Complexity in Pollution/Disease Management

  • Italian Society of Digital Health and Telemedicine
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Air pollution can be considered a model to describe complexity and its implication in medicine. The number of components and interactions, the distribution of airborne pollutants through space and time and the possible short-and long-term effects on cells, tissues, organs and apparatus are an exhaustive example. The whole human being is more complex than the sum of its parts which are systems more complex than the sum of their parts and so on. The risk for health which comes from exposure to air pollutants can be measured partially and the hazard may be known. However, the real long-term implications may remain unknown becoming a not crossable limit for medical research. We can estimate the risk for individual and population, and we can try to find solutions, such as new technologies like artificial intelligence; but the system will remain complex and so unpredictable.

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... Furthermore, environmental pollutants, climate changes and SARS-CoV-2 infection have been associated with changes in the central nervous system (CNS) that could lead to mental and/or behavioral alterations through different physiopathological mechanisms: inflammatory processes, activation of the immune system, oxidative stress, damage to blood vessels, dysfunctions of neurotransmitter systems (Costa et al., 2020a;Chan et al., 2020;Paniz-Mondolfi et al., 2020;Steardo et al., 2020a;Calderón-Garcidueñas et al., 2008a;Calderón-Garcidueñas et al., 2011;Calderón-Garcidueñas et al., 2012;Guxens and Sunyer, 2012;Brockmeyer and D'Angiulli, 2016). However, it is difficult to establish the specific cause-effect relationships of these phenomena on mental health, as they result from the interactions of two complex systems: the environment, with everything (biotic and abiotic elements) populating it, and human beings (Torres and Casey, 2017;Gaddi et al., 2018). ...
... Air pollutants were associated to the pathophysiology of different psychiatric disorders, such as psychotic, depression, anxiety, and neuropsychiatric disorders Costa et al., 2020a;Shin et al., 2018;Lim et al., 2012;Power et al., 2015;Pun et al., 2017;Saez et al., 2018;Volk et al., 2013;Jung et al., 2013), as well as with the exacerbation of psychiatric symptoms (Shin et al., 2018;Bernardini et al., 2020;Szyszkowicz, 2007;Yackerson et al., 2014;Szyszkowicz et al., 2010;Kim et al., 2010;Lin et al., 2016;Oudin et al., 2018;Lim et al., 2012;Jung et al., 2013). Certainly it should be considered that air pollutants impacts on human health depends on wide range of factors: pollutant type, sources and concentration, time and way of exposure, interaction between different pollutants, as well as biological and socio-cultural factors, such as age, sex, ethnicity, previous illnesses, income, education, and neighbourhood, city, or country in which subject lives (Gaddi et al., 2018;Stewart et al., 2015). All these variables may in part explain the still inconclusive results of the influence of environmental pollution on mental health. ...
Converging data would indicate the existence of possible relationships between climate change, environmental pollution and epidemics/pandemics, such as the current one due to SARS-CoV-2 virus. Each of these phenomena has been supposed to provoke detrimental effects on mental health. Therefore, the purpose of this paper was to review the available scientific literature on these variables in order to suggest and comment on their eventual synergistic effects on mental health. The available literature report that climate change, air pollution and COVID-19 pandemic might influence mental health, with disturbances ranging from mild negative emotional responses to full-blown psychiatric conditions, specifically, anxiety and depression, stress/trauma-related disorders, and substance abuse. The most vulnerable groups include elderly, children, women, people with pre-existing health problems especially mental illnesses, subjects taking some types of medication including psychotropic drugs, individuals with low socio-economic status, and immigrants. It is evident that COVID-19 pandemic uncovers all the fragility and weakness of our ecosystem, and inability to protect ourselves from pollutants. Again, it underlines our faults and neglect towards disasters deriving from climate change or pollution, or the consequences of human activities irrespective of natural habitats and constantly increasing the probability of spillover of viruses from animals to humans. In conclusion, the psychological/psychiatric consequences of COVID-19 pandemic, that currently seem unavoidable, represent a sharp cue of our misconception and indifference towards the links between our behaviour and their influence on the “health” of our planet and of ourselves. It is time to move towards a deeper understanding of these relationships, not only for our survival, but for the maintenance of that balance among man, animals and environment at the basis of life in earth, otherwise there will be no future.
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Systems Biology and the Modern Synthesis are recent versions of two classical biological paradigms that are known as structuralism and functionalism, or internalism and externalism. According to functionalism (or externalism), living matter is a fundamentally passive entity that owes its organization to external forces (functions that shape organs) or to an external organizing agent (natural selection). Structuralism (or internalism), is the view that living matter is an intrinsically active entity that is capable of organizing itself from within, with purely internal processes that are based on mathematical principles and physical laws. At the molecular level, the basic mechanism of the Modern Synthesis is molecular copying, the process that leads in the short run to heredity and in the long run to natural selection. The basic mechanism of Systems Biology, instead, is self-assembly, the process by which many supramolecular structures are formed by the spontaneous aggregation of their components. In addition to molecular copying and self-assembly, however, molecular biology has uncovered also a third great mechanism at the heart of life. The existence of the genetic code and of many other organic codes in Nature tells us that molecular coding is a biological reality and we need therefore a framework that accounts for it. This framework is Code biology, the study of the codes of life, a new field of research that brings to light an entirely new dimension of the living world and gives us a completely new understanding of the origin and the evolution of life.
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Meteorological conditions and air pollution in urban environments have been associated with general population and elderly mortality, showing seasonal variation. This study is designed to evaluate the relationship between apparent temperature (AT) and air pollution (PM₂.₅) vs. mortality in elderly population of Metro Vancouver. Statistical analyses are performed on moving sum daily mortality rates vs. moving average AT and PM₂.₅ in 1-, 2-, 3-, 5-, and 7-day models for all seasons, warm temperatures above 15°C, and cold temperatures below 10°C. Approximately 37% of the variation in all-season mortality from circulatory and respiratory causes can be explained by the variation in 7-day moving average apparent temperature (r² = 0.37, p<0.001). Although the analytical results from air pollution models show increasingly better prediction ability of longer time-intervals (r² = 0.012, p<0.001 in a 7-day model), a very weak negative association between elderly mortality and air pollution is observed. Apparent temperature is associated with mortality from respiratory and circulatory causes in elderly population of Metro Vancouver. In a changing climate, one may anticipate to observe potential health impacts from the projected high- and particularly from the low-temperature extremes.
Fundamentals of Air Pollution is an important and widely used textbook in the environmental science and engineering community. Written shortly after the passage of the seminal Clean Air Act Amendments of 1990, the third edition was quite timely. Surprisingly, the text has remained relevant for university professors, engineers, scientists, policy makers and students up to recent years. However, in light of the transition in the last five years from predominantly technology-based standards (maximum achievable control technologies or MACTs) to risk-based regulations and air quality standards, the text must be updated significantly. The fourth edition will be updated to include numerous MACTs which were not foreseen during the writing of the third edition, such as secondary lead (Pb) smelting, petroleum refining, aerospace manufacturing, marine vessel loading, ship building, printing and publishing, elastomer production, offsite waste operations, and polyethylene terephthalate polymer and styrene-based thermoplastic polymers production. Overall, revisions will reflect the numerous changes in the understanding of air pollution and the development of new technologies that has occurred in the past twelve years. * Focuses on the process of risk assessment, management and communication, the key to the study of air pollution. * Provides the latest information on the technological breakthroughs in environmental engineering since last edition * Updated inforamtion on computational and diagnostic and operational tools that have emerged in recent years.
Treccani: dizionario della lingua italiana: Istituto italiano della enciclopedia italiana
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