Since the inception of World Health Day in 1950, global health challenges have been highlighted and access to healthcare has been championed by health advocates all over the world as a way of improving the health of citizens the world over.
World Health Day is observed annually on 7 April, under the auspices of the World Health Organization (WHO) as well as many health organizations, health authorities and governments around the world. The 2022 theme: “Our Planet, our Health” is to demonstrate the important relationship between climate change, other planetary issues, and “our own health”.
This World Health Day, the WHO inspires each one of us to advocate for cleaner air, smarter cities and good overall health. The WHO estimates that more than 13 million deaths around the world each year are due to avoidable environmental causes and this includes climate change as one of the biggest health threats facing humanity.
The 2019 World Heart Federation’s (WHF) policy brief document on Air Pollution and Environmental Exposure, is an excellent expose on the harms of environmental pollution, which includes air pollution, particularly in relation to the development of Cardiovascular Disease (CVD). Air and environmental pollution is said to be the 4th highest ranking risk factor for CVD (WHF, 2019).
Air pollution is a complex toxic mixture of compounds of gaseous and particle form originating from diverse sources. The three common air pollutants include particulate matter (PM), ozone and nitrogen dioxide. The heart and the vascular system is highly vulnerable to a number of environmental agents and air pollution is an invisible killer affecting both the young and the old, causing deaths from heart attacks, strokes, lung disease and cancer. Particulate matter contributes to CVD by promoting atherosclerosis, leading to the narrowing of blood vessels, as well as causing cardiovascular inflammation and increasing blood clots, the effects of which include hypertension, heart attacks, heart failure and strokes (WHF, 2019).
In October 2018, the WHO Director-General, Dr Tedros Adhanom Ghebreyesus, declared that: “No one, rich or poor, can escape air pollution. It is a public health emergency”. In his statement, he said that more than 20% of all CVD deaths are caused by air pollution, resulting in 3 million deaths annually and nine out of ten people worldwide breathe polluted air, which disproportionately affects those living in low-resource countries.
It is imperative to have a simple understanding of how air pollution can affect the cardiovascular system (CVS). Once air pollutants are inhaled into the lungs, they are transmitted to the CVS after which cardiovascular function can be impaired in a number of ways. For example, blood vessels can experience stiffening or poor relaxation and increased blood pressure. The consequence is the accelerated development of CVD.
The WHF recommends interventions that involve cross-sectoral collaboration. This involves certain roles that need to be played by physicians, scientific societies, foundations and patient advocacy groups, policymakers at the city level as well as national governments and policymakers at the global level, all with the aim of standing up against the damage caused by air pollution.
The Third United Nations High-Level Meeting on Non-Communicable Diseases (NCDs) in 2018, transformed the “4×4” to “5×5” agenda, adding Environmental Air Pollution as one of the most important risk factors for NCD’s. One third of deaths from leading NCD’s such as strokes, heart attacks, Chronic Obstructive Pulmonary Disease (COPD) and lung cancer are caused by air pollution.
Tobacco use is the major risk factor for NCDs, namely, CVD, Diabetes, Respiratory disease and cancer. Tobacco remains the leading preventable cause of death, killing over 8 million people globally, of which 1.2 million people die as a result of Second-Hand Smoke (SHS) exposure. Conceptually, tobacco smoke also contributes to air pollution and environmental damage resulting in poor health outcomes. Exposure to second-hand or environmental tobacco smoke is associated with increased risk of heart disease and numerous adverse health effects, even among children and unborn babies, and causes substantial mortality and morbidity globally. Children exposed to SHS are at higher risk of developing lower respiratory infection, including TB and have a higher risk of suffering the onset of asthma, pneumonia, bronchitis and middle ear infections (Zar et al). In many populations, homes are the main place of exposure to SHS for women and children and it is the responsibility of countries to implement and enforce comprehensive smoke-free laws to protect their populations.
The HSFSA is aligned with the WHO’s goal of a 30% relative reduction in tobacco smoking. This reduction will result in a decline in people smoking, fewer premature deaths from smoking and a more productive and healthier society. In addition, evidence shows that tobacco use deepens poverty and food insecurity. Without comprehensive tobacco prevention and control policies, it is estimated that smoking prevalence in the African region will increase by nearly 39% by 2030 (The Tobacco Atlas, 6th Edition).
While the cultivation of tobacco leaves has generated many challenges, including health hazards, namely, greenleaf sickness among farmers, environmental degradation and child labor issues, the most pressing health challenge is how the tobacco Industry often uses tobacco farming to undermine Tobacco Control. Agriculture must be at the heart of economic development, however, the vast majority of Africa’s poor continue to live and work in rural areas as tobacco farmers that the Tobacco Industry continues to abuse and keep in poverty (Africa Center for Tobacco Monitoring).
Prof. Pamela Naidoo, CEO, Heart and Stroke Foundation South Africa, states that: “The Foundation is aligned with the World Health Organization, World Heart Federation, Governments and other health authorities to engender health as a fundamental right for everyone in accordance with the Geneva Convention ”. Addressing air pollution will require a multisectoral response and the Foundation will continue to mobilize communities by promoting population awareness and sharing scientific knowledge on the harmful effects of air pollution on cardiovascular health. We will join hands with Governments, Health Advocates, Civil Society Organizations, Healthcare Professionals, Scientific Societies and individuals to act on reducing air pollution for better population-level health. Supporting a healthy environment, making access to healthier food and clean water easier for citizens and making information on CVD health and climate change are top priorities to reduce CVD morbidity and mortality”.
For more information visit www.heartfoundation.co.za.
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