Urging our leaders to clean up their act and implement the Clean Air Act

Manny, a 50 -year-old bus dispatcher in Manila, is the only breadwinner in his family of three. He has two teenage boys and a daughter. For the past two years, Manny has noticed that whenever he gets a whiff of the sooty bus exhausts, he would develop chest pains. Later on, Manny would get tired easily and wake up short of breath.

When I saw this sickly man, I could not decipher the cause of his many heart attacks. An echocardiogram reveals that his heart has expanded like a rubber band and is only pumping at 20-percent capacity. Studies show that with such a lame heart, Manny may not last three years.

Manny could not understand why he was very ill. He vehemently denies smoking, drinking alcohol or taking prohibited drugs. Both his parents don’t have any history of heart disease. Looking at his case, the incriminating evidence points to his line of work — being a bus dispatcher exposed to air pollution.

Exposure to air pollution can cause red eyes, itchy throat, and make one prone to pneumonia and bronchitis. Air pollution also triggers and worsens the conditions of patients with asthma and emphysema.

These air pollutants can pass through our lungs and into the blood. And since the function of the heart is intertwined with the lungs, these pollutants can have a deleterious effect on the heart itself.

Like Manny, many of us are exposed to the toxic air of Manila. Since we are among the top polluted cities in the world, we are at risk of developing heart and lung disease.

The prestigious Lancet Journal provides convincing evidence that air pollution leads to heart and lung disease, and shortens our collective life span. Some experts believe that noxious air concentrations of sulphur oxides, nitrogen oxides, and other pollutants may cause inflammation of the blood vessels, resulting in hardening of the arteries (atherosclerosis) and heart attacks, like in Manny’s case.

In this fascinating study, Dr. Gerard Hoek from Netherlands finds that those living near a major road (like EDSA) have a higher risk of dying than the rest of the population. Hoek concludes that long-term exposure to traffic-related air pollution may shorten life expectancy.

Aside from Hoek’s study, other studies have shown that exposure to air pollution is associated with heart attacks, life-threatening heart rhythms, and thickening of the blood. To make it clear: All these bodily changes spell doom for the Filipinos living in Metro Manila and other densely populated cities.

Lately, I experienced the ill effects of air pollution in the poor patients we see in our medical missions. We noticed an increasing number of patients complaining of chronic, debilitating cough. Some patients are astute enough to point to the source: “We live just beside the road. Whenever we are exposed to the exhaust fumes of vehicles, we get this nagging terrible cough.”

With the preponderance of scientific and common-sense evidence linking air pollution to death and disease, we hope that the government will fully act on offending vehicles. You just have to look at those vehicles emitting black fumes.

Perhaps, our politicians would like to take a simple test. They only have to get out of their air-conditioned cars and take a stroll down EDSA during the rush hours. Then see if they can stand breathing the air for just an hour.

I assure you, within 15 minutes, they would experience a slight chest heaviness (lack of oxygen in the heart), a certain dizziness (lack of oxygen in the brain), and faster breathing (tiny particulate matters sticking to the lung tissue). As Hoek’s study points out, the incidence of lung disease increases if you live near the major roads and our posh villages are just a stone’s throw away from EDSA.

And if our people think that being inside air-conditioned cars protects them from air pollution, then they are terribly wrong. According to lung expert Dr. Raymund Fernandez, the air-conditioning can only filter some of the deadly particles but not all. During heavy traffic, these air pollutants will still find a way inside the car and into our lungs.

I just can’t imagine the health dangers being faced by our traffic enforcers, policemen, and motorcycle riders as they breathe in dirty air.

As doctors, we constantly face many stories like Manny’s heart problem, which some argue can be traced to our own negligence. In truth, we are all slowly dying of air pollution. It is mind-boggling the way we muddle up the issue and make it seem like a fight between several interest groups. There are no factions here for we are all in the same boat.

For it’s the very air that we breathe. We strongly urge our leaders to fully implement the Clean Air Act before it’s too late.