Journal of Indira Gandhi Institute Of Medical Sciences

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 5  |  Issue : 1  |  Page : 42--45

Effects of Ambient Air Pollution on Pulmonary Functions of Traffic Policemen


Tarun Kumar1, Manish Kumar1, Sunita2, Pooja Sakshi3, Ashok Sharan4,  
1 Additional Professor, Department of Physiology, IGIMS, Patna, India
2 Associate Professor, Department of Physiology, IGIMS, Patna, India
3 Assistant Professor, Department of Physiology, IGIMS, Patna, India
4 Professor & HOD, Department of Physiology, IGIMS, Patna, India

Correspondence Address:
Tarun Kumar
Additional Professor, Dept. of Physiology, IGIMS, Patna
India

Abstract

Background: Air pollution is a major threat to human health. World Health Organization (WHO) estimated 4.2 million premature deaths due to ambient air pollution in 2016. It's a serious problem in metropolitan cities like Delhi, Patna and Gwalior in India. Average daily exposure of traffic policemen to dust particles and toxic gases from automobile exhaust exceeds about 8-10 hr/day. Aims: The purpose of this study was to determine the effects of ambient air pollution on pulmonary functions of the traffic policemen. Materials & Methods: A cross-sectional study with 100 traffic policemen was conducted. The inclusion criteria were non- smoker males, aged between 25-50 years, working for last 1-5 years in the traffic department. The exclusion criteria were history of respiratory or cardiovascular disease or declined participation. Anthropometric measurements of the subjects were taken as per standard protocols, approved by the WHO. Pulmonary functions of the traffic policemen were assessed by determination of Forced vital capacity (FVC), Forced expiratory volume in 1st second (FEV1), FEV1/FVC%, Peak expiratory flow rate (PEFR) and Forced expiratory flow during 25-75% of expiration (FEF25-75%) by using the nomogram of Indian settings with a computer based Spirometer, Spiro Excel manufactured by Medicaid Systems Pvt. Ltd. The association of percentage of predicted values of the pulmonary function parameters with the duration of exposure to air pollutants was analysed by using Pearson correlation. Results: There were significant correlation between the duration of exposure to ambient air pollution and pulmonary function parameters FEV1(r=-.041), FEV1/FVC% (r=-.349), PEFR (r=-.027), & FEF25-75% (r=-.401) expressed as correlation-coefficient (rvalue). Conclusion: The findings showed that prolonged exposure to ambient air pollution leads to a trend of development of obstructive features among traffic policemen.



How to cite this article:
Kumar T, Kumar M, Sunita, Sakshi P, Sharan A. Effects of Ambient Air Pollution on Pulmonary Functions of Traffic Policemen.J Indira Gandhi Inst Med Sci 2019;5:42-45


How to cite this URL:
Kumar T, Kumar M, Sunita, Sakshi P, Sharan A. Effects of Ambient Air Pollution on Pulmonary Functions of Traffic Policemen. J Indira Gandhi Inst Med Sci [serial online] 2019 [cited 2021 Dec 4 ];5:42-45
Available from: http://www.jigims.co.in/text.asp?2019/5/1/42/301076


Full Text



 Introduction:



Air pollution is a major threat to human health in most of the countries of the world. It reduces the life expectancy of people who are constantly exposed to it. According to the World Health Organization (Update 2016), air pollution is the world's largest single environmental health risk in urban areas.[1] WHO estimates 4.2 million premature deaths worldwide in 2016 from exposure to outdoor air pollution. The Global Burden of Diseases (GBD) Study 2015 estimated 4.2 million anthropogenic PM2.5- related premature deaths per year.[2]

According to the global estimate made by the United Nations Environment Programme, 1.1 billion people breathe unhealthy air.[3] This increases daily deaths and hospital admissions throughout the world due to its wide range of effects on human health, especially the cardiopulmonary system.[4],[5],[6],[7] It is also estimated that urban air pollution is responsible for approximately 800,000 deaths and 4.6 million loss of lives each year around the globe.[8] Global daily death from diseases related to air pollution is put at 8000 and a yearly death toll due to air pollution about 2.4 million.[9]

The 2016 Environmental Performance Index ranked India 141 out of 180 countries surveyed.[10] Air pollution from automobile exhaust and vehicular traffic density has become a serious problem, particularly in metropolitan cities in India. Air quality crisis is mainly due to vehicular emission.[11] Automobile exhaust consists of Nitrogen, Carbon monoxide, particulate matter and others which may cause injury to terminal bronchioles and a decrease in the pulmonary compliance and vital capacity.[12]

The particles from the vehicular exhaust of more than 10 micron may be held in upper respiratory tract and accumulates in the lung and produces airway respiratory problems.[13] Fine particles of 2.5 micron causes asthma, respiratory inflammation, jeopardizes lung functions and even promotes lung cancer.[14] The occupational exposure to vehicular exhaust among traffic policemen is an important risk factor for the development of respiratory signs and symptoms.[15]

Average daily exposure of traffic policemen to dust particles and toxic gases (chemicals) generally exceeds about 8-10 hr/day. Many studies have been conducted to determine the long term effects of air pollutants among traffic policemen in different parts of our country. The situation is made worse due to gradual increase in number of vehicles and most of them are old and poorly maintained.

 Aims:



Patna is one of the few most polluted cities in India. Therefore this study was conducted to determine the effects of ambient air pollution on the pulmonary functions of the traffic policemen within five years to avoid worst condition and review current policies for their services for amendment by the government accordingly, so that preventive measures can be taken early for their good health.

 Materials & Methods:



This was a cross-sectional study with 100 participants recruited from the traffic police department of Bihar government. The study was conducted in April and May 2018, at Traffic police station, Gandhi Maidan, Patna.

The inclusion criteria were non-smoker male subjects, aged between 25-50 years, working for last 1-5 years in the traffic department without history of previous respiratory illness or treatment for the same.

The exclusion criteria were past history of respiratory diseases (asthma, tuberculosis and other chronic obstructive pulmonary diseases), cardiovascular diseases, anaemia, congenital anomalies, history of haemoptysis, drug history (such as anti-tuberculosis and ant-asthmatics), declined participation and improper completion of the questionnaire.

A questionnaire of 26 items selected from the Compendium of Respiratory Standard Questionnaire for adults, due to its high internal consistency and reliability.[16] The questionnaire consists of three sections: A, B and C. Section A included information regarding the participant's sociodemographic data such as age, educational level, ethnicity, area and nature of residence (number of rooms for family members and ventilation available for each room). Section B included questions regarding the participant's life style habits such as smoking status, alcohol intake, nutritional habits and status of baseline physical activity. Section C gathered information regarding the participants’ work characteristics and the environment such as duration and nature of job, usage of any precautionary measure like mask and number of hours per day/ week.

Three basic measurements included anthropometric, spirometric and air quality indices.

The anthropometric indices were measured as weight (kg) and height (m) using standard protocols as approved by the WHO.[17] Body Mass Index (BMI) was calculated as weight (kg)/height (m2). BMI of 18.5 - 24.9 was regarded as normal, 25-29.9 overweight and ?30 obese.

The pulmonary function assessment was done by measurement of Forced vital capacity (FVC), Forced expiratory volume in 1s (FEV1), Ratios of FEV1 to FVC (FEV1/FVC), PEFR and FEF25-75% of the subjects by using the nomogram of Indian settings. These parameters were measured by using Computer based Spirometer, Spiro Excel of Medicaid System Pvt. Ltd. Every subject performed forced expiratory manoeuvre thrice while sittng with free mobility and nostrils was closed with a nose clip to prevent the passage of air through the nose to ensure reproducibility of results. Average values and Standard deviation (SD) of these pulmonary function parameters of the traffic policemen were recorded and percentage of the predicted values of the same parameters were calculated and correlated with the duration of their exposure to the ambient air pollution.

The air quality was determined by measurement of the pollutants like Carbon monoxide, Sulphur dioxide, Nitrogen dioxide, Ozone and particulate matter. Evidence-based studies have shown that air pollutants are categorised in a number of different ways, but most of the air pollutants are generally not found in isolation but in a complex mixture, that creates the potential for synergistic effects on pulmonary functions of human beings.[18] The scenario creates a high level of traffic-related ambient air pollution. Statistical analysis was done by using the software ‘Epi Info 7.2 version’. Various parameters of Pulmonary Function Test were recorded and their Mean+SD were calculated. Then association between the duration of exposure and percentage of predicted values of the various parameters of pulmonary function tests was determined by using Pearson correlation.

 Results:



According to the questionnaire, 23% of the traffic policemen were suffering from mild to moderate breathlessness, 19% from occasional cough, 8% from mild chest pain and 21% from irritation in the respiratory tract. Mean age of the traffic policemen was 43.48 years (SD= ±10.63). Mean weight of the traffic policemen was 73.85±9.64 and mean height was 172.49±6.75. Mean BMI was 24.82 kg/m2 (SD=±2.95).

The average data of ambient air quality of Indira Gandhi Science Complex Planetarium during the study showed 1.26 mg/m3 of Carbon monoxide (CO), 10.6 mgm/m3 of Sulfur dioxide (SO2), 36.4 mgm/m3 of Nitrogen dioxide (NO2), 54.2 of mgm/m3 Ozone (O3) and particulate matter, 73.7 mgm/m3 of PM2.5. Most of the traffic policemen (>62%) were living away from their families in common halls in the areas near busy traffic, therefore they were continuously exposed to high level of air pollutants.

Following table shows the Mean±SD of the parameters of pulmonary function (PFT) tests:{Table 1}

Following table shows the correlation between % of predicted values of the various parameters of PFT and duration of exposure to the ambient air pollution:{Table 2}

 Discussion:



Occupational health hazard is a serious matter of concern for traffic policemen as they spend major portion of their life in highly polluted environment during their services. Delhi saw its worst Smog very similar to Great London Smog from 1st to 9th November, 2016 and is also named as Great Delhi Smog according to ambient air pollution, Database, WHO, May 2016. India has thirteen cities in the world's top twenty most polluted cities with Delhi leading the pack along Patna, Gwalior and Raipur respectively.[19] Patna is one of the most rapidly growing cities of India with increasing number of vehicles adding to more pollution and crowding. Present study was therefore focused on the effect of air pollutants on the pulmonary function of traffic policemen in Patna.

In a study done by Pravati P. et al, a significant reduction was observed in VC (P<0.05), FEV1 (P<0.01), FEF-25 (P<0.05) and PIF (P<0.05) in traffic police personnel in Pondicherry.[20] Many studies have also shown that the long term exposure to particulates and vehicular exhaust is associated with adverse effect on health.[21],[22],[23],[24],[25]

In the study done by Dockery et al, continuous vehicular exhaust inhalation was found to be associated with symptom of lower respiratory tract such as cough, shortness of breath and pain during inspiration.[26],[27] Particulate matters less than 10 micrometre were positively associated with symptom of chronic productive cough and increased severity of airway obstruction disease and asthma.[28]

In our study, 100 traffic policemen were selected on the basis of the inclusion and exclusion criteria. Mean+SD values of various pulmonary function parameters FVC, FEV1, FEV1/FVC, PEFR and FEV25.75% of the traffic policemen were recorded and correlated with the duration of their exposure to the ambient air pollution. It was found that there were significant negative correlation of percentage of predicted values of FEV1, FEV1/FVC%, PEFR and FEV25- 75% with the duration of exposure. FVC was also reduced among traffic policemen but its correlation with duration was not very significant because the ambient air pollutants from vehicular exhaust mainly cause obstructive features. Pinkerton KE et al observed that it is the finer particles (< 2.5 μm diameter) that are responsible for tissue remodelling. They also showed marked differences between particle retention and remodelling in the first-, second-, and third-generation respiratory bronchioles. The major site of impact and injury appeared to be the terminal bronchiole and adjacent first-generation respiratory bronchioles, with progressive decrease in both retention of particles and injury in the second- and third-generation respiratory bronchioles.[29]

 Conclusion:



The findings of this study showed a trend towards development of obstructive features amongst traffic policemen after prolonged exposure to ambient air pollution during their job. The results have important policy implications for the introduction of stringent measures towards reducing ambient air pollution in our cities. This could include ban over the old vehicles, not fulfilling the norms of pollution from the traffic control board, monitoring of traffic policemen at interval of certain period for the evaluation of their health impact of air pollution and avoidance of building air pollution hot spots in cities like old factories and brick-kilns.

Also, the workplace approach that addresses both individual and environmental factors could help ameliorate the adverse respiratory effect of ambient air pollution. Individual intervention could include the avoidance of exposure to indoor air pollutants, life style modifications such as well-ventilated houses, cessation of smoking, obesity preventive measures (eg. good nutrition, physical activity), avoidance of second-hand smoking, proper psychosocial stress management, and choice of residential area away from air pollution hot spots.

Also, effort should be directed towards tackling the problem of socioeconomic inequalities by encouraging early childhood education. Empirical evidences have shown that, the educational level can modify the effect of exposure to air pollutants on mortality, with higher risk among people with lower educational levels.[30]

Acknowledgement: I wish to express my deep sense of gratitude to my Prof. & HOD, Dr. Ashok Sharan for his continuous support and encouragement during my study. I would like to thank wholeheartedly Dr. Shishir Punai, Assistant Professor, Community Medicine who helped in statistics. I’m also grateful to other faculty members, tutors and my postgraduate students Dr. Sanaul Mustafa Ansari, Dr. Siddarth, Dr. Abhishek & Dr. Suman and technicians for their helping hands.

There was no conflict of interest.

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