Admissions for respiratory pathologies resulting from pollution peaks are growing

Health professionals have detected that admissions for respiratory and cardiovascular pathologies increase after episodes of air pollution. “When we have worse air quality, we also have more respiratory pathologies in children,” explains the pediatrician specialized in environmental health at the Olot and Garrotxa regional hospital foundation, Ferran Campillo, who adds that in adults, environmental pollution causes ” an increase in cardiovascular pathologies and, particularly, stroke”. In this sense, Girona’s health centers are calling for an increase in the number of stations that measure air quality so that the population can protect themselves. Currently, there are only five in the entire district.

Several scientific studies demonstrate, as detailed by Dr. Ferran Campillo, that “air pollution affects different organs and systems of the body”, although he points out that “those that have been studied the most are the respiratory systems.” “When we have worse air quality, we also have more respiratory pathologies, especially in children such as asthma, recurrent bronchitis or bronchiolitis,” explains the pediatrician in this line.

In addition, there are also studies that determine that air pollution worsens mental health and hinders the neurodevelopment of minors. “Children who live or go to school in an environment with poor air quality have worse cognitive development and academic performance,” details the pediatrician specialized in environmental health at the Olot and Garrotxa regional hospital foundation, who adds that It is a reality that “concerns” pediatricians.

To try to combat the effects caused by poor air quality in children, the Olot hospital has launched a pioneering initiative: the green leaf. This is a document that is completed by families with pediatric patients who present some respiratory pathology and that allows health professionals to “detect the triggers of their crises.” “We look for environmental factors in their environment and make recommendations to families to stop exposure to the pollutant and reduce the risk of worsening,” says Dr. Campillo.

In adults, it has been proven that these episodes of air pollution are associated with an “increase in cardiovascular pathologies and, in particular, stroke.” Campillo adds that “there are also scientific studies that show that after an episode of poor air quality, mortality from stroke increases over a period of one month.”

The main air pollutants that affect human health are nitrogen dioxide (NO2), tropospheric ozone (O?) and suspended particles with a diameter of less than ten microns (PM10), but also sulfur dioxide ( SO?), carbon monoxide (CO), benzene (C?H?), hydrogen sulfide (H?S) or suspended particles less than two and a half microns (PM2.5).

“Different pollutants have different effects on health,” clarifies the pediatrician specialized in environmental health. “In winter, we suffer from suspended particles and nitrogen dioxide, coming mainly from motorized traffic, industry, the burning of plant remains and heating,” he says. On the other hand, “tropospheric ozone is found in summer, due to exposure to the sun’s rays from the oxides generated by traffic,” says Campillo, who details that “ozone can travel with the wind to territories that in principle It doesn’t seem like they should be contaminated, like the mountain ones are.

The head of the Immissions section of the General Directorate of Climate Change and Environmental Quality, Eva Pérez, expresses the same line, explaining that “tropospheric ozone has a quite significant impact in areas that are downwind of large emissions, “like those produced in the metropolitan region.” In this sense, he details that “the plain of Vic, Ripollès or Cerdanya usually have high levels of ozone due to this contribution of pollution from other areas.”

Furthermore, pediatrician Ferran Campillo maintains that the current drought situation worsens air pollution levels. “The lack of rain, especially when it is cold, increases suspended particles and we have been able to confirm that there is a correlation between income and peaks in air pollution,” he says. To confront it and be able to apply measures, health centers demand an increase in the number of air quality monitoring stations in the territory.

In Catalonia, air quality monitoring is carried out through the Atmospheric Pollution Surveillance and Forecast Network (XVPCA). These stations measure the concentration in the air of the main atmospheric pollutants, that is, the immission levels. However, the majority of these stations installed in Catalonia have been concentrated in the metropolitan area, where there are currently more than thirty. Within the Girona regions, however, there are only five and they are located in Agullana (Alt Empordà), Begur (Baix Empordà), Gerona, Pardines (Ripollès) and Santa Pau (Garrotxa). Thus, in Girona each region has only one station except for La Selva and Cerdanya, where there is none.

“We do not have data from the majority of municipalities and knowing the quality of the air can allow us to see, on the one hand, what the sources of these pollutants are and where to focus to reduce them and also, have information in real time so that the population can take measures,” claims Dr. Campillo, a pediatrician at the Olot hospital. And the placement of the stations in the Girona district means that each population has to be governed by the data measured by the station that is closest to it. Along these lines, Campillo insists that “the stations in the territory allow us to have a global vision of air quality, but they do not offer real local data.”

Furthermore, the Girona stations are not capable of monitoring all air pollutants, nor providing information in real time. The Agullana and Pardines measurement points only evaluate tropospheric ozone, those in Santa Pau and Begur also have the capacity to measure nitrogen dioxide and, finally, the Girona station is capable of detecting the nitrogen dioxide present in the air, as well as suspended particles, but not ozone. The data, which can be consulted through the Generalitat website or the air mobile application, is updated every hour.

Apart from the automatic stations, the Climate Action department has four manual stations in the Girona district from which to measure particles suspended in the air, but which cannot be consulted online. These are located in Breda (Selva), Cassà de la Selva (Gironès) and La Bisbal d’Empordà, as well as in Cap de Creus (Alt Empordà). The latter is the only station in the Girona region capable of measuring the three main pollutants present in the air: suspended particles PM10, tropospheric ozone and nitrogen dioxide.

When there are episodes of contamination, the Government of the Generalitat “is notified to the administrations involved so that they can send self-protection recommendations to the population, especially in sensitive groups such as the elderly, children or pregnant women.” This is explained by the head of the Immissions section of the General Directorate of Climate Change and Environmental Quality, Eva Pérez.

However, according to a report from the General Directorate of Climate Change and Air Quality to which the ANC has had access, between 2019 and 2023, the permitted levels of air quality set by European regulations have been exceeded on rare occasions. In 2019, tropospheric ozone levels at the Cap de Creus measurement point exceeded the permitted information threshold twice and at the Begur station, ozone levels were detected above the target value for the protection of human health in 29 occasions (current regulations allow it to be exceeded up to a maximum of 25 days a year).

The same report argues that the levels of carbon dioxide and suspended particles have not exceeded the values ??established by legislation at any time in the last five years. Of course, it is worth remembering that there are only nine stations (five automatic and four manual) spread throughout the district and that only the one at Cap de Creus is capable of measuring the three main pollutants. Therefore, it cannot be assumed that air quality was not harmful in other parts of the Girona regions where its values ??cannot be measured.

In 2022, the Catalan Air Quality Index (ICQA) – which governs the impact it has on people’s health – was revised to match it with the European Air Quality Index. The ICQA is determined by the eight pollutants present in the air mentioned above and is calculated from data from the automatic stations installed in the territory. This index allows the population to communicate in a clear and understandable way what the state of the air is. It categorizes it into six bands ranging from “good”, “reasonably good” and “fair” to “unfavorable”, “very unfavorable” and “extremely unfavorable” and which are equivalent to a color ladder that moves from blue to lilac. , passing through green, yellow, red and purple, as the health hazard increases.

Currently, this European index that establishes the permitted limits of air pollution is under review. “Probably, in a short period of time we will see a change that restricts the current regulations and is firmer when it comes to applying measures against air pollution,” says Campillo, who states: “We know that at levels much lower than the that the directive establishes, it is already beginning to affect the health of people and, above all, children.

Meanwhile, doctors recommend “applying palliative measures to try to mitigate exposure urgently.” These measures, Campillo details, involve taking refuge in spaces with better air quality, when there are episodes of pollution. One option, he says, may be to stay indoors, especially if filters have been installed. In addition, you can opt for other measures that address the causes such as “reducing motorized traffic, improving home insulation or, in the case of heating, making a transition to sources that do not burn fuels such as aerothermal energy.”

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