Health Effects of Ultrafines:
Why Solid Particles
have highest Priority
a Presentation by J. Schiltknecht MD
Sept. 7th 2016
Soot-Free Tehran Workshop
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Table of Content
• Anatomy and Function of the Lungs and Defense
Mechanisms
• Size, Distribution, Dynamics and Toxicity of
Ultrafine Particles UFP
• Cellular Response to UFP and Health Impairment
• Distribution of the suspended Noxes, Monitoring
• Epidemiology and Economics
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Lung Performance
Air volume/day: 10 – 20 m3
40 000 000 000
particles/day
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Airways
Upper Airways
5-10 mm
Trachea
3-5 mm
Bronchi
2-3 mm
Bronchioles
1-2 mm
Alveoli
<1 mm
P. Straehl, BAFU, Abt. Luftreinhaltung und NIS
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Airways & Particle Uptake
Upper
Upper Airways
Airways
5-10mm
5-10
mm
Trachea
3-5 mm
Bronchi
2-3 mm
Bronchioles
1-2 mm
Alveoli
<1 mm
P. Straehl, BAFU, Abt. Luftreinhaltung und NIS
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Soot-Free Tehran Workshop
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Terminal Bronchioli & Alveoli
I200mm I
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Mucociliary Apparatus
Section of a bronchial wall with ciliated cells
tranporting a mucus layer and goblet cells
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Nanoparticles entering Alveoli
I200mm I
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Alveoli surrounded by Capillaries
Tissue Cell
Alveolar Macrophage
Alveolar Epithel Cells
Alveolar Wall
Blood Vessel (Capillary )
Red Blood Cell
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Airway Macrophage
1
2
3
4
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Surfactant film
Aqueos surface lining layer
Macrophages
Epithelium
Dendritic Cells
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American Journal of Respiratory Cell and Molecular Biology Vol. 36
Fabian Blank, Barbara Rothen-Rutishauser, Prof. Peter Gehr 15
Translocation of Nanoparticles
Nanoparticles
Brain
Nose
Lung
Skin
GI-Tract
Blood
Brain
Bone Marrow
Spleen
Wall
Blood Vessels
Degenerative
Changes
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Liver
Heart
Placenta
Fetus
By Courtesy
Prof. P. Gehr, University of Berne
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Size, Dynamics, Toxicity
• Size
2.5 µm
0.1 µm = 100 nm
10 µm
Equals 10’000’000
particles of 0.1 µm
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Size, Dynamics, Toxicity
• Size
• Persistence
Lung Tissue
1952 London Smog Autopsy
Multiple Nanoparticles
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Size, Dynamics, Toxicity
• Size
• Persistence
• Surface
Soot Particle, transmission eletronic microscopy
De la Roca, University of Nottingham
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Size, Dynamics, Toxicity
• Size
• Persistence
• Surface
• Chemical Composition
& Structure
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Uptake of Particles and Size
Polystyrene Particles
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1000 nm
Polystyrene Particles
78 nm
Courtesy B. Rothen- Rutishauser
University of Fribourg
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Cellular Uptake of Nanoparticles
E: Caveolae-mediated
Endocytosis
F: Adhesive interaction
(Entering)
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Brandenberger et al., Small, 2010
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Reactions of Cells to (atmosperic) Noxes
(simplified)
Inflammatory Response
Oxydative Stress
Dysfunction
Genetic Impairment
Damage
Cancer
Chronic Illness
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Death
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Most Important Air Pollution Related Disease
• Ischemic Heart Disease
IHD
• Chronic Obstructive Pulmunary
Disease
COPD
• Cerebrovascular Disease
CEV
• Acute Lower Respiratory Disease ALRI
• Lung Cancer
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LC
Lelievefeld et al. Nature 2015
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 Correlation with Fine
Particles only
Sulfate Particles [µg/m3]
Source: Dockery NEJM 1993
Rate Ratio
Sulfur Dioxide [ppb]
Rate Ratio
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Fine Particles [µg/m3]
Rate Ratio
Total Particles [µg/m3]
Rate Ratio
6-Cities-Study
USA 1978-93
15‘000 cases
Rate Ratio
Which TOC
correlates to
Mortality?
Rate Ratio
6-Cities Study
Aerosol Acidity [nmol/m3]
Ozone [ppb]
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Increase of Respiratory Symptoms
near Highways
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Soot-Free Tehran Workshop
Hazenkamp-von Arx et al.
Environmental Health 2011
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Distance to Heavy Traffic Highways (HTH) and
Respiratory Symptons
Wheezing with breathing problems
Wheezing w/o colds
Adjusted prevalence [%]
Chronic cough
Chronic cough or phlegm
Hazenkamp-von Arx et al.
Environmental Health 2011
Residential distance from highway [m]
Estimated adjusted prevalence rates of health outcomes
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Relative Concentration of Particles
Distance to HTH and Particle Distribution
100%
Fine Dust: homogenously distributed
80%
Soot Particles – and other
primary toxicans - strong
dependend on distance from
source
Zhu et al, J Air Waste Manage Assoc, 2002; 52: 1032
60%
Residential distance from highway [m]
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100%
80%
60%
Adjusted prevalence [%]
Relative Concentration of Particles
Ultrafine Patricle Distribution and Health
Symptoms match!
Fine Dust: homogenously distributed
Soot Particles – and other
primary toxicans - strong
dependend on distance from
source
Zhu et al, J Air Waste Manage Assoc, 2002; 52: 1032
Residential distance from highway [m]
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Soot-Free Tehran Workshop
Nino Künzli
Swiss Tropical and Public Health Institute
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Particle Number Concentration 10-300 nm
Streets with
Heavy Traffic
Rue de Lyon
Heavy Traffic
Quiet Streets
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Ultrafine Particle Concentration Geneva February 26th 2012
Particle Number Concnetratio (red) and Time (grey grid)
Diagramm on Google Earth Mapping
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Traffic Emission Abatement
Berlin LEZ: traffic emissions
reduced by 50 % but PM10 by <5 %
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London "Pea Soup" Smog 1952
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Picadilly Sqare, Unknown Photographer
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Premature Mortality p.a. related to PM 2.5 and Ozon
Estimate for Urban Population of 100 Million People
• Heart
IHD
15.000
• Lung
COPD
12.000
• Brain
CEV
8.000
• Lung Infections ALRI
5.000 Children!
• Cancer
2.000
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LC
Lelievefeld et al. Nature 2015
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Effect of Air Pollution During Pregnancy
PM
during Pregnancy
Increased Respiratory need
of the Newborn
2009 Philipp Latzin, Bern University Childrens Hospital
Lifelong impairment of the Lung
seems possible!
Baraldi & Filipone NEJM 2007
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WHO OECD Report
Economic Cost of the Health Impact of
air pollution in Europe
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WHO Regional Office for Europe, OECD (2015)
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Soot free Tehran!
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