Air Pollution reduces Vitamin D production - many studies

Summary: Air pollution and vitamin D:

Fact: Pollution reduces the amount of time that people are outdoors
Fact: Pollution is often associated with hot temperatures - another reason to not go outdoors
Fact: Less time outdoors results in lower Vitamin D levels
Fact: Pollution attenuates the amount of UVB getting to the skin (but by only a few percent)
Fact:The body's ability to fight Irritation/Inflammation is aided by vitamin D
Fact: All of the types of PM2.5 deaths are also associated with low vitamin D
       Most air pollutions reduce Vitamin D (PM2.5 is worst) – June 2021
Conclusion: Vitamin D supplementation helps the body fight the effects of pollution.

• There were 60+ references in Air Pollution reduces Vitamin D page as of June 2023
• Inhaled vitamin D might turn out to be especially good form as it goes directly to the lungs.

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41+ VitaminDWiki pages with POLLUTION in the title

This list is automatically updated

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Air pollution causes problems after organ transplants - review Nov 2023

Impact of air pollution on postoperative outcomes following organ transplantation: Evidence from clinical investigations
Clin Transplant . 2023 Nov 21:e15180. doi: 10.1111/ctr.15180

Introduction: Air pollution is a worldwide problem affecting human health via various body systems, resulting in numerous significant adverse events. Air pollutants, including particulate matter < or = 2.5 microns (PM2.5), particulate matter < or = 10 microns (PM10), ozone (O3 ), nitrogen dioxide (NO2 ), and traffic-related air pollution (TRAP), have demonstrated the negative effects on human health (e.g., increased cerebrovascular, cardiovascular, and respiratory diseases, malignancy, and mortality). Organ transplant patients, who are taking immunosuppressive agents, are especially vulnerable to the adverse effects of air pollutants. The evidence from clinical investigation has shown that exposure to air pollution after organ transplantation is associated with organ rejection, cardiovascular disease, coronary heart disease, cerebrovascular disease, infection-related mortality, and vitamin D deficiency.

Objectives and method: This review aims to summarize and discuss the association of exposure to air pollutants and serum 25-hydroxyvitamin D level and outcomes after transplantation. Controversial findings are also included and discussed.

Conclusion: All of the findings suggest that air pollution results in a hazardous environment, which not only impacts human health worldwide but also affects post-transplant outcomes.
A few of the 123 References

• Barrea L, Savastano S, Di Somma C, et al. Low serum vitamin D-status, air pollution and obesity: a dangerous liaison. Rev Endocr Metab Disord. 2017;18(2):207-214. doi:10.1007/s11154-016-9388-6
• Hoseinzadeh E, Taha P, Wei C, et al. The impact of air pollutants, UV exposure and geographic location on vitamin D deficiency. Food Chem Toxicol Mar. 2018;113:241-254. doi:10.1016/j.fct.2018.01.052
• Yang C, Li D, Tian Y, Wang P. Ambient air pollutions are associated with Vitamin D status. Int J Environ Res Public Health. 2021;18(13). doi:10.3390/ijerph18136887
• Lowery EM, Bemiss B, Cascino T, et al. Low vitamin D levels are associated with increased rejection and infections after lung transplantation. J Heart Lung Transplant. 2012;31(7):700-707. doi:10.1016/j.healun.2012.02.012
• Kalluri HV, Sacha LM, Ingemi AI, et al. Low vitamin D exposure is associated with higher risk of infection in renal transplant recipients. Clin Transplant. 2017;31(5). doi:10.1111/ctr.12955

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Air pollution is knocking up to eight years off life expectancy in 6 countries in Asia and Africa - Aug 2023

Note: Air pollution ==> reduced time outdoors ==> lower levels of vitamin D
The Telegraph stores does NOT mention Vitamin D
Worldwide pollution is reducing the average person’s life expectancy globally by 2.3 years.

• "It concludes that the impact is “comparable to that of smoking”. It accounts for
  three times as many life years lost as alcohol use and unsafe water, and more than
  five times that of transport injuries."

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10 µg/m3 increase in PM2.5 pollution decreased Vitamin D by 9 nmol (3.6 ng) - June 2021

Ambient Air Pollutions Are Associated with Vitamin D Status
Int. J. Environ. Res. Public Health 2021, 18(13), 6887; https://doi.org/10.3390/ijerph18136887
by Chenlu Yang 1,Dankang Li 2,Yaohua Tian 2 and Peiyu Wang 3,*

Evidence on the effect of ambient air pollution on vitamin D is limited. This study aimed to examine the association of air pollution exposure with serum levels of 25-hydroxyvitamin D (25OHD) using UK Biobank health datasets. A total of 448,337 subjects were included in this analysis. Land Use Regression was applied to assess individual exposures to particulate matter with diameters ≤2.5 µm (PM2.5), ≤10 µm (PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOx). Linear regression models evaluated the associations between air pollutants and serum vitamin D levels after adjustment of a series of confounders. All analyzed air pollutants were negatively associated with serum vitamin 25OHD levels.
After adjusting for potential confounders, a 10 μg/m3 increase in concentrations of PM2.5, PM10, NOx, and NO2 was associated with −9.11 (95%CI: −13.25 to −4.97), −2.47 (95%CI: −4.51 to −0.43), −0.56 (95%CI: −0.82 to −0.30), and −1.64 (95%CI: −2.17 to −1.10) nmol/L decrease in serum vitamin 25OHD levels, respectively. Interaction analyses suggested that the effects of air pollution were more pronounced in females. In conclusion, long-term exposures to ambient PM2.5, PM10, NOx, and NO2 were associated with vitamin D status in a large UK cohort.
 Download the PDF from VitaminDWiki

PM 2.5 notes:
2X more likely to have <10 ng/mL Vitamin D level if PM2.5 = 80 µg/m3
Unhealthy for sensitive groups: 55 µg/m3
Moderate: 35.4 µg/m3
Acceptable/good: 12 µg/m3 = “Good” Air Quality index

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5 Pollution and Vitamin D items from the web

• Atmospheric Pollution and Vitamin D – bad air & ultra-fine particles Grimes Jan 2020
• Low serum vitamin D-status, air pollution and obesity: A dangerous liaison -Sept 2016 https://doi.org/10.1007/s11154-016-9388-6 FREE PDF
• Air pollution, environmental chemicals, and smoking may trigger vitamin D deficiency: Evidence and potential mechanisms - Jan 2019 https://doi.org/10.1016/j.envint.2018.11.052 FREE PDF
• Particulate Air Pollution Exposure and Plasma Vitamin D Levels in Pregnant Women: A Longitudinal Cohort Study - Aug 2013 https://doi.org/10.1210/jc.2018-02713 FREE PDF
  • High air pollution ==> 1.48 more likely to be Vitamin D Deficient
• Pollution, Obesity, Vitamin D, or Why Is Asthma So Complicated—and Interesting- JULY 2019 -https://doi.org/10.1016/j.jaip.2019.04.015 FREE PDF
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Depression 1.4X more likely if heavy air pollution and Vitamin D deficient - Dec 2021

Fine particulate matter, vitamin D, physical activity, and major depressive disorder in elderly adults: results from UK Biobank
J Affect Disord . 2021 Dec 5;S0165-0327(21)01326-4. doi: 10.1016/j.jad.2021.12.009.
Mingyang Wu 1, Junqing Xie 2, Ziyi Zhou 1, Lulin Wang 1, Yonghua Hu 3, Yu Sun 4, Youjie Wang 1, Yaohua Tian 5

Objective: The present study aims to investigate the association between PM2.5 exposure and major depressive disorder, and to examine whether vitamin D and physical activity could attenuate the impact of PM2.5 on major depressive disorder.

Methods: 39168 elderly adults (age≥60 years) who had valid estimates on exposure of PM2.5 in 2010 and data on major depressive disorder were extracted from the UK Biobank. Major depressive disorder was assessed by lifetime experience of mild, moderate, and severe major depression with validated instruments. Logistic regression models were used to estimate the association between PM2.5 exposure and major depressive disorder.

Results: A total of 9079 participants had major depressive disorder, with a prevalence of 23.2%. The odds ratio (OR) of major depressive disorder was 1.096 (1.023, 1.175) for participants in the highest quartile compared with the lowest quartile of PM2.5. The correlation of PM2.5 with major depressive disorder generally increased with the decreasing levels of vitamin D. For instance, in participants with the highest quartile of PM2.5, the corresponding ORs were 1.141 (0.951, 1.369), 1.232 (1.027, 1.478), 1.286 (1.072, 1.543), and 1.390 (1.159, 1.667) for those who had adequate, desirable, insufficient, and deficient levels of vitamin D, respectively. Additionally, significant modification effects of physical activity on the relationship between PM2.5 and major depressive disorder were also observed.

Conclusions: Our study suggests that high levels of vitamin D and physical activity may attenuate the relationship between PM2.5 and major depressive disorder among elderly adults.
- - - - - - - - -
Observation: People tend to stay indoors during times of heavy air pollution.
Resulting lack of sun lowers vitamin D levels

3 Solutions:

1) Indoor UV lamp.
2) special plexiglass window that passes UVB light. ,
3) Mask/filter that removes particulate matter from the air (PM2.5)
It protected me from forest fire smoke and COVID while riding up hills on a bike   Amazon $40

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Decrease in UVB: ratio of the polluted sky in Tokyo vs clear sky in New Zealand
Note: Tokyo is much closer to equator, so should have much more UVB than NZ
Note: You can ignore the blue = winter line

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Air pollution, environmental chemicals, and smoking may trigger vitamin D deficiency: Evidence and potential mechanisms - Jan 2019

Environ Int. 2019 Jan;122:67-90. doi: 10.1016/j.envint.2018.11.052. Epub 2018 Nov 30.
Mousavi SE1, Amini H2, Heydarpour P3, Amini Chermahini F4, Godderis L5.

Beyond vitamin D (VD) effect on bone homeostasis, numerous physiological functions in human health have been described for this versatile prohormone. In 2016, 95% of the world's population lived in areas where annual mean ambient particulate matter (<2.5 μm) levels exceeded the World Health Organization guideline value (Shaddick et al., 2018). On the other hand, industries disperse thousands of chemicals continually into the environment. Further, considerable fraction of populations are exposed to tobacco smoke. All of these may disrupt biochemical pathways and cause detrimental consequences, such as VD deficiency (VDD). In spite of the remarkable number of studies conducted on the role of some of the above-mentioned exposures on VDD, the literature suffers from two main shortcomings: (1) an overview of the impacts of environmental exposures on the levels of main VD metabolites, and (2) credible engaged mechanisms in VDD because of those exposures. To summarize explanations for these unclear topics, we conducted the present review, using relevant keywords in the PubMed database, to investigate the adverse effects of exposure to air pollution, some environmental chemicals, and smoking on the VD metabolism, and incorporate relevant potential pathways disrupting VD endocrine system (VDES) leading to VDD. Air pollution may lead to the reduction of VD cutaneous production either directly by blocking ultraviolet B photons or indirectly by decreasing outdoor activity. Heavy metals may reduce VD serum levels by increasing renal tubular dysfunction, as well as downregulating the transcription of cytochrome P450 mixed-function oxidases (CYPs). Endocrine-disrupting chemicals (EDCs) may inhibit the activity and expression of CYPs, and indirectly cause VDD through weight gain and dysregulation of thyroid hormone, parathyroid hormone, and calcium homeostasis. Smoking through several pathways decreases serum 25(OH)D and 1,25(OH)2D levels, VD intake from diet, and the cutaneous production of VD through skin aging. In summary, disturbance in the cutaneous production of cholecalciferol, decreased intestinal intake of VD, the modulation of genes involved in VD homeostasis, and decreased local production of calcitriol in target tissues are the most likely mechanisms that involved in decreasing the serum VD levels.
See full study on VitaminDWiki: Air pollution, toxins, heavy metals and smoking each result in lower Vitamin D levels – Nov 2018

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Air pollution, environmental chemicals, and smoking may trigger vitamin D deficiency: Evidence and potential mechanisms - Feb 2019

Environment International https://doi.org/10.1016/j.envint.2018.11.052
Sayed Esmaeil Mousaviab Heresh Aminicde Pouria Heydarpourf Fatemeh Amini Chermahinig Lode Godderishi
Highlights

• Air pollution may lead to vitamin D deficiency (VDD) directly or indirectly.
• Heavy metals may lead to VDD by increasing renal tubular dysfunction and downregulating the transcription of CYPs.
• Endocrine-disrupting chemicals may directly inhibit the activity and expression of CYPs and through indirect pathways.
• Smoking causes VDD through several pathways.

 Download the PDF from VitaminDWiki

Beyond vitamin D (VD) effect on bone homeostasis, numerous physiological functions in human health have been described for this versatile prohormone. In 2016, 95% of the world's population lived in areas where annual mean ambient particulate matter (<2.5 μm) levels exceeded the World Health Organization guideline value (Shaddick et al., 2018). On the other hand, industries disperse thousands of chemicals continually into the environment. Further, considerable fraction of populations are exposed to tobacco smoke. All of these may disrupt biochemical pathways and cause detrimental consequences, such as VD deficiency (VDD). In spite of the remarkable number of studies conducted on the role of some of the above mentioned exposures on VDD, the literature suffers from two main shortcomings:

• (1) an overview of the impacts of environmental exposures on the levels of main VD metabolites, and
• (2) credible engaged mechanisms in VDD because of those exposures.

To summarize explanations for these unclear topics, we conducted the present review, using relevant keywords in the PubMed database, to investigate the adverse effects of exposure to air pollution, some environmental chemicals, and smoking on the VD metabolism, and incorporate relevant potential pathways disrupting VD endocrine system (VDES) leading to VDD.
Air pollution may lead to the reduction of VD cutaneous production either directly by blocking ultraviolet B photons or indirectly by decreasing outdoor activity.
Heavy metals may reduce VD serum levels by increasing renal tubular dysfunction, as well as downregulating the transcription of cytochrome P450 mixed-function oxidases (CYPs). Endocrine-disrupting chemicals (EDCs) may inhibit the activity and expression of CYPs, and indirectly cause VDD through weight gain and dysregulation of thyroid hormone, parathyroid hormone, and calcium homeostasis.
Smoking through several pathways decreases serum 25(OH)D and 1,25(OH)2D levels, VD intake from diet, and the cutaneous production of VD through skin aging.
In summary,

• disturbance in the cutaneous production of cholecalciferol,
• decreased intestinal intake of VD,
• the modulation of genes involved in VD homeostasis, and
• decreased local production of calcitriol in target tissues are the most likely mechanisms that involve in decreasing the serum VD levels.

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Vitamin D reduces air pollution cell damage by autophagy (disassemble the damaged cells) - Jan 2019

Vitamin D protects against particles-caused lung injury through induction of autophagy in an Nrf2-dependent manner
Environ Toxicol. 2019 Jan 30. doi: 10.1002/tox.22726.
Tao S1,2, Zhang H2, Xue L2, Jiang X1, Wang H1, Li B2, Tian H2, Zhang Z2.
1 Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, China.
2 Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Disease, School of Public Health, Soochow University, Suzhou, China.

Fine particulate matter is a well-known air pollutant threatening public health. Studies have confirmed long-term exposure to the particles could decrease the pulmonary function, induce asthma exacerbation, and chronic obstructive pulmonary disease, as well as increase the incidence and mortality of lung cancer. A clinical study has explored that the prevalence and risks of vitamin D (VD) deficiency in various chronic disease and toxins induced tissue damage. Our current study aimed to explore the mechanism and further therapeutic potential of VD administration to ameliorate fine particles exposure induced pulmonary damage in vivo and in vitro. To elucidate the effects and mechanisms of VD in particles-induced pulmonary damage, a murine model was established with fine particles intratracheal instillation along with VD intramuscular injection. Our study demonstrated that treatment with VD attenuated particles-induced pulmonary damage and promoted tissue repair by repressing of TGFβ1 signaling pathway and upregulation of MMP9 expression. VD treatment could also regulate the autophagy-related signals along with activation of Nrf2 transcription factor. Furthermore, the results from the in vitro study demonstrated that VD protected against particle-induced cells damage through the induction of autophagy in an Nrf2-dependent manner. VD treatment caused the degradation of P62 and its bound Keap1, which decreased the Nrf2 ubiquitination and increasing its protein stability. Our work explored a novel potential mechanism in the protection of VD in particles-induced pulmonary injury and tissue repair, and could further bring insights into exploring anti fine particles exposure caused inflammation among other natural products and contributes to inflammation disease medical therapies.

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Vitamin D treated particulate matter health problems - Aug 2018

Effects of vitamin D on inflammatory and oxidative stress responses of human bronchial epithelial cells exposed to particulate matter
PLoS One. 2018 Aug 29;13(8):e0200040. doi: 10.1371/journal.pone.0200040. eCollection 2018.
Pfeffer PE1,2, Lu H1, Mann EH1, Chen YH1, Ho TR1, Cousins DJ1,3, Corrigan C1, Kelly FJ4, Mudway IS4, Hawrylowicz CM1.
.
BACKGROUND: Particulate matter (PM) pollutant exposure, which induces oxidative stress and inflammation, and vitamin D insufficiency, which compromises immune regulation, are detrimental in asthma.

OBJECTIVES: Mechanistic cell culture experiments were undertaken to ascertain whether vitamin D abrogates PM-induced inflammatory responses of human bronchial epithelial cells (HBECs) through enhancement of antioxidant pathways.

METHODS: Transcriptome analysis, PCR and ELISA were undertaken to delineate markers of inflammation and oxidative stress; with comparison of expression in primary HBECs from healthy and asthmatic donors cultured with reference urban PM in the presence/absence of vitamin D.

RESULTS:
Transcriptome analysis identified over 500 genes significantly perturbed by PM-stimulation, including multiple pro-inflammatory cytokines. Vitamin D altered expression of a subset of these PM-induced genes, including suppressing IL6. Addition of vitamin D suppressed PM-stimulated IL-6 production, although to significantly greater extent in healthy versus asthmatic donor cultures. Vitamin D also differentially affected PM-stimulated GM-CSF, with suppression in healthy HBECs and enhancement in asthmatic cultures. Vitamin D increased HBEC expression of the antioxidant pathway gene G6PD, increased the ratio of reduced to oxidized glutathione, and in PM-stimulated cultures decreased the formation of 8-isoprostane. Pre-treatment with vitamin D decreased CXCL8 and further decreased IL-6 production in PM-stimulated cultures, an effect abrogated by inhibition of G6PD with DHEA, supporting a role for this pathway in the anti-inflammatory actions of vitamin D.

CONCLUSIONS:
In a study using HBECs from 18 donors, vitamin D enhanced HBEC antioxidant responses and modulated the immune response to PM, suggesting that vitamin D may protect the airways from pathological pollution-induced inflammation.

 Download the PDF from VitaminDWiki

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Air pollution in relation to U.S. cancer mortality rates - 2009

Air pollution in relation to U.S. cancer mortality rates: an ecological study; likely role of carbonaceous aerosols and polycyclic aromatic hydrocarbons
Anticancer Res. 2009 Sep;29(9):3537-45.
Grant WB1.Sunlight, Nutrition and Health Research Center (SUNARC), P.O. Box 641603, San Francisco, CA 94164-1603, USA. wbgrant at infionline.net

BACKGROUND:
There are large geographical variations of cancer mortality rates in the United States. In a series of ecological studies in the U.S., a number of risk-modifying factors including alcohol, diet, ethnic background, poverty, smoking, solar ultraviolet-B (UVB), and urban/rural residence have been linked to many types of cancer. Air pollution also plays a role in cancer risk.

MATERIALS AND METHODS:
Cancer mortality rates averaged by state for two periods, 1950-1969 and 1970-1994, were used in multiple-linear regression analyses with respect to many of the risk-modifying factors mentioned with the addition of an air pollution index in the form of a map of acid deposition in 1985. This index is correlated with emissions from coal-fired power plants. In addition, lung cancer mortality rates for five-year periods from 1970-74 to 1990-94 were used in multiple linear regression analyses including air pollution and cigarette smoking.

RESULTS:
The air pollution index correlated with respiratory, digestive tract, urogenital, female, blood and skin cancer. Air pollution was estimated to account for 5% of male cancer deaths and 3% of female cancer deaths between 1970-1994. Solar UVB was inversely correlated with all these types of cancer except the respiratory, skin and cervical cancer. Cigarette smoking was directly linked to lung cancer but not to other types of cancer in this study.

CONCLUSION:
Combustion of coal, diesel fuel and wood is the likely source of air pollution that affects cancer risk on a large scale, through production of black carbon aerosols with adsorbed polycyclic aromatic hydrocarbons.

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Note: Particulate matter problems apparently treated by inhaling Vitamin D

By the founder of VitaminDWiki, who lives near Seattle
In Aug of 2018 there was a lot of particulate matter in the air
The air pollution from wildfires has recently been called a smoke storm (by Cliff Mass)
I went for a bike ride when the smoke storm was almost gone
Felt a restriction in my breathing that night and the next morning.,
I inhaled 3 puffs of Vitamin D and the restriction totally went away in less than an hour
I do not know if the Vitamin D treated the health problem or it the problem would have gone away without it.
   Henry Lahore

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See also web

• Air pollution and multiple sclerosis: a comprehensive review - Aug 2021 $40 paywall . https://doi.org/10.1007/s10072-021-05508-4
• Particulate Air Pollution and Osteoporosis: A Systematic Review - 2021 PDF
• Ambient Air Pollutions Are Associated with Vitamin D Status - 2021 PDF
• The impact of outdoor air pollution on COVID-19: a review of evidence from in vitro, animal, and human studies - 2021 PDF
• Independent association between air pollutants and vitamin D deficiency in young children in Isfahan, Iran Aug 2013 free full text online
• The effects of air pollution on vitamin D status in healthy women: A cross-sectional study BMC Health 2010, Iran, free full text online
  Many reasons for low vitamin D in Iran (India, etc): Hot (so stay indoors in air conditioning), Dark skin, want lighter skin, lots of clothing, air pollution
• Independent association between air pollutants and vitamin D deficiency in young children in Isfahan, Iran 2014
  Publisher wants $54 for the PDF
• California Sees 76% Decline in Cancer Risk Thanks to Cleaner Air
  Scientific American, Sept 2015, no mention of Vitamin D
  Vitamin D increases when people can get sunshine when they no longer have to avoid pollution
• Alzheimer’s disease: Condition linked to exposure to air pollution and lack of Vitamin D
  Oct 2016 - not sure if Vitamin D is the link between air pollution and Alzheimer’s disease
• Low serum vitamin D-status, air pollution and obesity: A dangerous liaison Sept 2016
   Download the PDF from VitaminDWiki
• Vitamin D reduces some of the pollution problems in human cell culture (not in bodies so far) - May 2017
  Vitamin D Counteracts an IL-23-dependent IL-17A+IFNγ+ Response Driven by Urban Particulate Matter
  https://doi.org/10.1165/rcmb.2016-0409OC Publisher wants $25 for the PDF
• Air Pollution Tied to Kidney Disease NY Times Sept 2017
  Areas with high pollution have 27% more Chronic Kidney Disease - No mention of Vitamin D
  Free PDF is online
• Revealed: air pollution may be damaging ‘every organ in the body’ May 2019
  Nice animations, refers to "Air Pollution and Noncommunicable Diseases" Feb 2019, which does not conatin the word VITAMIN
  +:  Download the PDF from VitaminDWiki
• Air Pollution Now Strongly Linked to Mental Illness Mercola Oct 2019
  • "Worldwide, 93% of children live in areas with air pollution at levels above World Health Organization (WHO) guidelines."
  • "Why Children Are Especially Vulnerable to Air Pollution"

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Ozone on the web

• Temporal variation in air pollution concentrations and preterm birth-a population-based epidemiological study Sweden, Jan 2012 free full text online
  • Ozone during the first trimester associated with pre-term birth, unless it occurred in the fall when vitamin D levels were highest
• Breathing dirty city air is as bad for your lungs as smoking FastCompany Aug 2019
  • Ozone Worse: 10 years of high ozone = 30 years of smoking a pack a day
  • "Climate change, unfortunately, is making ground-level ozone increase; ozone is formed when sunlight reacts with chemicals emitted from cars and other sources of pollution, and warmer temperatures make things worse."
  • "Study = Association Between Long-term Exposure to Ambient Air Pollution and Change in Quantitatively Assessed Emphysema and Lung Function" Aug 2019
  • Free PDF doi:10.1001/jama.2019.10255
• Acute respiratory distress syndrome - April 2017. FREE PDF doi: 10.1183/16000617.0116-2016
  • "In addition to the well-known risk-factors for ARDS, exposure to high ozone levels and low vitamin D plasma concentrations were found to be predisposing circumstances"

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UN Realtime map of pollution

Firefox (not Chrome) Sept 6, 2021

Unitd States: red due to wild fires

Middle East

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Air pollution worse for global lifespan than cigarettes or alcohol - June 2020 (nothing about D)

 Washington Post PDF

• "Air pollution can lead to strokes, heart disease, lung cancer and other respiratory diseases, according to the World Health Organization. It is on track to reduce the global average life expectancy by 2.2 years, the report says."
• "In comparison, smoking cigarettes cuts life expectancy by about 1.9 years, while drinking alcohol reduces it by eight months."
• "If current levels persist, residents of South Asia are projected to lose about five years of life on average"

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