Climate change, the environment, and rhinologic disease .pptx

Climate change, the environment, and rhinologic disease .pptx

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  [email protected] [email protected] Dr.Azad A HaleemAL.Mezori FRCPCH,DCH, FIBMS Assistant Professor University Of Duhok College of Medicine Pediatrics Department Scan For Contact Climate change, the environment, and Allergic disease
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  INTRODUCTION
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  Air pollution  Airpollution is a major global health crisis,  causing one in nine deaths worldwide. accounts for an estimated 7 million premature deaths every year.  Exposure to (Particulate Matter ) PM2.5 reduced average global life expectancy by approximately one year in 2019.  It disproportionately affects those living in developing nations and particularly the most vulnerable, such as women, children and the elderly.  Healthcare industry itself contributes ∼8.5% of total greenhouse gas emissions in the United States.This is an alarming wake up call.
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  IRAQ • Exposure toPM2.5 = 48 µg/m3 each person's annual mean exposure • —9.6 times WHO's guideline. • 60 deaths per 100,000 people attributable to fine particle pollution in 2019 (25,378 in total in the country).
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  ALLERGIC DISEASES • Overthe past century, allergic disease has increased (currently estimated to affect from 10% to 30% of the world's population). • The basis of allergic disease is thought to be due to underlying genetic predisposing factors that are modified by environmental risk factors.
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  Prevalence of AllergicDisease • The prevalence of AR & allergic asthma has progressively increased throughout the world. This trend has been seen in • Finland (0.6% prevalence to 8.88%), • Sweden (21% to 31%), • United Kingdom (5.8 to 19.9%), • Italy (16.2% to 37.4%), • South Korea (13.5% to 17.1%), • Australia (21.9% to 46.7%). • About 200 million people worldwide, or approximately 3% of the global population, are estimated to suffer from nonallergic rhinitis (NAR). • CRS affects approximately 5% to 12% of the US population or up to ∼ 40 million Americans.
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  • Mechanistic studieshave shown that PM results in increased epithelial permeability, airway hyperresponsiveness, oxidative stress, immune dysregulation, and epigenetic changes. • A recently published study identify associations between sinonasal histopathology specimens and levels of air pollutants at the patients’ place of residence. • In fact, for each 1–part per billion (1-ppb) increase in ozone exposure, there was an 81% increased likelihood of having eosinophil aggregates, increased inflammation, CRS , nasal polyposis and allergic diseases. Allergic Exacerbations
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  Climate change • Increasedhuman fossil fuel use in the last half-century produces CO2 and methane greenhouse gases. • These gases absorb heat and result in global warming of the earth's surface. • This warming is accompanied by regional changes in precipitation and increases in many types of weather extremes. • There is growing evidence for climate change as a significant driver of human diseases; this results in exacerbation of human diseases, including cardiovascular, allergic, infectious, and mental health diseases. • These effects preferentially impact the lower socioeconomic populations.
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  • Climate changeand climate events have changed how individuals experience allergic diseases. • Spring has inched earlier in the year leading to earlier and prolonged release of tree pollens. • Also, there has been a progressive delay in the onset of fall and the associated first frost, increasing the length of ragweed pollination & pollen production. • As a result, higher levels of mold spores are present every fall and spring.
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  • Global warmingis associated with increased wildfire risk and increased droughtsin many regions, which leads to an associated increase in regional atmospheric concentrations of PM and other pollutants. • Allergic diseases & Asthma hospitalizations similarly correlate with both pollen load and climate events such as floods and fires. • These data highlight the fact that no corner of the world is exempt from the effects of climate change on allergic disease.
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  • Humidity: higherhumidity has been associated with lower concentrations of some allergens such as tree pollen, but increases in others such as mold spores. • The distribution of allergenic species has also been in changed, due to regional changes in temperature and precipitation. • Extremes in weather conditions induced by global warming modify pollination patterns and distribution resulting in growth of allergic microbes (mold and fungus), and promotion of allergic rhinitis and asthma exacerbations and then chronic rhinosinusitis (CRS).
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  NONALLERGIC RHINITIS • NARencompasses a broad range of nasal inflammatory conditions that are independent of typical infectious and allergic mechanisms. • The hallmark symptoms of NAR are nasal congestion, rhinorrhea, and various pain syndromes, including headaches and atypical facial pain, which are thought to occur through shared neurologic pathways of the sphenopalatine ganglion. • NAR is characterized by nasal hyperreactivity to various environmental triggers, including cold air, tobacco smoke, Air pollutants and chemical products.
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  • Exposure toairborne pollutants including particulate matter (PM), nitrogen dioxide (NO2), and ozone has been shown to contribute to the development and/or exacerbation of several common upper respiratory tract diseases including AR and CRS. • Clinically, long-term air pollution exposure has been found to be associated with the development of CRS in recent systematic review in USA , Germany, South Korean & China. • Affected domains such as sleep, emotion, and function directly impact on depression, productivity, lost days of work, and restriction of functional activity. Chronic Rhinosinusitis (CRS)
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  Summary and recommendations •We should emphasizes that, as health care providers, have both the opportunity and an obligation to urgently raise public awareness of the negative impact of climate change on upper airway health. • All government should continues to debate policy on ways to decrease greenhouse gases and pollution. • All academic societies in the world need to come together in vocal unity to highlight the importance for the need for researches to study effect of pollution on the immune response listed “The impact of the microbiome and of pollution on immune responses in developing, preventing, and managing asthma, allergic rhinitis, food allergy, and atopic dermatitis.
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  • Equality: higherrisk of harm from climate change, extreme weather events, and pollution affect the lower socioeconomic population and historically oppressed groups, and further worsen the healthcare disparities already present. • The question now becomes: Are we ready? it seems as though we are not. • Thus, the hot get hotter, the wet get wetter, the dry get dryer, and the poor get poorer with respect to health. Summary and recommendations
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  THANKS FOR YOUR ATTENTION