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Can we do more than run away from pollution?

Lung cancer is the leading cause of deaths from cancer worldwide. It has been and continues to be the most frequent cancer and one of the most difficult to defeat. One of the main reasons? More than 70% of cases are detected in advanced stages. Diagnosis in early stages is vital and conditions the prognosis.

For decades, lung cancer has been linked to smoking, but more and more cases are detected in non-smokers, living in areas with polluted air. In the last 50 years numerous scientific studies have been published that associate air pollution with the increased risk of this type of cancer.

Looking at this analysis, we ask ourselves: Is environmental pollution in the air we breathe an avoidable risk factor like tobacco? Or should we resign ourselves to it?

The Global Burden of Disease Study (GBD) and theHealth Effects Instituteestimated that by 2010 approximately 3.22 million deaths worldwide would be caused by exposure to polluted air. In 2017, the mortality rate reached 5 million – almost one in ten deaths – with 20% attributable to lung cancer. For the first time, a lower life expectancy attributed to this type of contamination is estimated for 2019, and not only for lung cancer, but also for other types of cancers, cardiorespiratory diseases and diabetes. We recommend reading this report published online at www.stateofglobalair.org/.

When experts have studied outdoor air pollution in detail they have detected substances such as ozone (O3) and nitrogen dioxide (No2), but above all, they have found particulate matter. Particulate matter, known as PM, was classified by the International Agency for Research on Cancer (IARC) as Group I i.e. carcinogenic to humans, at the same level as recognised carcinogens such as tobacco, asbestos and ultraviolet radiation. The number that accompanies the PM nomenclature refers to its size. Thus, PM 10 are mainly minerals and biological material: being larger they penetrate less easily into lung tissue. PM2.5, being smaller, penetrate deeper into the lungs and are more easily retained in the bronchi; they are also mostly combustion products, which are highly carcinogenic. Its harmful effect is due to the oxidative stress they produce in cells: they damage genes, induce epigenetic modification and activate inflammation and uncontrolled cell proliferation processes.

Polluted air is less dense in rural areas and much denser in cities, where the population is more concentrated, especially in areas with the most traffic. Faced with this reality, more and more people are considering changing where they live. But can we do more than run away? As individuals, we can limit our contribution to local pollution. How? By investing in electric vehicles for example, and, crucially, by being a part of organisations which are pressuring decision makers to continue reducing pollution. Unfortunately, our country is not a good example; the CCEE is considering filing a complaint against Spain with the Court of Justice of the European Union for not taking measures to improve air quality.

Meanwhile, to protect ourselves, we can get applications that calculate the level of air pollution and offer interesting ideas (Airvisual, Breezometer, Plumairreport, and AirACT).

Some people may consider wearing a mask, which is protective, but not impenetrable. A CSIC study recommends wearing a mask with European EN149 certification, with an exhalation valve and several filters, which are not expensive. Our body also helps: once the pollution particles enter the body, our cells produce ‘glutathione’, a very powerful antioxidant that counteracts oxidative damage and helps detoxification. But age, poor lifestyle and overexposure to pollution deplete this antioxidant’s reserves. Is there a way to “recharge” it? The answer is yes, through physical exercise in healthy spaces, eating foods rich in sulphides (garlic, onions and cruciferous vegetables), B vitamins and folates (brewer’s yeast and green leafy vegetables). For those who require an intensive recharge, taking ‘glutathione” (or its precursor N-acetylcysteine, under professional supervision) gives us a good protective shield so we can stay more or less unscathed.