pollution increases dramatically, more awareness and work must be done to counter it. Pretending that this is not a dramatic public health threat is absurd. More individual effort is needed as well to prevent and counter this enormous health threat, and standard medicine has no treatment to achieve this goal. Complementary and Integrative Medicine and the medical specialty of Traditional Chinese Medicine (CIM/TCM) provides each individual with an array of treatments to achieve individualized goals in this regard, insuring a better quality of life and prevention of future health problems. 

The subject of air pollution cannot be dumbed down and addressed in a simplistic manner. Not only vehicle exhaust and unchecked industrial pollution are a concern as the human population worldwide grows, as well as our increased use of technology and consumption of energy, with power plants contributing over 40 percent of our air pollution, but air quality inside the home and workplace is increasingly a threat, both from the rise in pathogenic types of mold, mildew and fungi, as well as the deterioration of newer types of building materials and chemicals used as insulation, lacquers, fireproofing, etc. As the concern grows, the complexity of the issue makes intelligent understanding more and more difficult, and the measures that the individual and their society need to institute more confusing. To solve a problem, the first step is understanding of the problem, and this problem is complex.

As research mounts into the adverse health effects of air pollution, we of course see more and more threat to health from airborne toxins, antigens and allergens. Not only respiratory disease and skin cancer, but cardiovascular disease, immunological disease, and neurological disease is now of great concern. This points to the fact that past assessment underestimated the health threat and that with increasing study we are realizing that many of our health problems relate to air pollution. For instance, in 2003, the Global Burden of Disease study estimated that fine particulate matter (PM) in the air in Europe causes about 100,000 deaths annually, with similar numbers for cause of COPD and hospital admissions for cardiovascular disease. More recent studies assessing adverse health effects in areas of China that were relatively free of serious air pollution in the near past, but now have levels comparable to more developed nations, show that the burden of disease and shortening of lifespan may be dramatic. These studies in China do not imply that the populations in polluted developed nations such as the United States and Europe are exempt from these negative health effects, though, as air pollution in industrialized countries has affected the population in these countries for decades and continues to worsen as the population rise, more energy is consumed and more cars are on the road daily. Air pollution presents both a global as well as a local concern, and this serious health problem must be tackled both on a global level and locally, using a comprehensive solution. Shifting the blame to developing nations will not solve our health problems and protect our children and their children. In 2015, CBS News reported that a number of studies showed that a fifth of the world's most polluting subcritical coal-fired power plants were in the United States, the richest country in the world, with one-fifth the population of China, an equal partner in this type of pollution. These oldest and dirtiest subcritical power plants emit 75 percent more carbon pollution than cleaner coal-fired power plants, and an agreement was reached with China to close these subcritical coal-fired power stations (SCPS) in both countries. The question now is not who to blame, but what is to be done to protect our children from a dramatically rising threat of air pollution. 

The countries with the largest contribution to air pollution in the world at present are the United States and China. While China has recently reached the level of the United States in overall contribution of greenhouse gases and the most harmful types of air pollution, with their fast-growing economy and technological development, the population of China is five times that of the United States, despite being about the same geographical size. This means that per person the United States still contributes five times the air pollution that China does. In addition, the direct levels of air pollution measured are still much lower from China than the United States, but have been adjusted technically to achieve the notice that China started exceeding the U.S. contribution in 2014 (an estimate of exceeding carbon emissions in 2006). Public health concerns, though, are not a sports competition, but a global concern. After the historic agreement between China and the U.S. to guarantee that carbon emissions in China would start to decrease despite technological growth by 2030, international experts suddenly stated that the estimates of pollutants and carbon emissions from the Chinese coal energy production had been greatly overestimated due to misinformation about the quality of the coal, setting the levels for the 2030 cap much lower than previously estimated. Such political tactics by environmental groups and organizations does not promote the healthy cooperation we need to solve this difficult health problem. All of this also succeeds in decreasing the emphasis on what needs to be done in the United States, the largest contributor to air pollution, to protect the health of the world. Finally, in 2015 we see that years of cooperative efforts by the Obama administration resulted in China and the United States leading the way for an achievement of the first global agreement to reduce carbon emissions and clear our air in Paris. Hopefully, such global cooperation will continue.

Citizens of the United States need to remain focused on what we can do, both as individuals, and as members of a free democracy, to solve this problem, not only for global health, but for the health of our own children. While air pollution is obviously a global concern, with air circulating around the planet, blaming China for our own problems does not solve all of these problems arising from air pollution in the United States. Since much of our air pollution is also localized, focusing on a country halfway around the world is not going to solve all of our health problems that are related to air pollution, and continuing to blame China for the world's air pollution is not only untrue, but arrogant when coming from the United States. The United States needs to take responsibility for our past, present, and future contributions to air pollution and the problems it causes, and realize that we can actually solve this problem and benefit both the economy and the health of the population if we just work together and take the numerous steps needed to understand and solve the problem. By setting a better example and creating green technology we will do more to help China from eventually producing as much air pollution per person that the United States does. By avoiding blame and antagonism, which certainly does not promote cooperative positive problem solving, Americans can solve the problems of air pollution and adverse health effects. Both the individual and the society can take effective steps in this process.

Hope is mounting. A March 17, 2015 article in the New York Times, Science Times, entitled The Optimist, outlines how the expectations of one of the leading proponents of change, Al Gore, have been greatly exceeded. Before the turn of the millennium, experts predicted that wind generated power could only reach 30 gigawatts due to the high price of production, and solar, likewise would only add a gigawatt a year, but by 2010 wind generated nearly 370 gigawatts, and by 2015 solar generated 48 gigawatts, with rapid expansion occurring in both as the cost with new technology was dropping to less than 6 cents per kilowatt hour. Industry reports stated that current trends show that solar power will provide 10 percent of the U.S. power generation by 2025. While the cost of energy production from abundant natural gas and coal will continue to be low for some time, with abundant natural reserves, the rapid solving of the problems of the cost of green technology, coupled with the enormous savings generated overall in slowing of climate change, better health for our civilization, and decreased costs of inevitable environmental cleanup are rapidly offsetting the cheap cost of fossil fuels. Soon, new technology will dramatically bring down the cost of biofuels, geothermal energy, and other green technologies, as well as fusion technology introduced by Lockheed Martin and the University of Washington (Dynomark), and these will be able to generate a much larger percentage of our energy needs than we could have imagined. In the meantime, we need to speed the implementation of clean coal and cleaner fracking technology. increased use of cleaner energy technologies and public demand are the key to bringing down the price of clean energy. As healthcare costs rise, paying a little more for clean energy to reduce healthcare costs is increasingly sensible.

Numerous studies have demonstrated that individuals with pre-existing cardiovascular and respiratory disease, as well as the old, young and economically disadvantaged, who may not have access to the healthy foods and lifestyle needed to combat the stress from air pollution, or who haven't developed a strong immune response, are much more affected by this problem. Persons in close proximity to heavy vehicular traffic, dirty power plants, smelters or other industrial polluters are more at risk, but studies show that overall ambient levels of air pollutants are also associated with disease. Individuals may counter this health threat by both increasing the health of the immune system, aiding detoxification, and increasing aerobic exercise to keep the respiratory and cardiovascular systems strong, as well as avoiding heavily polluted environments and working to decrease levels of these pollutants overall. Complementary and Integrative Medicine and Traditional Chinese Medicine (CIM/TCM) provides valuable tools to help achieve these goals, and is just part of the overall plan. By taking a comprehensive and holistic approach to the problem, adverse health effects may be minimized.

In May of 2015 the World Health Organization (WHO) reported that in urban areas of the world monitored for air pollution that now more than 80 percent of the population are exposed to air quality levels that exceed WHO limits, with low-income areas the most affected. While news in the United States almost completely focuses on cities in China, this definitely shows that the rising problem of air pollution is worldwide and is related to mass urbanization and industrialization. The study showed that 56 percent of cities in high-income countries with more than 100,000 inhabitants in the city also exceed the WHO limits. Such study clearly shows that over time, as air quality has worsened, the risk of stroke, heart disease, lung cancer, chronic and acute lung diseases, and other common and threatening health problems has dramatically increased in proportion to the air pollution. This study also noted some dramatic improvements in air quality in high-income countries, but that globally the levels of air pollution increased about 8 percent from 2008 to 2013. Clearly, much more work is needed, and pretending that the problem of environmental health was solved in the past and present efforts are just hurting businesses and are unnecessary is absurd. Pretending that the problem is just a Chinese problem, as most of the environmental groups in the United States continue to emphasize, is also absurd. One of the most polluted cities in the world has been Mexico City, just South of the U.S. border, which did much to clean their air in the 1990s, but in 2016 still had only 20 days below accepted limits of fine particulate matter and smog in the first half of the year. Like many mega-cities worldwide, Mexico City now limits who can drive on the dirtiest days, but this is not really solving the problem. Urban planning has accommodated developers and not public health, and most workers must commute a long distance, with the average rush hour traffic speed between 3 and 7 miles per hour, and an estimate of 5 million cars in the metropolitan area. This situation is untenable and a health hazard of enormous consequence, and economies must create new urban environments and more localized jobs that pay a living wage, not more mega-cities of poor workers tied to serve the rich 2 percent. Such greed will lead to ill health for everyone, and ever rising costs.

To effectively reduce air pollution and health risks we need to take a more holistic approach and further a more nuanced understanding of this complex problem. Motor vehicles contribute an estimated third of all nitrogen oxides and carbon monoxides to our air, and over a fifth of the air pollution that accelerates climate change and global warming. Recently, an emphasis on particulate matter (PM) has occurred in the press, and from our government, with an emphasis of the growing problems of PM in supersized cities in China, but the real problem with vehicle exhaust and dangerous air pollution still centers on nitrogen oxides, sulfur dioxides, and hydrocarbons, which are both primary sources of much PM, but also keys to the formation of ground level ozone, smog, and the main known causes of disease from air pollution. Particulate matter consists of very small particles of heavy metal toxins, such as lead and mercury, as well as soot, which can deposit in lung tissues, and enter the circulation. The main sources of particulate matter are diesel exhausts and smokestack emissions from power plants. The very fine PM, less than 100 nm in diameter, makes up a very small percentage of the total PM, but contributes to over 90 percent of the numbers of particles. This very fine PM also contributes the most to the overall health threat, with gas to particle conversions, recondensed metal vapors, most of the acidity, and the greatest mutagenic activity. Particulate matter is a combination of inorganic and organic molecules, and the larger particles can be seen as smoke and smog, but the unseen fine particles are what we need to worry about. Motor vehicles not only contribute to PM via their exhaust, but actually make many of these particles airborne by the movement of these vehicles. The smallest of the particulate matter is largely formed from gases, though, and these come mainly from high temperature vaporization and chemical reactions. Four classes of fine PM that are most important are 1) heavy metal toxins formed from combustion vaporization, 2) elemental carbon formed from combustion, 3) organic carbon and sulfates, and 4) nitrates.

Combustion of fossil fuels such as coal, oil and gas produce much of the airborne heavy metal toxins, carbon emissions, organic carbon and sulfates, and nitric oxides, and atmospheric reactions of sulphur (or sulfur) oxides and nitrogen oxides released as gases from these fuels form a large percentage of the secondary particles making up fine PM (particulate matter). The health risks from PM involve complex considerations related not only to the size and makeup of the particles, but to the chemical reactions that occur from reactive combinations of various types of air pollution and result from the concentrations of these pollutants and particles. While more recent studies have emphasized the adverse health effects of fine particulate matter (FPM), the cohort studies included in reports from the Health Effects Institute (HEI) reanalysis of the Harvard Six Cities Study showed that emphasis on PM might have over-adjusted the estimated adverse health effects of fine PM and sulphates while ignoring the important role of sulphur dioxides (SO2) in these estimates.

Sulphur dioxide, or sulfur dioxide, is a naturally occurring chemical compound that is toxic in a gaseous state, and was widely known in the 1970s as the main component of "acid rain", with widespread adverse effects on the environment as well as human health and industrial infrastructure. These adverse effects led to a worldwide effort to curb gaseous sulfur dioxide and resulted in approximately a third of sulphur dioxide emissions being eliminated by desulfurization of coal-fired smokestack emissions, treatment of coal prior to combustion, and eventually an array of fuel additives and other measures that achieved a 65 percent reduction in acid rain. The costs of this reduction in sulphur dioxide has been much less than originally anticipated, and the savings in healthcare costs, environmental problems, and deterioration in industrial infrastructure have been significant. Nevertheless, with the rise of industrialization worldwide, the planetary levels of sulfur dioxide are increasing, not decreasing, demanding even more effort to reduce this toxic air pollution. A number of new technologies in clean coal power technology further reduce the sulfur dioxide, such as fluidized bed combustion, and smokestack emission treatments. We desperately need to implement these technologies now. Employment related to the coal industry will increase dramatically with the adoption of clean coal technology, and ultimately, the only people who benefit from the persistent delay in implementing clean coal technology are the owners and investors in dirty coal power production. This greed is injuring and killing hundreds of thousands of our children, aging population, and those with respiratory and cardiovascular diseases.

We cannot assume that clean air legislation in the far past has taken care of our problems. Sulfur dioxide is increasing in our air as the world becomes more industrialized, and is both directly responsible for respiratory disease and exacerbations, premature death, and premature birth. In 2008, the American Conference of Governmental Industrial Hygienists further reduced the relatively safe exposure limit to 5 ppm (parts per million), and in 2010, the U.S. Environmental Protection Agency (EPA) revised the safe standard of sulfur dioxide as 75 ppb (parts per billion) measured over one hour, from 500 ppb over 3 hours. While the reduction of acid rain in the past decades has led the public to believe that this type of air pollution was taken care of, this is obviously not the case. The harm to health of sulfur dioxide was underestimated, and a new effort to clean our air needs to be accomplished. Fuel combustion still accounts for nearly 85 percent of sulfur dioxide emissions, according to the U.S. EPA, and density in the air around urban centers is, of course, dramatically higher than in rural areas. At present, the main health threat from sulfur dioxide is no longer acid rain, but fine particulate matter (FPM), and poses the largest health risks to children, and individuals afflicted with asthma and COPD. Nitrogen oxides are also a prevalent pollutant from fuel combustion, and assist in the formation of fine particulate matter and ground level ozone, as well as causing direct lung irritation and weakening immune defenses.

To resolve these air pollutants, a concerted effort to clean multiple pollutants must be initiated. For the individual, purchasing a cleaner vehicle, such as an electric car, could help considerably, but not if the source of the electricity is very polluting. An effort must also be made to continue support for clean coal technology, as as well as safe natural gas extraction, and continued increases in solar, wind and hydropower technology, which can not realistically supply all of our electricity, but should eventually supply about a third of it. If the public increases the purchase of electric vehicles, but the electrical generation creates much pollution, the effort is wasted, though. A more thorough holistic approach is needed. The installation of solar panels and utilization of this source of local electrical generation is ideal, providing cheaper energy for the electric car generated locally. Purchase of more fuel efficient vehicles also helps dramatically, and saves money. Contacting your Congressman or Senator to support clean coal technology and increased rise in solar, wind and hydropower electrical generation is also effective. In 2014, many of the dirtiest coal-fired power plants have closed in the United States, with conversion to gas-powered electrical plants and building of clean coal technology driven by economic incentive.

In China, an agreement was reached in 2015 to phase out the dirtiest coal-fired power plants and replace them with clean coal technology, and China is a leader in rapid development of cheaper technology in wind, solar and hydropower, as well as the battery storage technology needed to make this work in an electrical grid. President Xi JinPing of China signed an agreement with President Barack Obama to cap the rise in carbon emissions in China by 2020, implementing a cap-and-trade system, and leading the historic Paris agreement with a comprehensive and legally binding system to slow human contribution of accelerated global warming, and more importantly, to achieve less polluted air. In the U.S. the Clean Power Act was finalized in August of 2015, committed to a pragmatic plan to reduce CO2 emissions 32 percent below the 2005 levels by 2030, and in 2016 a plan to implement federal carbon emissions standards for power plants in states that do not commit to the Clean Power Act was put in place, resulting in a large shift by even the most coal-dominant companies to restructure. China committed to reducing its carbon emissions by 65 percent of its 2005 level by 2030, and the growth in new coal-fired power plant production changed to a decrease already in 2016. In addition, President Obama announced a two year plan to create a public-private partnership to dramatically reduce diesel emissions from trucks, and fuel costs, and strengthened measures to phase out hydrofluorocarbons (HFCs) through the Significant New Alternatives Policy (SNAP), with commitments from other countries, such as Germany, as well. By effectively partnering the public and private interests we may be able to achieve our goals of clean air and a healthier environment while also reducing costs and creating better profits overall in the long run. A number of companies have partnered with the Energy Department and are rapidly developing nuclear fusion technology that may soon contribute to pollution-free safe energy as well. An unrealistic demand to quickly replace fossil fuels is very unrealistic, but a number of steps combined are making a difference, but need strong support from the public and consumer. Each year under the Obama administration we have made great strides in solving this devastating health problem, and this good work needs to be continued and accelerated. So far, the predicted economic burden has not materialized, and some conservative states have led the way in clean energy, such as Iowa.

How air pollutants damage the health

Individuals concerned about health problems related to air pollution obviously need to consider this problem from an holistic perspective, not only working on specific related health problems, but preventive medicine, public health, and personal decisions on consumption and political perspectives that could slow or reverse this massive public health threat. Personal health problems related to air pollution are now know to be varied, and objectively addressing these health problems involves integrating an array of therapeutic tools and knowledge in a proactive manner. Waiting until the problems become severe and then resorting to harsh allopathic therapies is not a good plan. Clearly identifying goals and health concerns and utilizing Complementary and Integrative Medicine and Traditional Chinese Medicine (CIM/TCM) to address individual concerns and needs is a sensible, healthy and proactive approach. CIM/TCM provides many proven aids to respiratory, cardiovascular and neurological health, and a large array of treatment protocols that can be combined in a single therapeutic session to correct specific health problems and help the body detoxify. Short courses of frequent acupuncture with a step-by-step approach involving professional herbal and nutrient medicine is inexpensive, easy to accommodate into the schedule, and assures the greatest success, especially as a preventive medicine. One can go to the articles on this website and better understand the pathologies and review the research to achieve this practive approach to health. Once one understands the specific harmful air pollutants causing disease, one can better formulate specific ways to protect oneself from harm, or treat the specific related health problems.

The air pollutants of most concern in chronic disease and ill health are sulfur dioxide (SO2), fine particulate matter (FPM), nitrogen oxides (NO), carbon monoxide (CO), organic airborne lead, ozone (O3), and polycyclic aromatic hydrocarbons. Sulfur dioxide is a colorless pungent gas that enters the air mainly from burning of coal and oil, or from copper smelting. Chronic low level exposure to sulfur dioxide has been shown to impair lung function, aggravate symptoms in asthma, and contribute to airway inflammation. There is also evidence of fetal impairment, potential to decrease sperm motility, and increased risk for children to later develop airway diseases such as asthma and COPD. Sulfur dioxide in the body is changed into other pathogenic sulfur chemicals, which may interfere with the glutathione detoxification metabolism and promote low-grade fungal infections. Fine particulate matter (PM) is a leading environmental threat to human health, composed of a wide variety of chemicals, from many different sources, but mainly coal-fired power plants, motor vehicles, and industrial processes. PM is classified according to size, with particles less the 2.5 micrometers in width presenting the most serious threat, able to accumulate in airway tissues and enter the blood stream. Fine particulate matter is associated with cardiovascular and respiratory diseases, and low level chronic exposure may be a significant factor creating coronary heart disease and atherosclerosis. In addition, there is evidence that fine particulate matter may contribute to adverse birth outcomes, such as low birth weight, impaired lung development in children, lung cancer, and early death. The United Stated Environmental Protection Agency stated in 2016 that sulfur dioxide (SO2) takes many forms in the atmosphere, as acid rain and snow, fog and smog, as well as dry forms such as acid gas and dust (PM), and states that these toxic pollutants react with many other harmful chemicals to cause health problems as they fall to the earth, into waters and soil where crops are grown. Power plants that burn dirty coal and heavy oil refining account for 2/3 of all sulfur dioxide in the United States.

Many of the dangerous air pollutants affect human health because of a combination of pollutants that create a layer of smog or ozone that would not be harmful if they existed in the upper atmosphere, but a variety of factors work together to hold these chemicals in a ground level layer in the atmosphere. For instance, ozone, or trioxygen, in the upper atmosphere both protects us from harmful sun radiation, especially the types of ultraviolet radiation, such as UVA, that cause skin cancer, and UVB, which causes sunburn, as well as providing that lovely blue color to our sky. In the lower atmosphere, though, ozone, or trioxygen, is toxic. Ozone breaks down in the lower atmosphere to dioxygen, making it a potent oxidant, which is why it is widely used in industrial applications, but in the human organism this excess creation of oxidant free radicals in the lungs and bronchioles, and in deeper tissues and blood, contributes to many types of disease. In the upper atmosphere, ozone, or trioxygen, is formed from dioxygen (O2) by the action of ultraviolet light combined with upper atmosphere electrical discharges. The concentration of ozone in the upper atmosphere is usually 2 to 8 ppm. Ozone has been considered healthy as well as toxic, and the name ozone was created to signify that the air after lightning storms appeared to smell better and provide abundant oxygen. While oxidation can be a healthy process, excess creation of oxygen free radicals, or oxidants, greater than the ability of the individual body to clear them, is a major cause of disease. Therefore, the adverse health effects of lower atmosphere ozone is dependent on the health of the individual, and of course the level of antioxidants created and supplied by the diet. Of course, like all of these common air pollutants, the health risks are greater in individuals with respiratory and cardiovascular diseases, the aging, and the young.

Ozone, or trioxygen, is not a byproduct of fuel combustion or industrial processes, but is formed by the reaction of sun radiation on nitrogen oxides and polycyclic aromatic hydrocarbons. Thus, when considering the statistics of harm, we cannot isolate ozone from these other chemicals that cause higher levels of ground level ozone, or create a smog layer that traps greater concentrations of ozone where it does damage, not to healthy people, but to the unhealthy, aging and infants. Ozone also reacts directly with one of the most ubiquitous human toxins, aldehydes, which are hydrocarbons that literally are used to measure cellular toxicity in the human body. Acetaldehyde (CH3CHO), or ethenal, is a natural hydrocarbon byproduct of fermentation and yeast metabolism, and is considered the main cause of hangovers, as well as chronic fatigue symptoms in candidiasis and other low-grade fungal infections. The liver is able to detoxify alcohol into acetaldehyde, and then further detoxify it to harmless acetic acid. If there is excess stress on the liver, or liver disease that impairs function, this detoxification is hindered. In the brain, the same group of enzymes that detoxify in the liver may create excess acetaldehyde when one consumes alcoholic beverages. If the brain cells are already stressed with acetaldehyde toxicity, as happens with patients with chronic or recurrent low-grade fungal infections, consumption of alcohol produces a noticeable worsening of symptoms of fatigue and unclear mental state. Excess acetaldehyde is also shown to be an irritant to mucous membranes, the respiratory membranes, the eyes, and contributes to cancers of the gastrointestinal tract and liver. In the human cell, these acetaldehydes form a pathological malondialdehyde, which is now a biomarker for the level of oxidative stress in the body when measured in blood plasma. Various herbal and nutrient chemicals are shown to increase clearance of malondialdehyde (CH2(CHO)2), including beta carotene, methylselenocysteine, N-acetyl cysteine, R-lipoic acid, L-carnosine, and a wide variety of Chinese herbs and formulas, and addition of Vitamins B1 (thiamin and benfotiamine) and C may enhance these effects. To read more of this therapeutic protocol go the article on this website entitled Detoxification. The U.S. EPA states that half of all nitric oxide in the U.S. air comes from cars, buses, trucks and other forms of transportation, with about 40 percent from dirty power plant emissions.

Fluorocarbons, or perfluorocarbons, some of which are airborne, and called F-gases, contain fluorine and carbon, and while not the most disease-causing of pollutants, contribute heavily to climate change and affect the atmosphere in ways that may be enhancing the ill effects of the most damaging air pollutants. Hydrofluorocarbons (HFCs) are the most common type or organofluorine compounds, containing hydrogen, carbon and fluorine, and widely used in refrigerants as replacement for the older chlorofluorocarbons and hydrochlorofluorocarbons, such as R-12 and R-21. Fluorocarbons do not break down easily and accumulate and persist in the environment, leading to indirect adverse effects on the health, and while the negative health effects are downplayed, there is much concern for the future. HFCs have atmospheric lifetimes of tens to hundreds of years. Depletion of the stratospheric ozone layer will effect the health of the skin and eyes, and certain types of HFCs break down into harmful compounds, such as trifluoroacetic acid, a known carcinogen, especially linked to liver disease and cancer. Toxicity is a term linked to the level, or concentration, of a substance, and while some air pollutants present little threat at present levels, a future where persistent pollutants accumulate will lead to future toxicity and adverse health effects. The Swedish Environmental Protection Agency already confirms that HFCs likely cause adverse health in the heart and brain, and as the toxic accumulative level rises, we are sure to see evidence of more measurable adverse health effects if we do not eliminate production of hydrofluorocarbons. Further research has shown that fluorocarbons may damage fetal and hormonal health, and contribute to subfertility. 

More and more studies are elucidating the strong link between air pollution and neurodegenerative diseases such as Alzheimer's disease. We now know that the accumulation of beta-amyloid plaque that is the hallmark of the disease is not the cause, but a protective measure against brain toxins. The focus of research in standard medicine to treat the explosion of the incidence of Alzheimer's disease, a very slowly progressing disease that is not diagnosed until it reaches severity, has been to biochemically attack or inhibit this amyloid beta protein complex. We see now that this will not directly address the underlying causes of the disease, and by itself, could be causing harm by reducing innate protection against brain toxins. Study in the last decades has clearly shown the direct pathophysiology between air pollution and Alzheimer's development, starting early in life. Air pollution breaks down mucosal barriers and leads to chronic inflammatory stress that erodes neurovascular protections, allowing fine particulate matter and dioxides to leak into the brain tissues and stimulate unhealthy responses in both vascular membranes and the glial tissues and neurons. These studies are available in Additional Information, and obviously, a more holistic approach to treatment and prevention is needed.

Not only general air pollution, but air pollution in the home, school and workplace, is becoming an area of concern. This poorly studied, and largely ignored, health threat is not being again studied and these studies show that with modern building design, the lack of ventilated air and accumulation of a wide variety of pollutants, antigens and allergens work together to harm the most vulnerable populations, such as infants and individuals with chronic health problems. For instance, a 2015 multicenter study at Rutgers School of Public Health, the University of Alberta, and the National Institute of Cancerology in Mexico City, found that fine particulate matter in the air alters the anti-mycobacterial immune responses in airway membranes, which leads to a higher risk for diseases such as tuberculosis (PMID: 25847963). Studies cited below in Additional Information show that concentrations of fine particulate matter and toxic aromatic hydrocarbons are often higher in the home that outside, mainly due to lack of ventilation in modern home design. This is creating a growing burden on the ability of the innate immune system to prevent disease. Both the attention to fresh air circulation, and improved diet, and exercise, as well as increased use of Complementary and Integrative Medicine (CIM/TCM) and preventive medicine, is needed to counter this growing threat that explains the dramatic rise in respiratory and other diseases. The famed Florence Nightingale was a pioneer in health statistics and disease prevention in the nineteenth century, emphasizing this holistic approach in medicine, but has been largely ignored in modern medicine. Her research showed that the circulation of fresh air in hospital wards improved outcomes dramatically, noting the wide array of pathogens, antigens and toxins the may accumulate in the indoor air. This research was performed in nineteenth century and we are still ignoring it.

There is no doubt that the health burden of air pollution is enormous, and both the outdoor air and indoor air must be improved, and appropriate holistic treatment protocols adopted to prevent disease from this cause. Thus, when considering the ill effects of ozone, one must consider the levels of nitrogen oxides and polycyclic aromatic hydrocarbons in the air we breathe, as well as the level of aldehyde toxicity. As stated, these harmful chemicals may not affect healthy individuals, but to protect our friends and family with asthma, COPD, cardiovascular disease, chronic fatigue, etc. as well as our aging and infant friends and family, we should work to both prevent toxic levels of these air pollutants, as well as help these individuals understand their problem and utilize Complementary and Integrative Medicine (CIM/TCM) to help clear aldehyde toxicity, utilize antioxidants intelligently, improve the immune function, and make the respiratory and cardiovascular systems healthier. While we may cynically state that there is no proof that acupuncture will get rid of ozone, there are many ways that Complementary Medicine may provide effective treatment and prevention protocols with the adverse effects of air pollution.

New and viable technology to clean air pollution

Clean coal combustion technology has been implemented on a large scale in China. While the first large experimental clean coal power plant in the U.S. was stopped in construction in 2007 by the Bush Administration, the government in China was implementing rules that a clean coal power plant must be built for every new standard coal-fired power plant in the near future, and the companies formed in the U.S.A. that were stymied have moved to China to fulfill this task. Powerspan Management Company, of New Hampshire, is one of several firms that had to give up in the U.S. in order to build the technology that they created. China is welcoming such engineering, as its population, which is 5 times that of the U.S. is set to burn more coal in the future than most of the industrial powers combined, and the air pollution and climate change is considered intolerable, both to the the people and the government. Their goal is to achieve at least 20 percent of their power in the near future from non-fossil fuel production, such as hydropower, massive wind and solar farms, and other new technologies. Like the United States, coal is abundant and cheap, though, and will be used for energy. The rush to develop affordable technology, and install it, is strong. At least 9 Mitsubishi advanced scrubbers have been installed in coal-fired power plants by 2012, and an enormous GreenGen plant in Tianjin, outside of Beijing, is expected to come on line in 2013, with the most advanced clean coal technology on the planet. The integrated gasification combined-cycle (IGCC) power plant was developed completely in China, and will produce 250 megawatts of electricity. Carbon trading is also being implemented in China to make the business of carbon dioxide sequestration economically attractive. This means that China is far ahead of the United States and Europe.

At present, a number of technologies are being implemented in new clean coal power plants, including washing the coal to remove sulfur and ash, filtering the flue gases to remove 99 percent of the flue ash, novel desulfurization technologies for flue gas that may clean up to 97 percent of sulfur dioxide, depending on the level of sulfur in the coal, and Low-NOx burners coupled with reburning techniques can clean up to 70 percent of the nitric oxide. Newer plants utilize increased combustion efficiency, Integrated Gasification Combined Cycles and Pressurized Fluidised Bed Combustion to increase efficiency of burning by 50 percent. Coal gasification uses steam and oxygen to turn the coal into gaseous carbon monoxide and hydrogen to burn more cleanly, and carbon dioxide may be sequestered, or captured, to be placed in deep geological strata, or even used in industrial carbonization (e.g. carbonated drinks). Capturing and sequestering of carbon dioxide can be used without producing ultra-clean CO2. Already in the United States, Chevron and other companies have been sequestering huge amounts of carbon dioxide in sandstone formations 1800 meters deep, without problems. The carbon dioxide can be utilized for enhanced oil recovery as well, as well as displacing gas and methane extracted from the deep strata, and with the 2015 drop in world oil prices the industry utilized liquified CO2 in fracking to lower the cost of extraction and improve environmental safety. The U.S. Department of Energy (DOE), in 2010, announced that it was retrofitting a unit of an Ameren coal-fired plant in Meredosia, Illinois, with FutureGen 2.0 Oxy-combustion that could capture over 90 percent of CO2 and pipe it to a collective sequestration site. This first clean-coal plant is expected to be completed in 2015. About 6 other projects across the U.S. will also receive DOE funding to build clean coal power plants that can successfully capture CO2. As carbon credits are adopted into law these technologies are coming on line very quickly in the U.S.

Whether the initial costs will be readily accepted by the public, with coal-fired electrical generation still the cheapest today, is the question. Initial rises in the cost of electricity would decrease with advances in the technology, and the benefits of fewer health risks, healthcare costs, and less climate change may certainly offset these rises in energy costs, especially if the improved energy efficiency that we are achieving at present continues, with energy efficient appliances, heating, and improved home and business insulation. At present, the technologies utilizing coal gasification, high efficiency combustion with oxygen, and other inexpensive new technologies, will be able to achieve very low to zero emissions. The initial projection of increased cost is about 10 percent. What is lacking is public demand. Both the extreme right and the extreme left oppose clean coal implementation, and the middle American voice is not strong. The extreme right is financed by wealthy companies that make a huge profit from dirty coal at present, while the extreme left clings to a notion that we should just get rid of coal. Both of these attitudes are unrealistic and will not further the healthy goals of the majority of Americans. The arguments against clean coal technology are so weak as to be laughable in 2014. The left states that coal will never be 100 percent clean and so we must get rid of any support for clean coal technology, and the right states that EPA rules and regulation of carbon emissions will drive the entire coal industry out of business. Those who accept these weak arguments are just fools and fail to see that both are driven by special interests and monetary concerns by the individuals, organizations and businesses concerned.

Novel technologies developed in China to clean harmful air pollutants include membrane bioreactors, using microbial colonies in hollow-fiber membrane bioreactors to remove nitric oxide safely and efficiently. Studies in 2013 (cited below) at Dalian University of Technology, in Dalian, China, and the Harbin Institute of Technology, in Harbin, China, found that denitrifying bacteria could be very efficient, with a removal efficiency of 86 percent, and sulfur dioxide having little or no effect on efficiency. In 2013, researchers at Ohio State University, led by Professor Liang-Shih Fan, announced that a scaled down power plant using coal-direct chemical looping, where coal is chemically combusted in a sealed chamber, instead of burned at high heat, and the resultant gases then also combusted in a separate chamber, was able to efficiently produce electricity without producing carbon dioxide and the dangerous chemicals in air pollution. The success of this unique technology spurred the building of a larger pilot plant under the direction of the U.S. Department of Energy, National Carbon Capture Center, producing 250 megawatts, set to start producing electricity in 2014. This technology could produce clean electricity at low cost, reduced contribution to global warming dramatically, and contribute greatly to U.S. energy independence. Professor Fan was acknowledged with the 2012 Innovator of the Year award for his work. Combining these new technologies could produce much better results and less expense. The combination of scientific ingenuity, increased efficiency in all aspects of energy use, public demand, and continued government support will result in both clean air and controlled costs, and a drastic decrease in the burdens of ill health, both on quality of life and overall costs to business and our government. The individual must also understand that as the population gets healthier, the individual cost of health insurance will fall, and with health insurance now as costly as the home utility bill, this offset is important. While there will be problems and hurdles, the replacing of dirty coal-fired power plants with new clean coal technology will be a net benefit for the economy, the environment and the public health.

Microbial technology to clean polluted waters is also being developed. In 2014, researchers at the University of California Los Angeles, U.S.A. announced that specific types of fungus have been found that can dramatically break down fluorocarbons safely. The lead author, Dr. Shaily Mahendra, was quoted: "Our research on the use of microbes for detoxifying chemical pollutants will have broad applications in protecting drinking water resources by developing technologies for the monitoring and remediation of hazardous substances in the environment." Hopefully, more of this research will provide ways that we may utilize nature to help with the problems created by industrialization.

Information Resources / Additional Information and Links to Scientific Studies

  1. The United States Environmental Protection Agency (EPA) lists the main types of air pollution and their sources: http://www.epa.gov/air/emissions/multi.htm
  2. A World Health Organization report on the growing health threat of air pollution in 2008 emphasized PM (fine particulate matter, or smog), O3 (ozone), SO2 (sulfur dioxide), and NO2 (nitric oxide), with the rise of mega-cities leading to alarming health threats. The levels of NO2 exceeded the safe WHO levels in New York, Los Angeles, Beijing, Shanghai, Tokyo, Osaka, Sao Paolo and Mexico City in 2008. The levels of SO2 were still lower than threatening levels in mega-cities in India and Indonesia because the government had insisted on low sulfur content in gasoline and diesel fuel, and progress was being made on motor vehicle fuel sulfur levels in China, the United States and Europe. While fine particulate matter (FPM, or PM10/PM2.5) was emphasized, some studies in large cities did not note a rise in overall mortality with the rise in PM10, while all studies showed a strong correlation between overall population mortality and the rise of SO2 and NO2, types of air pollution that are not visible, like smog: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2698272/
  3. The history of the Clean Air Act and its amendments by the United States Environmental Protection Agency (EPA) shows how we have done much, but not enough, and as the environment and industry changes, new protections must be sensibly applied. The period from 1990 to 2008 brought us much research into negative health consequences of air pollution, but little further progress in protecting the most vulnerable in our society: http://www.epa.gov/air/caa/amendments.html
  4. A 2016 World Health Organization report on air pollution shows clearly that the problem is worsening despite stronger efforts to reverse this health threat, with now wide measurement of air quality in urban areas around that world revealing that over 80 percent of the urban population in the world are exposed to air toxins that exceed the WHO limits, with low-income countries now exposing their urban populations to almost universal threats, with 98 percent of these cities of over 100,000 exceeding safe standards. Clearly, the world has to quickly further technology to reverse world air pollution, and to pay close attention to preventive medicine and reduce to the health risks from air pollution: http://www.who.int/mediacentre/news/releases/2016/air-pollution-rising/en/
  5. The U.S. China Joint Presidential Statement on Climate Change in 2015 legally bound the countries to their historic 2014 agreement, leading the way to a strong Paris agreement on climate change, the first comprehensive legally binding international agreement. The U.S. committed to reducing its carbon emissions to 32 percent below 2005 levels by 2030, while President Xi JinPing of China committed to a cap by 2020, and reaching a reduction to 65 percent below its 2005 levels by 2030, already showing a significant decline in growth of coal energy production in 2016, as the country shifts from an export manufacturing growth plan to its inevitable consumer economy. While U.S. environmentalists continue to deride China and show arrogant ethnic and sociopolitical bias, the clearly outlined goals in China for decades to reach reasonable levels of prosperity for its people, to reject military intrusion in other countries, and to promote international standards of global equality should be applauded rather than derided. This agreement, outlined here, shows the thoughtful and comprehensive actions that are achievable: https://www.whitehouse.gov/the-press-office/2015/09/25/us-china-joint-presidential-statement-climate-change
  6. An historic agreement on air pollution and its effects on climate change and global warming was reached in 2015 in Paris, led by the two largest contributors to air pollution, the United States and China, who had come to historic agreements prior to this global meeting and signed agreements to dramatically reduce overall carbon emissions. This reduction in 'greenhouse gases' of course also reduces air pollution dramatically, saving a fortune in healthcare costs and suffering from disease. Here we have a summary and analysis of this complex agreement published by magazine The Atlantic. We see that the people of the Earth still need to take action to make sure that these agreements achieve results. Opposition to global agreements to try to curb devastating consequences of global warming and the accompanying air pollution will result in unbelievable levels of harm and disease: http://www.theatlantic.com/science/archive/2015/12/a-readers-guide-to-the-paris-agreement/420345/
  7. A 2012 article in Slate interviewed U.S. engineers who are creating the complex array of clean coal technologies which are becoming economically competitive, but failure to adopt simple measures such as a carbon tax are preventing investment in the United States, and these engineers now believe that China will be the country where these new technologies are first installed and developed. Carbon capture, the most dramatic aspect of clean coal technology, is being installed in Canada, Norway, China, and the first large power plants with carbon sequestration have opened in Canada, and delayed, but expected to open in the U.S. in Mississippi, by late 2016. Initial government subsidy is needed to fully develop this clean coal technology, but will lead to relatively inexpensive and competitive plants in the near future, saving many billions of dollars in healthcare and environmental costs: http://www.slate.com/articles/...http://www.slate.com/articles/health_and_science/coal/2012/11/clean_coal_technology_china_is_the_new_testing_ground_for_coal_fired_power.html
  8. A 2016 article in the Smithsonian describes the breakthrough technology developed in Iceland that converts carbon waste captured and sequestered in the Earth to hardened carbon minerals and rocks within 2 years. This would eliminate the dangers of large deposits of liquified carbon dioxide, and create layers of basalt rock that are stable. Initially costs are high, as well as water use, but with development this CarbFix technology could be cost effective on a large scale and use seawater, leading to future safety and a stable layer of rock, perhaps aiding the areas where fracking (fracturing rock to extract oil and gas) has created instability: http://www.smithsonianmag.com/...http://www.smithsonianmag.com/science-nature/iceland-carbon-capture-project-quickly-converts-carbon-dioxide-stone-180959365/?no-ist
  9. A 2015 map of the world air quality by the Citylab of The Atlantic magazine shows that while levels of air pollution are worse in urban centers of mega-cities of India and China, moderate to unhealthy levels of fine particulate matter (FPM) air pollution are noted especially in Europe, and the United States Southern, Midwestern industrial belt, and in California in the United States, as well as coastal cities of South America. On the day that this reading was taken, Buffalo, New York in the U.S. has a reading of 126, and Beijing was between 175 and 126: http://www.citylab.com/weather/2015/09/mapping-the-worlds-air-pollution-in-real-time/406411/
  10. We see from this 2015 map of predicted air pollution in Europe, published in The Washington Post, that by 2030, air pollution will be very high in many urban areas, including Paris, Milan, Turin, Krakow, Warsaw, Sofia, and Gigon, Spain. Already in 2015, driving had to be curtailed in Milan and Paris on occasions due to warnings of dangerous levels of air pollution, as had been done in New Delhi, India and a number of other severely polluted cities: https://www.washingtonpost.com/news/worldviews/wp/2015/02/23/map-these-will-be-europes-most-polluted-cities-by-2030/
  11. A project to map the air pollution in hundreds of Chinese cities, by Greenpeace, showed that almost 90 percent of Chinese cities reduced their air pollution by at least 13 percent in 2015 over 2014, and overall, the Chinese cities with the worst air pollution reduced fine particulate matter by nearly a third in the first quarter of 2015 compared to the first quarter of 2014, and in Hebei Province around Beijing, the PM2.5 levels decreased 31 percent: http://phys.org/news/2015-04-air-pollution-china-greenpeace.html
  12. A January 1, 2016 report from Renewable Energy World.com, reported on Bloomberg news, shows that China intends to continue to expand wind and solar power capacity by more than 21 percent in 2016 and has announced that it will stop approving new coal mines as the amount of coal being used in China has finally decreased in 2014 and 2015, and a considerable surplus has been accumulated. The country has pledged to cap and reduce greenhouse gas emissions by 2030, but many experts expect this to occur even sooner. Economic policies in China are rapidly making the cost of renewable energy more equal to dirty coal power production, especially with a surcharge on electric bills intended to subsidize the development of green energy technology: http://www.renewableenergyworld.com/articles/2016/01/china-to-increase-wind-solar-power-capacity-by-21-percent-in-2016.html
  13. A study in the U.S. by NASA showed that observable levels of sulfur dioxide in the U.S. decreased dramatically between 2005 and 2014, with as much as 80 percent reduction in the higher atmosphere in the Eastern United States, mainly due to energy policies of the Obama administration that worked with energy companies to close the dirtiest coal-fired power plants and increase power production from renewable sources and clean natural gas. Global changes, such as the shift of smelting and steel production to China has also decreased U.S. sulfur dioxide and acid rain considerably:http://earthobservatory.nasa.gov/IOTD/view.php?id=87182
  14. A 2009 explanation of the effects on air pollution from all aspects of the mining and processing of Canadian Oil Sands Bitumen Oil by the United Nations University shows how this dirtiest of oil sources, comprising an estimated 10 percent of all world oil reserves, releases not only the standard pollutants from oil processing, but many very harmful chemicals such as benzene, and high levels of airborne heavy metal toxins. It should be noted that 4 gallons of water are needed with present technology to produce each gallon of bitumen oil, also releasing an eventual array of pollutants not only into the water sources, but eventually into the air from this water. The debate should be on how to develop technology to produce a cleaner processing for such an energy source, not just on whether to fully support the present system. The binary nature of politics and big business has prevented a reasonable debate and scientific solution, but finally the pressure to clean oil sands production has resulted in a 2015 announcement that chemical solvent, not steamed water, will be used to separate oil from sand in the future, and hopefully this solvent will not present even more health challenges: http://ourworld.unu.edu/en/canadas-oil-sands
  15. The Union of Concerned Scientists succinctly describes the main types of air pollution and their individual characteristics: http://www.ucsusa.org/clean_vehicles/why-clean-cars/air-pollution-and-health/cars-trucks-air-pollution.html
  16. A 2003 assessment of air pollution with an emphasis on particulate matter and ozone, by the World Health Organization: http://www.euro.who.int/__data/assets/pdf_file/0005/112199/E79097.pdf
  17. A 2013 assessment and meta-review of cardiovascular risk from air pollution, by the University of Washington, in Seattle, Washington, the University of New Mexico, Albuquerque, and the Lovelace Respiratory Research Institute, in Albuquerque, New Mexico, U.S.A., found that there is strong consistent evidence that organic carbons (OC) and sulfates together in the air we breath (polycyclic hydrocarbons and sulfur dioxide) constituted strong association with cardiovascular disease in the population, and that mixed vehicular emissions (MVE) from a combination of diesel and gasoline engines, and other fine particle matter (PM), were important in producing the adverse cardiovascular effects. Such assessment shows that we need to focus on all of these aspects of the air pollution, and achieve a more holistic outcome in air quality in the future: http://www.ncbi.nlm.nih.gov/pubmed/24377210
  18. A 2013 study of hospitalizations related to the level of sulfur dioxide in the air, by the French Institute for Public Health Surveillance, in Saint-Maurice, France, found that medium or high exposure to sulfur dioxide in the air was associated with significant risk of myocardial infarction in women, and that high exposure was associated with myocardial infarction in men: http://www.ncbi.nlm.nih.gov/pubmed/23864868
  19. A 2013 study of the harmful effects of sulfur dioxide on the brain, by researchers at Peking University, Beijing, China, found that sulfur dioxide regulates many physiological mechanisms in the human organism, and in excess is involved in the development of febrile seizures and related brain damage in animal studies. Such study shows the potential for excess sulfur dioxide to contribute to a variety of central nervous system diseases and neuronal damage: http://www.ncbi.nlm.nih.gov/pubmed/24373994
  20. A 2004 study of the harmful effects of carbon monoxide combined with nitrogen oxides on the brain, by researchers at Peking University, Beijing, China, found that this combination of air pollutants, in excess, is involved in the development of febrile seizures and related brain damage in animal studies as well. Such study shows the potential for excess air pollutants in combination to contribute to a variety of central nervous system diseases and neuronal damage: http://www.ncbi.nlm.nih.gov/pubmed/14766214
  21. A 2007 study at the National Institutes of Pediatrics, in Mexico City, Mexico, showed that exposure to high levels of fine particulate matter (PM) in Mexico City, one of the most polluted cities in the world for some time, leads to disruption of immune protection in respiratory membranes, systemic inflammation, dramatic upregulation of inflammatory mediators such as COX2, IL-1beta, and increased formation of amyloid beta plaques in the brain. This is a direct link between rising rates of Alzhemimer's disease and air pollution: http://www.ncbi.nlm.nih.gov/pu...http://www.ncbi.nlm.nih.gov/pubmed/17325984
  22. A 2016 controlled study by experts at the Boise State University School of Medicine, in Idaho, U.S.A. outlines the strong pathophysiological connection between air pollutants, especially fine particulate matter, and dramatically increased risk of Alzheimer's disease, a slowly developing pathology. Brain matter in laboratory animals was analyzed, and compared to healthy controls, the exposure to fine particulate matter and air pollution caused poor vascular health, a breakdown of protective barriers in the brain, and increased amyloid beta plaque in response. Damage to neurovascular health points to a number of strategies with CIM/TCM that could be used to prevent or correct this pathology: http://scholarworks.boisestate...http://scholarworks.boisestate.edu/math_facpubs/173/
  23. A 2009 study at the Whitehead Institute for Biomedical Research at Cambridge, Massachusetts, U.S.A. showed that beta-amyloid accumulation was not the cause of Alzheimer's disease, but instead a protective response to toxins in brain tissues: http://www.ncbi.nlm.nih.gov/pu...http://www.ncbi.nlm.nih.gov/pubmed/19411847
  24. A 2013 study of the relationship between levels of fine particulate matter in the air and hypertension, at the University of Taubate', Brazil, found a strong relationship between levels of this air pollution and admission to local hospitals for symptoms related to high blood pressure: http://www.ncbi.nlm.nih.gov/pubmed/24005922
  25. A 2013 assessment of major urban areas and the level of air pollution by a British group called Enviropedia, provides the data and succinct explanation of harm. We see that a number of rapidly developing megacities, such as Beijing, Seoul, Shanghai and Rio de Janeiro, now have very high levels often of sulfur dioxide and fine particulate matter, while some megacities that experienced development in the past, such as Mexico City, also continue to have frequently high levels. Los Angeles and New York continue to have moderate levels of fine particulate matter, carbon monoxide, and ozone, despite decades of work to reduce these levels. It is assumed that once these Asian megacities are developed, that the measures being taken to reduce air pollution will also bring down the levels that are now associated with rapid development and construction. We see that findings of high air pollution in Beijing does not exempt the populations from other large urban areas from concern, and that this is a global concern, and should be met with a cooperative and constructive attitude from the whole world: http://www.air-quality.org.uk/11.php
  26. A 2008 report on the health injury to infants and developing fetuses in the most polluted city in the U.S., Los Angeles, California, elucidates the extent of injury to our most vulnerable citizens. The mounting threat of air pollution on infant health due to rising populations and energy and transportation needs predicts a high level of health injury, despite progress on these issues. The most vulnerable children are those living close to heavy traffic and near polluting industries, such as coal-fired power plants, oil refineries, smelting and chloralkili production. What is not as well studied is the array of airborne toxins that interact with these main sources of pollution to increase adverse health effects, but such information is forthcoming: http://www.environment.ucla.edu/reportcard/article1700.html
  27. A 2009 study at the University of Edinburgh, UK, found that immediate exposure to higher levels of particulate matter (PM10) resulted in stiffening of peripheral blood vessels and higher blood pressure in athletic exercise, and that face masks did offer protection for those exercising in worse air quality in the city, but that the effectiveness of face masks varied widely. The 3M 8812 N95 mask was rated in some studies as the best of those available on the Asian market, but has been recommended only for adults with cardiovascular risk or history of asthma or COPD, and some discouraging data on masks for children have been published. Of course, eliminating times of high levels of find particulate matter and smog/ozone would be a much better outcome, and a number of tactics could be used together to reduce this air pollution, reducing the economic impact: http://www.sciencedaily.com/releases/2009/03/090312205224.html
  28. A 2013 study of the efficiency of denitrifying bacteria used in hollow-fiber membrane bioreactors to clear nitric oxide from flue gases in power plants, conducted at 2 Universities in China, Dalian University of Technology, and the Harbin Institute of Technology, found that this method was 86 percent efficient, and presented a superior option to other costlier methods: http://www.ncbi.nlm.nih.gov/pubmed/24552052
  29. A 2014 study of the efficiency of sodium humate from alkiline treatment sludge to remove sulfur dioxide from flue gas in power plants, at Shanghai Jiao Tong University, showed that this method could be 98 percent effective, and the byproduct humic acid sediment could be used in fertilizer: http://www.ncbi.nlm.nih.gov/pubmed/24453875
  30. A 2014 announcement by researchers at Ohio State University describe the dramatic success with coal-direct chemical looping and secondary combustion of syn-gas from the process, producing electricity with almost no air pollution or carbon dioxide waste. Construction employment to build this technology, as well as employment in the coal industry would be greatly improved with quick adoption of such technology. It is time for states that support coal to rally around such technology, rather than fight it: http://www.osu.edu/features/2013/ohio-state-develops-clean-coal-technology.html
  31. A brief succinct description of standard clean coal technology in 2014: http://www.nma.org/pdf/fact_sheets/cct.pdf
  32. A 2016 article in Seeker describes the first successful hardening of carbon dioxide emissions into rock at the Hellisheidi geothermal power plant near Reykjavik, Iceland. Carbon dioxide sequestered into the abundant basalt of the Earth crust with water converts to a chalk-like material, creating the potential to safely sequester greenhouse gas emissions soon: http://www.seeker.com/scientists-turn-carbon-dioxide-emissions-to-stone-1851588611.html
  33. Not only general environmental air pollution, but pollution generated in the interior of the home and workplace is becoming more of a concern for public health by 2015. This U.S. Consumer Product Safety Commission guide shows the conservative concern for health problems generated by lack of ventilation in modern homes and the workplace, combined with slow accumulation of toxic and cancer causing pollutants in the air. There are now thousands of toxic chemicals used in industrial production, largely unregulated in the United States until strong proof of harm is demonstrated, and even an advertising campaign suggesting a new emphasis on natural and green products does not negate the evidence of this mounting toxic chemical threat: http://www.cpsc.gov/en/Safety-Education/Safety-Guides/Home/The-Inside-Story-A-Guide-to-Indoor-Air-Quality/
  34. The Columbia University Center for Children's Environmental Health, in New York, New York, U.S.A. reveals that levels of polycyclic aromatic hydrocarbons (PAHs) are generally much higher indoors than outdoors, presenting a serious health threat to infants and children. Modern design with poor indoor ventilation, and a variety of sources of these compounds, present a growing health threat that has been overlooked. A number of healthy corrections need to be addressed, and individuals may both improve indoor air quality by avoiding cigarette smoking, charred foods, using a kitchen fan while cooking, and limit the use of candles in the home, but also by campaigning to improve air monitoring in residential areas, closing polluting industrial plants near residential areas, require cleaner vehicle standards, and improve general health, diet, and preventive medical care: http://ccceh.org/our-research/research-studies/air-pollution
  35. Study in 2015, by experts at Asutosh College and the National Institute of Science, in India, shows that indoor air pollution is proven to negatively affect stem cell development, both impacting future health treatment with stem cell therapy, but also revealing how indoor air pollution affects developing fetuses and infants, where health stem cell development has future health implications: http://www.ncbi.nlm.nih.gov/pubmed/25942342
  36. A 2014 study at UCLA revealed how the study of microbes that break down chemicals naturally is being investigated, and that fungi and other microbes in nature are being found that may safely and dramatically decrease the levels of fluorocarbons in drinking water, which are known threats to fetal and hormonal health:http://www1.cnsi.ucla.edu/news/item?item_id=2269674
  37. An alarming lack of study of the effects of indoor air pollution on the development of asthma is seen in a 2015 meta-review of published studies by the Florence Nightingale School of Nursing and Midwifery, at King's College, London, U.K. This review found only 8 such studies that were case-controlled, only 8 studies assessing exposure to specific chemicals, and only 2 studies that assessed the exposure to a combination of bio-aerosols and air chemicals. Only 11 high-quality studies were found that examined the association of exposure to indoor air pollution and asthma, and none exploring long-term health effects. The understated conclusion was that we need to conduct some serious research to clarify this obvious health threat and evaluate medical in design interventions to prevent disease: http://www.ncbi.nlm.nih.gov/pubmed/25872014
  38. One of the first comprehensive studies of indoor air pollution and the health threats to childhood development began in 2015 at the University of Toronto, the University of Manitoba, McMaster University, the University of British Columbia, the University of Waterloo, Edith Cowan University, and coordinated at Simon Fraser University, in Vancouver, Canada. There is hope that such a long-term longitudinal study will finally bring concern regarding the health threats posed by a growing threat of both outdoor and indoor air pollution: http://www.ncbi.nlm.nih.gov/pubmed/25805254
  39. A 2015 study at the University of Modena and Reggio Emilia, in Modena, Italy, showed that there is a significant association between indoor air pollution and risk of childhood leukemia, especially as related to exposure to traffic pollution. The need to reduce vehicle exhaust and the stirring up of fine particulate matter near residential areas is growing as the population increases and moves to more dense urban environments. For those at risk, a better and more holistic model of disease prevention is also needed: http://www.ncbi.nlm.nih.gov/pubmed/25803195
  40. A 1997 study at Odense University, in Denmark, showed that the toxin malondialdehyde, a frequent biomarker used to diagnose lipid peroxidation, can also be used as a reliable biomarker for overall oxidative stress measured in blood plasma: http://www.ncbi.nlm.nih.gov/pubmed/9216458
  41. A 2015 study at the University of New Brunswick, the University of Toronto, and the Dalhousie University, in Canada, and the University of Massachusetts, in the United States, showed that fine particulate matter (FPM) in air pollution largely contributes to deaths from cardiorespiratory disease and cancer by its relation to glutathione potential in the individual. What such study shows is that we must reduce air pollution and also individually improve our glutathione metabolism and oxidant clearing capability. Complementary and Integrative Medicine (CIM/TCM) can help dramatically with these goals: http://www.ncbi.nlm.nih.gov/pubmed/26745732
  42. A 2015 study of the effects of elevated ozone and FPM on the lung, by experts at the University of Colorado Denver and the National Jewish Health center, in Denver, Colorado, U.S.A., showed that the negative health responses to elevated ozone were related to the immune cytokine receptor Toll-like Receptor 4 (TLR4), which mediates neutrophil reponse, and is associated with inflammatory reactivity. TLR4 is now well known as the protein that guides reaction to lipopolysaccharides (LPS) on gram negative bacterial membranes, and various viruses, and immune dysfunction in infants and the elderly increases the toxic effects of ozone pollution: http://www.ncbi.nlm.nih.gov/pubmed/26410792
  43. A muliticenter comprehensive review of air quality and climate change in relation to allergies and asthma provides a wealth of data on the subject: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499913/