CHEST Guidelines-Surviving-With-Smog-and-Smoke_2017

Surviving-With-Smog-and-Smoke_2017_chest

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Air pollution, particularly smog and haze, remains a critical public health threat globally, with severe episodes such as the London Smog of 1952 and recent smog events in Beijing causing significant morbidity and mortality. European smog and Chinese haze contribute to 400,000 and 1.2 million premature deaths annually, respectively, primarily through respiratory, cerebrovascular, and ischemic heart diseases. Apart from air pollution, secondhand smoke compounds these health issues, affecting countries with high smoking prevalence, including China, India, the US, and Russia.<br /><br />Recent genomic and epigenomic studies have shown that air pollution and smoking are linked to specific mutational signatures and epigenetic alterations, making precision medicine interventions viable. These interventions focus on targeting disease pathways activated by these specific mutations or epigenetic changes. For instance, genomic biomarkers and gene-drug interactions are increasingly being used to guide new therapies. Whole genome sequencing has identified mutations related to air pollution-induced lung cancer, and studies have found distinct mutational signatures for smoking-related cancers.<br /><br />Precision interventions could offer targeted protection for individuals exposed to unavoidable smog and smoke. Such strategies may involve personalized therapeutic approaches that exploit newfound genomic information to mitigate oxidative stress—a common consequence of exposure to pollution and smoking that leads to DNA damage and disease. Additionally, antioxidants like B vitamins and certain dietary phytochemicals have shown promise in reducing air pollution-induced oxidative stress.<br /><br />Despite ongoing governmental efforts, air pollution remains a pervasive issue requiring urgent solutions. Precision medicine emerges as a promising approach to not only treat but potentially prevent diseases associated with smog and smoke exposure, suggesting a pivotal role in public health strategy advancements.

Keywords

air pollution

smog

haze

precision medicine

genomic studies

epigenetic alterations

mutational signatures

oxidative stress

public health

antioxidants