Eleven months after Bangkok’s last major air pollution episode, the city is under threat again. The culprit is particulate matter (PM) pollution, an especially hazardous type of air pollution that is small enough to make its way into the body’s lungs and bloodstream and inflict significant short-term and long-term damage to health.
 
Here are six things you should know about the dangers of particulate matter pollution, and how to guard against them.


1. Particle pollution comes from many sources. PM pollution includes dust, dirt, soot, and smoke, and is produced from both natural (sea salt, for example) as well as man-made sources like the exhaust from cars and trucks. Big cities and industrial areas with traffic-clogged roads, factories, and a lot of construction activity tend to be more dangerous for exposure to particle pollution. But rural areas can be risky as well, from dusty unpaved roads; from agricultural pollution in the form of ammonia, which enters the air as a gas from fertilized fields and animal waste; and from the smoke produced by fires set by farmers to prepare the soil for the next crop.
 

2. The smaller the particle, the greater the threat. All pollution is bad, but smaller-sized particulate matter pollution is especially hazardous to health because it is both inhalable and small enough to penetrate deeply into the lungs and respiratory airways — some particles may eventually enter the bloodstream and circulate throughout the body.
 

3. The health impact is worse than previously thought. Thanks to significant research efforts during the past decade, we now know that air pollution represents a bigger health threat than we once thought. The WHO now estimates the number of “premature deaths” caused by air pollution is over 6 million people worldwide every year. And roughly 10 percent of the early deaths — almost 600,000 — are children under the age of five. Research has demonstrated that when air quality worsens, hospitalizations and emergency room visits go up, as pollution aggravates existing health problems and triggers heart attacks, strokes, asthma attacks, and more.
 

• Heart-related threats: Research has shown that exposure to particulate air pollution can lead to acute cardiovascular events, including heart attacks, arrhythmias, increased heart rate, decreased heart rate variability, and increased risk for sudden cardiac death. Recent evidence also points to a connection between long-term small sized particulate matter exposure and atherosclerosis, the condition involving a build-up of plaque inside arteries that can lead to fatal heart attacks and strokes. 
• Lung and respiratory threats: Air pollution is both a cause and an aggravating factor of many diseases of the lungs and respiratory system, including asthma, chronic obstructive pulmonary disease (COPD), and lung cancer.
• Brain threats: Long-term air pollution exposure is believed to increase stroke risk by hardening the brain’s arteries, raising blood pressure, and increasing blood thickness — all of which are risk factors for blood clots developing in the brain.

4. You may be in a high-risk group. Particle pollution exposure is a greater health danger for children, pregnant women, older adults, and people who have heart or lung diseases.

• Children are considered high-risk for several reasons — and in most cases, the younger the child, the greater the risk. Children’s lungs and immune systems are still developing, with research showing that air pollution exposure hinders lung growth in school-age children. Compared to adults, children spend more time outdoors engaging in sports and physical activities. And they have higher rates of asthma and other acute respiratory conditions, which are easily aggravated when pollution levels are high.
• Pregnant women appear to be vulnerable to air pollution; recent studies point to a connection between high levels of particle pollution exposure during pregnancy and premature delivery, low birth weight, and increased risk of miscarriage and infant mortality. Older people face a higher risk for pollution-related problems as their immune systems are generally weaker, and their bodies are less able to offset the effects of pollution exposure. Older adults are also more likely to have an undiagnosed respiratory or heart-related condition that air pollution can aggravate.
• People with heart or lung diseases, such as coronary artery disease, congestive heart failure, asthma, emphysema, and chronic obstructive pulmonary disease (COPD), are at increased risk because particles can aggravate these pre-existing conditions.

Photo caption: The Air Quality Index (AQI) is a daily air quality report that indicates how clean or polluted the air is and informs the public about potential health effects based on the day’s corresponding index. The AQI uses a zero-to-500-point scale, with a higher number indicating higher pollution levels.


5. You can reduce the risks to your health. Monitor real-time pollution levels and Air Quality Index (AQI) forecasts, which are readily available online and through smartphone apps, such as Asia Air Quality (Android), Global Air Quality (Android), and Air Quality Index (iOS). During elevated pollution periods:
 

• Reduce outdoor activity: The potential damage from particle pollution increases with more strenuous physical activity, the longer the time spent outdoors, and the worse the pollution. So the harm can be reduced by lowering the exertion level (e.g. walking instead of jogging), shortening the amount of time spent outdoors, and planning activities outside the most polluted times and further away from the most polluted places, like traffic-clogged roads and heavily-used highways.
• Stay indoors when pollution levels are high: When pollution reaches harmful levels, consider staying indoors and shift outdoor activities indoors. Instead of an outdoor workout, exercise at an indoor gym to take advantage of the cleaner air-conditioned environment.
• Improve indoor air quality at home: Close all windows during high-pollution periods. Shift air conditioner settings to re-circulate indoor air instead of drawing fresh air from outside. Consider using high-efficiency particulate air (HEPA) filter air cleaners to reduce particle levels indoors, but be sure the cleaner is correctly sized to fit the room in which it is being used. Keep your home environment smoke-free, and avoid using anything that burns, like candles, wood-burning barbeques, or any other smoke-producing products.
• Wear the right kind of respirator mask: When worn correctly, respirator masks are capable of filtering out up to 99 percent of airborne particulate pollution (N95 masks filter out at least 95 percent, while N99 masks filter out 99 percent). But the mask only works when it is worn properly, so be sure to follow the instructions and check for proper fit frequently. Also, be aware that anti-pollution respirator masks are different from the surgical masks worn by doctors and nurses, or masks made of cloth or paper — these types of masks are completely ineffective against particle pollution. N95 and N99 respirator masks are sold at most home improvement and safety products stores.

6. Pay attention to symptoms. Consult your doctor if you experience new symptoms indicating a cardiovascular or respiratory problem, or if you notice a worsening of an existing health condition.

 

The Pulmonary Center at Bumrungrad
Persistent symptoms such as shortness of breath, excessive fatigue, or severe coughing may be a sign of an underlying pulmonary or lung condition. The Pulmonary Center at Bumrungrad International Hospital offers comprehensive diagnostic testing and medical treatment for lung-related conditions, including asthma, COPD, bronchitis, emphysema, lung infections, lung cancer, and interstitial lung diseases.
 

For more information, or to make an appointment, contact the Pulmonary Center by phone at +66 (0) 2011 2222, request an appointment online, or send us your inquiry.