HYDERABAD: The adverse health effects of ambient (outdoor) air pollution have been recognised since increased mortality due to smog. Since then, ambient air pollution is labelled as one of the leading causes of global disease burden. Air pollution is a complex mixture of gaseous components, and solid and liquid particles suspended in the air and can vary substantially in chemical composition between different cities. Air pollution contains fine particulate matter or PM2.5, which is a cocktail of microscopic particles.
This particulate matter (PM), which primarily comprises solid particles derived from the combustion of coal, gasoline and diesel, is the major element of air pollution that causes the most adverse health effects. Environmental air pollution may be composed of additional components, such as different sized PM, gaseous pollutants, and heavy metals such as mercury, lead, cadmium etc. Smoking and second-hand smoke increase your risk of kidney disease as well.
Exposure to tobacco smoke has also been linked to kidney and heart disease. Smoking also increases your risk of bladder and kidney cancer. We have also noticed that there have been reports of herbicides and pesticides increasing people’s risk of CKD in many countries. Higher rates of CKD among farm workers have been linked to heavy exposure to herbicides and pesticides.
Research
Over the past decade, a growing body of research has suggested a causal relationship between ambient air pollution exposure and adverse cardiovascular health. Chronic kidney disease (CKD) is another worldwide public health problem with a variety of adverse outcomes, including premature death, and it is regarded as cardiovascular disease (CVD) risk equivalent. Apart from traditional risk factors, such as hypertension and diabetes, an increasing body of evidence demonstrates that air pollution may be a novel environmental risk factor for CKD, which occurs when a person’s kidneys become damaged or cannot filter blood properly.
According to the research report, for every increase in pollution of 10 micrograms per cubic meter of air, there was a 25 to 37 per cent increase in the number of persons with new kidney disease, a 36% increase in rapid loss of kidney function, and a 31% increase in risk of kidney failure followed by dialysis.
CKD is a common condition with important long-term health implications that often goes unrecognised until advanced stages or kidney failure. CKD currently afflicts millions of Indians and significantly elevates the risk of death, cardiovascular disease, end-stage renal disease (ESRD), and other complications. Individuals with CKD are at an 8-10-fold increased risk of cardiovascular mortality, compared to those without kidney dysfunction.
CKD is typically a progressive disease with loss of kidney function over time. The rate of function loss is variable and dependent on both treatment and patient factors, including level of proteinuria, older age, diabetes mellitus, blood pressure control, obesity, metabolic syndrome, and family history of kidney disease.
Sources of PM2.5 include all types of combustion activities, such as motor vehicle emissions, power plants, and wood burning, as well as common indoor activities, such as smoking, cooking, burning candles or oil lamps, and operating fireplaces and fuel-burning space heaters (e.g., kerosene heaters). The major components of PM2.5 include ammonium sulfate, ammonium nitrate, organic carbonaceous mass, elemental carbon, and crustal material. Air pollution from these sources can be mitigated. Thus, it is important to study its link with CKD.
Risk factors
People with diabetes, obesity, high blood pressure or heart disease are at increased risk of developing CKD. It is important to take precautions when exposed to air pollution, especially for people who have existing health conditions or who live in densely populated or polluted cities. Many people don’t see the seriousness of air pollution because it isn’t something visible, but that doesn’t mean it’s any less important for your health. In heavily polluted areas, consider wearing masks that cover your nose and mouth, limit hours outside and limit long hours commuting to work in high traffic as well.
( The writer is chief nephrologist, medical director, NephroPlus Dialysis Centre)