MMS Physician Focus: March 2009
By Robert P. Naparstek, M.D.
How often does an opportunity come along to put the Golden Rule
into practice? We now have a chance to 'treat others as we wish to
be treated' and to do so on a grand scale. We can treat our
neighbors and indeed, the whole world, as ourselves while at the
same time supporting our health and well being.
The New England Journal of Medicine recently reported on a
statistically significant increase in life expectancy as a result
of reducing air pollution. The relationship between air pollution
and illnesses such as asthma, heart disease and certain cancers is
well proven. However, for the first time, actual increases in life
span have been verified as a result of cleaner air.
Air pollution is the result of how we produce energy, use our
cars and appliances, and heat and cool our homes. The larger our
"carbon footprint," the more air pollution we cause, which in turn,
leads to serious illness and premature death. This air pollution is
primarily due to the burning of fossil fuels: gasoline and diesel
for our vehicles, coal for electricity, and natural gas for heating
and other energy uses.
Our combustion of these fuels as individuals and as a society
contributes to heart disease and stroke. Repeated epidemiological
studies worldwide have demonstrated these connections, especially
in relation to particulate matter in air pollution. Particulate
matter, in fact, may prove to be the biggest culprit of all air
pollution components.
Particulates are generated from such sources as vehicle
emissions, tire fragmentation, industry, power generation,
smelting, demolition, forest fires and volcanoes (We have no
control over volcanoes, of course, but we can work to modify other
sources.). Other components of air pollution include carbon
monoxide, nitrates, sulfur dioxide, ozone, lead, and tobacco
smoke.
The Environmental Protection Agency has declared that "tens of
thousands of people die each year from breathing tiny particles in
the environment." And Science Magazine recently published a study
that showed death rates in 90 large U.S. cities rising by 0.5
percent for every tiny increase of particulates (ten micrograms per
cubic meter). It's also clear that people with asthma are
especially vulnerable to nitrogen dioxide from power plants and
other fossil fuel burning sources. Additionally, the American
Cancer Society demonstrated that long-term exposure to particulate
air pollution raises the risk of cardiovascular death by 12 percent
(also for every ten micrograms per cubic meter).
So here we are in the early years of the 21st century. We are
well informed by science, aware of the harm we cause through our
choices and capable of profoundly decreasing the amount of pain and
suffering that occur all around us. Can we afford to continue to
ignore the facts or can we as individuals take collective actions
to improve health and extend life spans? If we choose to
reduce our carbon footprint locally, we can simultaneously
contribute to the global effects of decreasing our dependence on
foreign oil and helping to alter global warming and climate
change.
All it takes to have such a grandiose impact on the world is to
make choices that improve our health. These include choosing cars
with high gas mileage and cleaner burning engines, insulating our
homes effectively, and improving the efficiency of our appliances.
Making choices for greener energy sources (such as wind and solar)
can also have a huge impact on our health and our neighbor's health
and improve the well-being of the community and even the whole
world.
We all have a deep reservoir of power by way of these choices.
The result can be large, and at the same time, provide the quiet
inner peace that comes with bringing the golden rule to practice
for the public health. For more actions you can take to make better
choices for our health and the environment, visit the Environmental
Protection Agency at www.epa.gov.
Robert P. Naparstek, M.D. is Medical Director of Caritas
Good Samaritan Occupational Health Services and Chair of the
Massachusetts Medical Society's Committee on Environmental and
Occupational Health. Physician Focus is a public service of the
Massachusetts Medical Society. Readers should use their own
judgment when seeking medical care and consult with their physician
for treatment. Comments toPhysicianFocus@mms.org
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