# Air Pollution in Cigarettes per year and increased health risks

Myhealthbeijing has reported that the first official particulate matter 2.5 micron readings from Beijing have been 72 to 93 micrograms per cubic meter.

Converting micrograms per cubic meter of particulars in air into weight of particulates through lungs each year

Do not let the air pollution units confuse you. I will convert the micrograms per cubic meter in the air into pounds through your lungs each year.

In major cities there is between 20-370 micrograms of particulates (PM10 10 micron) per cubic meter of air.

Each day you take over 20,000 breaths and breathe about 35 pounds (15.9 kg) of air. At sea level and at 20 °C, dry air has a density of approximately 1.2 kg per m³ (cubic meter). So every day you are breathing 13.2 m³ of air. (Note – some use 18 cubic meters of air per day. the amount of air breathed depends upon elevation and other individual factors.) Therefore,

13.2 m³ • 20 micrograms = 265 μG (micrograms) = 0.265 mg (milligrams)
13.2 m³ • 370 micrograms = 4910 μG (micrograms) = 4.91 mg (milligrams)

So 0.2-4.9 mg of particulates enter into your lungs every day unless you live some of the particularly clean air areas.

In one year per the above statistics, 97-1800 mg (0.097 to 1.8 grams) of particulates enter your lungs. So in Beijing (with a very high average particulate load) over 1/8 ounce of particulates gets into each person’s lungs each year. This may not sound like a lot, but the lungs don’t have very effective mechanisms for expelling particulates that collect, so the effect is mostly accumulative.

The particulates from “smog” are not chemically and biologically inert either. They interact with the lungs, and from there the body, transferring their water and lymph soluble compounds directly to the blood stream. These in turn are well known to cause cardiovascular, pulmonary and hepatotoxic effects.

At 100 micrograms of PM2.5 per cubic meter and 18 cubic meters breathed, that converts to 60 cigarettes per year. Three twenty cigarette packs per year. In Los Angeles, at about 15 micrograms of PM2.5 per cubic meter it is about 10 cigarettes per year or half a pack.

The air pollution cigarettes are for everyone. Babies, children, senior citizens, non-smokers, asthmatics, people with heart and lung diseases etc…

Converting Air Pollution to actual increased health risks

Beijing’s 2011 average PM2.5 AQI of 174 = daily 1.8 mg of inhaled PM2.5 = lung cancer deaths 1.49 RR (relative risk) and heart disease deaths 1.32 RR

In other words, living long-term in Beijing (at least 6 years in these studies) causes a 49% increase in lung cancer and 32% increase in heart disease deaths, when compared to perfectly clean air of 0 (although background baseline is 3-5 ug/m3). And even if the average was crazy-bad 500, which doesn’t happen anywhere in the world, the increased risk is around 50-150% higher.

* LA: 14.8 = 0.27 mg = lung cancer RR 1.12, heart disease death RR 1.19
* London: 13.5 = 0.24 mg = lung cancer RR 1.11, heart disease death RR 1.19
* Paris: 22.9 = 0.41 mg = lung cancer RR 1.17, heart disease death RR 1.21
* San Francisco: 9.2 = 0.17mg = lung cancer RR 1.09, heart disease death RR 1.17

So even in almost-perfect San Francisco (where fog truly is called fog and not smog), the death rate from the almost non-existent air pollution is still 9-17% higher than zero pollution. And in LA, the risks are 12-19% higher; in Paris the risk is around 20%. So for those of you who are constantly thinking of fleeing Beijing to “better” areas, you need to ask yourself: is your next city’s improved risk clinically and physically relevant? In other words, does it make sense to run away from Beijijng’s risks of 32-49% when your next city’s risks are also in double digits?

These are increased death risks. There are also increased hospitalizations. Each asthma hospitalization can cost \$4000 for medical treatment and for lost work time costs.

Most US cities are in the range of 8 to 17 micrograms per cubic meter of PM2.5.

In US studies, a microgram per cubic meter increase in PM2.5 exposure was related to increases in hospitalizations for cerebrovascular disease [strokes] by 0.81% (95% CI 0.3% to 1.32%), peripheral vascular disease by 0.86% (95% CI −0.06% to 1.79%), ischemic heart disease by 0.44% (95% CI 0.02% to 0.86%), arrhythmias by 0.57% (95% CI −0.01% to 1.15%), and heart failure by 1.28 (95% CI 0.78% to 1.78%). The most rapid effects, which occurred largely on the same day of PM2.5 elevation, were seen for cerebrovascular, arrhythmia, and heart failure admissions. Ischemic heart disease events tended to increase to a greater extent 2 days after exposures.