Health

Dying Breaths

By Mike Diez, Additional Reporting by John Brant

 

Three times a week for the past two years, I have been unwittingly poisoning myself. Each morning I have been working out in a gym along EDSA, in Quezon City. Without air-conditioning, the ventilation comes from opened windows, facing one of the busiest streets of Metro Manila. I fancied myself a hardcore weightlifter, thinking this is how it should be done. No frills, man. The day comes when, after a relatively intense workout, it felt like my head was spinning. I was able to muster enough strength to make it home and, unable to cope with the vertigo, I took a nap. Later on my doctor would tell me that I might’ve had a mild heart attack.

I consider myself a relatively healthy guy. I quit smoking a long time ago. I watch my liquor intake. I eat all the right foods. I sleep at sensible hours.

I look outside my window.

It’s mid-afternoon and a thick black cloud hangs over the metro, filling a million lungs with a witch’s brew of ozone, carbon monoxide, microscopic particulate matter, sulfur dioxide, lead, and other pollutants. And, “although the lungs are the ones primarily affected by pollution, our whole system are interconnected,” says cardiologist Romeo Meriño, MD. “Once the particulates are in your blood, it starts to affect all the organs in your body, your heart included.” His words confirmed what my doctor told me then, that I could’ve suffered a mild stroke.

It all seems common-sensical; you see the polluted air, you stay indoors. And yet here’s another sensible thought: Vigorous outdoor exercises equals a healthy body. So how do you reconcile these schools of thought? We set out to find answers.

It is ironic that your pursuit of a healthy lifestyle can be counter-productive. But the explanation is simple: When you’re running, cycling, or shooting hoops, you breathe in more air. Bad air, included.

A sedentary person inhales approximately 15,000 liters of air per day, or 6-10 liters per minute. When you exercise, you draw in 60-150 liters per minute. That’s 10-15 times more pollution that’s being sucked deep into your lungs whenever you try to beat the clock at 8:30 AM when you go to work. The numbers grow more harrowing, because you breathe primarily through your mouth during exercise. As I prove my masculine mettle in that gym along the highway, I’m bypassing my body’s remarkably effective air-filtering system: the nasal passages. Mucus traps particulates, and tiny, waving, hairlike structures called cilia push the old mucus up and out of the body. The triple whammy of breathing fast, deeply, and through the mouth makes my regular workouts—and perhaps yours—an ozone/particulate/carbon monoxide orgy.

Eventually, our bodies defend themselves against air pollution by breathing less. Air passages tighten, and breathing becomes difficult. Our exercising bodies are ensnared in a dilemma: While working furiously to process more air to feed oxygen-hungry muscles, they simultaneously strive to protect us from that air. Our pulmonary and cardiovascular systems strain like air-conditioners in an extended heatwave and eventually, inevitably break down. Early symptoms often include wheezing, coughing, a scratchy throat, headache, chest pains and watery eyes. Other longer-term effects are considerably more dire, as my would-be heart attack.

In Scotland, for instance, researchers studied 30 healthy men cycling on exercise bikes while exposed to diluted diesel exhaust. After an hour’s exposure to the fumes, the cyclists developed constricted blood vessels and showed reduction in tPA, an enzyme that breaks down clots in the heart. In another study, 17 competitive cyclists were exposed to varying levels of ozone while exercising; their endurance decreased by approximately 30 percent, and their lung function by 22 percent.

Research conducted in Finland shows an even clearer connection between dirty air and heart attack risk. Every two weeks over a six-month period, scientists monitored 45 volunteers as they exercised in simulated dirty air conditions. Results linked both fine-particle pollution (the emissions out of smokestacks) and ultra-fine particles (the invisible emissions from motor vehicles) with a threefold increase in the risk of ischemia, a potentially lethal shortage of oxygen reaching the heart muscle.

 

"There is definitely a perceived threat among Filipinos, brought about by pollution," says Carole Sarthou, managing director of Synovate Philippines, a global market research team with offices worldwide. In 2005, Sarthou's group surveyed the perception that pollution is impacting the lives of Asians (Filipinos included), both physically and emotionally. Ninety-four percent of local respondents believe that pollution comes from motor vehicle emissions. "The respondents feel that they should do more to keep healthy, as a consequence of having polluted air," she adds.

It doesn't take a genius to know that these perceptions are a reality. The Department of Health holds data that convincingly link pollution to pulmonary diseases among street sweepers and jeepney drivers, both exposed daily to polluted air. "Malaking bagay na na-phase out na natin yung lead sa ating mga gasoline," says John Paul Balayon, » operations manager of Bantay Kalikasan, a non-government organization that promotes environmental awareness. "But as far as we know, the quality of our diesel still does not meet the standards set by the Clean Air Act." The Clean Air Act (Republic Act No. 8749) is comprised of comprehensive legislation to address air quality, pollution control, and sustainable development. For instance, it sets specifications and standards for all types of fuel, additives, substances, and pollutants. It's why we've started loading up on unleaded gasoline. Of course, you only have to see the thick emissions from buses that ply the metro to know that these standards are still defied. What further compounds our air quality problems are the hand-me down engines that most bus operators and jeepney builders use. "It's a war of attrition, " says Daisy Jacobo, chief of traffic safety division of the Land Transportation Office (LTO). Jacobo is referring to the government's effort in enforcing traffic laws, with pollution and vehicle volume as their main concerns. "We'll impound the buses of violating operators, sometimes even revoking some licenses to operate." But the LTO is just one of 17 attached agencies under the Department of Transportation and Communication. And Jacobo admits that they are undermanned, forcing her to go out and check the streets herself most of the time. But she is hopeful that public utility vehicles will be outmoded in time, as more commuter trains are made and linked together as a more efficient means of transportation. "I would personally love to walk leisurely around the streets with my kids," she says. "Pero hindi puwede e. Di bale, parang yung nangyari sa mga kalesa, mawawala rin yan mga buses and jeeps."

Until then, would moving outside the metropolis help? "There is considerable difference in the quality of air from Metro Manila to, say, Laguna or Pampanga," says Balayon. "But you have to consider that winds blow from polluted areas to the provinces." At any given time, however, the air is significantly cleaner in the rural areas. It's likely why real estate sales in the south are growing. But if you can't relocate, plant trees. Research shows that 10 full grown trees are needed to clean vehicle emissions of one car. Or you can move to Las Piñas. According to the Environmental Management Bureau's air quality monitoring, this area has the cleanest air within Metro Manila. "This could be due to the wind moving in Laguna de Bay and Manila Bay," says Balayon.

So, what can you do if you really love the great outdoors but don't want to get emphysema? Unfortunately, unlike bad food or water that you can easily dispose of in favor of better alternatives, breathing in bad air leaves us with no choice.

You walk out the door and you inhale it. But we are lucky to be in a tropical environment. "Malaking bagay ang itinutulong ng ulan," Balayon tells me. "When the rain falls, it washes away the pollutants in the air." It is also important to know the time of the day that you can exercise without doing your body harm. Henry Gong Jr, MD, an air-pollution researcher at the University of Southern California medical school, suggests exercising early in the day; diesel particulates, ozone, and other pollutants are at their lowest then. Or jog at nightfall, when traffic subsides. Ozone forms when sunlight reacts with automobile and industrial emissions, so it accumulates to significant levels by about 11 AM and peaks at around 3 PM. (After sunset, ozone can no longer form, so the concentration decreases.) By the same token, ozone levels are significantly higher during the sunnier months. Other practical tactics include keeping away from congested streets. Idling motors release more pollutants than vehicles in motion. Sunsets at Manila Bay may inspire you to jog at Roxas Boulevard, but the lines of diesel-fueledbuses plying that route can choke your lungs. Try the tree-rich environment of the University of the Philippines in Diliman and the Ateneo de Manila University in Katipunan, instead. Stay away from the Quezon City Memorial Circle as well, which now houses more commercial establishments than trees. It does not help that the park sits as an island in the middle of heavy traffic.

Experts agree that if we can all get our acts together, Metro Manila's air can exponentially be improved within 2-3 years. Political will goes a long way in helping the cause, but you can also do your part (see "What goes around comes around"). "In the end, we are all accountable," says Balayon. "Apparently, most of us aren't deterred unless the matter becomes immediate; we only get concerned when we get affected." Visually, because it's nearly invisible, bad air does not disgust as much as dirty water does. But go up any high rise and that thick, black smoke that hangs like a twisted, evil halo on top of our streets becomes glaringly apparent.

I should know—I inhale it everyday, from that opened window in the gym by EDSA. And here's one thing I've come to learn: when it comes to health, it's often what you can't see that gets you.
 

 

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