Air Pollution and Its Health Effects

Air
“ Air is the immediate environment to man “
Functions:
 Oxygen Supply
 Cooling effects to the body
 Special senses functions through air
 Circulation of the disease agents(Viruses, Bacteria,
Spores etc…)
 Pollution of air through(dust, smoke, toxic gases &
chemical vapours) causing sickness and death too.
 Exp: Bhopal gas tragedy
 Daily requirement: 10-20 meters cub per day.
2

3
Composition of
Air
 It is combination
of various gases
as shown besides.
 It also contains
Water vapours,
traces of
ammonia &
suspended
matter (bacteria,
spores, vegetable
debris.
78.10%
0.03%
20.93% 1.77%
Occupancy of the main
gases in Environments
N2
CO2
O2
other gase

4
Air Pollution
 Definition:
 “Presence of atmospheric substances
like gases, mixtures of gases,
particulate matters in a concentration
which may adversely affect human
health, safety or comfort, or injurious
to animals, vegetation & other
environmental media resulting in
chemical entering the food chain or
being present in drinking water and
thereby constituting additional source
of human exposure”

5
Sources of Air Pollution
 Two types:
1. Manmade: 98%
2. Natural : 2%
 According to a WHO
assessment, more than 2
million premature deaths
each year can be attributed to
the effects of air pollution.
5

6
Air Pollutants
 “More than 100 air pollutants identified”
Gases Organic
Compounds
Metallic
Compounds
Others
Carbon Dioxide Hydrocarbon Arsenic Photochemical
compounds(O3)
Hydrogen sulphide Aldehydes Zinc Radioactive Com.
Sulphur dioxide Ketones Iron Asbestos,
Beryllium
Sulphur trioxide Hydrochloric
acid
Mercury, Benzene
Nitrogen Oxide Sulphuric
acid
Fluorides, Vinyl
chloride
Fluoride
Compounds
Nitric acid Benzene
Carbon Monoxide Lead & radiation
6

Air pollution indicators
1. Sulphur dioxide Concentration
2. Smoke or soiling index: a measured volume of air is
passed through white filtered paper & the stain on
the paper is measured by photoelectric meter.
3. Grit & Dust measurement: monthly analysis
4. Coefficient haze: asses amount of gases and other
aerosol in air, mainly used in USA
5. Air pollution index: an arbitrary index takes in
account 1 or more air pollutants for measuring air
pollution.
Best indicators are Sulphur dioxide, smoke and
suspended particles.
8Air & Air pollution, GMER,Sola,Ahmedabad

of the Air Pollution
Over 1.3 million urban residents are exposed to air
pollution.
1. Health aspects/effects
2. Socio-economical aspects/effects
Toxic effects :
1. Early or Immediate effects
2. Delayed or long term effects
Most common health hazards:
Lead, Sulphur dioxide, nitrogen oxide, Ozone &
Hydrocarbon.

Health Hazards of Air Pollution

1.Health aspect/Physical effects
Route of entry: Respiratory or Skin contact
Severity: Allergic reaction to lung cancer and death
Exp: Air pollution epidemic in London(1952)
Acute effects:
1. Acute bronchitis
2. Allergic dermatitis
3. Sense of Suffocation & physical discomfort
4. Sudden death, i.e. death chamber of “Hitler”
5. Elevation of Blood pressure & Pulse rate
6. Worsening of underlying lung disease, i.e. COPD &
Bronchial asthma
7. Chemical conjunctivitis “itching & burning in eyes”

Death chambers
 Most commonly used gases for acute
poisoning:
1. Hydrogen cyanide
2. Carbon monoxide
12
Hitler`s Death Chamber

Physical effects continue…………
Chronic or delayed effects:
1. Impaired respiratory immunity
2. Increased chances of secondary infections
3. Increased respiratory fatigue
4. Lack of concentration, easy fatigability & early
ageing
5. Chronic bronchitis
6. Lung cancer
7. Bronchial asthma
8. Emphysema
9. Hypertension
10. Skin cancers
11. Impaired neurological development, i.e. lead
exposure

2.Socio economical Aspects/Effects
Due to toxic effects of air pollutants
1. Destruction of plants/ animal life
2. Corrosion of metals
3. Damages to buildings
4. Cost for maintenance, repair and cleaning
5. Aesthetic nuisance
6. Reduced visibility

Effects on Pregnant women and Children
Pregnant women:
Increased spontaneous abortion/Miscarriages
Preterm labor
IUGR/ IUFD/ LBW (active/ passive smoking)
Increased birth defects
Children:
sore throat, cough, morning phlegm and wheezing
Tears, runny nose and chest tightness
Impaired IQ level
Neurological under development
Worsening of Bronchial asthma or allergy

Prevention & control of Air pollution
1. Containment: Prevention of toxic gas to enter ambient air
(Enclosure, ventilation, Air cleaning or arresters)
2. Replacement: Technological process causing air pollution
is replaced by machineries not causing air pollution(Use
of electricity, natural gas & central heating then Coal,
Use of unleaded petrol etc…)
3. Dilution: Development of Green belts
4. Legislation: Prevention through Air pollution acts,
“The air act “1981
1. International action: World wide establishment of Air
pollution laboratories, 2 in London & Washington, 3 in
Moscow, Nagpur & Tokyo & 20 more in all over the world.

Disinfection of Air
1. Mechanical ventilation:
It facilitates the air movement and allows fresh air to
enter the contaminated area and reduces bacterial
density. i.e., Air condition principal
2. Ultra violate radiation:
Lethal for various viruses, bacteria and spores
Mostly seen in case of OT and Hospital wards
3. Chemical Mists:
Mostly used agent is “ Triethylene glucol “ vapours
It is very effective against bacteria in droplets & dust
4. Dust Control:
Application of oil on hospital floor reduces bacterial
count

Acute Air borne Outbreaks
1. Chemical pollution
2. Biological Contamination like SARS, Swine flue,
Plague outbreaks etc
 Chemical air pollution:
i. Biggest Chemical induced Air borne outbreak
was Bhopal gas tragedy (1984) - 3000 people
died & 50,000 affected
ii. Biggest outbreak of London (1952) due to
great smog - killed around 4000 people in 6
days & 8000 people in next months

18

Photochemical smog
1952 London-type smog
in Beijing, China

Bhopal Gas Tragedy December 1984
Methyl Iso Cyanate (MIC) being used by UBCL for
manufacturing of insecticides, pesticides
Point of Leakage Congenital Malformations
Air & Air pollution, GMER,Sola,Ahmedabad

Meteorology is the science concerned with the
phenomena occurring in the atmosphere.
 Air temperature
 Atmospheric pressure
 Humidity
 Rainfall
 Direction and speed of wind

Atmospheric Pressure
 Atmospheric pressure is
measured with the help of an
instrument called as a
barometer.
 The barograph is a continuous
measurement of pressure over
a 24 hour period.

Atmospheric Humidity
 Atmospheric humidity or the moisture content of air is
generated from large watery surfaces, which are exposed to
atmosphere.
 can be expressed in
◦ Absolute humidity
◦ Relative Humidity.
 It varies directly with the atm. temperature
 Comfortable relative humidity level is 30-65%
 Hygrometer and sling psychrometer

Air Movement
 Air movement determines the cooling
power of air and it influences the comfort
levels in an environment.
 Kata thermometer and anemometers

Air Temperature
 Recorded by a thermometer
 Both mercury and alcohol thermometers are used
 Mercury boils at a higher temperature, has an even
expansion; alcohol has the advantage of not solidifying even
at very low temperature.
 Dry and Wet bulb, maximum n minimum thermometer

Green house effects & Global Warming
Global warming
Continuing rise in the average temperature of
Earth's atmosphere and oceans
Cause: Increasing levels of green house gases due
to Deforestation and burning of fossile fuel and
not because of industrialization and urbanization
Green house gases:
Water vapor(36-70%), CO2(9-26%), Methane(4-
9%), Ozone(3-7%) etc…
Temperature rise:
During 20th century: 0.74 degree C.
During 21st century: likely rise 1.5-1.9 degree C to
3.4-6.1 degree C

Greenhouse effect
Global Warming

Effects
Main 4 effects
Natural:
Rising of sea level, expansion of deserts, melting
of glaciers, extremes of weather like heat waves,
droughts & heavy rainfall events
Ecosystem:
Seasonal variations, increased earth
temperature, plant, birds and crops destructions
Species migrations:
Mostly in sea exp: whale migrations
Social effects:
Population migration, Increased morbidity,
Decreased working capacity etc…

Heat Stress
 Heat stress is the burden of heat that must be
dissipated if body is to remain in thermal
equilibrium.
 The rate at which a man sweats is good index of
heat stress
 Effects: heat stroke, hyperpyrexia, exhaustion,
cramps, syncope

ENVIRONMENTAL FACTORS
The major determinants of heat illness are,
 Air Temperature (by Dry Bulb Thermometer)
 Relative humidity (by using psychrometric charts)
 Mean Radiant Temperature (MRT) whose main
source is radiations from hot objects
and which is determined by the
Globe Thermometer
 Speed of the air (by anemometers)

Thermal Stress Indices
Based on the permutation and combination of these
parameters, certain indices of environmental heat
illness have been developed.
 Cooling Power: Kata thermameter
 Effective Temperature : ET is defined as the
subjective feeling of warmth (or cold) at a given
temp. of air
 Corrected Effective Temperature: obtained by
prepared normograms by reference to the globe
thermometer, wet bulb thermometer and air speed
 McArdle’s maximum allowable sweat rate
 Oxford (WD) Index : 0.85 WBT + 0.15 DBT

Prevention of Heat related
illnesses
 Proper protective measures in the industries as
isolation of furnaces, and spray of cold aerosols.
 Seeking shade and wind to the extent possible.
 Frequent rest pauses interspersed between phases of
physical activity.
 Full use of audio-visual and print mass media must
be made during the onset of hot weather and also
well before the expected heat wave.
 Public Health measures directed towards
communities as well as towards individuals

 Do not venture out in the sun, especially between 10
am to 4 pm unless the same is necessary.
 Avoid strenuous physical exertion during the hot
weather unless necessary for reasons of occupation.
 Drink at least 4 to 5 litres of cool water in a day even if
not feeling thirsty.
 If exposure to sun is necessary, place a wet hand towel
around your neck.
 Put on a wide - brimmed hat of light colour when
going out.
 Put on sunglasses when going out in the sun.
 Apply a sun screen ointment with a Sun-Protection-
Factor (SPF) of at least 15
 Dress for hot, humid weather should be ‘breathable’
i.e. Loose fitting, light weight, light colored, preferably
of cotton material and in one or two layers only.

PUBLIC HEALTH ASPECTS OF EXTREME COLD
ENVIRONMENT

ADVERSE HEALTH EFFECTS
Adverse effects of cold environment can manifest
as:
 Generalized effects (hypothermia)
 Local “tissue-freezing” effects - frost bite
 Non-Freezing Cold Injuries (NFCI) - trench foot
and chilblains

Management At First Aid Level
 Immediately wrap the patient all around, including head,
with warm clothes or blankets of about 4 inches thickness all
around the patient.
 Make hot packs with warm water bottles covered with a cloth,
or warm pads, at 42°C to 45°C, and apply them to axillae,
groin and neck.
 Do not warm the extremities at this juncture. Place arms and
hands on the sides and not on the abdomen.
 If patient can take orally give warm tea or milk.
 Do not massage the limbs.

Frost Nip and Frostbite
 Frost nip involves freezing of top layers of skin tissue and
manifests as numbness and white, waxy or rubbery feeling of
the affected skin.
 Frostbite is the more severe form and affects all layers of the
skin and often the deeper tissue also.
 As an urgent first aid measure, remove any constrictive
clothing or bands.
 Start local warming by placing the affected part in a warm
water bath at 40-42°C.
 Analgesics and sedatives are given for relief of pain.

Non - Freezing Cold Injuries
Chilblain Trench Foot
 Occur due to prolonged exposure to cold environment
with wet conditions

PUBLIC HEALTH ASPECTS OF
HIGH ALTITUDE

HIGH ALTITUDE ILLNESS
 High Altitude illness is a collective term for the
syndromes that can affect unacclimatised
travellers, shortly after ascent to high altitude
 The term “high altitude illness” encompasses the
syndromes of
1. Acute Mountain Sickness (AMS)
2. High Altitude Cerebral Oedema (HACO)
3. High Altitude Pulmonary Oedema
(HAPO)

Prevention of Adverse Effects of
High Altitude
 AMS and HAPO commonly affect subjects who have not
properly acclimatized.
 Acclimatization: taking 1 to 2 days of complete rest
followed by gradually increasing physical effort for next 2 to 4
days at a particular level of high altitude. This process should
be repeated for every 1000 mtrs.
 Acclimatization should be undertaken whenever a person
reaches an altitude of 2500 metres or above.
 Chemoprophylaxis : Acetazolamide orally, for three days
before induction into high altitude areas has been
recommended
 Avoidance of tobacco and alcohol is also desirable.

Noise
 Definition: Wrong Sound, in the wrong place, at
the wrong time.
 Sources
4545

Properties of Noise
1. Loudness or Intensity
• Measured in decibels (dB)
• Measured in reference to standard sound
pressure
2. Frequency
• Measured in Hertz (Hz),1 Hz = One wave per
second
• For human: 20-20,000 Hz
instruments:
• Sound lever meter (dB)
• Octave band frequency analyzer: pitch
• Audiometer : Hearing ability 46

47
Acceptance level (in dB)
Commercial Office 35-45
Conference 40-45
Restaurant 40-60
Industries Workshops 40-60
Laboratories 40-50
Hospitals Wards 20-35
Residential Bed room 25
Living room 40
Educational Class room 30-40
Library 35-40

Effects of Noise Exposure
Auditory:
• Auditory fatigue- 90 dB
• Deafness- Temporary or permanent
Non- Auditory:
• Speech interference
• Annoyance
• Reduced efficiency
• Physiological changes: Raised blood pressure
• Psychological changes: Inability to concentrate
• Economical Loss
48

Control of Noise
A) Careful planning of the city with green belts
-Division of the city
-Separation of residential area
-Widening of the street
B) Control of the vehicles
C) Improve acoustic insulation of buildings
D) Industries and railway
E) Personal protection like ear muffs, ear plugs
F) Legislation noise pollution Act
G) Education – use of horn
H) Periodical examination of workers
49

50
Noise Control -1
Source Host

51
Noise Control -2
Source Host
Silencer
Soundproof walls/ doors
Ear Muff

52
Noise Pollution Control Rule 2000
 It is under Environment Protection Act 1996
 Under this Act State governments shall take measures for
abatement of noise
 An area not less than 100 m around hospitals, education
institutions and courts may be declared as ‘silence area’
 A loud speaker system shall not be used except after
obtaining written permission
 The same shall not be used at night, between
10 pm to 6 am

Types of Radiation:
A. Ionizing radiation: Penetrates tissues
 Electromagnetic: X rays, Gamma rays
 Corpuscular: αlpha particles, β particles,
protons or neutrons
B. Non-ionizing radiation (wavelength > IR)
 Ultraviolet radiation
 Artificial light sources (electric radiation)
 Natural or manmade electromagnetic fields
Like – infrared, microwave, radiofrequency
radiations.
54

55
Sources
Radiation
Natural
Cosmic rays
Environment
Terrestrial
(K40, uranium)
Atmospheric
(radon, thoron)
Internal
radiation
Manmade
X Rays
Patient
Radiologist or
Technician
Radioactive fall
out (Cs, Sr)
Miscellaneous
TV, Mobiles (?)

Electric Radiation
Sources:
 Power lines
 Broadcast mobile towers
 Video display terminals
 Refrigerator, electronic tooth brush, shavers
and toasters
Effects:
 Electric shock
 Skin rashes
 Psychological changes (depression & suicide )
 (Melatonin) depletion in night causing disturbed
circadian rhythm, risk of cancer
 Leukemia especially children
56

UV Radiation
UV rays: UV-A, UV-B & UV-C
Sources of UV radiation:
I. Natural: Sun light
II. Manmade:
 Incandescent sources: Tungsten lamps
 Gas discharge: mercury lamp, xenon lamp,
hydrogen lamp,
 Fluorescent lamps
 Lasers: used in surgery & cosmetic procedures
57

Units & Measurement
Units:
1 Bq = 1 disintegration per second(Bq = Becquerel)
Measurement: Potency parameter
1. Roentgen
2. Rad (used in radiotherapy)
3. Rem: Degree of danger
59

Biological Effects
1. Somatic effects:
Immediate:
 Radiation sickness
 Acute radiation syndrome
 LD 50: 400-500 roentgen exposure
 It affects WBCs and muscles
Delayed: Leukemia, carcinogenesis, premature death
2. Genetic:
due to chromosomal mutation or point mutation
(sterility, abortion or birth of children with
congenital defects)
60

Radiation Protection
 Permissible dose from man-made sources: <=5
rad/yr
 Unnecessary X-ray should be avoided in children
and pregnant women
 Surveillance of X-ray installations
 Protection of workers: Lead shields and lead
aprons
 Film badge or dosimeter measures exposure
 Periodic medical examinations of workers
61

62Noise, Radiation & Light GMERS,Sola, Ahmedabad

“Good light is essential for good vision”
Essential light factors
 Sufficiency (15 to 20 foot candle)
 Uniform distribution
 Absence of glare: Excessive contrast
 Absence of sharp shadows
 Steadiness
 Colour of light
 Surroundings
63

64
Measurement of light
Description Quantity
measured
name
Recommend
ed unit
Other units
Brightness of
point source
Luminous
Intensity
Candela Candle
power
Flow of light Luminous flux Lumen
Amount of
light reaching
surface
Illumination Lux Foot candle
Amount of
light re-
emitted by
surface
Brightness Lambert Foot lambert

Day light
 Day light factor (DF)
 In buildings rapidly measured by Day light
factor meter
 For kitchen: DF should be 10%
 For Living room: DF should be 8%
65

66
Biological effects of light
Useful effects:
 Day light: Phototherapy for premature infants with
jaundice (degradation of bilirubin with UV rays)
 Activation/ synthesis of vitamin D
 Adrenocortical secretion
 Stimulation & synthesis of melanin
 Maintains biological rhythms of body temperature
 Regulation of physical activities
Ill-effects of glare:
Eye strain, watering/redness of eyes, headache
aggravation of migraine

Ventilation
Movement of air from outside a building to inside
“ It is not only the replacement of vitiated air by
supply of fresh outdoor air but also control of
quality of incoming air in regards to its
temperature, humidity and purity with a view
to provide a thermal environment that is
comfortable and free from risk of infection “
68

Types of Ventilations
Ventilation
Natural Artificial
Exhaust
Ventilation
Plenum
Ventilation
Balanced
Ventilation
Air
conditioning
69

Standards
Cubic space
 From 300-3000 c.ft. /per person
 CO2 form expired air- 0.6 c.ft/hour/person
 Permissible impurities & required air-0.6/0.0002
or 3,000 c.ft./hour air will be required
Air Change: It is a better standard.
 Physical & Chemical changes of air
 For living room: 2-3 air changes/hour
 Work room: 4-6 air changes/hour
 Optimum space: 1000-1200 c.ft./person
Floor space:
 Optimum space: 50-100 sq.ft.
 Heights of wall: optimum 10-12 feet 70

Applied aspect of Ventilation
Health problems owing to ventilation are due to physical &
not chemical changes
Symptoms in ill ventilated space:
 Heat radiation & Increased temperature
 Feeling of suffocation/Discomfort
 Inability to concentrate
 Head ache
 Drowsiness
 Giddiness
 Increased susceptibility to respiratory infections
 Worsening of bronchial asthma or cardiac disease.
 Death
72

Housing
House:-
 “ Human innovation for creation of congenial
environment for the protection and rising of
family which is institution to human existence,
evolution and culture. “
Housing:-
 “ All places in which a group of people reside &
pursue their life goals; the size of settlement
may vary from a single family to millions of
people. “
 Modern concept includes not only `physical
structure` but also the immediate surrounding,
and related community services and facilities. “ 74

Social goals of housing
 Shelter
 Family life
 Access to community facilities
 Family participation in community life
 Economic stability
 Establishment of minimum & maximum standards
 Creation of financial & fiscal institution for people
with low income to obtain credit for building or
improving their houses.

Essentials of household
Site:
 Elevated from surroundings
 Independent access to street
 Away from breeding spaces
 Away from the ethical nuisance
 Should have pleasing surroundings
 Soil quality
Set back:
 Provision of open space for ventilation & lighting
 Built up area
 Set back should be free from obstructions
78

Floor:
 Pucca & Impermeable
 Smooth & free from cracks & cervices
 Damp proof
 Plinth height 2-3 feet
Walls:
 Reasonably strong; Not easily damageable
 Heat resistant
 Unfavorable for rats & vermin
 Width- 9 inch brick wall with plasters & smooth
white colored finishing
79

Roof:
 Height not less then 10 feet
 Low heat transmission coefficient
Rooms:
 Not less then 2 rooms
 Area of should be increased as per family
size
Floor area:
 For living room at least 100-120 sq.ft
 Per person floor area not less then 50 sq.
ft (optimum 100 sq. ft)
Cubic space:
 In the terms of air, air space of at least
500 c.ft. per capita (preferably 1000 c.ft)

Windows:
 Living room should have at least 2 windows
 Height from ground not more then 3 feet
 Window occupancy should be 1/5th of floor area
 Doors & Windows combined should occupy at
least 2/5th of floor area
Lighting:
 Day light factor should exceed 1% over the half
the floor area
Water supply:
 Provision of safe & wholesome water with
preferably 24 hours constant supply
81

Kitchen:
 A separate kitchen
 Protected against dust, smoke
 Adequate lighting
 Provision of food, water, fuel, sink &
optimum drainage system
Privy:
 Sanitary type latrine is must
 Garbage & refuse: daily removal & disposed in
sanitary manner
 Bathing & Washing:
82

Overcrowding
“ Situation in which more people are living within
dwellings then there is space for, so the
movement is restricted, privacy secluded,
hygiene impossible and rest & sleep is difficult. “
Health effects:
 Irritability
 Frustration
 Lack of sleep
 Anxiety & Violence
 Mental disorders
 Increased respiratory infections(TB, Influenza,
Diphtheria, etc….) 83

Standards for Overcrowding
There are 3 criteria for deciding overcrowding
& even if one is not fulfilled, it is labeld as
overcrowding
(1) Person/living room: Degree of overcrowding
 1 room…………………………………………………….2 persons
 2 room…………………………………...................3 persons
 3 room…………………………………...................5 persons
 4 rooms………………………………………………….7 persons
 5 or more rooms………………………………..10 persons
Infants not counted & children 1- 10 years as
half
84

Standards for Overcrowding
(2) Floor space:
 110 sq.ft or more………………………………..2 persons
 90-100 sq.ft………………………………………1.5 persons
 70-90 sq.ft…………………………………………….1 person
 50-70 sq.ft…………………………………………0.5 person
 Less then 50 sq.ft……………………………………………nil
(3) Sex Separation
if 2 persons over 9 years of age and of opposite
sex (not husband & wife) are obliged to sleep in
same room
85

Poor housing and health
hazards
Respiratory infections-
 Common cold, TB, Influenza
 Diphtheria, bronchitis, measles, whooping cough
(more in winter?)
Skin-
 Scabies, ring worm, leprosy, impetigo
Rat infestations-
 Plague
Arthropods-
 Housefly, mosquito, bugs and flea
Accidents-
 Defective home or environmental factor 87

Poor housing and health
hazards
Morbidity & Mortality-
 Directly proportionate to sub standard housing
condition
Psychosocial effects-
 A sense of isolation claustrophobia
 Separation from home
 Increased risk of neurosis &
behavioral changes, Depression & anxiety
 Poor working efficiency
 Quarrels & Violence
 Abuse & addictions
 Alcoholism & Smoking 88

HOUSING AND THE
GOVERNMENT POLICY
 In India the NFHS collects data on housing
condition of people.
 The data from NFHS 3 shows that only about 26%
of rural India lives in pucca houses
 Only 28% have access to piped drinking water and
26% have access to toilet facilities
89

Air Pollution and Its Health Effects

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