Fuel Quality, Air Pollution and Health in Pakistan.ppt

7/28/2019 Fuel Quality, Air Pollution and Health in Pakistan.ppt

1/26

Zafar Fatmi, Head Division of EnvironmentalHealth Sciences & Assistant Professor

Dept. of CHS, Aga Khan University

National Workshop on Cleaner Fuelsand Vehicles

Islamabad, Pakistan19th May, 2010


2/26

Synopsis

1. Major air pollutants of concerns for health.

2. Fuel/vehicle emissions and its health effects.

3. Air pollution in developed and developing

megacities.4. First large scale health effects study on air

pollution (PM) in Karachi preliminary results[one-year]


3/26

Burning MOUTH/LUNGS

Burning KITCHEN

BurningCITIES

NOTE: 60-90% similar chemicals. Difference in distance and concentration.


4/26

Environmental BurdensPremature Deaths

Source: WHO Global Burden of Disease

Environmental

Risks

Global Asian Asian %

of

Global

Outdoor Air 799,000 487,000 61%

Indoor Air 1,619,000 1,025,000 63%

Tobacco 5,400,000 3,700,000 69%

Lead 234,000 88,000 37%


5/26

Effects of Air Pollution

Human Health Respiratory, cardiovascular morbidity (illness) Mortality (death)

Heritage

Nitric/Sulfuric Acid erosion Natural Resources

Acidification (lake and stream biology) Visibility

Agriculture

Ozone crop effects Global warming and climate change

Increase in green house gases Increase temperature --- diseases like mosquito growth and

related diseases


6/26

Major Vehicle/Fuel Emissions

CO2

,

CO Diesel Exhaust

Particulate matter

Lead

Nitrogen Oxides (NOx) Hydrocarbons (HC)

Secondary by-products

(Ozone and PM)

Air Toxics (mobile source)

Aldehydes

Benzene

Methanol

Polycyclic aromatichydrocarbons

Vehicle type (HTV, LTV), Age, Maintenance, Exhaust treatment, Wear of parts (tires and breaks), Type and Quality of Fuel, Engine lubricants


7/26

Particulate Matter in Ambient Air

Coarse particles: TSP /PM10 /PM5 Include wind blown dust as well as

bacteria, pollens and mold spores.

Fine particles (PM2.5): Tinyparticles or droplets in the airmainly from combustion.

Sources: Motor vehicles and reaction ofgases or droplets in the atmosphere.


8/26

BloodIncreased coagulability

Peripheral thrombosis

Altered rheology (flow)

Reduced oxygen saturation

Systemic InflammationOxidative Stress

Proinflammatory mediators

Leukocyte & platelet activation

PM2.5 Inhalation

Brain

Increased cerebrovascular

ischemia

HeartAltered cardiac

autonomic function

Increased dysrhythmic

susceptibility

Increased myocardial

ischemia

Vasculature Accelerated atherosclerosis

Endothelial dysfunction

Vasoconstriction and Hypertension

Lungs

Inflammation Oxidative stress

Accelerated progression

and exacerbation of COPD

Increased respiratory symptoms

Reduced lung function

Multiple mechanistic pathways / complex interactions and interdependencies


9/26

Lungs have a greater

exposure to theenvironment than anyother part of the body including the skin.

6 liters per minute airinhaled

Lungs surfaces area isequal to land area ofa small house (80m2)

Why lungs are exposed more?


10/26

Pollutant Potential health effects

TSP/PM10/2.5

Wheezing, asthma Respiratory infections

COPD and exacerbation

Excess mortality including CVD

Nitrogen dioxide Wheezing

Respiratory infections and reduced lung

functions

Sulphur dioxide Wheezing, asthma

COPD, CVD

CO Low birth weight Increase peri-natal deaths

Benzopyrene Lung cancer

Cancer of mouth, pharynx, larynx

Smoke

Cataract

Health Effects Studies


11/26

Lead in Blood and IQ decline amongChildren

[Lanphear BP et al., 2005]


12/26

Health Effects of Diesel

Advantages of diesel engines:

higher fuel efficiency

low CO and CO2 emissions

Disadvantages:

High emission of PM, NOx, and chemicalsattached to PM (e.g. PAHs)

Health effects:Acute effects (e.g. exacerbating asthma)

Cancer


13/26

Diesel Effects on Childhood Illness(Janssen NA, et al., 2003)


14/26

-6

-5

-4

-3

-2

-1

0

15-64 65+ 15-64 65+

Reductions in Deaths after Sulphur Restriction

Cardiovascular Respiratory

%R

eductionin

annualtrend

-1.6%

-2.4%

-4.8%

-4.2%


15/26

Megacities and Air Pollution

An estimated 20-30% of all respiratorydiseases in Asian mega-cities such as

Beijing Jakarta, Karachi, Kolkata and NewDelhi arise due to air pollution.


16/26

Particulate Matter (PM10) (g/m3)Source: World Development Indicator, 2008, Volume 8, 3.14

WHO guidelines = annual mean < 50 g/m3


17/26

Nitrogen Oxide (NO2) (g/m3)Source: World Development Indicator, 2008, Volume 8, 3.14

Developed megacities

Middle-income or developing megacities

WHO guidelines = annual mean


18/26

Sulphur Oxide (SO2) (g/m3)

Source: World Development Indicator, 2008, Volume 8, 3.14

Developed megacities

Middle-income or developing megacities

WHO guidelines = annual mean


19/26

Association of PM2.5 with Cardiovascular and

Respiratory Diseases in Karachi

Pakistan PI: Dr. Zafar Fatmi

Co-inv.: Dr Ambreen Kazi

Division of Environmental HealthSciences, Department of CommunityHealth Sciences, Aga Khan University,Pakistan.

Dr Nadeem Rizvi, Jinnah PostgraduateMedical Center.

Dr Sardar Alam Siddiqui, Karachi

University.

Joint Project of Pakistan-US Science and Technology Cooperative program

US PI: Dr. David O Carpenter

Co-inv.: Dr. Haider Khwaja &

Dr Azhar Siddiqui

Institute of Environment and Health,University at Albany, US.


20/26

Association of PM2.5 with Cardiovascular and

Respiratory Diseases in Karachi

PM2 5 Tib t C t K hi


21/26

0

50

100

150

200

250

300

PM2.5

Tibet Center, Karachi[WHO guideline (red line) = 24-hrs mean 25 g/m3] [Annual mean=15 g/m3]

0

50

100

150

200

250

300

30 Aug 14 Oct, 2008 24 Dec, 2008 08 Feb, 2009

18 Mar, 2009 03 May, 2009

0

50

100

150

200

250

300

0

50

100

150

200

250

300

29 Jun, 2009 15 Aug, 2009

PM2 5 K i K hi


22/26

0

50

100

150

200

250

300

24 Dec, 2008 08 Feb, 2009

PM2.5

Korangi, Karachi[WHO guideline (red line) = 24-hrs mean 25 g/m3]

0

50

100

150

200

250

300

30 Aug 2008 14 Oct, 2008

0

50

100

150

200

250

300

18 Mar, 2009 03 May, 2009

0

50

100

150

200

250

300

29 Jun, 2009 15 Aug, 2009


23/26

PM 2.5 in KarachiMinimum Maximum Annual mean

[Annualmean=15g/m3]

Tibet Centre 27 258 77.68

Korangi 29.6 278 99.28


24/26

Results

Results adjusted for time trends,meteorological factors, seasonal patterns

Interpretation: For every 10 /m3 increasein PM2.5 leads to 16% more admissions (duecardiovascular diseases including myocardial

infarction, cardiac failure, ischemic heartdiseases), which needs medical attention.


25/26

DPSEEA Framework

ACTIONEconomic and

Social Policies;

Clean

Technologies(Fuel)

Hazard

Management

Environmental

Improvement;

Pollution monitoring

and control

Education;Awareness

raising

Treatment

Rehabilitation

Driving Forces

(e.g. population

growth, economicdevelopment,

technology)Pressures

(e.g. Production,

consumption,

waste release)

States

(e.g. Natural

hazards, resource

availability, pollution

levels )

Exposures

(e.g.External

exposures, abnormal

dose, target organ

dose)

Effects

(e.g. well-being,

morbidity,

mortality)

Health and environment cause-effect framework(Ref: Kjellstriim T & Briggs D et al)


26/26

Thank You!Zafar Fatmi

Email: [email protected]

Website: http://www.aku.edu/CHS/ehs-index.shtml
mailto:[email protected]://www.aku.edu/CHS/ehs-index.shtmlhttp://www.aku.edu/CHS/ehs-index.shtmlhttp://www.aku.edu/CHS/ehs-index.shtmlhttp://www.aku.edu/CHS/ehs-index.shtmlmailto:[email protected]

Documents

Fuel Quality, Air Pollution and Health in Pakistan.ppt