{"id":621,"date":"2017-10-17T15:54:40","date_gmt":"2017-10-17T15:54:40","guid":{"rendered":"http:\/\/joshmitteldorf.peachpuff-wolverine-566518.hostingersite.com\/?p=621"},"modified":"2017-10-19T17:44:16","modified_gmt":"2017-10-19T17:44:16","slug":"air-pollution-and-life-expectancy","status":"publish","type":"post","link":"https:\/\/scienceblog.com\/joshmitteldorf\/2017\/10\/17\/air-pollution-and-life-expectancy\/","title":{"rendered":"Air Pollution and Life Expectancy"},"content":{"rendered":"<p><em><span style=\"font-weight: 400\">\u201c<\/span><span style=\"font-weight: 400\">Increased air pollution cuts victims\u2019 lifespan by a decade, costing billions<\/span><span style=\"font-weight: 400\">\u201d blared the <\/span><a href=\"https:\/\/www.eurekalert.org\/pub_releases\/2017-07\/e-iap062917.php\"><span style=\"font-weight: 400\">headline from Eurekalart<\/span><\/a><span style=\"font-weight: 400\"> last summer. \u00a0I spent five months of the last 15 in Beijing, with arguably the worst air quality in the world. \u00a0I call Philadelphia my home, with the 10th worst air pollution in the US. \u00a0In the past, before good statistics were available, I have been an advocate, board member and even expert witness in support of clean air legislation. \u00a0Now I dreaded discovering what air pollution might be doing to my long-term health.\u00a0 I procrastinated, and left this project on a back burner for a year.\u00a0 But when I finally chained myself to my desk to research this column, the results were not nearly so bad as my fears.<\/span><\/em><\/p>\n<hr \/>\n<p><span style=\"font-weight: 400\">The above Eurekalert article referred to <\/span><a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S1470160X17301693?via%3Dihub\"><span style=\"font-weight: 400\">this research from Denmark<\/span><\/a><span style=\"font-weight: 400\">, and the summary, it turned out was misleading. \u00a0The question it appears to be asking is, \u201cif you live in a city with 10\u03bcg per m<sup>3<\/sup> of particulate pollution, how much sooner must you expect to die?\u201d\u00a0 But in fact, it addresses a different question: \u00a0\u201cAssume that air pollution has zero effect on the great majority of people, and that the entire burden of increased mortality comes from a small number of unlucky people. \u00a0If you are one of those unlucky people, how much is your life cut short because of air pollution?\u201d \u00a0(Even for this unrealistic assumption, I am not convinced that the author did the calculation correctly.)<\/span><\/p>\n<p><span style=\"font-weight: 400\">For context, the study was based on the concentration of the smallest particulate pollution, particles less than 2.5\u03bcm in size, which are thought to do the most damage. \u00a0A concentration of 10\u03bcg\/m<sup>3<\/sup> for such particles is a level typical of a large American city on an average day. \u00a0<\/span><a href=\"http:\/\/www.phila.gov\/health\/pdfs\/AQR_2015.pdf\"><span style=\"font-weight: 400\">Philadelphia<\/span><\/a><span style=\"font-weight: 400\"> has many days each year exceeding this level. \u00a0Beijing air on a summer day has 150\u03bcg\/m<sup>3<\/sup>, and winter days are typically 400-600\u03bcg. \u00a0If my reading of the Danish study is correct, it implies that the average citizen of Beijing loses 500 years of life to air pollution.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><b>Questions<\/b><\/p>\n<p><span style=\"font-weight: 400\">Beginning my reading, here are the questions I was curious about:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">How much life is being lost to air pollution in American cities and Chinese cities?<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">What pollutants are responsible?<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Is the risk linear with pollution, or is there a threshold?<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Are sources of pollution predominantly local or regional?<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Where are the best and worst places to live?<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">What diseases are associated with air pollution?<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">What can be done to mitigate health consequences of exposure to air pollution?<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Is it better to exercise in polluted air or not exercise at all?<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">I came away realizing that some of these questions are difficult to address with field studies and epidemiology, and others have not been addressed, even though they are not so difficult. \u00a0But generally, I was re-assured that air pollution is not as big a health threat as headlines had led me to fear.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><b>How big is the effect overall?<\/b><\/p>\n<p><a href=\"https:\/\/www.nature.com\/articles\/srep40482?WT.feed_name=subjects_environmental-impact\"><span style=\"font-weight: 400\">This study<\/span><\/a><span style=\"font-weight: 400\"> looked at day-to-day variations in death rates in Wuhan, a large, polluted city in China\u2019s heartland. \u00a0They find that 10% of all deaths are due to respiratory disease, and some large fraction of respiratory deaths are triggered by the day\u2019s SO<sub>2<\/sub> level. \u00a0(Sulfur dioxide is a significant pollutant in China, but not America, because so much coal is burned in and near cities.) \u00a0This speaks of the \u00a0immediate effect only, and corresponds to less than one year of life lost. \u00a0But this kind of study can tell us nothing about long-term effect. \u00a0<\/span><a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0013935117302487\"><span style=\"font-weight: 400\">Another study<\/span><\/a><span style=\"font-weight: 400\"> in Eastern China (Jiangsu province) compares across cities, so is potentially sensitive to long-term as well as immediate effects. \u00a0They find a smaller effect of ozone (O<sub>3<\/sub>), corresponding to a few months of lost life. <\/span><\/p>\n<p><span style=\"font-weight: 400\">One of my first discoveries in researching an <a href=\"https:\/\/scienceblog.com\/joshmitteldorf\/2012\/11\/10\/mortality-and-life-expectancy\/\">early ScienceBlog column<\/a> five years ago was that large differences in mortality correspond to small differences in life expectancy.\u00a0 The deep cause of this counter-intuitive effect is the steep rise in mortality curves, building a wall of death into actuarial tables. \u00a0This is what <\/span><a href=\"https:\/\/en.wikipedia.org\/wiki\/Gompertz_function\"><span style=\"font-weight: 400\">Benjamin Gompertz<\/span><\/a><span style=\"font-weight: 400\"> realized two centuries ago, but I was a little late to the party. \u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">These mortality statistics are large enough to detect unambiguously, and a few percent increased mortality (up to 10% in China\u2019s most polluted cities) sounds quite serious. \u00a0But when these numbers are translated into life expectancy changes, the results are far less alarming. \u00a010% in the worst Chinese cities corresponds to less than 1 year of life expectancy. \u00a01% &#8211; 2% typical of American cities corresponds to about a month of life expectancy. \u00a0Much more difficult to quantify is the extent to which the health effects of air pollution are focused on a subset of people who are particularly sensitive, and who will suffer a seriously early death. \u00a0This is the question addressed by the headline-grabber I quoted at the top of this column [<\/span><a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S1470160X17301693?via%3Dihub\"><span style=\"font-weight: 400\">ref<\/span><\/a><span style=\"font-weight: 400\">]. <\/span><\/p>\n<p><span style=\"font-weight: 400\">The most recent comparison of South and North China (where coal was burned freely for winter heat) is featured in \u00a0Eurekalert with the sensational headline, <\/span><a href=\"https:\/\/www.eurekalert.org\/pub_releases\/2017-09\/uoc-apc091017.php\"><span style=\"font-weight: 400\">Air Pollution Cuts 3 Years in Northern China<\/span><\/a><span style=\"font-weight: 400\">, but the <\/span><a href=\"http:\/\/www.pnas.org\/content\/114\/39\/10384.short\"><span style=\"font-weight: 400\">research article<\/span><\/a><span style=\"font-weight: 400\"> behind it reports 8 months.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><strong>My own informal study: Life Expectancy in American Cities<\/strong><\/p>\n<p>Can we see an effect of pollution on life expectancy in America\u2019s largest cities?\u00a0 I looked up the data, and found a surprisingly large variation in life expectancy.\u00a0 Here is a scatterplot of life expectancy plotted against EPA\u2019s measurement of average morning pollution levels for the smallest particles (PM2.5).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-625\" src=\"https:\/\/scienceblog.com\/wp-content\/uploads\/sites\/2\/2017\/10\/LifeExpectancy-v-Particulates.png\" alt=\"\" width=\"574\" height=\"336\" srcset=\"https:\/\/scienceblog.com\/joshmitteldorf\/wp-content\/uploads\/sites\/2\/2017\/10\/LifeExpectancy-v-Particulates.png 574w, https:\/\/scienceblog.com\/joshmitteldorf\/wp-content\/uploads\/sites\/2\/2017\/10\/LifeExpectancy-v-Particulates-300x176.png 300w, https:\/\/scienceblog.com\/joshmitteldorf\/wp-content\/uploads\/sites\/2\/2017\/10\/LifeExpectancy-v-Particulates-500x293.png 500w\" sizes=\"auto, (max-width: 574px) 100vw, 574px\" \/><\/p>\n<p>There is a correlation that goes in the expected direction, but not statistically significant, and no clear\u00a0visible trend.\u00a0 For comparison, look at the plot of life expectancy vs per capita income:<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-626\" src=\"https:\/\/scienceblog.com\/wp-content\/uploads\/sites\/2\/2017\/10\/LifeExpectancy-v-Income.png\" alt=\"\" width=\"574\" height=\"339\" srcset=\"https:\/\/scienceblog.com\/joshmitteldorf\/wp-content\/uploads\/sites\/2\/2017\/10\/LifeExpectancy-v-Income.png 574w, https:\/\/scienceblog.com\/joshmitteldorf\/wp-content\/uploads\/sites\/2\/2017\/10\/LifeExpectancy-v-Income-300x177.png 300w, https:\/\/scienceblog.com\/joshmitteldorf\/wp-content\/uploads\/sites\/2\/2017\/10\/LifeExpectancy-v-Income-500x295.png 500w\" sizes=\"auto, (max-width: 574px) 100vw, 574px\" \/><\/p>\n<p>Here there is a statistically significant correlation (p=0.01) and a trend that is visible to the eye.\u00a0 Across 25 cities, 29% of the variance in life expectancy can be explained by wealth alone.<small><br \/>\n[<a href=\"https:\/\/docs.google.com\/viewer?url=https%3A%2F%2Fwww.epa.gov%2Fsites%2Fproduction%2Ffiles%2F2017-07%2Fctyfactbook2016.xlsx\" target=\"_blank\" rel=\"noopener\">Source for pollution data]<\/a><br \/>\n[<a href=\"http:\/\/vizhub.healthdata.org\/subnational\/usa\" target=\"_blank\" rel=\"noopener\">Source for life expectancy data]<\/a><br \/>\n<a href=\"https:\/\/en.wikipedia.org\/wiki\/List_of_United_States_counties_by_per_capita_income\" target=\"_blank\" rel=\"noopener\">[Source for income data]<\/a><br \/>\n<\/small><br \/>\n<b>Mechanism of long-term damage<\/b><\/p>\n<p><span style=\"font-weight: 400\">When mice breathe air with particulate pollution, their arterial walls thicken and stiffen, arterial plaques increase, and inflammation rises over a period of months [<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19486979\/\"><span style=\"font-weight: 400\">ref<\/span><\/a><span style=\"font-weight: 400\">]. \u00a0Similar effects in humans would be expected to increase risk of heart disease and ischemic stroke. \u00a0Much of this damage is thought to be reversible after ths source of the pollution is removed [<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/12619374\"><span style=\"font-weight: 400\">ref<\/span><\/a><span style=\"font-weight: 400\">].<\/span><\/p>\n<p><a href=\"https:\/\/www.hsph.harvard.edu\/joel-schwartz\/\"><span style=\"font-weight: 400\">Joel Schwartz<\/span><\/a><span style=\"font-weight: 400\"> of Harvard School of Public Health has persisted through a long career in creating some of the most solid and credible connections between pollution and its health consequences. \u00a0<\/span><a href=\"https:\/\/sci-hub.cc\/http:\/\/www.sciencedirect.com\/science\/article\/pii\/S001393518471005X\"><span style=\"font-weight: 400\">This classic study<\/span><\/a><span style=\"font-weight: 400\">, more than two decades old, uses conservative statistical methods to separate effects of weather from pollution. \u00a0(Weather is known to be highly correlated with daily mortality, more so than pollution, and pollution, of course, is correlated with daily weather and also with season.) \u00a0The result is a robust conclusion that TSP of 100 \u03bcg\/m<sup>3<\/sup> increases risk of death by a factor 1.06. \u00a0The weakness of this finding is that, since the time of this study, TSP=\u201ctotal suspended particulates\u201d has gone out of fashion as a measure of pollution.\u00a0 TSP measures large particles more heavily than small, but we now know that the smallest particles are most damaging.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Air quality in America has improved in the last 20 years, and most days, most places are compliant with EPA limits. \u00a0Nevertheless, a difference in mortality rates can be detected between the good days and the bad. \u00a0A recent study from Schwartz\u2019s group investigated the question of <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5226700\/\"><span style=\"font-weight: 400\">low-level pollutants<\/span><\/a><span style=\"font-weight: 400\">. \u00a0They are able to detect effects from three pollutants: PM2.5, O<\/span><span style=\"font-weight: 400\">3<\/span><span style=\"font-weight: 400\"> and NO<sub>2<\/sub>, and report a total ~1% increase in daily mortality.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><b>Dose-Response<\/b><\/p>\n<p><span style=\"font-weight: 400\">This is a large unanswered question, very difficult to pose in an epidemiological study design. \u00a0It is plausible that high exposure for a short time is more damaging than low exposure for a longer time, but the opposite is possible. \u00a0It is plausible that the combination of chemical irritants (e.g., O<sub>3<\/sub>, SO<sub>2<\/sub>, NO<sub>2<\/sub> with micron-size particles is worse than either of the two separately, but we don\u2019t know. \u00a0A \u201clatency\u201d is often assumed, such that today\u2019s exposure to bad air can produce hidden damage that shows up a decade later to cause disease or death. \u00a0But it is just as plausible that those who are fortunate to escape disease in the immediate aftermath of pollution exposure suffer no long-term consequences. \u00a0We do know that hospital admissions and both cardiovascular and pulmonary mortality rise in times of major pollution events. \u00a0But smaller day-to-day fluctuations in air pollution also produce smaller fluctuations in a city\u2019s mortality and morbidity rates, and these can be correlated in <\/span><a href=\"https:\/\/sci-hub.cc\/http:\/\/www.sciencedirect.com\/science\/article\/pii\/S001393518471005X\"><span style=\"font-weight: 400\">long-term studies<\/span><\/a><span style=\"font-weight: 400\">. \u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><b>Is there a threshold, below which low levels of pollutants cause no problem?<\/b><\/p>\n<p><span style=\"font-weight: 400\">Probably not. \u00a0<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5226700\/\"><span style=\"font-weight: 400\">This study<\/span><\/a><span style=\"font-weight: 400\"> by Schwartz found that 1% or 2% of all deaths in Boston are arguably attributed to particulate and ozone pollution, and Boston air is cleaner than most large American cities, and was within EPA guidelines virtually all during the time of the study (2000-2009). \u00a0<\/span><a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0013935117302487\"><span style=\"font-weight: 400\">A study<\/span><\/a><span style=\"font-weight: 400\"> across different cities in Eastern China also could find no evidence of a \u201csafe threshold\u201d. \u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><b>Do filter masks do any good?<\/b><\/p>\n<figure style=\"width: 543px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/s.wsj.net\/public\/resources\/images\/BN-BS071_csmog0_G_20140227062030.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-large\" src=\"http:\/\/s.wsj.net\/public\/resources\/images\/BN-BS071_csmog0_G_20140227062030.jpg\" width=\"553\" height=\"369\" \/><\/a><figcaption class=\"wp-caption-text\">Masks are common in China<\/figcaption><\/figure>\n<p><span style=\"font-weight: 400\">These cheap, simple respirator masks are a common sight in Beijing. \u00a0They are so thin that it is easy to imagine that they can\u2019t be doing much of anything, but apparently this simple measure is quite effective. \u00a0<\/span><a href=\"https:\/\/www.eurekalert.org\/pub_releases\/2016-04\/fda-rmr040616.php\"><span style=\"font-weight: 400\">This study<\/span><\/a><span style=\"font-weight: 400\"> from University of S\u00e3o Paulo was based on metabolic response to pollution, and found the response was reduced to undetectable levels by wearing a mask.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Also common in China are indoor air purifiers that continually circulate air through a HEPA filter. \u00a0The <\/span><a href=\"http:\/\/www.berkeleywellness.com\/self-care\/over-counter-products\/article\/air-cleaner-effectiveness\"><span style=\"font-weight: 400\">Berkeley Wellness Letter<\/span><\/a><span style=\"font-weight: 400\"> offers some suggestions and emphasizes limitations. \u00a0A room air purifier provides less effective protection than a mask.<\/span><\/p>\n<figure style=\"width: 331px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"\" src=\"https:\/\/www.dhresource.com\/0x0s\/f2-albu-g2-M00-7C-F4-rBVaGlbtQVWAYiGqAAHrLlKKgKQ405.jpg\/ionizer-air-purifier-air-cleaner-air-ionizer.jpg\" width=\"341\" height=\"341\" \/><figcaption class=\"wp-caption-text\">Room air purifier<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p><b>Can B Vitamins Shield you from Harm?<\/b><\/p>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5377246\/\"><span style=\"font-weight: 400\">This study<\/span><\/a><span style=\"font-weight: 400\"> looked at short-term effects of particulate pollution only. \u00a0These include elevated heart rate, suppressed immune function, certain <\/span><a href=\"https:\/\/www.eurekalert.org\/pub_releases\/2017-03\/cums-tbv031317.php\"><span style=\"font-weight: 400\">epigenetic changes<\/span><\/a><span style=\"font-weight: 400\"> (DNA methylation), \u00a0and a decrease in <\/span><a href=\"https:\/\/en.wikipedia.org\/wiki\/Heart_rate_variability\"><span style=\"font-weight: 400\">heart rate variability<\/span><\/a><span style=\"font-weight: 400\">. \u00a0(The latter is a somewhat mysterious but apparently robust measure of health that has begun to gain recognition as an indicator in recent years [<\/span><a href=\"https:\/\/watermark.silverchair.com\/17-3-354.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAfIwggHuBgkqhkiG9w0BBwagggHfMIIB2wIBADCCAdQGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM5frOGGWqeDH0gWnoAgEQgIIBpYfPakCt9qiqxERKm7Dm_VO51qyISYoaOUpZv_1gKO8xb4oQsDObPyTPIGYOeLtNI23QbwpRtX-EsWWgI-VWYQPGciRzbl2YGkIgGm-eZi1x7iti0d11V7gGH1U9YOGdCuzoxspIqz9RTbtSW_TN8PqPxnYR1VkYVFlZlC0zJ3fFnOgGzVRkH1kq6xgP871UZEGq78yvX_KwUPqlnMptoZ8cW50_5KkUscEWVq7GVUSy9BZeDdrEsHVXJvZosLz8K5NXzr1Dk1g9HGvaTRUL2vrzGfhGSY4QHEmTKVMz-qiW8Uch0_MmZkX6gd9XZBvLrDxEKFs4DsSQYNwUg6uLt629KoOsmwOniDi2ittdNA2-5V7bVWe6xiuuh7BTK10FOZ8IwynMGyI0pkCluztCp-T68c4coH5Q_s8npcpLm9K8cp0qt5qaeSzKwdwV1-EnjjgyXh4_D3aso3eeuQkYBKcol3rs6DyTSumQ50an0fFUyYLCKxo3J-4Sh29ux4Qur7OIHCNWD58CDKICo-zUe89KrmAXHObceT3Eqvt2_DRf9xHwlIU\"><span style=\"font-weight: 400\">ref<\/span><\/a><span style=\"font-weight: 400\">].) \u00a0By all these measures, a modest course of B vitamin supplementation for several weeks preceding exposure completely prevented the physiological response. \u00a0On the one hand, it\u2019s a very impressive result; on the other hand, what we care most about is long-term damage to the lungs and CV system, and the short-term protection may or may not correspond to long-term protection.<\/span><\/p>\n<p><b>To Exercise or Not to Exercise?<\/b><\/p>\n<p><a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0091743516000402\">This study<\/a> finds that the benefits of walking and cycling outweigh the damage done by breathing more polluted air. \u00a0The claim is that this is overwhelmingly true in moderately polluted Western cities, and remains true in all but the most polluted cities of the developing world. \u00a0The methodology of the study looks good to me, although the data on which it is based are uncertain. \u00a0The study doesn\u2019t address high-intensity exercise, which necessarily involves rapid hyperventilation. \u00a0It is hard to know if lung damage might be caused at an extra-high rate when the body\u2019s cleansing mechanisms are overwhelmed, as they are in cigarette smoking. \u00a0People in China tend to exercise less on high-pollution days, but when they live in high-pollution cities, they make the most of it and exercise indoors, or outdoors when the pollution is as good as it\u2019s going to get [<a href=\"https:\/\/link.springer.com\/article\/10.1007\/s12529-017-9647-2\">ref<\/a>].<\/p>\n<figure style=\"width: 980px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-large\" src=\"http:\/\/inapcache.boston.com\/universal\/site_graphics\/blogs\/bigpicture\/chinapollution_012513\/bp1.jpg\" width=\"990\" height=\"661\" \/><figcaption class=\"wp-caption-text\">Early morning Tai Chi, an old Chinese tradition all year &#8217;round<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p><b>The Bottom Line<\/b><\/p>\n<p><span style=\"font-weight: 400\">Mitigating air pollution is an important environmental project, with health benefits that far outweigh the costs.\u00a0 It is indeed a travesty that our EPA is bowing to pressure from GM and Exxon, decade after decade.\u00a0 \u00a0Mitigation is well worth pursuing in the US, let alone in developing Asian cities.\u00a0 Nevertheless, even in the worst areas of China and India, the air pollution is a major health problem only for a sensitive segment of the population, and overall robs city-dwellers of less than a year off life expectancy.<\/span><\/p>\n<hr \/>\n<p><b>Two Personal Notes<\/b><\/p>\n<ol>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">I fasted for five days last month, coordinated to end on the Jewish fast day of Yom Kippur. \u00a0The last two days I took large doses of quercetin, thinking to purge senescent cells. \u00a0Fasting is supposed to protect normal cells, while sensitizing senescent cells to toxins. \u00a0Quercetin is a supplement commonly found in health food stores, a flavonoid extracted found in onions and green tea. \u00a0It has been identified as a senolytic. \u00a0Results: \u00a0Difficult to say with any certainty, but I did feel an ease and speed in swimming after I began re-feeding, and perhaps an easing of chronic stiffness in my low back.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">I have a yoga practice that goes back to 1972 and, I believe, has helped me to retain range of motion. \u00a0The place I feel loss of suppleness most is my lower spine, and MRIs showed a loss of discs beginning 20 years ago. \u00a0I take daily aspirin, 325 mg at bedtime, and I think I associate this with an easing of flexibility in the low back. \u00a0Recently, I\u2019ve noticed that if I substitute naproxen (200 mg) for the aspirin, my low back feels less stiff in the morning. \u00a0Naproxen is a stronger over-the-counter NSAID than aspirin, more likely to produce side effects in sensitive stomachs; some studies claim to detect long-term heart risks. \u00a0The best reason to prefer aspirin over naproxen is the long history attesting to the safety of aspirin (for most people). \u00a0<\/span><span style=\"font-weight: 400\"><br \/>\n<\/span><span style=\"font-weight: 400\"><br \/>\n<\/span><span style=\"font-weight: 400\">I intend to try more controlled experiments over the next few weeks to see if my first impressions of naproxen\u2019s benefit hold up.<\/span><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u201cIncreased air pollution cuts victims\u2019 lifespan by a decade, costing billions\u201d blared the headline from Eurekalart last summer. \u00a0I spent five months of the last 15 in Beijing, with arguably the worst air quality in the world. \u00a0I call Philadelphia my home, with the 10th worst air pollution in the US. \u00a0In the past, before &#8230; <a title=\"Air Pollution and Life Expectancy\" class=\"read-more\" href=\"https:\/\/scienceblog.com\/joshmitteldorf\/2017\/10\/17\/air-pollution-and-life-expectancy\/\" aria-label=\"Read more about Air Pollution and Life Expectancy\">Read more<\/a><\/p>\n","protected":false},"author":65,"featured_media":623,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-621","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Air Pollution and Life Expectancy - Josh Mitteldorf<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, 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