Guest post: Dr. César Berenstein, Argentine Society of Cardiology
Cardiovascular disease is the most common cause of death worldwide, causing more than 18 million deaths in 2019. On the other hand, air pollution caused 6.7 million deaths in 2019, 50% of which are due to cardiovascular disease. It is also important to consider that air pollution has a greater impact as a cause of death than many of the conventional risk factors such as body mass index, high LDL cholesterol, impaired fasting blood glucose or alcohol consumption with a loss in life expectancy (2.9 years) that exceeds the one caused by smoking.
In a recent position statement by the most prestigious societies related to cardiovascular health, the World Heart Federation, the American College of Cardiology, the American Heart Association and the European Society of Cardiology said: “We aim to generate awareness about the impact of air pollution on cardiovascular disease as a means towards reaching the World Heart Federation’s goal of a 25% reduction in premature cardiovascular mortality by 2025”.
We might think that this is a problem especially related to urban and industrialised areas, but this may be incorrect if we consider that we should not only consider the pollution of the environment “outside” but also the household pollution, especially where polluting fuels such as wood or coal are used. Also, the burning of plant waste in rural or suburban areas and the inappropriate use of pesticides can contribute to disease from air pollution.
Despite extensive evidence of the link between air pollution and the disease and the fact that 90% of the world’s population is exposed to high levels of pollution, there is little awareness of its importance.
In 2011, the World Health Organisation proposed working on the risk factors for non-communicable diseases (high blood pressure, obesity and diabetes, sedentary lifestyle, high cholesterol, excessive alcohol consumption) to reduce premature cardiovascular mortality by 25% by 2025, before the age of 70. The World Heart Federation joined the proposal and later the Argentine Society of Cardiology echoed it. The members of the “Objective 25 by 25” campaign of this scientific society are leaders in the promotion of preventive measures, sending our message to the communities to which we belong. We are mostly cardiologists from the provinces of the country (Regional Districts of the A.S.C.), we are active in reaching out to the mass media, social networks and until the beginning of the pandemic by interacting personally with many state institutions and NGOs. Since March 2020 we replaced this modality, holding our meetings virtually through internet platforms.
As a group that belongs to the Argentine Society of Cardiology, following the guidelines of the World Heart Federation, we decided to take the initiative to be the forerunners in raising awareness about the relationship between air pollution and cardiovascular disease, which motivated this activity “A Healthy Heart in a Healthy Environment”.
It is an initiative that integrates representatives from very distant parts of our vast country, with the aim of promoting cardiovascular prevention both in large cities and in remote rural areas, sometimes forgotten by the health system. The members of the group are the cardiologists: Dr. Hernán Cohen Arazi (City of Buenos Aires, General Coordinator), Dr. César Berenstein (El Bolsón, Rio Negro, Coordinator for the Regional Districts), Dr. Ana Constanza Lagos and Dr. Ezequiel Schnyder (El Bolsón, Rio Negro, Coordinator for the Regional Districts), Dr. Ana Constanza Lagos and Dr. Ezequiel Schnyder (El Bolsón, Rio Negro, Regional Districts). Ezequiel Schnyder (Concordia, Entre Rios), Dr. Ana María Grassani (Ushuaia, Tierra del Fuego), Dr. Andrés Duarte and Dr. Eliana Kotlirevsky (Corrientes), Dr. Mildred Colaberardino (Junín, Prov. de Buenos Aires), Dr. Koji Ishino (Puerto Madryn, Chubut), Dr. Ricardo Sebastián Galdeano (Tucumán, Argentina), Dr. Ricardo Sebastián Galdeano (Tucumán, Argentina), Dr. Ricardo Sebastián Galdeano (Tucumán, Argentina), Dr. Ricardo Sebastián Galdeano (Tucumán, Argentina), Dr. Ricardo Sebastián Galdeano (Tucumán, Argentina). Guillermina Eleit (Jujuy), Dr. Daniela Luconi (Mendoza), Dr. María Emilia Saavedra (Bariloche, Rio Negro), Dr. Nicolás Esteybar (Mar del Plata), Dr. Marcelo Murillo (San Martín, Province of Buenos Aires), Dr. Mauro Ruise (Santiago del Estero). Collaborating with the group are Dr. Miriam Herrera (general practitioner, Gobernador Costa, Chubut), Dr. Carla Meier (general practitioner, Lucas Gonzalez, Entre Rios) and Laura Lopez (Physical Education Teacher, San Martín, Buenos Aires Province).
We decided to celebrate Air Pollution Awareness Day to improve cardiovascular health by creating a day called “A Healthy Heart in a Healthy Environment”. Coinciding with the day of remembrance of the Chernobyl disaster (26 April), we developed this activity to be repeated annually to insist on the promotion of healthy habits and to inform about the deleterious effects of pollution.
On 26 April, a meeting was held on the web platform with the community, with the participation of the president of the Argentine Society of Cardiology, Dr Alejandro Hershson and one of the coordinators of the group, Dr César Berenstein, with a large audience from all over the country.
Colleagues were informed about the topic through the home page of the Argentine Society of Cardiology website by commenting on two articles in medical journals and on one of its community sites (wikicardio).
We used social networks and the media to raise public awareness of the issue of air pollution.
The day was declared of interest by the Deliberative Council of El Bolsón, a town in the province of Rio Negro, and is included in a draft law of this Argentinean province and in the National Congress.
Air pollution is a risk factor for cardiovascular disease that is often overlooked by medical professionals and the general population. It is our responsibility to promote measures to improve our relationship with the environment and our health. We propose to declare April 26th as an awareness day for the relationship between air pollution and cardiovascular disease under the name “A Healthy Heart in a Healthy Environment”.