Pollution affects everyone, but the very young are the hardest hit. We asked pulmonologist Roberto Dal Negro to explain the effects of smog on our lungs.
"It is children and adolescents who pay the highest price for air pollution." Roberto Dal Negro, a highly experienced pulmonologist and former head of Cesfar, the national centre for studies in respiratory pharmacoeconomics and pharmacoepidemiology in Verona, whom we consulted to better understand the effects of smog on our bodies. The expert leaves no room for doubt about the seriousness of the situation, on which the World Health Organisation has long since pronounced.
"Asthma, bronchitis, persistent cough. Even in Italy, acute and chronic respiratory diseases are on the rise in younger generations, in clear correlation with the amount of fine particles inhaled," explains Dal Negro. Poisons that trigger bronchial hyperactivity, starting with the very young and extending to the elderly, and ultimately causing premature death. Exposure to carcinogenic particulate matter, nitrogen dioxide and tropospheric ozone has cost the lives of no fewer than 76,200 people in our country in a single year, according to the European Environment Agency. According to a very recent study published in The Lancet, Italy ranks first in Europe for mortality from smog.
"Acute and chronic conditions, in the presence of a pollution source such as traffic, within a hundred metres, lead to between 36 and 64 per cent more asthma attacks. A phenomenon that in children accounts for a further 34 per cent. With an increase in persistent cough of up to 70 per cent," the pulmonologist specifies. "And in adolescents, the same symptoms rise by between 30 and 60 per cent." In the elderly, by contrast, there is an exacerbation of chronic bronchitis, while among adults it is women who face a 50 per cent greater likelihood of falling ill compared to men, owing to reduced lung capacity. Allergic events are also aggravated by smog. "A person with allergies living in a polluted area has 300 per cent more chance of having an episode compared to someone living in healthier areas. Pollen in turn becomes a carrier of particulate matter and toxins into our airways."
High levels of pollution are recorded almost everywhere. But the worst figures in Europe come from Italy itself, particularly from the Po Valley, where they are truly alarming. "In addition to fine and ultrafine particulate matter, ozone and nitrogen dioxide, we must also add sulphur dioxide and carbon monoxide, which are also highly irritating and dangerous to our health," Dal Negro stresses. We also need to pay close attention to the severity of the effects of particulate matter, the doctor explains.
"While pm10 particles are coarser and stop at the upper airways, as their diameter decreases — from 2.5 microns to 0.1 — the fine particles penetrate the respiratory tree, passing directly from the bronchioles to the alveoli." Producing profound damage and a highly inflammatory state. "The most serious thing is that, unfortunately, to this day very little is said about pm0.1, the most penetrating and dangerous particulate matter, except within the realm of scientific research. Consider that it is not yet detected by air quality monitoring stations. Yet its harmful effects are, by now, more than well established in the literature." As epidemiologists confirm and Professor Dal Negro reiterates: "for every 10 micrograms per cubic metre of particulate matter there is a 6 per cent increase in all-cause mortality and a 9 per cent increase in cardiorespiratory causes, including lung cancer."
Air pollution and climate change are making quality of life a cause for concern among the youngest, both in summer and in winter. "In summer there is the problem of tropospheric ozone which, through photochemical reactions, becomes highly inflammatory for the airways." Children and vulnerable adults, such as the elderly, who go outdoors during the hottest hours are highly exposed to it. "And the youngest, as they play, breathe in greater volumes of air, full of toxic substances." Hence the advice to avoid prolonged exposure outdoors during the hours of peak smog concentration. Winter is no better. "Under low pressure, pollutants remain in the lowest layers of the atmosphere, right at a child's height."
To shield ourselves from peaks of exposure to both particulate matter (in winter) and tropospheric ozone (in summer), are we left with no choice but to stay indoors? "At present we have no other way to protect and safeguard the youngest. In the absence of structural interventions, in the most polluted areas, there are no alternatives," the pulmonologist confirms. "In recent years air quality has not improved, especially in the regions of the Po Valley, with a geographical configuration that favours the stagnation of pollutants," Dal Negro reiterates.
"From my vantage point as a doctor, I have seen only an increase in conditions. The healthcare cost is truly very high. Protective measures for the most vulnerable people and drastic action on the environment are needed. They would certainly cost far less than the harm we are inflicting on future generations by doing nothing."
