What We Breathe Matters

By Natasha DeJarnett, PHD
July 19, 2022

This week’s contributor is Natasha DeJarnett, an Assistant Professor in the Christina Lee Brown Envirome Institute in the University of Louisville Division of Environmental Medicine where she researches the cardiovascular impacts of heat and air quality along with environmental health disparities. 

What we breathe matters. I’ve experienced this personally, and it’s what led me to become an environmental health researcher, leader and advocate. During graduate school, I discovered that many of my childhood experiences with asthma occurred when I was breathing poor air quality in areas riddled with environmental injustices. 

A recent article underscores the links between air quality and health and how climate change is making things worse. As part of a new New England Journal of Medicine series on climate change and health, Anjeni Keswani, Hana Akselrod and Susan Anenberg summarized evidence from nearly 100 articles exploring how air pollution harms human health. 

The articles reviewed show that air pollution can affect nearly every organ system. Effects on heart health, for example, include heart disease progression, heart attacks, hypertension and elevated blood pressure, and death. Effects on the lungs include asthma (or worsening asthma), worsening of COPD, pneumonia, allergies and lung cancer. When it comes to mental health, air pollution has been linked to dementia, Parkinson’s disease, anxiety, depression and suicide. The endocrine, urinary, gastrointestinal, immune and neurologic systems are also negatively impacted by air pollution, according to the evidence. 

Other articles in the review show that climate change makes air pollution worse and vice versa. Climate change and air pollution share several sources, including the burning of fossil fuels, which release greenhouse gasses in the atmosphere, resulting in heat and air pollution to be trapped below.

In addition to laying out the evidence connecting air pollution, climate change and poor health, the authors also provided detailed recommendations for reducing air pollution and for how clinicians can counsel their patients to mitigate air pollution’s effects. They suggest national policies like improving energy efficiency in buildings, planning for health care resources during poor air quality and improving people’s access to nature. They say clinicians should assess their patients’ risk for air pollution exposure and encourage patients to reduce exposure with face masks, filtration systems and staying indoors when air quality is bad. They also encourage medical schools to incorporate climate change and eco-health education into their curricula. 

I hope decision-makers will use this information to inform patient care and health education. I wish someone had made the connections between my childhood asthma and exposure to poor air quality. This could have protected my health and wellbeing in profound ways, but I am encouraged by a future where climate is used to inform health care practice.

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