Air pollution and respiratory health among diabetic and non-diabetic subjects in Pune, India—results from the Wellcome Trust Genetic Study

Abstract

Diabetics may be more vulnerable to the harmful effects of ambient air pollutants than healthy individuals. But, the risk factors that lead to susceptibility to air pollution in diabetics have not yet been identified. We examined the effect of exposure to ambient PM on chronic symptoms and the pulmonary function tests (PFT) in diabetic and non-diabetic subjects. Also, to investigate possible determinants of susceptibility, we recruited 400 type 2 diabetic and 465 healthy subjects who were investigated for chronic respiratory symptoms (CRSs) and then underwent measurement of forced vital capacity (FVC) and forced expiratory volume 1 (FEV1) according to standard protocol. Percent predicted FEV1 and FVC (FEV1% and FVC%, respectively) for each subject were calculated. Particulate matter (PM) concentrations at residence place of subjects were estimated using AERMOD dispersion model. The association between PM and CRSs was explored using logistic regression. We also used linear regression models controlling for potential confounders to study the association between chronic exposure to PM and FEV1% and FVC%. Prevalence of current wheezing, allergy symptom, chest tightness, FEV1/FVC <70%, and physician-diagnosed asthma and COPD was significantly higher among diabetic subjects than non-diabetics. There was no significant difference between percent predicted value of PFT among diabetic and non-diabetic subjects (P < 0.05). We estimated that 1 SD increase in PM concentration was associated with a greater risk of having dyspnea by 1.50-fold (95% CI, 1.12-2.01). Higher exposure to PM concentration was also significantly associated with lower FVC%. The size of effect for 1 SD μg/m (=98.38) increase in PM concentration was 3.71% (95% CI, 0.48-4.99) decrease in FVC%. In addition, we indicated that strength of these associations was higher in overweight, smoker, and aged persons. We demonstrated a possible contribution of air pollution to reduced lung function independent of diabetes status. This study suggests that decline in exposure may significantly reduce disease manifestation as dyspnea and impaired lung function. We conduct that higher BMI, smoking, and older age were associated with higher levels of air pollution effects.

Development of Ahmedabad’s Air Information and Response (AIR) Plan to Protect Public Health

“…Based on the background literature review, roundtable discussions, and a participatory workshop documented in the issue brief, the conceptual model is premised on several factors: Air pollution poses a significant public health risk [ 50 ]; this risk is under-recognized by the public; air pollution is inadequately monitored and managed [ 65 ]; and documenting air quality through an AQI and communicating specific exposure mitigation strategies can improve public health and facilitate long-term improvement of air quality [ 25 , 51 , 66 ]. Another underlying premise is that certain populations are at greater risk to air pollution-related health effects because of relatively high exposures (e.g., occupational exposures among outdoor workers, including traffic police, construction workers, and street vendors, among others [ 42 , 67 , 68 ]) or low coping capacity (e.g., school children, patients with pre-existing respiratory illnesses [ 69 , 70 , 71 ]). The model also posits that strategies for conveying risk information and corresponding exposure mitigation recommendations would reduce the population health risks related to air pollution [ 66 ].…”

“…The peer-reviewed public health literature was surveyed to better understand the burden of air pollution in Ahmedabad, as well as the need for improved air quality monitoring data at higher spatial and temporal resolution. The focus was on the quantification of health effects in vulnerable sub-populations in the city, including children [ 69 , 84 ], the elderly [ 85 ], people with pre-existing medical conditions [ 70 , 86 , 87 , 88 ] and those exposed to especially high levels of pollution due to their socioeconomic status [ 89 , 90 ] or occupation [ 67 , 68 , 91 ].…”

“…Medical professionals (especially pulmonologists) from Ahmedabad and New Delhi were essential members of the coalition. Experts from AMC MET Medical College, Ashrai Associates and Sparsh Chest Diseases Center, and Apollo Hospital provided advice on the numerous risks that polluted air poses to public health with a focus on vulnerable groups [ 66 , 70 , 84 , 97 ]. Local physicians, pediatricians, medical officers, community-based healthcare professionals, ambulance service staff, medical colleges, urban planners, and other local environmental professionals were also engaged in the coalition and plan development process.…”

Imperative role of particulate matter in innate immunity during RNA virus infection

“…Numerous studies revealed that particulate matter collected from different locations all over the world is strongly associated with the elevated morbidity and mortality and various diseases [8-13]. Several studies have attempted to understand the link between PM isolated from heavily populated regions of India and associated health concerns in term of occurrence of disease [14-19]. Although, most of the studies were based on the epidemiological data and cross-sectional studies, there were few studies about involvement of PM in respiratory diseases [20-22], asthma [23], cancer [24-27], tuberculosis [28, 29].…”

Dispersion Modelling of Odoriferous Compounds from Landfill

“…If the exposure to such volatile compounds is eternal it can result in health issues like respiratory problems, damage to central nervous system and are carcinogenic [1]; [20]; [25]. Mortality in patients having long term exposure to such odorous gases can be caused by obnoxious reactions like stress on physical as well as mental health which involve respiratory problems, anxiety headache, vomiting, irritation in eye and other health problems [3]; [14]; [16]; [17]; [18]; [28]; [36];. These issues have led to rising concerns and complaints for analysis of odour pollution [23]; [36]; [38].…”