Policies that Reduce Air Pollution Could Have a Major Impact on Asthma Globally

Boy using an asthma inhaler

New research quantifying air pollution’s global impact on asthma suggests that policies which target known sources of air pollution, including automotive exhaust, could have a major impact on the global burden of asthma and improve respiratory health around the world.

Published in Environmental Health Perspectives, the new research shows that 9 to 33 million visits to the emergency room (ER) for asthma worldwide may be triggered by breathing in air polluted by ozone or fine particulate matter—pollutants that can enter the lung’s deep airways. While scientists have long known that breathing in air sullied by car emissions and other pollutants could trigger asthma attacks, the new study is the first to quantify air pollution’s global impact on asthma.

“Millions of people worldwide have to go to emergency rooms for asthma attacks every year because they are breathing dirty air,” says Susan C. Anenberg, PhD, MS, lead author of the study and an Associate Professor of Environmental and Occupational Health at the George Washington University Milken Institute School of Public Health (Milken Institute SPH). “Our findings suggest that policies aimed at cleaning up the air can reduce the global burden of asthma and improve respiratory health around the world.”

Approximately 95 percent of the world’s population lives in places with unsafe air. Asthma is the most prevalent chronic respiratory disease worldwide, affecting about 358 million people.  The new findings suggest that car emissions and other types of pollution may be a significant source of serious asthma attacks.

Countries like India and China may be harder hit by the asthma burden because they have large populations and tend to have fewer restrictions on factories belching smoke and other sources of pollution, which can then trigger breathing difficulties, the authors say.

“We know that air pollution is the leading environmental health risk factor globally,” Anenberg says. Previously, the Global Burden of Disease Study focused on quantifying the impacts of air pollution on heart disease, chronic respiratory disease, lung cancer, and lower respiratory infections – finding that fine particulate matter and ozone were associated with 4.1 million and 230,000 premature deaths in 2016, respectively. “Our results show that the range of global public health impacts from breathing dirty air are even more far reaching—and include millions of asthma attacks every year.”

To reduce the global burden caused by asthma, Anenberg suggests that policymakers aggressively target known pollutants such as ozone, fine particulate matter and nitrogen dioxide. She says policies that result in cleaner air might reduce not just the asthma burden but other health problems as well.

One way to reduce pollutants quickly would be to target emissions from cars, especially in big cities. Such policies would not only help people with asthma and other respiratory diseases but it would help everyone breathe a little easier, she said.

Anenberg’s research combines data on emergency room visits for asthma in 54 countries and Hong Kong with epidemiological exposure-response relationships and global pollution levels derived from satellites orbiting the earth.

“The value of using satellites is that we were able to obtain a consistent measure of air pollution concentrations throughout the world,” says Daven Henze, who is the principal investigator on the project and an associate professor for the University of Colorado Boulder. “This information allowed us to link the asthma burden to air pollution even in parts of the world where ambient air quality measurements have not been available.”

“Estimates of the Global Burden of Ambient PM2.5, Ozone, and NO2 on Asthma Incidence and Emergency Room Visits,” appeared online October 24 in the journal Environmental Health Perspectives.