Health Effects of Ultrafines: Why Solid Particles have highest Priority. a Presentation by J. Schiltknecht MD

Transcription

1 Health Effects of Ultrafines: Why Solid Particles have highest Priority a Presentation by J. Schiltknecht MD 1

2

3 Table of Content Anatomy and Function of the Lungs and Defense Mechanisms Size, Distribution, Dynamics and Toxicity of Ultrafine Particles UFP Cellular Response to UFP and Health Impairment Distribution of the suspended Noxes, Monitoring Epidemiology and Economics 3

4 4

5 Lung Performance Air volume/day: m particles/day 5

6 6

7 Airways Upper Airways 5-10 mm Trachea 3-5 mm Bronchi Bronchioles 2-3 mm 1-2 mm Alveoli <1 mm P. Straehl, BAFU, Abt. Luftreinhaltung und NIS 7

8 Airways & Particle Uptake Upper Airways 5-10 mm mm Trachea 3-5 mm Bronchi Bronchioles 2-3 mm 1-2 mm Alveoli <1 mm P. Straehl, BAFU, Abt. Luftreinhaltung und NIS 8

9 Terminal Bronchioli & Alveoli I200mm I 9

10 Mucociliary Apparatus Section of a bronchial wall with ciliated cells tranporting a mucus layer and goblet cells 10

11 11

12 Nanoparticles entering Alveoli I200mm I 12

13 Alveoli surrounded by Capillaries Tissue Cell Alveolar Macrophage Alveolar Epithel Cells Alveolar Wall Blood Vessel (Capillary ) Red Blood Cell 13

14 14

15 Airway Macrophage 1 Surfactant film 2 Aqueos surface lining layer 3 Macrophages 4 Epithelium 5 Dendritic Cells American Journal of Respiratory Cell and Molecular Biology Vol. 36 Fabian Blank, Barbara Rothen-Rutishauser, Prof. Peter Gehr 15

16 Translocation of Nanoparticles Nanoparticles Brain Nose Lung Skin GI-Tract Blood Brain Bone Marrow Spleen Wall Blood Vessels Liver Heart Placenta Fetus Degenerative Changes By Courtesy Prof. P. Gehr, University of Berne 16

17 17

18 Size, Dynamics, Toxicity Size 2.5 µm 0.1 µm = 100 nm 10 µm Equals particles of 0.1 µm 18

19 Size, Dynamics, Toxicity Size Persistence Lung Tissue 1952 London Smog Autopsy Multiple Nanoparticles 19

20 Size, Dynamics, Toxicity Size Persistence Surface Soot Particle, transmission eletronic microscopy De la Roca, University of Nottingham 20

21 Size, Dynamics, Toxicity Size Persistence Surface Chemical Composition & Structure 21

22 22

23 Uptake of Particles and Size Polystyrene Particles 1000 nm Polystyrene Particles 78 nm Courtesy B. Rothen- Rutishauser University of Fribourg 23

24 Cellular Uptake of Nanoparticles E: Caveolae-mediated Endocytosis F: Adhesive interaction (Entering) Brandenberger et al., Small,

25 Reactions of Cells to (atmosperic) Noxes (simplified) Inflammatory Response Oxydative Stress Dysfunction Damage Genetic Impairment Cancer Chronic Illness Death 25

26 Most Important Air Pollution Related Disease Ischemic Heart Disease Chronic Obstructive Pulmunary Disease Cerebrovascular Disease Acute Lower Respiratory Disease Lung Cancer IHD COPD CEV ALRI LC Lelievefeld et al. Nature

27 27

28 Rate Ratio Rate Ratio Rate Ratio Rate Ratio Rate Ratio Rate Ratio 6-Cities Study Which TOC correlates to Mortality? Total Particles [µg/m 3 ] Fine Particles [µg/m 3 ] 6-Cities-Study USA cases Correlation with Fine Particles only Sulfur Dioxide [ppb] Sulfate Particles [µg/m 3 ] Aerosol Acidity [nmol/m 3 ] Ozone [ppb] Source: Dockery NEJM

29 Increase of Respiratory Symptoms near Highways Hazenkamp-von Arx et al. Environmental Health

30 Adjusted prevalence [%] Distance to Heavy Traffic Highways (HTH) and Respiratory Symptons Wheezing with breathing problems Wheezing w/o colds Chronic cough Chronic cough or phlegm Hazenkamp-von Arx et al. Environmental Health 2011 Residential distance from highway [m] Estimated adjusted prevalence rates of health outcomes 30

31 Distance to HTH and Particle Distribution 80% 60% Relative Concentration of Particles 100% Fine Dust: homogenously distributed Soot Particles and other primary toxicans - strong dependend on distance from source Zhu et al, J Air Waste Manage Assoc, 2002; 52: 1032 Residential distance from highway [m] 31

32 Ultrafine Patricle Distribution and Health Symptoms match! Adjusted prevalence [%] 80% 60% Relative Concentration of Particles 100% Fine Dust: homogenously distributed Soot Particles and other primary toxicans - strong dependend on distance from source Zhu et al, J Air Waste Manage Assoc, 2002; 52: 1032 Residential distance from highway [m] Nino Künzli Swiss Tropical and Public Health Institute 32

33 Particle Number Concentration nm Rue de Lyon Heavy Traffic Streets with Heavy Traffic Quiet Streets Ultrafine Particle Concentration Geneva February 26 th 2012 Particle Number Concnetratio (red) and Time (grey grid) Diagramm on Google Earth Mapping 33

34 Traffic Emission Abatement Berlin LEZ: traffic emissions reduced by 50 % but PM10 by <5 % 34

35 London "Pea Soup" Smog 1952 Picadilly Sqare, Unknown Photographer 35

36 Premature Mortality p.a. related to PM 2.5 and Ozon Estimate for Urban Population of 100 Million People Heart IHD Lung COPD Brain CEV Lung Infections ALRI Children! Cancer LC Lelievefeld et al. Nature

37 Effect of Air Pollution During Pregnancy PM during Pregnancy Increased Respiratory need of the Newborn 2009 Philipp Latzin, Bern University Childrens Hospital Lifelong impairment of the Lung seems possible! Baraldi & Filipone NEJM

38 38

39 WHO OECD Report Economic Cost of the Health Impact of air pollution in Europe WHO Regional Office for Europe, OECD (2015) 39

40 40

41 Soot free Tehran! 41