Air pollution harms not just the lungs but also the heart and brain, specialist warns

Air pollution is not only an environmental problem; it also has serious effects on the human body. When air quality deteriorates, the heart and brain, along with other organs, can be damaged in addition to the lungs, according to pulmonologist Dr Malabika. The lungs and the heart are the organs most affected by pollution, she said.

PM2.5 particles in polluted air are so small that they can bypass the natural defences of the nose and upper airway and travel directly into the alveoli of the lungs. PM2.5 refers to extremely fine particulate matter with a diameter of 2.5 micrometres or less; it can be airborne solid particles or liquid droplets.

The alveoli are microscopic, cup-shaped air sacs at the very end of the respiratory tract. These microscopic particles and the chemical elements present in the air can mix into the blood, which means other organs of the body are not spared the effects of pollution either.

Explaining the damage to the lungs, Dr Malabika said air pollution can cause severe inflammation of the airways. The airway muscles can contract, a condition called bronchospasm. Breathing can also become difficult, accompanied by a whistling sound known as wheezing.

For people who already have asthma or chronic obstructive pulmonary disease (COPD), those conditions can become more severe. According to Dr Malabika, people with asthma can suddenly suffer an attack, while COPD patients may experience increased coughing, phlegm and breathlessness.

Pollution also affects the heart. Air pollution can change heart rate and blood pressure and can inflame blood vessels, the doctor said. Oxidative stress can also increase — a state that arises when the balance between reactive oxygen species and the antioxidant capacity that neutralises them breaks down, creating a risk of damage to cells and tissues. Pollution can also raise the risk of blood clotting, she said.

The risk to the brain is different again. Exposure to severe air pollution can damage blood vessels, which increases the risk of stroke. Dr Malabika explained that the first and most direct impact of air pollution falls on the respiratory system.

Long-term exposure to airborne fine particles, especially PM2.5, can affect the normal functioning of the lungs. The presence of PM2.5 in polluted air can also be a major cause of lung cancer — smoking is not the only cause of lung cancer. Prolonged exposure to polluted air also raises the risk of heart attack and stroke.

Continued exposure to polluted air can cause coughing and phlegm problems, and a person may feel fatigued during physical exertion or exercise. In Dr Malabika's words, airway infections can recur frequently, asthma can become difficult to control, and breathing difficulties can gradually increase.

Whether brief exposure to pollution causes permanent lung damage cannot be said with certainty, she said. For most people, mild swelling and inflammation of the lungs are temporary, and the effects are likely to lessen once exposure stops. But people with pre-existing lung disease remain at risk of serious and permanent damage, and scarring of lung tissue, or fibrosis, can cause long-term harm.

Treatment depends on the patient's symptoms and the severity of the condition. If the airways narrow, bronchodilators may be given; if blood oxygen levels are low, oxygen therapy may be needed; and persistent difficulty during exertion may require pulmonary rehabilitation. However, antibiotics, steroids or nebulisation are not needed as precautionary measures — treatment based on symptoms and medical test results is sufficient, the specialist said.