For years I did lung surgery every day of the week. When I opened a patient’s chest to operate in a lung, I would see between the dimensions and the truth of our environment would be there in front of me.
I often saw the lungs tanned by chronic inhaled carbon particles. I saw the pleural surface covered with wings and bolts caused by the particles and oxidants of the cigarette smoke. I felt the tumors that grew up where they once lived healthy cells. The damage was not abstract. It was visceral. It was permanent. And often, it was preventive.
This type of damage – the scars, the inflammation, the cancer that seems to me so much in the operating room – is now accelerated by a changing climate that magnifies the pollution we breathe daily. I noticed this in the operating suite, but to better understand what lies beneath these observations, it helps to follow the path of a single inhalation.
Calcutta, Western Bengal, India – in Fortis Hospital, Calcutta, an elderly woman has been urgently hospitalized due to lung infection. When air is more infected, the number of patients with respiratory diseases and symptoms increases. According to the World Economic Forum, in 2020, India hosts six of 10 of the world’s most polluted cities. The majority of India’s energy production comes from fossil fuels. (Photo by Jonas Gratzer/Lightrocket via Getty Images)
Lightrocket through Getty Images
The journey of a particle
Imagine it is an inflated day, possibly small or full of smoke. You take a breath and a stigma of fine particles (dust, soot and smoke in the air consisting of particles so small that you cannot see – what scientists call PM2.5). a thirty The width of a human hair bypasses the usual defenses of your nose and throat. The mucus and the blotching that normally trap larger dust cannot catch it.
It drifts under Windpipe (the trachea) and in the branch bronchi. Here, lining cells feel an invader and release alarms, chemical signals that draw on immune cells and produce oxidative stress. This irritation makes the airway more broken, more inflammatory and prone to narrow. For a person with asthma or COPD (chronic obstructive pulmonary disease, or bronchitis and emphysema), this means cough, whistle or suffocation or even a journey into the emergency room.
The invading particle does not stop there. It travels down through the smaller air ducts or bronchioles, to the road to the cells, the tiny airbags where the oxygen moves to the blood. The cellular wall is only a thick cell. It is made for gas exchange, not for poison filtering. When the particle is deposited here, protective cellular macrophage haste to flood it. In the process, they release cytokines and free radicals, starting more inflammation. Some particles crush these natural defenses. The smallest, what is said supernatural particlesEven slipping through the cellular capillary barrier, which crosses blood circulation and from there traveling throughout the body, including the heart, brain and kidney to begin even more destruction and illness (see below).
Acute and chronic damage
In the short term, this waterfall means stricter and more limited airways, more mucus and overall reduced lung function. Therefore Hospitals are increasing on bad days of air. But the long -term story is more insidious.
To people with Hop (for 16 million Diagnosed Americans, and in fact a multiple of it), the repeated particle deposition leads to permanent scars and remodeling of the bronchus, deterioration of preventing the flow of air and oxygen delivery and accelerate the reduction of pulmonary function. In asthma (for 20 million adult Americans and 4.7 million children) particles Enhance allergic inflammation by reducing the limit for an attack. And in the context of lungs Cancer (ultra 200,000 new cases Per year in the United States), the story is intense: particles cause DNA damage and mutations. The International Research Office of the World Health Organization for Cancer Organization stated External air pollution and particulate substance group 1 carcinogens, proven causes of lung cancer.
This is precisely what emphasizes what I saw as a surgeon every day as I opened the patient’s chest. The lungs are hard with scar tissue. The airway blocked with carbon deposits. The tumors that develop where the chronic injury has abolished DNA repair and allowed malignant cells to escape control.
The horizon of Los Angeles in the center of Los Angeles was bathed in a brown cloud. View from Griffith Park.
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Pollution does not remain in the lungs
Once the particles cross blood circulation, they cause systematic inflammation throughout the body. We can count it in raised C reactive protein flat. This systematic response in turn accelerates atherosclerosis or “hardening of the arteries”, increasing the risk of heart attack and stroke. Some overly particles still Get to the brainwhere they have been detected in human tissue and appear on animal models to travel along the olfactory nerve. Numerous studies have shown that long -term exposure to air pollution from car evaporation, fires and factory tobacco is linked to increased growth risk neurodegenerative diseasesincluding Parkinson’s disease with dementia. I will process in future articles of extensive pollution of impacts on other organ systems.
So how does the changing climate play in all this?
The changing climate enhances pollution and therefore the impact of pollution on human health.
Hotter days (remember, last year 2024 was the hottest in the recorded story) Accelerate chemical reactions that create ground ozoneA powerful respiratory irritant that makes air ducts contract and inflammation. In addition, stagnant air during thermal waves traps the pollutants near the ground, creating prolonged bad events. And then there are fires, powered by warmer and drier conditions, which now send huge calves of tobacco to entire continents, launch emergency visits to places away from flames. In addition, the warmest seasons lengthen pollen cycles and increase pollen numbers, lung starts for more asthma episodes and more allergy attacks.
The changing climate is not separate from pollution. It is an engine that makes the particle impact on the entire respiratory system worse – more ozone, more smoke, more allergens – and therefore the changing climate is an immediate driver of many, if not most of the lung diseases I treat and regularly treat.
Forest fire at Yellowstone National Park, Wyoming.
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Because all this matters to you
I describe this journey of a single particle because it makes it clear how personal and immediate the problem is. This is not a rocket science. It is a basic biology. And this is not about 10 years from now. It is not a polar ice or disappearance away from the islands. This is here and now, and it’s for you and me. It is the air we breathe, the lungs in our breasts, the health of our children and grandparents. Each breathing in an infected, overheating of the day has the ability to inflammation, scars and long -term diseases.
As a surgeon, I can blame a new lung cancer or transplant, but prevention, as we all know, is stronger than any scalpel. Understanding that climate change and pollution are two sides of the same coin and that both are directly damaging our lungs are necessary to protect health and formulate the right policy for the coming decades.
Each of us lasts about twenty thousand breaths each day – about thousands of chances of the air around us either to keep life or to harm it quietly. Breathing with breathing, particle particle, the changing climate writes itself in our body.
