INTERNSHIP PROJECT REPORT

Session 2023-24

Narvadeshwar Degree College

Narendra Nagar , Malhour Railway Station Road (Opposite Vikalp Khand ),
Gomti Nagar , Lucknow , Uttar Pradesh

Topic- Damage Caused by Air Pollution

Submitted in fulfillment of the award of the Degree
Bachelor of Arts (Subject- Home Science)
Lucknow University

Submitted by: Under the Guidance:

Sindhu Kumari Dr. Devendra P.B. Srivastava
B.A. 5th Semester

Roll No.- 2111521010038

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 Certificate
This is to certify that the project entitled “Damage Caused by
Air Pollution” is carried by Sindhu Kumari during year 2023 in the
Partial fulfillment of the requirements for the award of Bachelor of
Arts from Narvadeshwar Degree College, Lucknow.

Signature of Student Signature of Guide

Sindhu Kumari Dr. Devendra P.B. Srivastava
(2111521010038)

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(2111521010038)

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 CONTENT

SN Title Page No.

1 Introduction 1-5

2 Sources of Air Pollution 6– 8

3 Global Warming 9 – 11

4 Approach to the Problem 11 – 27

5 Effect of Air Pollution on Health 27 – 33

6 Discussion 34 – 42

7 Reference 43 - 58

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INTRODUCTION:
AIR POLLUTION
Air is composed of ~78% nitrogen, ~21% oxygen, ~0.9% argon. The remaining
elements include carbon dioxide, water vapour, hydrogen, and other trace elements.
Although gases like carbon dioxide and methane may only exist in small absolute
concentrations, their outsized heat-trapping potential as greenhouse gases makes them
the major factor in accelerating climate change. Air pollution occurs when there is an
alteration to the composition of air, either by volume, or in the chemical, physical, or
biological properties. The atmosphere is a delicate balance of elements and particles.
Any imbalance, even in small proportions can be detrimental to living organisms
including animals and crops.
Air pollution is caused by a combination of gaseous and particulate pollutants such as
carbon dioxide, methane, and nitrogen dioxide emitted from point sources such as
factories and motor vehicles that burn fuel. Some gaseous emissions are visible to the
eye and sometimes may even diffuse into the atmosphere and become invisible.
Particulate pollution, on the other hand, such as soot and black carbon, is always
visible.
Air pollution is caused by a variety of sources including but not limited to
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transportation, factory emissions, biomass combustion, and agricultural production .
The air pollution emitted from point sources is somewhat easy to quantify. However,
the cost of air pollution is much more challenging to quantify because each product
and material has a different impact embedded within it. When air pollutants are
released into the atmosphere, they have adverse effects on humans and the
environment. A notable feature of air pollution is that the effects are compounding,
indicating that it can trigger a chain reaction of other environmental effects. Some
examples of Effect → Chain Reaction → Compounded Effect are:
1. Health problems to human beings and other living beings: respiratory problems, poisoning blood stream due to inhalation
of noxious gases, extinction of species → accelerated requirement of manufacturing of pharmaceuticals & medical care which
requires more energy → more energy

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 required is obtained by burning more fuels → more emissions into the atmosphere
2. Ocean acidification → aquatic and marine life dies faster, rocks in oceans erode faster → creates imbalance in the ocean
composition which reduces ocean capacity to absorb pollutants from the atmosphere → more pollutants remain in the atmosphere
3. Greenhouse effect → global mean temperatures rise which causes irregular and unpredictable weather patterns → Increased devastation from as
wildfires for

weeks, natural calamities and disasters which required emergency services → increased uncontrolled emission in the atmosphere

CASE STUDY
An example of how air pollutants impact the environment and human life is through
detailing the compounding effects of melting ice caps in the north and south poles,
which then increases air pollution. When glaciers grow, they store pollutants from the
contemporary environment. Now that glaciers are melting, pollutants from various
periods release into the atmosphere, which, as a net effect, compounds and accelerates
the effects of air pollution. The pollutants reflect the state of when they were
preserved; if they weren’t melting, they would be a stored away history of human
interaction with the environment. However, the warming climate poses a risk of
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accelerated environmental pollution and health risk .
TAKE ACTION
A great method for combating air pollution is to advocate for governments and
organizations to adopt a combination of innovative policies, financial incentives, and
invest in non-polluting sustainable technologies.
Air pollution consists of chemicals or particles in the air that can harm the health of
humans, animals, and plants. It also damages buildings. Pollutants in the air take many
forms. They can be gases, solid particles, or liquid droplets.
Sources of Air Pollution
Pollution enters the Earth's atmosphere in many different ways. Most air pollution is
created by people, taking the form of emissions from factories, cars, planes, or aerosol
cans. Second-hand cigarette smoke is also considered air pollution. These man-

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made sources of pollution are called anthropogenic sources. Some types of air
pollution, such as smoke from wildfires or ash from volcanoes, occur naturally. These
are called natural sources.
Air pollution is most common in large cities where emissions from many different
sources are concentrated. Sometimes, mountains or tall buildings prevent air pollution
from spreading out. This air pollution often appears as a cloud making the air murky.
It is called smog. The word "smog" comes from combining the words "smoke" and
"fog."
Large cities in poor and developing nations tend to have more air pollution than cities
in developed nations. According to the World Health Organization (WHO), some of
the worlds most polluted cities are Karachi, Pakistan; New Delhi, India; Beijing,
China; Lima, Peru; and Cairo, Egypt. However, many developed nations also have air
pollution problems. Los Angeles, California, is nicknamed Smog City.
Indoor Air Pollution
Air pollution is usually thought of as smoke from large factories or exhaust from
vehicles. But there are many types of indoor air pollution as well. Heating a house by
burning substances such as kerosene, wood, and coal can contaminate the air inside
the house. Ash and smoke make breathing difficult, and they can stick to walls, food,
and clothing.
Naturally-occurring radon gas, a cancer-causing material, can also build up in homes.
Radon is released through the surface of the Earth. Inexpensive systems installed by
professionals can reduce radon levels.
Some construction materials, including insulation, are also dangerous to people's
health. In addition, ventilation, or air movement, in homes and rooms can lead to the
spread of toxic mold. A single colony of mold may exist in a damp, cool place in a
house, such as between walls. The mold's spores enter the air and spread throughout
the house. People can become sick from breathing in the spores.
Effects On Humans
People experience a wide range of health effects from being exposed to air pollution.
Effects can be broken down into short-term effects and long-term effects. Short-term
effects, which are temporary, include illnesses such as pneumonia or bronchitis. They

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also include discomfort such as irritation to the nose, throat, eyes, or skin. Air
pollution can also cause headaches, dizziness, and nausea. Bad smells made by
factories, garbage, or sewer systems are considered air pollution, too. These odors are
less serious but still unpleasant.
Long-term effects of air pollution can last for years or for an entire lifetime. They can
even lead to a person's death. Long-term health effects from air pollution include heart
disease, lung cancer, and respiratory diseases such as emphysema. Air pollution can
also cause long-term damage to people's nerves, brain, kidneys, liver, and other
organs. Some scientists suspect air pollutants cause birth defects. Nearly 2.5 million
people die worldwide each year from the effects of outdoor or indoor air pollution.
People react differently to different types of air pollution. Young children and older
adults, whose immune systems tend to be weaker, are often more sensitive to
pollution. Conditions such as asthma, heart disease, and lung disease can be made
worse by exposure to air pollution. The length of exposure and amount and type of
pollutants are also factors.
Effects On The Environment
Like people, animals, and plants, entire ecosystems can suffer effects from air
pollution. Haze, like smog, is a visible type of air pollution that obscures shapes and
colors. Hazy air pollution can even muffle sounds.
Air pollution particles eventually fall back to Earth. Air directly pollution can
contaminate the surface of bodies of water and soil. kill crops or reduce This can
their yield. It can kill young trees and other plants.
Sulfur dioxide and nitrogen oxide particles in the air, can create acid rain when they
mix with water and oxygen in the atmosphere. These air pollutants come mostly from
coal-fired power plants and motor vehicles. When acid rain falls to Earth, it damages
plants by changing soil composition; degrades water quality in rivers, lakes and
streams; damages crops; and can cause buildings and monuments to decay.
Like humans, animals can suffer health effects from exposure to air pollution. Birth
defects, diseases, and lower reproductive rates have all been attributed to air pollution.

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Global Warming
Global warming is an environmental phenomenon caused by natural and
anthropogenic air pollution. It refers to rising air and ocean temperatures around the
world. This temperature rise is at least partially caused by an increase in the amount
of greenhouse gases in the atmosphere. Greenhouse gases trap heat energy in the
Earths atmosphere. (Usually, more of Earths heat escapes into space.)
Carbon dioxide is a greenhouse gas that has had the biggest effect on global
warming. Carbon dioxide is emitted into the atmosphere by burning fossil
fuels (coal, gasoline, and natural gas). Humans have come to rely on fossil fuels to
power cars and planes, heat homes, and run factories. Doing these things pollutes the
air with carbon dioxide.
Other greenhouse gases emitted by natural and artificial sources also
include methane, nitrous oxide, and fluorinated gases. Methane is a
major emission from coal plants and agricultural processes. Nitrous oxide is a
common emission from industrial factories, agriculture, and the burning of fossil
fuels in cars. Fluorinated gases, such as hydrofluorocarbons, are emitted by
industry. Fluorinated gases are often used instead of gases such as
chlorofluorocarbons (CFCs). CFCs have been outlawed in many places because they
deplete the ozone layer.
Worldwide, many countries have taken steps to reduce or
limit greenhouse gas emissions to combat global warming. The Kyoto Protocol, first
adopted in Kyoto, Japan, in 1997, is an agreement between 183 countries that they
will work to reduce their carbon dioxide emissions. The United States has not signed
that treaty.
Regulation
In addition to the international Kyoto Protocol, most developed nations have adopted
laws to regulate emissions and reduce air pollution. In the United States, debate is
under way about a system called cap and trade to limit emissions. This system would
cap, or place a limit, on the amount of pollution a company is allowed. Companies
that exceeded their cap would have to pay. Companies that polluted less than their cap

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could trade or sell their remaining pollution allowance to other companies. Cap and
trade would essentially pay companies to limit pollution.
In 2006 the World Health Organization issued new Air Quality Guidelines. The
WHOs guidelines are tougher than most individual countries existing guidelines. The
WHO guidelines aim to reduce air pollution-related deaths by 15 percent a year.
Reduction
Anybody can take steps to reduce air pollution. Millions of people every day make
simple changes in their lives to do this. Taking public transportation instead of driving
a car, or riding a bike instead of traveling in carbon dioxide-emitting vehicles are a
couple of ways to reduce air pollution. Avoiding aerosol cans, recycling yard
trimmings instead of burning them, and not smoking cigarettes are others.
FAST FACT
Down winders
The United States conducted tests of nuclear weapons at the Nevada Test Site in
southern Nevada in the 1950s. These tests sent invisible radioactive particles into the
atmosphere. These air pollution particles traveled with wind currents, eventually
falling to Earth, sometimes hundreds of miles away in states including Idaho, Utah,
Arizona, and Washington. These areas were considered to be "downwind" from the
Nevada Test Site.
Decades later, people living in those downwind areascalled "downwinders"began
developing cancer at above-normal rates. In 1990, the U.S. government passed the
Radiation Exposure Compensation Act. This law entitles some downwinders to
payments of $50,000.
FAST FACT
Greenhouse Gases
There are five major greenhouse gases in Earth's atmosphere.
FAST FACT
London Smog
What has come to be known as the London Smog of 1952, or the Great Smog of 1952,
was a four-day incident that sickened 100,000 people and caused as many as 12,000
deaths. Very cold weather in December 1952 led residents of London, England, to

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burn more coal to keep warm. Smoke and other pollutants became trapped by a thick
fog that settled over the city. The polluted fog became so thick that people could only
see a few meters in front of them.
One of our era's greatest scourges is air pollution, on account not only of its impact on
climate change but also its impact on public and individual health due to increasing
morbidity and mortality. There are many pollutants that are major factors in disease in
humans. Among them, Particulate Matter (PM), particles of variable but very small
diameter, penetrate the respiratory system via inhalation, causing respiratory and
cardiovascular diseases, reproductive and central nervous system dysfunctions, and
cancer. Despite the fact that ozone in the stratosphere plays a protective role aagainst
ultraviolet irradiation, it is harmful when in high concentration at ground level, also
affecting the respiratory and cardiovascular system. Furthermore, nitrogen oxide,
sulfur dioxide, Volatile Organic Compounds (VOCs), dioxins, and polycyclic
aromatic hydrocarbons (PAHs) are all considered air pollutants that are harmful to
humans. Carbon monoxide can even provoke direct poisoning when breathed in at
high levels. Heavy metals such as lead, when absorbed into the human body, can lead
to direct poisoning or chronic intoxication, depending on exposure. Diseases
occurring from the aforementioned substances include principally respiratory
problems such as Chronic Obstructive Pulmonary Disease (COPD), asthma,
bronchiolitis, and also lung cancer, cardiovascular events, central nervous system
dysfunctions, and cutaneous diseases. Last but not least, climate change resulting
fromenvironmental pollution affects the geographical distribution of many infectious
diseases, as do natural disasters. The only way to tackle this problem is through public
awareness coupled with a multidisciplinary approach by scientific experts; national
and international organizations must address the emergence of this threat and propose
sustainable solutions.
Approach to the Problem
The interactions between humans and their physical surroundings have been
extensively studied, as multiple human activities influence the environment. The
environment is a coupling of the biotic (living organisms and microorganisms) and the
abiotic (hydrosphere, lithosphere, and atmosphere).

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Pollution is defined as the introduction into the environment of substances harmful to
humans and other living organisms. Pollutants are harmful solids, liquids, or gases
produced in higher than usual concentrations that reduce the quality of our
environment.
Human activities have an adverse effect on the environment by polluting the water we
drink, the air we breathe, and the soil in which plants grow. Although the industrial
revolution was a great success in terms of technology, society, and the provision of
multiple services, it also introduced the production of huge quantities of pollutants
emitted into the air that are harmful to human health. Without any doubt, the global
environmental pollution is considered an international public health issue with
multiple facets. Social, economic, and legislative concerns and lifestyle habits are
related to this major problem. Clearly, urbanization and industrialization are reaching
unprecedented and upsetting proportions worldwide in our era. Anthropogenic air
pollution is one of the biggest public health hazards worldwide, given that it accounts
for about 9 million deaths per year (1).
Without a doubt, all of the aforementioned are closely associated with climate change,
and in the event of danger, the consequences can be severe for mankind (2). Climate
changes and the effects of global planetary warming seriously affect multiple
ecosystems, causing problems such as food safety issues, ice and iceberg melting,
animal extinction, and damage to plants (3, 4).
Air pollution has various health effects. The health of susceptible and sensitive
individuals can be impacted even on low air pollution days. Short-term exposure to air
pollutants is closely related to COPD (Chronic Obstructive Pulmonary Disease),
cough, shortness of breath, wheezing, asthma, respiratory disease, and high rates of
hospitalization (a measurement of morbidity).
The long-term effects associated with air pollution are chronic asthma, pulmonary
insufficiency, cardiovascular diseases, and cardiovascular mortality. According to a
Swedish cohort study, diabetes seems to be induced after long-term air pollution
exposure (5). Moreover, air pollution seems to have various malign health effects in
early human life, such as respiratory, cardiovascular, mental, and perinatal disorders
(3), leading to infant mortality or chronic disease in adult age (6).

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National reports have mentioned the increased risk of morbidity and mortality (1).
These studies were conducted in many places around the world and show a correlation
between daily ranges of particulate matter (PM) concentration and daily mortality.
Climate shifts and global planetary warming (3) could aggravate the situation.
Besides, increased hospitalization (an index of morbidity) has been registered among
the elderly and susceptible individuals for specific reasons. Fine and ultrafine
particulate matter seems to be associated with more serious illnesses (6), as it can
invade the deepest parts of the airways and more easily reach the bloodstream.
Air pollution mainly affects those living in large urban areas, where road emissions
contribute the most to the degradation of air quality. There is also a danger of
industrial accidents, where the spread of a toxic fog can be fatal to the populations of
the surrounding areas. The dispersion of pollutants is determined by many parameters,
most notably atmospheric stability and wind (6).
In developing countries (7), the problem is more serious due to overpopulation and
uncontrolled urbanization along with the development of industrialization. This leads
to poor air quality, especially in countries with social disparities and a lack of
information on sustainable management of the environment. The use of fuels such as
wood fuel or solid fuel for domestic needs due to low incomes exposes people to bad-
quality, polluted air at home. It is of note that three billion people around the world
are using the above sources of energy for their daily heating and cooking needs (8). In
developing countries, the women of the household seem to carry the highest risk for
disease development due to their longer duration exposure to the indoor air pollution
(8, 9). Due to its fast industrial development and overpopulation, China is one of the
Asian countries confronting serious air pollution problems (10, 11). The lung cancer
mortality observed in China is associated with fine particles (12). As stated already,
long-term exposure is associated with deleterious effects on the cardiovascular system
(3, 5). However, it is interesting to note that cardiovascular diseases have mostly been
observed in developed and high-income countries rather than in the developing low-
income countries exposed highly to air pollution (13). Extreme air pollution is
recorded in India, where the air quality reaches hazardous levels. New Delhi is one of
the more polluted cities in India. Flights in and out of New Delhi International Airport

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are often canceled due to the reduced visibility associated with air pollution. Pollution
is occurring both in urban and rural areas in India due to the fast industrialization,
urbanization, and rise in use of motorcycle transportation. Nevertheless, biomass
combustion associated with heating and cooking needs and practices is a major source
of household air pollution in India and in Nepal (14, 15). There is spatial
heterogeneity in India, as areas with diverse climatological conditions and population
and education levels generate different indoor air qualities, with higher PM 2.5
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observed in North Indian states (557–601 μg/m ) compared to the Southern States
3
(183–214 μg/m ) (16, 17). The cold climate of the North Indian areas may be the main
reason for this, as longer periods at home and more heating are necessary compared to
in the tropical climate of Southern India. Household air pollution in India is associated
with major health effects, especially in women and young children, who stay indoors
for longer periods. Chronic obstructive respiratory disease (CORD) and lung cancer
are mostly observed in women, while acute lower respiratory disease is seen in young
children under 5 years of age (18).
Accumulation of air pollution, especially sulfur dioxide and smoke, reaching 1,500
mg/m3, resulted in an increase in the number of deaths (4,000 deaths) in December
1952 in London and in 1963 in New York City (400 deaths) (19). An association of
pollution with mortality was reported on the basis of monitoring of outdoor pollution
in six US metropolitan cities (20). In every case, it seems that mortality was closely
related to the levels of fine, inhalable, and sulfate particles more than with the levels
of total particulate pollution, aerosol acidity, sulfur dioxide, or nitrogen dioxide (20).
Furthermore, extremely high levels of pollution are reported in Mexico City and Rio
de Janeiro, followed by Milan, Ankara, Melbourne, Tokyo, and Moscow (19).
Based on the magnitude of the public health impact, it is certain that different kinds of
interventions should be taken into account. Success and effectiveness in controlling air
pollution, specifically at the local level, have been reported. Adequate technological
means are applied considering the source and the nature of the emission as well as its
impact on health and the environment. The importance of point sources and non-point
sources of air pollution control is reported by Schwela and Köth-Jahr (21). Without a
doubt, a detailed emission inventory must record all sources in a given area. Beyond

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considering the above sources and their nature, topography and meteorology should
also be considered, as stated previously. Assessment of the control policies and
methods is often extrapolated from the local to the regional and then to the global
scale. Air pollution may be dispersed and transported from one region to another area
located far away. Air pollution management means the reduction to acceptable levels
or possible elimination of air pollutants whose presence in the air affects our health or
the environmental ecosystem. Private and governmental entities and authorities
implement actions to ensure the air quality (22). Air quality standards and guidelines
were adopted for the different pollutants by the WHO and EPA as a tool for the
management of air quality (1, 23). These standards have to be compared to the
emissions inventory standards by causal analysis and dispersion modeling in order to
reveal the problematic areas (24). Inventories are generally based on a combination of
direct measurements and emissions modeling (24).
As an example, we state here the control measures at the source through the use of
catalytic converters in cars. These are devices that turn the pollutants and toxic gases
produced from combustion engines into less-toxic pollutants by catalysis through
redox reactions (25). In Greece, the use of private cars was restricted by tracking their
license plates in order to reduce traffic congestion during rush hour (25).
Concerning industrial emissions, collectors and closed systems can keep the air
pollution to the minimal standards imposed by legislation (26).
Current strategies to improve air quality require an estimation of the economic value
of the benefits gained from proposed programs. These proposed programs by public
authorities, and directives are issued with guidelines to be respected.
In Europe, air quality limit values AQLVs (Air Quality Limit Values) are issued for
setting off planning claims (27). In the USA, the NAAQS (National Ambient Air
Quality Standards) establish the national air quality limit values (27). While both
standards and directives are based on different mechanisms, significant success has
been achieved in the reduction of overall emissions and associated health and
environmental effects (27). The European Directive identifies geographical areas of
risk exposure as monitoring/assessment zones to record the emission sources and
levels of air pollution (27), whereas the USA establishes global geographical air

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quality criteria according to the severity of their air quality problem and records all
sources of the pollutants and their precursors (27).
In this vein, funds have been financing, directly or indirectly, projects related to air
quality along with the technical infrastructure to maintain good air quality. These
plans focus on an inventory of databases from air quality environmental planning
awareness campaigns. Moreover, pollution measures of air emissions may be taken
for vehicles, machines, and industries in urban areas.
Technological innovation can only be successful if it is able to meet the needs of
society. In this sense, technology must reflect the decision-making practices and
procedures of those involved in risk assessment and evaluation and act as a facilitator
in providing information and assessments to enable decision makers to make the best
decisions possible. Summarizing the aforementioned in order to design an effective air
quality control strategy, several aspects must be considered: environmental factors and
ambient air quality conditions, engineering factors and air pollutant characteristics,
and finally, economic operating costs for technological improvement and
administrative and legal costs. Considering the economic factor, competitiveness
through neoliberal concepts is offering a solution to environmental problems (22).
The development of environmental governance, along with technological progress,
has initiated the deployment of a dialogue. Environmental politics has created
objections and points of opposition between different political parties, scientists,
media, and governmental and non-governmental organizations (22). Radical
environmental activism actions and movements have been created (22). The rise of the
new information and communication technologies (ICTs) are many times examined as
to whether and in which way they have influenced means of communication and
social movements such as activism (28). Since the 1990s, the term “digital activism”
has been used increasingly and in many different disciplines (29). Nowadays, multiple
digital technologies can be used to produce a digital activism outcome on
environmental issues. More specifically, devices with online capabilities such as
computers or mobile phones are being used as a way to pursue change in political and
social affairs (30).

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In the present paper, we focus on the sources of environmental pollution in relation to
public health and propose some solutions and interventions that may be of interest to
environmental legislators and decision makers.
Sources of Exposure
It is known that the majority of environmental pollutants are emitted through large-
scale human activities such as the use of industrial machinery, power-producing
stations, combustion engines, and cars. Because these activities are performed at such
a large scale, they are by far the major contributors to air pollution, with cars
estimated to be responsible for approximately 80% of today's pollution (31). Some
other human activities are also influencing our environment to a lesser extent, such as
field cultivation techniques, gas stations, fuel tanks heaters, and cleaning procedures
(32), as well as several natural sources, such as volcanic and soil eruptions and forest
fires.
The classification of air pollutants is based mainly on the sources producing pollution.
Therefore, it is worth mentioning the four main sources, following the classification
system: Major sources, Area sources, Mobile sources, and Natural sources.
Major sources include the emission of pollutants from power stations, refineries, and
petrochemicals, the chemical and fertilizer industries, metallurgical and other
industrial plants, and, finally, municipal incineration.
Indoor area sources include domestic cleaning activities, dry cleaners, printing shops,
and petrol stations.
Mobile sources include automobiles, cars, railways, airways, and other types of
vehicles.
Finally, natural sources include, as stated previously, physical disasters (33) such as
forest fire, volcanic erosion, dust storms, and agricultural burning.
However, many classification systems have been proposed. Another type of
classification is a grouping according to the recipient of the pollution, as follows:
Air pollution is determined as the presence of pollutants in the air in large quantities
for long periods. Air pollutants are dispersed particles, hydrocarbons, CO, CO 2, NO,
NO2, SO3, etc.

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Water pollution is organic and inorganic charge and biological charge (10) at high
levels that affect the water quality (34, 35).
Soil pollution occurs through the release of chemicals or the disposal of wastes, such
as heavy metals, hydrocarbons, and pesticides.
Air pollution can influence the quality of soil and water bodies by polluting
precipitation, falling into water and soil environments (34, 36). Notably, the chemistry
of the soil can be amended due to acid precipitation by affecting plants, cultures, and
water quality (37). Moreover, movement of heavy metals is favored by soil acidity,
and metals are so then moving into the watery environment. It is known that heavy
metals such as aluminum are noxious to wildlife and fishes. Soil quality seems to be
of importance, as soils with low calcium carbonate levels are at increased jeopardy
from acid rain. Over and above rain, snow and particulate matter drip into watery '
bodies (36, 38).
Lastly, pollution is classified following type of origin:
Radioactive and nuclear pollution, releasing radioactive and nuclear pollutants into
water, air, and soil during nuclear explosions and accidents, from nuclear weapons,
and through handling or disposal of radioactive sewage.
Radioactive materials can contaminate surface water bodies and, being noxious to the
environment, plants, animals, and humans. It is known that several radioactive
substances such as radium and uranium concentrate in the bones and can cause
cancers (38, 39).
Noise pollution is produced by machines, vehicles, traffic noises, and musical
installations that are harmful to our hearing.
The World Health Organization introduced the term DALYs. The DALYs for a
disease or health condition is defined as the sum of the Years of Life Lost (YLL) due
to premature mortality in the population and the Years Lost due to Disability (YLD)
for people living with the health condition or its consequences (39). In Europe, air
pollution is the main cause of disability-adjusted life years lost (DALYs), followed by
noise pollution. The potential relationships of noise and air pollution with health have
been studied (40). The study found that DALYs related to noise were more important
than those related to air pollution, as the effects of environmental noise on

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cardiovascular disease were independent of air pollution (40). Environmental noise
should be counted as an independent public health risk (40).
Environmental pollution occurs when changes in the physical, chemical, or biological
constituents of the environment (air masses, temperature, climate, etc.) are produced.
Pollutants harm our environment either by increasing levels above normal or by
introducing harmful toxic substances. Primary pollutants are directly produced from
the above sources, and secondary pollutants are emitted as by-products of the primary
ones. Pollutants can be biodegradable or non-biodegradable and of natural origin or
anthropogenic, as stated previously. Moreover, their origin can be a unique source
(point-source) or dispersed sources.
Pollutants have differences in physical and chemical properties, explaining the
discrepancy in their capacity for producing toxic effects. As an example, we state here
that aerosol compounds (41–43) have a greater toxicity than gaseous compounds due
to their tiny size (solid or liquid) in the atmosphere; they have a greater penetration
capacity. Gaseous compounds are eliminated more easily by our respiratory system
(41). These particles are able to damage lungs and can even enter the bloodstream
(41), leading to the premature deaths of millions of people yearly. Moreover, the
aerosol acidity ([H+]) seems to considerably enhance the production of secondary
organic aerosols (SOA), but this last aspect is not supported by other scientific teams
(38).
Climate and Pollution
Air pollution and climate change are closely related. Climate is the other side of the
same coin that reduces the quality of our Earth (44). Pollutants such as black carbon,
methane, tropospheric ozone, and aerosols affect the amount of incoming sunlight. As
a result, the temperature of the Earth is increasing, resulting in the melting of ice,
icebergs, and glaciers.
In this vein, climatic changes will affect the incidence and prevalence of both residual
and imported infections in Europe. Climate and weather affect the duration, timing,
and intensity of outbreaks strongly and change the map of infectious diseases in the
globe (45). Mosquito-transmitted parasitic or viral diseases are extremely climate-
sensitive, as warming firstly shortens the pathogen incubation period and secondly

19
shifts the geographic map of the vector. Similarly, water-warming following climate
changes leads to a high incidence of waterborne infections. Recently, in Europe,
eradicated diseases seem to be emerging due to the migration of population, for
example, cholera, poliomyelitis, tick-borne encephalitis, and malaria (46).
The spread of epidemics is associated with natural climate disasters and storms, which
seem to occur more frequently nowadays (47). Malnutrition and disequilibration of
the immune system are also associated with the emerging infections affecting public
health (48).
The Chikungunya virus “took the airplane” from the Indian Ocean to Europe, as
outbreaks of the disease were registered in Italy (49) as well as autochthonous cases in
France (50).
An increase in cryptosporidiosis in the United Kingdom and in the Czech Republic
seems to have occurred following flooding (36, 51).
As stated previously, aerosols compounds are tiny in size and considerably affect the
climate. They are able to dissipate sunlight (the albedo phenomenon) by dispersing a
quarter of the sun's rays back to space and have cooled the global temperature over the
last 30 years (52).
Air Pollutants
The World Health Organization (WHO) reports on six major air pollutants, namely
particle pollution, ground-level ozone, carbon monoxide, sulfur oxides, nitrogen
oxides, and lead. Air pollution can have a disastrous effect on all components of the
environment, including groundwater, soil, and air. Additionally, it poses a serious
threat to living organisms. In this vein, our interest is mainly to focus on these
pollutants, as they are related to more extensive and severe problems in human health
and environmental impact. Acid rain, global warming, the greenhouse effect, and
climate changes have an important ecological impact on air pollution (53).
Particulate Matter (PM) and Health
Studies have shown a relationship between particulate matter (PM) and adverse health
effects, focusing on either short-term (acute) or long-term (chronic) PM exposure.
Particulate matter (PM) is usually formed in the atmosphere as a result of chemical
reactions between the different pollutants. The penetration of particles is closely

20
dependent on their size (53). Particulate Matter (PM) was defined as a term for particles by the United States
Environmental Protection Agency (54). Particulate matter (PM) pollution includes particles with diameters of 10
micrometers (μm) or smaller, called PM 10, and extremely fine particles with diameters that are generally 2.5
micrometers (μm) and smaller.

Particulate matter contains tiny liquid or solid droplets that can be inhaled and cause serious
health effects (55). Particles <10 μm in diameter (PM10) after inhalation can invade the lungs and
even reach the bloodstream. Fine particles, PM2.5, pose a greater risk to health (6, 56) (Table 1).

Table 1

TABLE 1. Penetrability according to particle size.

Multiple epidemiological studies have been performed on the health effects of PM. A
positive relation was shown between both short-term and long-term exposures of
PM2.5 and acute nasopharyngitis (56). In addition, long-term exposure to PM for years
was found to be related to cardiovascular diseases and infant mortality.
Those studies depend on PM2.5 monitors and are restricted in terms of study area or city

area due to a lack of spatially resolved daily PM 2.5 concentration data and, in this way,
are not representative of the entire population. Following a recent epidemiological study
by the Department of Environmental Health at Harvard School of Public Health (Boston,

MA) (57), it was reported that, as PM2.5 concentrations vary spatially, an exposure error
(Berkson error) seems to be produced, and the relative magnitudes of the short- and long-
term effects are not yet completely elucidated. The

21
team developed a PM2.5 exposure model based on remote sensing data for assessing
short- and long-term human exposures (57). This model permits spatial resolution in
short-term effects plus the assessment of long-term effects in the whole population.
Moreover, respiratory diseases and affection of the immune system are registered as
long-term chronic effects (58). It is worth noting that people with asthma, pneumonia,
diabetes, and respiratory and cardiovascular diseases are especially susceptible and

vulnerable to the effects of PM. PM2.5, followed by PM10, are strongly associated with
diverse respiratory system diseases (59), as their size permits them to pierce interior
spaces (60). The particles produce toxic effects according to their chemical and

physical properties. The components of PM10 and PM2.5 can be organic (polycyclic
aromatic hydrocarbons, dioxins, benzene, 1-3 butadiene) or inorganic (carbon,
chlorides, nitrates, sulfates, metals) in nature (55).
Particulate Matter (PM) is divided into four main categories according to type and size
(61) (Table 2). Table 2

22
TABLE 2. Types and sizes of particulate Matter (PM).
Gas contaminants include PM in aerial masses.
Particulate contaminants include contaminants such as smog, soot, tobacco smoke, oil
smoke, fly ash, and cement dust.
Biological Contaminants are microorganisms (bacteria, viruses, fungi, mold, and
bacterial spores), cat allergens, house dust and allergens, and pollen.
Types of Dust include suspended atmospheric dust, settling dust, and heavy dust.

Finally, another fact is that the half-lives of PM10 and PM2.5 particles in the
atmosphere is extended due to their tiny dimensions; this permits their long-lasting
suspension in the atmosphere and even their transfer and spread to distant destinations
where people and the environment may be exposed to the same magnitude of
pollution (53). They are able to change the nutrient balance in watery ecosystems,
damage forests and crops, and acidify water bodies.
As stated, PM2.5, due to their tiny size, are causing more serious health effects. These
aforementioned fine particles are the main cause of the “haze” formation in different
metropolitan areas (12, 13, 61).
Ozone Impact in the Atmosphere
Ozone (O3) is a gas formed from oxygen under high voltage electric discharge (62). It
is a strong oxidant, 52% stronger than chlorine. It arises in the stratosphere, but it
could also arise following chain reactions of photochemical smog in the troposphere
(63).
Ozone can travel to distant areas from its initial source, moving with air masses (64).
It is surprising that ozone levels over cities are low in contrast to the increased
amounts occuring in urban areas, which could become harmful for cultures, forests,
and vegetation (65) as it is reducing carbon assimilation (66). Ozone reduces growth
and yield (47, 48) and affects the plant microflora due to its antimicrobial capacity
(67, 68). In this regard, ozone acts upon other natural ecosystems, with microflora (69,
70) and animal species changing their species composition (71). Ozone increases
DNA damage in epidermal keratinocytes and leads to impaired cellular function (72).

23
Ground-level ozone (GLO) is generated through a chemical reaction between oxides
of nitrogen and VOCs emitted from natural sources and/or following anthropogenic
activities.
Ozone uptake usually occurs by inhalation. Ozone affects the upper layers of the skin
and the tear ducts (73). A study of short-term exposure of mice to high levels of ozone
showed malondialdehyde formation in the upper skin (epidermis) but also depletion in
vitamins C and E. It is likely that ozone levels are not interfering with the skin barrier
function and integrity to predispose to skin disease (74).
Due to the low water-solubility of ozone, inhaled ozone has the capacity to penetrate
deeply into the lungs (75).
Toxic effects induced by ozone are registered in urban areas all over the world,
causing biochemical, morphologic, functional, and immunological disorders (76).
The European project (APHEA2) focuses on the acute effects of ambient ozone
concentrations on mortality (77). Daily ozone concentrations compared to the daily
number of deaths were reported from different European cities for a 3-year period.
During the warm period of the year, an observed increase in ozone concentration was
associated with an increase in the daily number of deaths (0.33%), in the number of
respiratory deaths (1.13%), and in the number of cardiovascular deaths (0.45%). No
effect was observed during wintertime.
Carbon Monoxide (CO)
Carbon monoxide is produced by fossil fuel when combustion is incomplete. The
symptoms of poisoning due to inhaling carbon monoxide include headache, dizziness,
weakness, nausea, vomiting, and, finally, loss of consciousness.
The affinity of carbon monoxide to hemoglobin is much greater than that of oxygen.
In this vein, serious poisoning may occur in people exposed to high levels of carbon
monoxide for a long period of time. Due to the loss of oxygen as a result of the
competitive binding of carbon monoxide, hypoxia, ischemia, and cardiovascular
disease are observed.
Carbon monoxide affects the greenhouses gases that are tightly connected to global
warming and climate. This should lead to an increase in soil and water temperatures,
and extreme weather conditions or storms may occur (68).

24
However, in laboratory and field experiments, it has been seen to produce increased
plant growth (78).
Nitrogen Oxide (NO2)
Nitrogen oxide is a traffic-related pollutant, as it is emitted from automobile motor
engines (79, 80). It is an irritant of the respiratory system as it penetrates deep in the
lung, inducing respiratory diseases, coughing, wheezing, dyspnea, bronchospasm, and
even pulmonary edema when inhaled at high levels. It seems that concentrations over
0.2 ppm produce these adverse effects in humans, while concentrations higher than
2.0 ppm affect T-lymphocytes, particularly the CD8+ cells and NK cells that produce
our immune response (81).It is reported that long-term exposure to high levels of
nitrogen dioxide can be responsible for chronic lung disease. Long-term exposure to
NO2 can impair the sense of smell (81).
However, systems other than respiratory ones can be involved, as symptoms such as
eye, throat, and nose irritation have been registered (81).
High levels of nitrogen dioxide are deleterious to crops and vegetation, as they have
been observed to reduce crop yield and plant growth efficiency. Moreover, NO 2 can
reduce visibility and discolor fabrics (81).
Sulfur Dioxide (SO2)
Sulfur dioxide is a harmful gas that is emitted mainly from fossil fuel consumption or

industrial activities. The annual standard for SO 2 is 0.03 ppm (82). It affects human,
animal, and plant life. Susceptible people as those with lung disease, old people, and
children, who present a higher risk of damage. The major health problems associated
with sulfur dioxide emissions in industrialized areas are respiratory irritation,
bronchitis, mucus production, and bronchospasm, as it is a sensory irritant and
penetrates deep into the lung converted into bisulfite and interacting with sensory
receptors, causing bronchoconstriction. Moreover, skin redness, damage to the eyes
(lacrimation and corneal opacity) and mucous membranes, and worsening of pre-
existing cardiovascular disease have been observed (81).
Environmental adverse effects, such as acidification of soil and acid rain, seem to be
associated with sulfur dioxide emissions (83).

25
Lead
Lead is a heavy metal used in different industrial plants and emitted from some petrol
motor engines, batteries, radiators, waste incinerators, and waste waters (84).
Moreover, major sources of lead pollution in the air are metals, ore, and piston-engine
aircraft. Lead poisoning is a threat to public health due to its deleterious effects upon
humans, animals, and the environment, especially in the developing countries.
Exposure to lead can occur through inhalation, ingestion, and dermal absorption.
Trans- placental transport of lead was also reported, as lead passes through the
placenta unencumbered (85). The younger the fetus is, the more harmful the toxic
effects. Lead toxicity affects the fetal nervous system; edema or swelling of the brain
is observed (86). Lead, when inhaled, accumulates in the blood, soft tissue, liver, lung,
bones, and cardiovascular, nervous, and reproductive systems. Moreover, loss of
concentration and memory, as well as muscle and joint pain, were observed in adults
(85, 86).
Children and newborns (87) are extremely susceptible even to minimal doses of lead,
as it is a neurotoxicant and causes learning disabilities, impairment of memory,
hyperactivity, and even mental retardation.
Elevated amounts of lead in the environment are harmful to plants and crop growth.
Neurological effects are observed in vertebrates and animals in association with high
lead levels (88).
Polycyclic Aromatic Hydrocarbons(PAHs)
The distribution of PAHs is ubiquitous in the environment, as the atmosphere is the
most important means of their dispersal. They are found in coal and in tar sediments.
Moreover, they are generated through incomplete combustion of organic matter as in
the cases of forest fires, incineration, and engines (89). PAH compounds, such as
benzopyrene, acenaphthylene, anthracene, and fluoranthene are recognized as toxic,
mutagenic, and carcinogenic substances. They are an important risk factor for lung
cancer (89).
Volatile Organic Compounds(VOCs)
Volatile organic compounds (VOCs), such as toluene, benzene, ethylbenzene, and
xylene (90), have been found to be associated with cancer in humans (91). The use of

26
new products and materials has actually resulted in increased concentrations of VOCs.
VOCs pollute indoor air (90) and may have adverse effects on human health (91).
Short-term and long-term adverse effects on human health are observed. VOCs are
responsible for indoor air smells. Short-term exposure is found to cause irritation of
eyes, nose, throat, and mucosal membranes, while those of long duration exposure
include toxic reactions (92). Predictable assessment of the toxic effects of complex
VOC mixtures is difficult to estimate, as these pollutants can have synergic,
antagonistic, or indifferent effects (91, 93).
Dioxins
Dioxins originate from industrial processes but also come from natural processes,
such as forest fires and volcanic eruptions. They accumulate in foods such as meat and
dairy products, fish and shellfish, and especially in the fatty tissue of animals (94).
Short-period exhibition to high dioxin concentrations may result in dark spots and
lesions on the skin (94). Long-term exposure to dioxins can cause developmental
problems, impairment of the immune, endocrine and nervous systems, reproductive
infertility, and cancer (94).
Without any doubt, fossil fuel consumption is responsible for a sizeable part of air
contamination. This contamination may be anthropogenic, as in agricultural and
industrial processes or transportation, while contamination from natural sources is also
possible. Interestingly, it is of note that the air quality standards established through
the European Air Quality Directive are somewhat looser than the WHO guidelines,
which are stricter (95).
Effect of Air Pollution on Health
The most common air pollutants are ground-level ozone and Particulates Matter (PM).
Air pollution is distinguished into two main types:
Outdoor pollution is the ambient air pollution.
Indoor pollution is the pollution generated by household combustion of fuels.
People exposed to high concentrations of air pollutants experience disease symptoms
and states of greater and lesser seriousness. These effects are grouped into short- and
long-term effects affecting health.

27
Susceptible populations that need to be aware of health protection measures include
old people, children, and people with diabetes and predisposing heart or lung disease,
especially asthma.
As extensively stated previously, according to a recent epidemiological study from
Harvard School of Public Health, the relative magnitudes of the short- and long-term
effects have not been completely clarified (57) due to the different epidemiological
methodologies and to the exposure errors. New models are proposed for assessing
short- and long-term human exposure data more successfully (57). Thus, in the
present section, we report the more common short- and long-term health effects but
also general concerns for both types of effects, as these effects are often dependent on
environmental conditions, dose, and individual susceptibility.
Short-term effects are temporary and range from simple discomfort, such as irritation
of the eyes, nose, skin, throat, wheezing, coughing and chest tightness, and breathing
difficulties, to more serious states, such as asthma, pneumonia, bronchitis, and lung
and heart problems. Short-term exposure to air pollution can also cause headaches,
nausea, and dizziness.
These problems can be aggravated by extended long-term exposure to the pollutants,
which is harmful to the neurological, reproductive, and respiratory systems and causes
cancer and even, rarely, deaths.
The long-term effects are chronic, lasting for years or the whole life and can even lead
to death. Furthermore, the toxicity of several air pollutants may also induce a variety
of cancers in the long term (96).
As stated already, respiratory disorders are closely associated with the inhalation of air
pollutants. These pollutants will invade through the airways and will accumulate at the
cells. Damage to target cells should be related to the pollutant component involved
and its source and dose. Health effects are also closely dependent on country, area,
season, and time. An extended exposure duration to the pollutant should incline to
long-term health effects in relation also to the above factors.
Particulate Matter (PMs), dust, benzene, and O3 cause serious damage to the
respiratory system (97). Moreover, there is a supplementary risk in case of existing
respiratory disease such as asthma (98). Long-term effects are more frequent in people

28
with a predisposing disease state. When the trachea is contaminated by pollutants,
voice alterations may be remarked after acute exposure. Chronic obstructive
pulmonary disease (COPD) may be induced following air pollution, increasing
morbidity and mortality (99). Long-term effects from traffic, industrial air pollution,
and combustion of fuels are the major factors for COPD risk (99).
Multiple cardiovascular effects have been observed after exposure to air pollutants
(100). Changes occurred in blood cells after long-term exposure may affect cardiac
functionality. Coronary arteriosclerosis was reported following long-term exposure to
traffic emissions (101), while short-term exposure is related to hypertension, stroke,
myocardial infracts, and heart insufficiency. Ventricle hypertrophy is reported to

occur in humans after long-time exposure to nitrogen oxide (NO2) (102, 103).
Neurological effects have been observed in adults and children after extended-term
exposure to air pollutants.
Psychological complications, autism, retinopathy, fetal growth, and low birth weight
seem to be related to long-term air pollution (83). The etiologic agent of the
neurodegenerative diseases (Alzheimer's and Parkinson's) is not yet known, although
it is believed that extended exposure to air pollution seems to be a factor. Specifically,
pesticides and metals are cited as etiological factors, together with diet. The
mechanisms in the development of neurodegenerative disease include oxidative stress,
protein aggregation, inflammation, and mitochondrial impairment in neurons (104)
(Figure 1).

29
 FIGURE 1. Impact of air pollutants on the brain.
Brain inflammation was observed in dogs living in a highly polluted area in Mexico
for a long period (105). In human adults, markers of systemic inflammation (IL-6 and
fibrinogen) were found to be increased as an immediate response to PNC on the IL-6
level, possibly leading to the production of acute-phase proteins (106). The
progression of atherosclerosis and oxidative stress seem to be the mechanisms
involved in the neurological disturbances caused by long-term air pollution.
Inflammation comes secondary to the oxidative stress and seems to be involved in the
impairment of developmental maturation, affecting multiple organs (105, 107).

30
Similarly, other factors seem to be involved in the developmental maturation, which
define the vulnerability to long-term air pollution. These include birthweight, maternal
smoking, genetic background and socioeconomic environment, as well as education
level.
However, diet, starting from breast-feeding, is another determinant factor. Diet is the
main source of antioxidants, which play a key role in our protection against air
pollutants (108). Antioxidants are free radical scavengers and limit the interaction of
free radicals in the brain (108). Similarly, genetic background may result in a
differential susceptibility toward the oxidative stress pathway (60). For example,
antioxidant supplementation with vitamins C and E appears to modulate the effect of
ozone in asthmatic children homozygous for the GSTM1 null allele (61).
Inflammatory cytokines released in the periphery (e.g., respiratory epithelia)
upregulate the innate immune Toll-like receptor 2. Such activation and the subsequent
events leading to neurodegeneration have recently been observed in lung lavage in
mice exposed to ambient Los Angeles (CA, USA) particulate matter (61). In children,
neurodevelopmental morbidities were observed after lead exposure. These children
developed aggressive and delinquent behavior, reduced intelligence, learning
difficulties, and hyperactivity (109). No level of lead exposure seems to be “safe,” and
the scientific community has asked the Centers for Disease Control and Prevention
(CDC) to reduce the current screening guideline of 10 μg/dl (109).
It is important to state that impact on the immune system, causing dysfunction and
neuroinflammation (104), is related to poor air quality. Yet, increases in serum levels
of immunoglobulins (IgA, IgM) and the complement component C3 are observed
(106). Another issue is that antigen presentation is affected by air pollutants, as there
is an upregulation of costimulatory molecules such as CD80 and CD86 on
macrophages (110).
As is known, skin is our shield against ultraviolet radiation (UVR) and other
pollutants, as it is the most exterior layer of our body. Traffic-related pollutants, such
as PAHs, VOCs, oxides, and PM, may cause pigmented spots on our skin (111). On
the one hand, as already stated, when pollutants penetrate through the skin or are
inhaled, damage to the organs is observed, as some of these pollutants are mutagenic

31
and carcinogenic, and, specifically, they affect the liver and lung. On the other hand,
air pollutants (and those in the troposphere) reduce the adverse effects of ultraviolet
radiation UVR in polluted urban areas (111). Air pollutants absorbed by the human
skin may contribute to skin aging, psoriasis, acne, urticaria, eczema, and atopic
dermatitis (111), usually caused by exposure to oxides and photochemical smoke
(111). Exposure to PM and cigarette smoking act as skin-aging agents, causing spots,
dyschromia, and wrinkles. Lastly, pollutants have been associated with skin cancer
(111).
Higher morbidity is reported to fetuses and children when exposed to the above
dangers. Impairment in fetal growth, low birth weight, and autism have been reported
(112).
Another exterior organ that may be affected is the eye. Contamination usually comes
from suspended pollutants and may result in asymptomatic eye outcomes, irritation
(112), retinopathy, or dry eye syndrome (113, 114).
Environmental Impact of Air Pollution
Air pollution is harming not only human health but also the environment (115) in
which we live. The most important environmental effects are as follows.
Acid rain is wet (rain, fog, snow) or dry (particulates and gas) precipitation containing
toxic amounts of nitric and sulfuric acids. They are able to acidify the water and soil
environments, damage trees and plantations, and even damage buildings and outdoor
sculptures, constructions, and statues.
Haze is produced when fine particles are dispersed in the air and reduce the
transparency of the atmosphere. It is caused by gas emissions in the air coming from
industrial facilities, power plants, automobiles, and trucks.
Ozone, as discussed previously, occurs both at ground level and in the upper level
(stratosphere) of the Earth's atmosphere. Stratospheric ozone is protecting us from the
Sun's harmful ultraviolet (UV) rays. In contrast, ground-level ozone is harmful to
human health and is a pollutant. Unfortunately, stratospheric ozone is gradually
damaged by ozone-depleting substances (i.e., chemicals, pesticides, and aerosols). If
this protecting stratospheric ozone layer is thinned, then UV radiation can reach our
Earth, with harmful effects for human life (skin cancer) (116) and crops (117). In

32
plants, ozone penetrates through the stomata, inducing them to close, which blocks
CO2 transfer and induces a reduction in photosynthesis (118).
Global climate change is an important issue that concerns mankind. As is known, the
“greenhouse effect” keeps the Earth's temperature stable. Unhappily, anthropogenic
activities have destroyed this protecting temperature effect by producing large
amounts of greenhouse gases, and global warming is mounting, with harmful effects
on human health, animals, forests, wildlife, agriculture, and the water environment. A
report states that global warming is adding to the health risks of poor people (119).
People living in poorly constructed buildings in warm-climate countries are at high
risk for heat-related health problems as temperatures mount (119).
Wildlife is burdened by toxic pollutants coming from the air, soil, or the water
ecosystem and, in this way, animals can develop health problems when exposed to
high levels of pollutants. Reproductive failure and birth effects have been reported.
Eutrophication is occurring when elevated concentrations of nutrients (especially
nitrogen) stimulate the blooming of aquatic algae, which can cause a disequilibration
in the diversity of fish and their deaths.
Without a doubt, there is a critical concentration of pollution that an ecosystem can
tolerate without being destroyed, which is associated with the ecosystem's capacity to
neutralize acidity. The Canada Acid Rain Program established this load at 20 kg/ha/yr
(120).
Hence, air pollution has deleterious effects on both soil and water (121). Concerning
PM as an air pollutant, its impact on crop yield and food productivity has been
reported. Its impact on watery bodies is associated with the survival of living
organisms and fishes and their productivity potential (121).
An impairment in photosynthetic rhythm and metabolism is observed in plants
exposed to the effects of ozone (121).
Sulfur and nitrogen oxides are involved in the formation of acid rain and are harmful
to plants and marine organisms.
Last but not least, as mentioned above, the toxicity associated with lead and other
metals is the main threat to our ecosystems (air, water, and soil) and living
creatures (121).

33
DISCUSSION
In 2018, during the first WHO Global Conference on Air Pollution and Health, the
WHO's General Director, Dr. Tedros Adhanom Ghebreyesus, called air pollution a
“silent public health emergency” and “the new tobacco” (122).
Undoubtedly, children are particularly vulnerable to air pollution, especially during
their development. Air pollution has adverse effects on our lives in many different
respects.
Diseases associated with air pollution have not only an important economic impact
but also a societal impact due to absences from productive work and school.
Despite the difficulty of eradicating the problem of anthropogenic environmental
pollution, a successful solution could be envisaged as a tight collaboration of
authorities, bodies, and doctors to regularize the situation. Governments should spread
sufficient information and educate people and should involve professionals in these
issues so as to control the emergence of the problem successfully.
Technologies to reduce air pollution at the source must be established and should be
used in all industries and power plants. The Kyoto Protocol of 1997 set as a major
target the reduction of GHG emissions to below 5% by 2012 (123). This was followed
by the Copenhagen summit, 2009 (124), and then the Durban summit of 2011 (125),
where it was decided to keep to the same line of action. The Kyoto protocol and the
subsequent ones were ratified by many countries. Among the pioneers who adopted
this important protocol for the world's environmental and climate “health” was China
(3). As is known, China is a fast-developing economy and its GDP (Gross Domestic
Product) is expected to be very high by 2050, which is defined as the year of
dissolution of the protocol for the decrease in gas emissions.
A more recent international agreement of crucial importance for climate change is the
Paris Agreement of 2015, issued by the UNFCCC (United Nations Climate Change
Committee). This latest agreement was ratified by a plethora of UN (United Nations)
countries as well as the countries of the European Union (126). In this vein, parties
should promote actions and measures to enhance numerous aspects around the subject.
Boosting education, training, public awareness, and public participation are some of the
relevant actions for maximizing the opportunities to achieve the targets and goals

34
on the crucial matter of climate change and environmental pollution (126). Without
any doubt, technological improvements makes our world easier and it seems difficult
to reduce the harmful impact caused by gas emissions, we could limit its use by
seeking reliable approaches.
Synopsizing, a global prevention policy should be designed in order to combat
anthropogenic air pollution as a complement to the correct handling of the adverse
health effects associated with air pollution. Sustainable development practices should
be applied, together with information coming from research in order to handle the
problem effectively.
At this point, international cooperation in terms of research, development, administration
policy, monitoring, and politics is vital for effective pollution control. Legislation
concerning air pollution must be aligned and updated, and policy makers should propose
the design of a powerful tool of environmental and health protection. As a result, the
main proposal of this essay is that we should focus on fostering local structures to
promote experience and practice and extrapolate these to the international level through
developing effective policies for sustainable management of ecosystems.
Health impacts of air pollution

EEA, "Healthy environment, healthy lives ," 2019

Note: Particulate matter with a diameter of 2.5 µm or less (PM 2.5), particulate matter
with a diameter of 10 µm or less (PM 10), ozone (O3), nitrogen dioxide (NO2),
benzo[a]pyrene (BaP) and sulphur dioxide (SO2).

35
 Fine particulate matter (PM2.5) is the air pollutant driving the most significant
health problems and premature mortality. In 2021, 97% of the urban population was
exposed to concentrations of fine particulate matter above the health-based guideline
level set by the World Health Organization.
238,000 premature deaths due to fine particulate matter above WHO-guideline level.

In 2020, approximately 238,000 premature deaths were attributable to PM 2.5 in the 27

Member States. In 2020, premature deaths attributed to exposure to fine particulate
matter fell by 45% in the EU-27, compared to 2005.
Residential, commercial and institutional energy consumption was the principal
source of particulate matter in 2020. The manufacturing and extractive industry was
also a significant source, while agriculture was an equally important source of PM 10.
Between 2005 and 2020, emissions of particulate matter, PM10 and PM2.5, fell by 30%
and 32%, respectively.
In 2021, the World Health Organization (WHO) published new air quality guidelines
following a systematic review of the latest scientific evidence demonstrating how air
pollution damages human health. The European Union (EU) has also set standards for
key air pollutants in the ambient air quality directives. In the European Green Deal,
the European Commission committed to further improving air quality and to aligning
EU air quality standards more closely with the WHO recommendations. This
commitment was echoed in the zero pollution action plan, which set a vision for 2050
to reduce air, water and soil pollution to levels no longer considered harmful to health
and natural ecosystems. In addition, the zero pollution action plan introduced targets
for 2030, two of which focus on air and aim to:
 reduce the health impacts of air pollution (premature deaths) by more than 55%,
compared to 2005;
 reduce the share of EU ecosystems where air pollution threatens biodiversity by 25%,
compared to 2005.
Stricter air quality standards would also contribute to the objectives of Europe’s
Beating Cancer Plan. Air pollution is a known cause of cancer in Europe; in
particular, lung cancer (EEA, 2022).

36
 In terms of the past trend, from 2005 to 2020, premature deaths attributed to PM 2.5
exposure in the EU-27 fell by 33% to reach 238,000. Should air quality continue to
improve, and the number of premature deaths per year continue to fall at a comparable
rate in the future, then the zero pollution target would be achieved by 2032, as shown
in the figure below.
Commission proposes new rules for cleaner air
In October 2022, the European Commission published a proposal for a revision of the
Ambient Air Quality Directive. Key measures are listed below.
 Stricter thresholds for pollution, more closely aligned with new limits set by the World
Health Organization.
 Enhancing the right to clean air, improved access to justice.
 Current law does not include provisions for citizens to claim compensation for health
damage due to air pollution. The new rules will bring more effective penalties and
compensation possibilities for violating air quality rules.
 Strengthened rules for air quality monitoring to support preventive action and targeted
measures.
 Requirements to improve air quality modelling, especially if and where air quality is
poor.
 Better public information.
The above measures are aligned with other legislative proposals, such as the revision
of the Industrial Emissions Directive and recent proposals on the Euro 7 emission
standards for road vehicles, which will support the achievement of stricter air quality
standards.
Inequalities in exposure and vulnerability to air pollution in Europe
Air pollution affects people in different ways. Older people, children and those with
pre-existing health conditions are more sensitive to the health impacts of air pollution.
In addition, the most deprived people in society often have poorer health and less
access to high-quality medical care, increasing their vulnerability.
There is strong evidence linking lower socio-economic status to increased exposure to
air pollution. In large parts of Europe, poorer people are more likely to live next to
busy roads or industrial areas and thus, face higher levels of exposure to air pollution.

37
At the same time, exposure patterns vary across European cities. In some cities,
wealthier people live in central, polluted areas, while in other European cities central
areas are inhabited by poorer communities.
In Europe, regions characterised by lower GDP per capita are found to have
higher levels of PM2.5 and tend to occur in Eastern and South-eastern Europe. This
pattern is largely driven by the combustion of low-quality solid fuels (e.g. coal and
wood) in low-efficiency ovens for domestic heating in those areas. The higher
population exposure to PM2.5 in particular regions, translates into higher numbers of
premature deaths attributed to air pollution.
Mapping mortality attributed to PM2.5 against regional wealth in Europe
Besides premature death, air pollution also causes morbidity. People live with diseases
related to exposure to air pollution; this is a burden in terms of personal suffering as

well as significant costs on the healthcare sector. In 2019, exposure to PM 2.5 led to
175,702 years lived with disability (YLDs) due to chronic obstructive pulmonary
disease in 30 European countries. At the same time, exposure to NO2 led to 175,070
YLDs due to diabetes mellitus (also known as Type 2 diabetes) in 31 European
countries. That same year, 12,253 people across 23 European countries were admitted
to the hospital with lower respiratory infections resulting from acute exposure to
ozone.
The interactive map viewer shows the spatial distribution of population-weighted

concentrations of PM2.5 (as an indication of population exposure) across Europe and

the associated mortality. The viewer also allows to display data against GDP per
capita as a proxy for the average socio-economic characteristics of the population in
each region. The data is presented for NUTS3 regions (between 150,000 and 800,000
inhabitants).
Interactive map: Associations between exposure to PM2.5, mortality and GDP
per capita

38
GDP per capita - Eurostat; Premature deaths, years of life lost and population-
weighted concentrations are based on an EEA analysis of interpolated annual
statistics of reported monitoring data from 2018.

Effects of Air Pollution

Air pollution affects all things. It is harmful to our health, and it impacts the
environment by reducing visibility and blocking sunlight, causing acid rain, and
harming forests, wildlife, and agriculture. Greenhouse gas pollution, the cause of
climate change, affects the entire planet.
Harming Human Health
According to the World Health Organization, an estimated seven million people die
each year from air pollution. More than 4,000 people died in just a few months due to
a severe smog event that occurred in London in 1952. Ground-level ozone causes
muscles in the lungs to contract, making it difficult to breathe. Exposure to high ozone
levels can cause sore throat, coughing, lung inflammation, and permanent lung
damage.
Symptoms from short-term exposure typically resolve quickly, but long term exposure
is linked to serious illness and disease in multiple body systems. Children, the elderly,
and people with ongoing illnesses are more vulnerable to air pollution than other
groups. Urban populations are also at greater risk due to high concentrations of
pollution within cities. Check the current air quality in your area to determine if you
should take precautions such as reducing or avoiding outdoor activity.

39
Harming Animals and Plants:

Brown patches on these potato leaves are evidence of moderate ozone damage.
Danica Lombardozzi/NCAR
Wildlife can experience many of the same negative health effects of air pollution that
humans do. Damage to respiratory systems is the most common effect on animals, but
neurological problems and skin irritations are
Short-term exposure to air pollution can cause:
Long-term exposure to air pollution can cause:
 Coughing
 Wheezing/difficulty breathing
 Irritation to eyes, nose, and throat
 Headache
 Dizziness
 Fatigue
 Respiratory diseases (asthma, emphysema)
 Cardiovascular damage
 Harm to liver, spleen, and blood
 Nervous system damage
 Cancer
 Birth defects
Plants and crops grow less when exposed to long-term air pollution. Ozone pollution
harms plants by damaging structures called stomata, which are tiny pores on the
underside of leaves that allow the plant to "breathe."
Some types of plants can protect themselves by temporarily closing their stomata or
producing antioxidants, but others are particularly sensitive to damage. Between 1980
and 2011, nine billion dollars-worth of soybeans and corn were lost in the US as a
result of ozone pollution. When acid rain, lead toxicity, and exposure to nitrogen
oxides change the chemical nature of the soil, plants are robbed of the nutrients that
they need to grow and survive. This impacts agriculture, forests, and grasslands.
There are many other ways that air pollution affects living things, such as damaging
the habitat, water, and food sources that plants and animals need to survive.
40
UCAR/NAME
Burning fossil fuels releases sulfur and nitrogen oxides into the atmosphere. Acid rain
forms when sulfur dioxide and nitrogen dioxide mix with water droplets in the
atmosphere to make sulfuric acid and nitric acid. Winds can carry these pollutants for
thousands of miles, until they fall to the Earth's surface as acid rain, which damages
the leaves of vegetation, increases the acidity of soils and water, and is linked to over
500 deaths each year. Buildings and other structures are also impacted by acid rain,
which causes an estimated five billion dollars of property damage each yea. Acid rain
dissolves mortar between bricks, causes stone foundations to become unstable, and is
destroying ancient buildings and statues carved from marble and limestone.

Reducing Sunlight
High levels of particulate pollution from all types of burning reduces the amount of
sunlight that reaches the surface and even changes the appearance of the sky. When
less sunlight is available for photosynthesis, forests grow at a slower rate and crops
are less productive. Hazy skies not only reduce visibility, but also impact the weather
and even the climate.

Making a Hole in the Ozone Layer

The hole in the ozone layer is caused by air pollutants. Chemicals used as refrigerants,
such as chlorofluorocarbons (CFCs), contain chlorine atoms. Releasing chlorine atoms
into the atmosphere destroys ozone. Asingle chlorine atom can destroy thousands of
ozone molecules. The ozone layer blocks harmful ultraviolet-B (UVB) radiation from
the Sun — it protects us in a way that is similar to putting sunscreen on your skin to
prevent sunburn. The ozone hole puts all living things at risk by increasing the amount
of UVB that reaches thesurface. Exposure to UVB increases the risk of skin cancer in
humans, restricts growth and development in plants, slows the development of fish
and amphibians, and reduces the number of phytoplankton in marine ecosystems.
UVB also causes natural and synthetic materials to breakdown at an accelerated rate.

Adding Too Much Nitrogen to the Land

Gaseous ammonia (NH3) from agriculture and nitrogen dioxide (NO2) from car,
truck, and airplane emissions increase the amount of nitrogen in soils. Plants need

41
nitrogen to grow, but too much nitrogen can limit the growth of some plants and
increase the growth of others, disrupting the balance of species within an ecosystem.
This disruption is negatively impacting grasslands and other fragile environments
around the world.

42
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