Environmental effects on respiratory health & solutions.

This post is only educational,kindly refer to your physician for personalised advice.

Our surrounding environment has a direct impact one's health , especially

the respiratory system. There are various factors in the air we breathe which can pose

some harm these including dust, smoke pollution, respiratory infections and other pollutants. Whilst a person may feel

helpless to this situation there is actually a lot of preventive steps one can

take . The following will highlight these hazards and actions one may take to help

decrease their effects and prevent worsening of respiratory health, through

controlling the environment and how it affects us.

Construction dust, traffic pollutants & other air pollutants Being surrounded by construction or quarry sites leads to the presence of dust particles in the air flying around especially in our dry Maltese summer. These dust particles or rather particulate matter(PM), in some individuals can irritate the respiratory tract causing wheezing, coughing and breathlessness. The same may be experienced by those living near busy traffic roads, with black sooth lining our limestone walls being a result of pollution arising from automobiles and traffic due to combustion of fuel fossils and tire wear. These are also PM, that may affects negatively the respiratory tract.

Particulate matter (PM) is also associated with increased risk of respiratory illness

exacerbations and hospitalizations. Studies , suggest they may also lead to lung cancer and pneumonia (1) . Though these risks are there , currently several preventative measures to help decrease these effects are being implemented .

An article issued in the Times of Malta on 15 th July 2022 (on Times of Malta ) , pointed out that there are 8 major roads Malta that exceed the European Standard for nitrogen oxide. This is a harmful chemical released as a result of traffic

pollution, unfortunately effects lung function negatively , increasing inflammation and

leads to cough (5). These roads include8 streets are ;Floriana;St Anne Street, Swieqi’; St

Andrews, Marsa;Aldo Moro Road , Hamrun: St Joseph High Street, Luqa: St Thomas Street

, Paola: Kordin Street,Rabat: Saqqajja Hill , Żebbug: Mdina Roads. Recommendations to try avoid when possible traversing through these roads and other streets with a lot of traffic is put forward and for those living in the vicinity, preventative measures such as air purifiers and masks can be used.

Other hazards we breathe are air-borne viral or bacterial infections, that increase risk of chest infections (i.e pneumonia) . Respiratory Illnesses With Covid-19 head lining the news for more than 2 years, we all have become more aware of viral and bacterial infections , and the risks they pose to our health. The pathway for transmission are usually 3 ; airborne , droplet and contact .

Airborne and droplet transmission are generally expelled from an infected person through aerosols, ones which are generally expelled once the sick person coughs or speaks. These aerosols , move around the air increasing chance of cross-infection, whilst in droplet transmission the infective droplet or mucus expelled generally contaminates an individual directly or a surface leading to contact transmission. Contact transmission implies that a person touches an infected surface and then proceeds to touching his face, nose, or eyes leading to infection. Solutions to decrease side effects from Pollutants In this day and age there are a lot of solutions to lessen the negative side effects that pollutants have on our respiratory tract and also prevent cross contamination from respiratory infections. Technologies have also come about, to help us control how our environment effects us, whilst other solutions do not require any new-tech, The following are some of the solutions one may take. Avoid going out at midday One of the best solutions would be do avoid going out close to midday , the drier and warmer air makes particulate matter more prevalent in the air , thus increasing chance of being inhaled (2). This is especially true in our drier and warmer months , whilst a bit less prevalent in cooler months. This does not mean you aren't free to go out safely in public , as one can do so safely with precautionary steps; such as wearing a mask .

Avoid Respiratory illness -Washing your hands regularly with soap and water, or with alcohol may help prevent infectious from contact transmission. Cleaning surfaces even of daily devices such as the mobile phone will also help prevent contact transmission(4). -Avoiding going near sick people and staying at home when sick will also help prevent such infections(4) . -Avoiding crowded areas and keeping a safe 1 meter or so distance may also help prevent airborne and droplet modes of transmission. -Wear a facemask such as an N95 will also help decrease such illnesses.

The N95 prevents around 95% of all pollutants from being inhaled. N95 use in areas with high particulate matter (PM) has been linked with improves objective measurements of heart (myocardial ischemia), exercise-related blood pressure rises, and heart rate variability in heart disease patients.N95 use when walking in high PM locations improves objective measurements of the heart (myocardial ischemia), exercise-related blood pressure rises, and heart rate variability in coronary heart disease patients(1). Whilst the N95 is suggested to prevent PM inhalation and prevent worsening of respiratory conditions it can have some slight negative side effects. Healthy people can safely wear the n95 for a 1-4 hours without any significant side-effects as only some people complained of headache after 4hours of use.(1) Whilst COPD patients especially those with severe COPD, those with a Spirometer result of FEV1 of less than 30%, resulted in a higher risk of forming respiratory distress (1). If the mask wearer experiences shortness of breath, headache or dizziness he should safely remove the mask. Air purifiers (HEPA) In this day and age there are various ways to control and clean air through air filters which clean the air from PM which can be harmful to our respiratory system. These filters generally work by pushing air through a couple of filters and purify the air coming in ,leaving the PM within the filter and cleaner air is expelled outward . The most common is HEPA ("high efficiency particulate air" filter ) , though other air-purifiers such as UV Air Filtration also exist. HEPA filters are available to buy locally and these are effective to remove at most 99.97% of 0.3-micrometer particles, and are usually more effective for particles which are larger(3). These form of air purifiers help remove particulate matter, certain viruses and bacteria and even toxic pollutants , leaving cleaner air for the person to enjoy. These air purifiers can be bought ready made or the filter can be bought and applied to a fan as demonstrated in the video below .

Conclusion Overall even though there are multiple factors that may influence one's health negatively through the environment, in this day and age multiple preventive steps can be taken to decrease these negative side-effects of pollution and harmful air . Whilst I urge you to do so I also suggest you educate others about the importance of aiming to pollute less , for the respiratory health of the Maltese population and the children too.