Air pollution may lead to eye problems too

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Corneal damage can be irreversible and cause blindness

New Delhi, 21 March 2019: With a large ageing population, growing middle-class and chronic nature of the disease, India is on the verge of a dry eye disease epidemic, says the study. The prevalence of dry eye disease will be in about 40% of the urban population by 2030. Since the disease tends to be progressive with age, once corneal damage becomes irreversible it can lead to visual impairment and even blindness. Early diagnosis and treatment is therefore important.

A study has found that the onset of dry eye disease is early in men than in women. In men, the age of disease onset is early 20s and 30s compared with 50s and 60s in women. Hormonal imbalance could be a likely reason for higher cases in women in their 50s and 60s.

Speaking about this, Padma Shri Awardee, Dr K K Aggarwal, President, HCFI, said, “Apart from the deterioration of eye health due to certain conditions, expanding areas of arid land, air pollution and greater exposure to ultraviolet (UV) radiation all present potential health hazards to the eyes. The cornea, eyelid, the sclera and even the lens—are all exposed directly to the environment. Rising temperatures and shifting atmospheric circulation patterns force dry air into regions. Drier air means that more people are likely to suffer from dry eye, a condition in which tears aren’t produced properly or evaporate too quickly. There is no evidence that drier conditions cause dry eye, but they can accelerate symptoms in people who are prone to dry eye. Air pollution has long been linked to respiratory disorders; more recently it’s been shown to play a role in eye disease.”

Recurrent infections over a lifetime lead to scarring inside of the eyelids, which in turn causes the eyelashes to turn inward and brush against the cornea, eventually resulting in damage that impairs vision.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “Eye exercises may not improve or preserve vision, help eye health, or reduce the need for glasses. Our vision depends factors such as the shape of our eyeball and the health of the eye tissues. Neither of these can be altered greatly by eye exercises.”

Using a computer does not affect eye health. However, staring at a computer screen all day can contribute to eyestrain or tired eyes. People who stare at a computer screen for long periods tend not to blink as often as usual, which can cause the eyes to feel dry and uncomfortable. To help prevent eyestrain, adjust the lighting so it doesn’t create a glare or harsh reflection on the screen, rest your eyes briefly every 20 minutes, and make a conscious effort to blink regularly so that your eyes stay well lubricated.

Stubble burning causes both loss of life and work revenue

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Air pollution needs to be combated with efforts at all levels

New Delhi, 5 March 2019: The burning of agricultural residue — a contributor to north India’s winter pollution — increases the risk of respiratory illnesses threefold for those who experience it. It may also be responsible for an annual $3 billion (approximately Rs 2 trillion) loss in terms of days of work lost in states affected by crop burning, according to a study by the International Food Policy Research Institute (IFPRI).

The research has found that living in an area where crop burning is practiced was a leading risk factor for respiratory disease in northern India. Whereas the total burden of diseases from air pollution declined between 1990 and 2016 due to efforts to reduce the burning of solid fuel for household use, outdoor air pollution increased by 16.6%.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Whenever we talk of air pollution, suspended particulate matter or PM as it is commonly referred to, is generally taken as representative of the level of pollution. In all there are eight air quality parameters, which are taken into consideration when the Air Quality Index (AQI) is calculated: Suspended particulate matter (PM2.5 and PM10), sulfur dioxide (SO2), ozone (O3), nitrogen oxides (NO2), carbon monoxide (CO), ammonia (NH3) and lead (Pb). Particulate matter consists of a complex mixture of solid and liquid particles of organic and inorganic substances suspended in the air. It is mainly made up of sulfates, nitrates, ammonia, sodium chloride, black carbon, mineral dust and water and allergens (fragments of pollen or mold spores). When outdoor levels of particulate matter are high, their levels also increase indoors.”

According to the WHO, nine out of 10 people breathe air containing high levels of pollutants and around 7 million people die every year from exposure to fine particles in polluted air.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “The larger PM 10 particles can irritate the eyes, nose and throat. PM10 mainly affects the respiratory system and may precipitate an acute asthma attack and acute exacerbation of chronic bronchitis or may cause other respiratory problems such as cough, wheeze. The fine and ultra-fine particles also affect the heart so they may trigger an acute cardiovascular event such as heart attack or stroke or atrial fibrillation as they increase the resting blood pressure due to sympathetic overactivity and cause endothelial dysfunction and thickening of the blood. PM 2.5 and PM 0.1 particles also have a greater association with increased mortality due to heart disease.”

Some tips from HCFI

·       Exercise well as it will help your lungs to function to their full potential. Do exercises that will make you breath fast to ensure healthy lungs.

·       Avoid smoking as it reduces lung function and is a major factor leading to COPD.

·       Eat healthy and food that is rich in omega 3 fatty acids such as fish and nuts for healthy lungs.

·       Avoid exposure to air pollution as it can damage the lungs and make it more prone to infections and diseases. Ensure that you dust furniture frequently and make your home a smoke-free zone.

Should air pollution be named as one of the causes of sudden death?

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Nine out of ten people now breathe polluted air, which kills 7 million people every year, says the World Health Organization (WHO).

Air pollution has now emerged as a major environmental risk factor for health. “The health effects of air pollution are serious – one third of deaths from stroke, lung cancer and heart disease are due to air pollution. This is having an equivalent effect to that of smoking tobacco, and much higher than, say, the effects of eating too much salt” (WHO).

In 2016, as per WHO, ambient or outdoor air pollution caused an estimated 4.2 million premature deaths worldwide in both cities and rural areas; 58% of outdoor air pollution-related premature deaths were due to ischemic heart disease and strokes, while 18% of deaths were due to chronic obstructive pulmonary disease (COPD) and acute lower respiratory infections respectively, and 6% of deaths were due to lung cancer. More than 90% of these deaths occurred in low- and middle-income countries.

And it’s just not outdoor air pollution; household (indoor) air pollution also causes 4 million deaths annually.

Pollutants with the strongest evidence for public health concern include particulate matter (PM), ozone (O3), nitrogen dioxide (NO2) and sulfur dioxide (SO2).

Air pollution has been identified as a trigger of acute cardiovascular events (myocardial infarction and stroke). A recent study presented at Heart Rhythm 2018, the Heart Rhythm Societys 39th Annual Scientific Sessions, which evaluated 112,700 women in the ongoing Nurses Health Study showed that lower-risk women exposed to particular matter (PM) for even a short amount of time are at an increased risk of sudden cardiac death. This association was significant on cold days – at low temperatures below 13°C.

In a report published by the ICMR in The Lancet Planetary Health in December 2017, ICMR clearly stated that 1.24 million deaths in 2017 were caused by exposure to air pollution; one in eight deaths was due to the constantly deteriorating air quality. ICMR also observed that life expectancy in India is reduced by 1.7 years on an average due to bad air quality.

This report was considered devoid of merit by the Environment ministry.

But, prior to the ICMR report, in 2015, the health ministry had released a report saying that air pollution causes impacts similar to that of tobacco smoking. The report also said that there was evidence of adverse pregnancy outcomes, tuberculosis, asthma exacerbation, cancer and thus, air pollution needs to be addressed during public health programs.

The environment ministry maintains that since no death certificates have pollution listed as the reason of death there is no correlation between air quality and deaths due to the same.

Doctors do not mention pollution as a cause of death, because pollution is not recognized as a cause of death and has no insurance cover. Natural disasters are generally not covered in routine insurance.

However, these statistics only serve to emphasize that perhaps the time has come to declare pollution as one of the causes of all sudden deaths, particularly when the pollution levels in the city are high.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

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