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Anti-Aging Medicine: environmental links to respiratory health: an anti-aging perspective.

As defined by the US National Institute of Environmental Health Sciences (NIEHS): "Lung disease refers to any disease or disorder in which the lungs do not function properly. Lung disease is the third leading killer in the United States, responsible for one in seven deaths."

Continuing, NIEHS reports: "Research has shown that longterm exposure to air pollutants can reduce lung growth and development and increase the risk of developing asthma, emphysema, and other respiratory diseases. Results from the NIEHS-supported Harvard Six Cities Study, the largest available database on the health effects of outdoor and indoor air pollution, show a strong association between exposure to ozone, fine particles and sulfur dioxide, and an increase in respiratory symptoms, reduced lung capacity, and risk of early death."

Indeed, environment-related respiratory illnesses are an underestimated cause of compromised quality, and quite possibly quantity, of life. In this column, we thus review environmental links to respiratory health, to raise awareness of the insidious role of air pollution in longevity.

Lung disease [Web page]. US National Institute of Environmental Health Sciences. Accessed 21 Aug. 2012.

Urban Residents at Greater Cardiovascular Disease Risk

People who live in city centers are twice as likely to suffer from coronary artery calcification, a common precursor to heart disease. Jess Lambrechtsen and colleagues from Svendborg Hospital (Denmark) interviewed 1225 men and women, aged 50 and 60 years, including 251 people who lived in the centers of major Danish cities. Air pollution levels were extracted from a national surveillance source. This showed that rates were approximately three times higher in city centers than other urban areas and seven times higher than in rural areas. The researchers found that coronary artery calcification was more common in people living in city centers than other urban or rural areas--in men (69[degrees]/0 vs. 56%), women (42% vs. 30%), 50-year-olds (48% vs. 32%) and 60-year-olds (61% vs. 53%). When the researchers looked at the odds ratio, this showed that people living in city centers were 80% more likely to develop coronary artery calcification than those living in other areas. Further, men were more than three times as likely as women to develop coronary artery calcification, with a 220% higher odds risk. And 60-year-olds were approximately twice as likely to develop coronary artery calcification as 50-year-olds (120% higher) as were smokers than nonsmokers (90% higher) and people with diabetes when compared with those without diabetes (100% higher). The study authors conclude: "Both conventional risk factors for [cardiovascular disease] and living in a city centre are independently associated with the presence of [coronary artery calcification] in asymptomatic middle-aged subjects."

Lambrechtsen J, Gerke 0, Egstrup K, et al. The relation between coronary artery calcification in asymptomatic subjects and both traditional risk factors and living in the city centre: a DanRisk substudy. J Int Med. May 2012;271(5):444-450.

Air Pollution Linked to Chronic Heart Disease

High pollution increases risk of repeated heart attacks by over 40%. Yariv Gerber and colleagues from Tel Aviv University (Israel) followed 1120 first-time myocardial infarction (MI) patients who had been admitted to one of eight hospitals in central Israel between 1992 and 1993, all of whom were under age 65 at the time of admittance. The patients were followed up until 2011, a period of 19 years. Air quality was measured at 21 monitoring stations in areas where the patients lived, and analyzed by a group of researchers at the Technion in Haifa. After adjusting for other factors such as socioeconomic status and disease severity, the researchers identified an association between pollution and negative clinical outcomes, including mortality and recurrent vascular events such as heart attack, stroke, and heart failure. Compared with patients who lived in areas with the lowest recorded levels of pollution, those in the most polluted environment were 43% more likely to have a second heart attack or suffer congestive heart failure and 46% more likely to suffer a stroke. The study also found that patients exposed to air pollution were 35% more likely to die in the almost 20-year period following their first heart attack than those who were exposed to lower levels of pollution.

Molshatzki N, Broday D, Koton 5, et al. Cumulative exposure to air pollution, socioeconomic status and post-myocardial infarction outcomes in central Israel. A cohort study [Abstract P0411. Presented at: the Epidemiological Meeting of the American Heart Association. Circulation. 2012;125:AP041.

Air Pollution Raises Hospitalizations

Short-term exposure to fine-particle air pollution, particulates measuring 2.5 microns or less, has been linked to spikes in hospitalizations among older men and women, for causes ranging from pneumonia to cardiovascular disease and diabetes. Chronic long-term exposure to fine-particle air pollution is also suspected to be an underrecognized health concern. Joel D. Schwartz and colleagues from Harvard University (Massachusetts, US) engaged a model using satellite data to predict short-and longterm exposure to small particulate matter in the atmosphere in the New England region of the US. The team found increased hospitalizations for respiratory causes, cardiovascular disease, stroke, and diabetes, with the increases in hospitalizations for each of the conditions being at the highest for long-term exposure. Specifically, for each 10 microgram/m3 increase in short-term exposure to fine airborne particulate matter, there was a 0.70% increase in hospital admissions for respiratory illness among patients 65 and older, and for each 10 microgram/m3 increase in long-term exposure, there was a 4.22% increase in respiratory hospitalizations. The study authors warn: "Chronic exposure to particles is associated with substantially larger increases in hospital admissions than acute exposure."

Kloog I, Coull BA, Zanobetti A, Koutrakis P. Schwartz JD. Acute and chronic effects of particles on hospital admissions in New-England. PLoS ONE. 17 Apr 2012.

Detriments of Diesel

The exhaust from diesel-fuelled vehicles, wood fires, and coal-driven power stations contains small particles of soot that flow into the atmosphere. The soot is not only a climate hazard but also threatens human health. Jenny Rissler and colleagues from Lund University (Sweden) recruited 10 healthy men and women, who inhaled fumes from idling and transient engine running conditions of a heavy-duty diesel engine. Studying the respiratory tract deposition fraction in the size range 10 to 500 nm, the researchers have elucidated how diesel soot deposits in the lungs, and reveal that more than half of all inhaled diesel soot particles remain in the body.

Rissler I, Swietlicki E, Berigtssah A., et at. Experimental determination of deposition of diesel exhaust particles in the human respiratory tract.) Aerosol Sci. June 2012;48:18-33.

Plants Reduce Urban Pollution

Fortunately, there are ways in which air pollution may be reduced. Green plants reduce city street pollution, cutting nitrogen dioxide (NO2) by 400/o and particulate matter (PM) by 60%. Thomas Pugh and colleagues from Karlsruhe Institute of Technology (Germany) report that green plants can improve urban air quality by removing NO2 and PM pollutants from the air. The researchers found that judicious placement of grass, climbing ivy, and other plants in urban settings can reduce the concentration at street level of NO2 by as much as 40%, and PM by 60%, much more than previously believed. The study authors propose that cities build plant-covered "green billboards" to increase the amount of foliage, concluding: "judicious use of vegetation can create an efficient urban pollutant filter, yielding rapid and sustained improvements in street-level air quality in dense urban areas."

Pugh TAM, MacKenzie AR, Whyatt JD, Hewitt CN. Effectiveness of green infrastructure for improvement of air quality in urban street canyons. Environ Sci Technol. 2012;46(14):7692-7699.

To stay updated on the latest environmental links to respiratory health, visit the World Health Network (, the official educational website of the A4M and your one-stop resource for authoritative anti-aging information. Be sure to sign up for the free Longevity Magazine e-journal, your weekly health newsletter featuring wellness, prevention, and biotech advancements in longevity.

by Ronald Klatz, MD, DO, and Robert Goldman, MD, PhD, DO, FAASP
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Author:Klatz, Ronald; Goldman, Robert
Publication:Townsend Letter
Geographic Code:1USA
Date:Dec 1, 2012
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