Contents page 1 — So many years of life cost of the fine dust, nitrogen oxides and smoke page 2 — Obesity and Smoking are main risk factors for stroke page 3 — How limits are from referrals? On a page

How harmful nitrogen oxides to read how unhealthy fine dust? How risky is Smoking? And how many years of life cost the Germans an unhealthy diet? In studies, doctors try to approach the answers to these questions. Some of them work in a particular part of the health Sciences dealing with the quantitative exploration of the health risks of companies: the epidemiology.

epidemiologists observe involve people in real Environment. For nitrogen oxides that is about: In the Ruhr area, a researchers examined a team, over several generations, and whether and, if so, to what extent – a permanent air pollution to the local Residents and residents in cardiovascular diseases. The most well-known example for such an approach: The American Framingham heart study in 1948, several Thousand people were supported to understand what is causing heart disease, such as genetics, behavior and environment play together and what can follow from heart diseases, dementia, for example, (The Lancet: Mahmood et al., 2013).

unlike experimental studies, in which researchers test animals or subjects, exposing random and controlled pollutants, radiation or a high calorie intake, is the great strength of epidemiology is that it is more reflective of the actual loads and the associated risk of disease. “A key task of epidemiology is to study disease frequencies in the population under real-life conditions,” explains Andreas Seidler, Director of the Institute for occupational medicine and social medicine at the TU Dresden. “This must be calculated with statistical methods, other influences, which can lead to the same diseases.”

the measure of all things DALYs

Specially developed health dimensions help. A measure to pour the influence of environmental factors like poor air, noise, or UV-radiation in a number and to compare, the impairment adjusted life years, in English disability-adjusted life years and DALY. The advantage of DALYs is that they do not take into account only the years of life lost through early death, but also the years in which a person at a risk factor caused disease suffers.

Who understand, will cost how many years of life risk factors in Germany, can draw a measure and the data from the Global Burden of Disease Study. Show: In Germany, approximately three percent of pollution from all of the years of life lost due to illness or death, to the account of the air (see graphic).

compared to poor diet or Smoking, this is little. The value has decreased since 1990 to a third in the air in Europe has become better and better. In absolute terms, the Numbers look significantly more threatening in the year 2017, estimated at 790.000 years of life lost in Germany, in consequence of pollutants in the air. Based on more than 80 million German citizens, with a life expectancy of around 80 years – you would be just a lost year per Person.

think about this number, you should be a little longer. Because the burden of disease due to environmental pollution is not distributed evenly on all shoulders. So it may be that 40 people are due to environmental pollution, sick, and in each case, for example, a year shorter of 40 years of life lost), or a single die of an asthma attack life (and not 80, but only 40 years old (40 lost years).

“In the case of environmental factors such as air pollution, it is more difficult to determine the exact risk of disease than lifestyle factors such as Smoking or Obesity,” says Seidler. Because the effects of individual pollutants are much lower. Therefore, epidemiology can sometimes get close to their limits. Nevertheless, the risk of disease had been underpinned as a result of fine dust and nitrogen oxide in the last years by many epidemiological studies. And: risks from air pollutants are population-based “highly relevant,” says Seidler, because environmental factors can not escape, well, no one. Also children or already do not have cancer, were at risk in the case of relatively low pollutant concentrations.

The data record of the Global-Burden-of-Disease study is from a broader perspective consider: What is the burden of disease, a single disease to which environmental or life style factor?

First example: Diabetes. The chart above shows that in the year 2017, air pollution led to around 188 years of life lost due to Diabetes per 100,000 people. The results to date indicate that particulate matter and other air pollutants, on the one hand, inflammatory processes trigger that can push the blood sugar into the amount. On the other hand, you can alter the fat metabolism. Both of these could contribute to the development of Diabetes (see, for example, the Journal of Diabetes Investigation: He et al., 2017 and Toxicological Sciences: Rao et al., 2015).

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