Basic information and advice on air pollution

This information is intended for

This information is for expat staff and operational managers, working at a Dutch representation abroad.

Clarification

Air quality depends on air pollution. An important component of this is usually the level of particles in the air (fine dust). Other elements taken into consideration are gasses such as Sulphur dioxides, nitrogen and ozone.

Particulate matter, also called PM10, are tiny particles with a diameter smaller than 10 micrometre (1 micrometre is 1 thousandth of a millimetre). Lately more attention has been given to PM2,5 dust, particles with a diameter smaller than 2,5 micrometre. Through breathing, these particles enter deeper in the lungs than the PM10 particles.

The contribution from natural sources to the PM2.5 concentration is also smaller than the PM10 concentration. Ultrafine particles consist of even smaller particles (nanoparticles). These can be absorbed into the bloodstream after inhalation and thus cause health damage. 'Black smoke' is also a measure for particulate matter. This is a measure for diesel soot. Many scientists think that it is this proportion of fine dust in particular, that relates to health effects. There are no standards for ultrafine dust and black smoke. There are standards for PM10 and since 2015 for PM2.5 also.  For clarity sake, these standards do not however, provide any health guarantee. Health damage can occur even below these standards.

Fine dust can also have a natural source, for example sea salt or fine sand particles. In fact, fine dust is a mixture of different particles, which differ in origin and properties. Particulate matter is seen as one of the most harmful components of air pollution.

An air quality index is used to assess air quality. This is sometimes abbreviated as AQI (Air Quality Index), sometimes other abbreviations are used such as API or PSI. The AQI for most cities can be found on the internet.

What is the risk of complaints?

In general, the elderly, people with heart or lung disease and children develop health problems the fastest. Research has also shown that air pollution has a negative effect on the weight of new-born babies. Those breathing in more air pollutants in the open air, for example during heavy physical exertion (such as exercising and working) are at greater risk of developing complaints.

In as far as is readily available, data on the health effects of air pollution is mostly confined to large-scale statistical data on the average life expectancy (which clearly decreases the longer people are exposed, and the higher the air pollution is). According to the RIVM, exposure to particulate matter leads to a reduction in working life estimated at 12 months for the average Dutch person.

In 2005, the WHO put the most important facts available in a row. This information shows, among other things, that the individual sensitivity to air pollution varies greatly and depends on factors such as age and health. That individual sensitivity is difficult to measure. In practice, a person's susceptibility to air pollution appears to be an experiential fact: you can only find out by being exposed to it.

Short-term effects

These are mostly caused by excessive ozone concentrations. This exacerbates health problems in the airways, heart or blood vessels, especially in people from sensitive groups. At high concentrations, healthy people can also suffer from e.g. eye irritation or coughing.

The effects of air pollution that occur immediately are usually reversible. By this is meant that the health effects disappear as soon as the air pollution decreases. For most people the complaints disappear, however the worsening of symptoms (in high-risk categories) after short-term high exposure can also be so severe that they prove fatal.

Long-term effects

There is no doubt that long-term exposure to serious forms of air pollution can cause health damage. Determining the amount and degree of damage related to exposure, is still a largely open question.

Severe air pollution can affect the condition of the heart and lungs, but reliable data is only partially available, and considerably more research is needed.

Groups most at risk

Very young children, seen their respiratory tracts and lungs are still developing, are probably more susceptible to the adverse effects of long-term exposure to air pollution. But here too, there is insufficient reliable data to indicate how big the chances of long-term damage are.

Pregnant women also form a risk group. An increase in low birth weight and new-born mortality has been shown in pregnant women who were exposed to air pollution. This increase in risk is not significant, but nevertheless is still an increase. (RIVM note air quality April 2015)

Severe air pollution is a particular risk for people already suffering from health issues. For people with (chronic) diseases of the heart and / or lungs, the symptoms can increase sharply in a short time. But for these groups too, the determining factor is individual sensitivity and it varies widely: where one person experiences hardly any hindrance, the other can suffer a lot.

Possible measures to be taken

Air pollution is a problem of the living environment on which the individual has very limited influence. It is hardly possible, at a personal level to remove or reduce the harmful stimulus; this requires global changes in politics, production processes and societies.

Housing environment

In many polluted cities, however, the degree of air pollution is not the same everywhere. This means that your choice of where to live will have an impact on the amount of pollution you are submitted to in your living environment.

Air purifiers

There are measures available (special filters) that can be placed in the air treatment systems of buildings; however, they only offer partial relief. Small filter systems are also available for residential use, but research shows that their effectiveness is very much dependent on keeping the rest of the house 'airtight' (closed windows and doors).

In practice, this means that an air treatment system does have an effect in areas where people only infrequently go in and out (once or twice a day) and keep everything closed the rest of the time. As a rule, this usually means only bedrooms.

Advice is then to ventilate, preferably in the morning period when the air pollution is not yet too strong, then close everything and turn on the air purifier. Enter the room again when you go to sleep and sleep with windows and doors closed (making the bedroom 100% tight is not recommended because of the necessary fresh air supply).

Mouth masks

The effect of mouth masks is doubtful, by far not all types of mouth masks stop the small particles.

If you still want to use them, we recommend using caps with a class P2 / 3 (Europe) or N95 (Asia, USA) because they offer protection against small dust particles. The masks the most comfortable to wear however, are also the ones that leak the most and thus cancel out the protection. The P2 / 3 masks that do not leak cause however heavy breathing, so they are hardly worn in practice, especially not when they are the most needed such as when exercising for example.

Behaviour

Furthermore, it is recommended to avoid doing strenuous exercise in polluted air outside. There is no problem in exercising in well ventilated inner areas where the air is clean.

When cleaning, it is also recommended to use wet cloths in order to bind the dust and avoid stirring it around.

Recovery / recovery leave

For acute complaints it is clear that removing oneself from the polluted area for a short period of time will provide some relief, but this effect is short-lived and will be reversed when you return to the polluted area. For potentially chronic symptoms, periods of one / two / three weeks a year outside the area has no effect whatsoever and the only choice must be to leave the contaminated area completely.

Medical inspections

It makes sense to ask to what extent research can be carried out during the periodic medical inspections to the effect of the air pollution. Sadly, this makes little sense.

The possible damage caused by air pollution is so non-specific and develops so gradually, that signs of this during physical and laboratory research will be lost in the overall effects of, for example, ageing, familial predisposition and damage caused by other causes (such as smoking). It is not possible to clearly demonstrate which damage is caused by air pollution through specific examinations such as periodic X-rays, blood tests, ECGs or exercise tests.

What you can do during the medical inspection – and it certainly makes sense to do so, is to map out any additional risk factors you may have and your experience so far with living and working in areas with air pollution. As mentioned earlier, you have the option of refraining from choosing postings with serious air pollution, the medical inspection can help you make that decision if needed.

You can find more information on the Safety page of the Governmental portal (Rijksportaal)

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