AIR = 78% N, 21% O2 (#2), Argon 1% (#3), .04% Co2 (#4)
Temperature inversion can trap pollutants, London's "killer fog" 1952 Dec 12,000 dead

US REGS
1955 Air Pollution control act
1963 Clean Air Act in US
1967 Air Quality Act, ammentments in 70,77, 90, www.epa.gov/air/caa/peg
2011 current political debate: industry "stifled" by regulation vs people stifled by nasty air

SOURCES OF AIR POLLUTION
fires (forest, prairie)
volcanoes (#1 mercury source!)
dust storm
industry (more than 50%)
transportation (27%)
agriculture
heating

HEALTH IMPACTS
mostly respiratory see pubmed for acutes 19781092
chronic-->pulmonary fibrosis
immune response, immune suppression
erosion dt acid/caustic
cancer

RESOURCES

AirNow.gov to monitor outdoor air pollution
0-500 relative scale
100 is max for safety

Enviroflash.info
automatic email updates on outdoor air pollution
alerts for pts with resp dz
on twit and fb
www.enviroflash.info (put this on asthma and RADS tx plans)

TYPES OF AIR POLLUTION
regulated by EPA: particulates, ozone, NO2, SO2, CO, Pb

PARTICULATES
usudt combustion, organic
3 sizes PM10, PM2.5, PM0.1
PM10
coarse particles, above 10 doesn't get to lungs (hair = 50 microns across)
high around roadways, causes inflam of bronchi, mucus
bronchitis, asthma trigger, CV effects, damages mitos (2010 Hou), oxidizing (1996 Occup Env Med)
2.5-10 usu gets stopped in bronchioles or earlier
PM2.5
dt high temp combustion, mostly diesel engines, also fires, manufacturing
smaller than 2.5 gets into alveoli
many effects: incr ROS, inflam, allerg, infx, stress, coag
chronic exposure-->incr infx esp in elders, inflam
affects nervous system, decreases heart rate variability, disrupts vagal fx
vascular inflam if crosses into blood, vasoconstrx, incr BP, decr CO, incr mort
new: correlation between particulate exposure with obesity and insulin resistance
PM0.1
nanoparticles, ultrafine, completely synthetic
easily pass thru membranes, enter cells, nuclei

OZONE
naturally and industrially made
smell after a lightning storm
need it in the stratosphere (20-50km up) to filter UV, CFC ban, ozone hole
"good up high, bad nearby"
up high protects vs UV radiation: ozone hole-->more skin ca, etc
nearby: ROS, resp irritant-->pulmonary inflammation-->fibrosis
oxidizes chol in vasc-->atherosclerosis
strong oxidant that reacts
with nitrogen oxides (vehicle emissions) and VOC's (volatile organic compounds)
creates smog
sx: sore throat, chest pain, cough, etc, edema, hemorrhage, infx
alveolar damage-->hypoxia
ozone damages crops too

NOx
Nitrogen Oxides
combustion byproducts usu from fossil fuels, also from fertilizers
a main component of smog, reacts with VOC's
sx: resp
environmental justice: exposure risk correlates with station in life

SO2
sulfur dioxide from coal
small tall smokestacks to get it up above us
scrubbers remove most SO2 thanks to Carter 1970's
sx: resp irritant
acid rain

CO
carbon monoxide
preferentially binds HGB, he says irreversibly
sx: hypoxia, cyanosis, dizziness, headache, coma, death
esp bad for preg women, fetal HGB binds it even more strongly
*preg women must avoid exhaust!
dx: carboxyhemoglobin in serum
sx: cherry red around lips
tx: O2 100% hyperbaric chamber
homes required to have CO testers

LEAD
for later

AIR PURIFIERS (see air purifier page in notes)
"everyone should have one, or two or three"
CATR = clean air delivery rate, look at this, match to size of room
HEPA is the standard we promote; 99.97% of all particulates filtered
UV
Ionizers helpful for SAD (new study)
Activated carbon
Ozone generators destroy chemicals and biologics, removes infx and chem but no help for particulates, dangerous, usu best for industrial purposes, not for where people are
Ozonators on hot tubs?