Introduction

Atmospheric pollution suspended in humid air is known as smog. Exposure to these harmful substances is a significant modifiable risk factor contributing to various hazardous health conditions. Substances present in smog that negatively impact public health include particulate matter (PM) of various sizes—PM2.5, PM2.5–10, PM10—along with sulfur dioxide, nitrogen dioxide, ozone, carbon monoxide, and lead. Special attention is given to the smaller dust particles (PM2.5 and PM10) because they can penetrate the lower respiratory tract, leading to serious respiratory health issues. This article will discuss the effects of smog pollutants on the development and exacerbation of respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), respiratory infections, and lung cancer.

Mechanism of damage    

“How Smog Affects the Respiratory and Cardiovascular Systems: The Impact of PM1 Dust Particles”

Smog, a harmful air pollutant, affects multiple organs and systems in the body, with the respiratory and cardiovascular systems being the most vulnerable. Exposure to smog can lead to severe health complications, as it contains various particulate matter (PM) sizes, including dangerous fine particles like PM1, which are smaller than one micrometer. These particles are so tiny that they can easily bypass the blood-air barrier, entering the bloodstream and causing direct tissue damage. While larger dust particles (PM10) are typically blocked in the upper respiratory tract, smaller particles such as PM1 can penetrate deeper into the lungs, reaching the lower respiratory tract. PM1 particles can even pass from the lung alveoli into the microcirculation, further increasing the risk of systemic health problems, including respiratory diseases and cardiovascular conditions.

Historical Stats 

“Impact of Air Pollution on Life Expectancy and Mortality“

Based on 2005 data, exposure to particulate matter (PM2.5) shortens the average lifespan of EU citizens by approximately 8 months, collectively depriving them of 3.6 million years of life each year. Globally, PM2.5 exposure is ranked as the fifth leading risk factor for death. Nitrogen dioxide (NO2) is the second most significant health risk, followed by ozone, which is responsible for approximately 21,000 deaths annually in the EU. Similar findings were reported in Poland in 2012, with annual deaths attributed to PM2.5, nitrogen dioxide, and ozone exposure estimated at 44,600, 1,600, and 1,100, respectively. Studies have shown that for every 10 µg/m³ increase in fine particulate matter (PM2.5), there is a corresponding 4% increase in all-cause mortality, a 6% rise in cardiopulmonary mortality, and an 8% increase in lung cancer deaths.

Worsened Symptoms of different respiratory diseases due to smog are given below: 

Acute Respiratory Irritation 

•  Coughing 
• throat irritation 
•  a feeling of tightness in the chest 
• Increased Coughing 
• shortness of breath
• Wheezing 
• Sore Throat 
• Nasal and Sinus Congestion 
• Chest Tightness or Pain

Asthma  

• Increased frequency and severity of asthma attacks 
• More intense wheezing, coughing, and shortness of breath 
• Persistent chest tightness 
• Reduced effectiveness of inhaled medications, making it harder to manage symptoms 

Chronic Obstructive Pulmonary Disease (COPD) Exacerbation 

• More frequent COPD exacerbations, often requiring medication adjustment or hospitalization 
• Worsening shortness of breath, especially when doing physical activities 
• Chronic cough with increased phlegm, possibly discolored or thicker than usual 
• Greater fatigue due to the effort required to breathe 
• Intensified Coughing and Mucus Production 
• Increased Chest Tightness and Discomfort 
• Worsening Wheezing 
• Fatigue and Reduced Physical Stamina 
• Headache, Dizziness, and Mental Fog 
• Increased Risk of Respiratory Infections 

Bronchitis and Emphysema 

• Increased Coughing 
• More Mucus Production
• Worsened Shortness of Breath 
• Chest Tightness 
• Increased Risk of Respiratory Infections
• Fatigue 
• Decreased Exercise Tolerance 
• Worsened Wheezing 
• Increased Chest Discomfort 

Strategies to Reduce Respiratory Diseases Due to Smog

Stay Indoors

• On high-smog days, stay indoors to reduce exposure to harmful pollutants.
• Use air conditioning or air purifiers with HEPA filters to improve indoor air quality. 

Limit Physical Exertion

• Avoid outdoor activities during times of high pollution.
• Physical exertion increases the demand for oxygen and worsens symptoms of breathlessness.

Use Medications as Directed

• People with bronchitis or emphysema should continue to use prescribed medications, including inhalers, nebulizers, or steroids, to help manage symptoms
• Consult with a healthcare provider about adjusting medications during high-pollution periods

Wear Protective Masks

When going outside is necessary, wear an N95 mask or another form of filtration mask to reduce inhalation of harmful particles.

Monitor Air Quality

Check local air quality indices (such as the AQI) to stay informed about pollution levels. If levels are high, take extra precautions to limit outdoor activities.

Stay Hydrated

 Drink plenty of fluids to help thin mucus, making it easier to clear from the airways

Government Actions for Cleaner Air

• Enforce air quality standards to limit PM2.5, NO2, and ozone levels.
• Promote renewable energy and create more green spaces to reduce smog.

Eco-Friendly Transportation

• Encourage the use of electric vehicles (EVs) and public transport to reduce emissions
• Support carpooling and ridesharing to cut down on vehicle pollution.

Air Quality Monitoring & Awareness

• Implement real-time air quality monitoring and raise awareness about smog risks.
• Educate the public on using indoor air purifiers to reduce exposure.

Protective Measures for Individuals

• Stay indoors during high pollution periods, especially for those with asthma or COPD.
• Use N95 masks and HEPA air purifiers to filter harmful pollutants.

Healthcare Interventions

• Focus on early diagnosis and management of respiratory diseases like asthma and COPD.
• Promote vaccinations for flu and pneumonia to reduce complications from smog exposure.

Research & Technological Solutions

• Fund research into the health effects of air pollution and develop pollution control technologies.
• Invest in advanced air filtration to improve indoor air quality.

When to Seek Medical Attention 

If the following symptoms occur, it’s essential to seek immediate medical attention: 

• Severe shortness of breath or difficulty breathing that doesn’t improve with medication or rest 

• Persistent chest pain or a feeling of tightness in the chest 

• Bluish or gray discoloration of lips or nails, indicating low oxygen levels 

• Worsening cough or changes in mucus color or consistency 

• Confusion, dizziness, or fainting, which may indicate inadequate oxygen supply to the brain