Pollution is universally recognized to have a negative effect on public health and society. Despite periodic increases in opposition, society has accepted pollution as a necessary evil for economic growth and the success of the industry. However, with years of uncontrollable growth and largely increasing global pollution levels, there have been far-reaching consequences on public health. Maternal health, which is already in a vulnerable state due to ongoing or recent pregnancy, is impacted extensively as demonstrated by recent research. Such outcomes are dangerous to the well-being of both the mother and the child, negatively impacting future generations and public health issues and costs. This article will discuss the extent of pollution in the global environment, its close interaction with maternal health, and provide recommendations towards sustainable pollution management.
State of the Global Environment
Global assessments indicate that pollution issues are extensive. Air quality has become a concern in practically all regions of the world, particularly urban centers. Water pollution is prominent, seen in many sources of fresh water as well as marine ecosystems, being a major cause of death for both natural species as well as human children. Pollution is on the rise in the context of the rising amount of trash and plastics, unseen chemical contamination, and a lack of acceptable storage and disposal options for highly toxic elements such as nuclear fuel. Overall, pollution is affecting biodiversity and shifts in ecosystems as well as major planet-wide process functioning such as seen in climate change (UN Environment Assembly, 2017). While technology has grown to improve some techniques in tracking and managing pollution, there are evident gaps in data that prevent researchers from understanding the full magnitude of the issue. A significant concern is that, despite Earth having some mechanisms of clearing out pollutants, it is unable to effectively manage the onslaught of waste products from human activity. Therefore, pollution creates a build-up effect that is having exponentially detrimental impacts on both, ecosystems and human health.
Air pollution is the most prominent type of pollution, and it is estimated that 90% of the global population lives in areas where air quality does not meet even the lowest WHO guidelines (Health Effects Institute, 2019). The healthy air quality is recommended to be at 2.5 micrometers of particular matter (PM). Most of the urban centers exceed this due to vehicle and industrial emissions, coal power plants, and other human and natural sources. Air pollution is directly associated with a range of public health conditions related to respiratory or cardiovascular diseases as well as cancers. The burden of disease coming from air pollution exposure is linked to hospitalization, disability, and early death. Researchers estimate that air pollution has contributed to 8,7% of global deaths and 147 million years of healthy life lost in 2017, with industrialized and developed countries being the largest contributors to this trend (Health Effects Institute, 2019).
Impact on Maternal Health
Exposure to pollution and toxicants during pregnancy can significantly impact fetal growth and development. Prenatal exposure to ambient air pollution can create adverse birth outcomes including but not limited to preterm delivery, low birth weight, and small gestational weight (Franklin et al., 2019). Low birthweight is critical as it increases the rate of infant mortality but creates a lifelong risk of chronic illness such as diabetes or cardiovascular issues along with lung or brain development damage. There is unfortunately limited data regarding deaths resulting from exposure in pregnancy, but despite researchers not yet being able to prove a causal relationship, the observed correlation is significant (Carrington, 2017).
Pollutants may also have an effect on a developing fetus, whose physiology requires high oxygen demand and rapid cellular turnover. As a result, exposure may lead to structural or genetic damage, and in rare cases, functional changes may occur. Pollutants are associated with endocrine disruption and have been related to genitourinary and reproductive issues in offspring. It is also theorized that genetic expression can be negatively impacted. Regardless, fetal exposure to pollutants is a high risk since most can easily pass through the placenta via diffusion (Hackley, Feinstein & Dixon, 2007).
In modern developed countries, pregnant women spend the majority of their time indoors, which helps to mitigate outside air pollution to an extent, but there is also exposure to indoor pollutants such as formaldehyde, nitrogen dioxide, and household chemicals (Franklin et al., 2019). Furthermore, pregnancy induces profound physiological changes in the mother, such as increased ventilation rates and a decrease in oxygen-binding capacity. Therefore, a pregnant woman can experience approximately 50% greater uptake of inhaled pollutants, thus greater fine particulate matter compared to non-pregnant woman due to the increased ventilation rate, increasing health risks to the fetus as well as lung damage to the mother (Hackley, Feinstein & Dixon, 2007). Increased PM exposure has also been associated with depressive and anhedonia symptoms post-partum, particularly in racial minorities (Sheffield et al., 2018).
The evidence above demonstrates the negative impacts of pollution on maternal health, but it is also important to consider potential causes or influencing factors. Mothers and children are at high risk for pollution-related disease during periods of vulnerability in utero and early infancy that can result in illness or disability stretching across their lifespan as well as early death. Pollution has been neglected often in low and middle-income countries and communities, which bear the primary burden of disease stemming from pollution also since they compromise the majority of the population in most regions. Ambient air, chemical, and soil pollution have been increasing significantly, introduced by heavy industry, electricity generation, mechanized agriculture, and petroleum-driven vehicles. Pollution in such communities can be caused by vehicle exhaust, industrial emissions, and toxic chemicals. Despite 70% of conditions caused by the pollution being non-communicable, they are not mentioned in international action plans (Landrigan et al., 2018). Rapidly growing cities that contain 55% of the world’s population are often centerpieces of pollution production. In addition to unprecedented levels of industrial and vehicular emissions in major cities, there are also various dangerous levels of chemical pollution associated with infrastructure or waste such as lead, asbestos, PCB or pharmaceutical wastes (Landrigan et al., 2018).
One strong indicator in society is that pollution disproportionately affects minorities and individuals with a low socioeconomic status. Mothers from these higher-risk groups are more likely to have poor birth outcomes, living in areas where they have higher exposure to air pollution. Controlling for demographic factors, in the United States, mothers from ethnic and racial minorities were twice as likely to live in counties with higher levels of air pollution compared to white counterparts and had a small increase in preterm delivery odds (Woodruff et al., 2003). This demonstrates that the health effects of pollution are not just environmental, but also societal, stemming from evident disparities in an exposure.
The biggest issue is that pollution effects are often a factor that mothers cannot account for in pregnancy or how it will impact the unborn baby. Pollution increases the risk of low birth weight along with other damages to health. Meanwhile, UNICEF suggests that 17 million newborns breathe in air six times more toxic than recommended. However, there is virtually no reliable way of living in a city to avoid chronic exposure, often three times or higher than the legal limit. The implication is that the effects of pollution are approaching a public health catastrophe. The level of uncertainty, lack of environmental control, and evident health impacts endanger pregnant mothers as well as the future of society as a whole, trivializing the health of future populations (Carrington, 2017).
Global environmental change can no longer be ignored in the context of public health and the very existence of humanity. Rockström et al. propose a series of nine planetary boundaries which are necessary to maintain a safe space for humanity’s well-being. These include climate change determined by CO2 levels, ocean acidification, stratospheric ozone, biogeochemical nitrogen cycle limits, global freshwater use, land system change, biodiversity loss, chemical pollution, and atmospheric aerosol loading (Rockström et al., 2009, p.32). All of these are directly or indirectly impacted by pollution discussed in this paper, and human civilization has transgressed at least three of these – leading to visible environmental changes. The story of a Great Turning presents an anthropogenic evolution of humanity from an Industrial Growth Society that is uncontrollable and inequitable to a Life-Sustaining Society that emphasizes a sustainable, cooperative, and regenerative approach to civilization. The Great Turning can occur in three areas of taking action to resist damage to the environment, reforming socio-economic foundations of society, and a status quo shift in moral and cognitive paradigms – all of which are critical to creating a sustainable and equitably just society (‘Three stories of our time’, n.d.).
Achieving a state of a pollution-free planet is seemingly fantastical, but is possible with current and developing technologies, sustainable governance frameworks, and targeted interventions. However, despite this, the priority lies in international, regional, and local cooperation in terms of environmental agreements and national regulations that often address pollution levels. Sustainable development goals often laid out in agreements or proposals are based on scientific and economic data, creating effective but also realistic targets to be achieved. To be even more effective, multilateral environmental agreements should include multi-level engagement from all involved stakeholders including all levels of governments, international governing bodies, global corporations, NGOs, and others that are directly and indirectly involved in the governance, business/industry, and social aspects which are contributing or affected by pollution (UN Environment Assembly, 2017).
It is evident that pollution has become extensively dangerous to ecosystems and public health. Maternal health is an element of healthcare that is specifically impacted by this, endangering the health of in utero and newborn children in a variety of ways while mothers have no method to mitigate or avoid pollution. Socioeconomic disparities around the world can exacerbate the situation further. The far-reaching consequences of pollution can only be eliminated by removing it completely or at least beginning to reduce it significantly. Limits to pollution should be established and international governance frameworks must be undertaken to address this global ecological issue in order to protect the health of future generations.
Franklin, P. et al. (2019) ‘Maternal exposure to indoor air pollution and birth outcomes.’ International Journal of Environmental Research and Public Health, 16(8). Web.
Hackley, B., Feinstein, A. and Dixon, J. (2007) ‘Air pollution: impact on maternal and perinatal health.’ Journal of Midwifery & Women’s Health, 52(5), pp.435–443.
Health Effects Institute. (2017) State of global air 2019: Special report. Boston: Health Effects Institute.
Landrigan, P. J. et al. (2018) ‘The Lancet Commission on pollution and health’, The Lancet Commissions, 391(10119). pp.942–946.
Rockström, J. et al. (2015) ‘Planetary boundaries: exploring the safe operating space for humanity’, Ecology and Society, 14(2). Web.
Sheffield, P.E. et al. (2018) ‘Association between particulate air pollution exposure during pregnancy and postpartum maternal psychological functioning.’ PLOS ONE, 13(4).
Three stories of our time (n.d.) Web.
UN Environment Assembly. (2017) Towards a pollution-free planet. Web.
Woodruff, T.J., Parker, J.D., Kyle, A.D. & Schoendorf, K.C. (2003) ‘Disparities in exposure to air pollution during pregnancy.’ Environmental Health Perspectives, 111(7), pp.942–946.
Carrington, D. (2017) ‘Air pollution harm to unborn babies may be global health catastrophe, warn doctors’, The Guardian. Web.