Talking about air pollution

Bethan Davies's picture

Should we be talking to our patients about air pollution?  Does anyone have experience of doing this routinely when addressing other stroke risk factors?  

https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(16)30073-4/fulltext

Comments

Blend it into the conversation about exercise?

Rustam Al-Shahi Salman's picture

When I see patients with TIA/stroke, I address their lifestyle risk factors for stroke, before I move on to medical interventions. I advocate exercise and discuss ways they can do this, so when we talk about outdoor exercise this inevitably brings up a discussion about pollution (itself a major risk factor for stroke [as GBD has shown]), and thereby a discussion about the need for climate change. People with diseases related to pollution and climate change are powerful advocates for change to the root causes of their illnesses!

like0

Clean air day

Bethan Davies's picture

Good resources here

https://www.cleanairday.org.uk/free-resources/healthcare

like0

Pollution not frequently addressed in consults

Dheeraj Kalladka's picture

To be honest, I haven't been able to cover air pollution and its effects, during consults with stroke patients frequently, except for certain specific occupations. Blending it into the conversation about exercise post-stroke is an excellent idea. Thanks for the clean air day link

like0

WHO and UN guidance on health and environment

Bethan Davies's picture

Just published compendium of WHO and UN guidance on actions to address environmental pollution and other environmental risks contributing to global disease burden.  

Up to 28% of stroke globally could be prevented through environmental improvements.  Sections on air pollution and sustainable diets most relevant for stroke, with education and raising awareness as actions for the health community to take.

https://www.who.int/tools/compendium-on-health-and-environment#

like0

Air pollution and stroke during covid

Bethan Davies's picture

Air pollution is estimated to be responsible for 14% of all stroke-related deaths worldwide.  This paper (link below) speculates whether acute drop in air pollution during covid lockdown may partially explain the drop in hospital admissions for stroke during this period.

Also suggests development of "personalised preventative strategies" for those at highest risk, e.g. not exercising outside during rush hour.  Responsibility for air pollution lies with the polluter but unless there is rapid action to reduce levels to the new WHO targets we do need to be able to advise patients on how to best protect themselves.

https://www.thelancet.com/action/showPdf?pii=S2542-5196%2821%2900145-5

like0

Familiar pattern?

Rustam Al-Shahi Salman's picture

I agree that this is an interesting hypothesis about the effect of decreased exposure to pollution on stroke incidence during the COVID-19 pandemic (although my understanding is that admissions for moderate/severe stroke remained unchanged, so the apparent reduction in incidence way have been due to people with minor stroke staying at home). If the hypothesis is true, was there a similar reduction in stroke incidence during the other CO2 emission dips after other major catastrophes? See the graph here: https://grist.org/climate/was-2020-the-year-we-reached-peak-carbon-emissions/

like0

Register or log in to join our networks!