Neglected Link: Air Pollution's Impact on Women's Health
Air pollution poses a danger to everyone, and yet little is known about the extent to which it affects women specifically.
As epidemiologic and environmental health professor Budi Haryanto explains, once an air pollution particle is inhaled, it will travel through the respiratory system and into the lungs, affecting all humans regardless of gender or age.
"Every human's respiratory organs, without exception, are bound to be polluted by air pollution," he said. This is true for men and women, and pollutants can quickly spread to other organs through the nose. Therefore, the health effects of air pollution on the respiratory organs are similar for all genders and ages.
A Look at Gender Disparities
Particulate matter (PM) is composed of fine particles in the air that measure less than or equal to 2.5 micrometers or one-third the diameter of a human hair.
Exposure to PM 2.5, "including toxic metals, organic compounds, and gases, can cause inflammation with systemic effects, affecting respiratory organs and those located far from the lungs, including the reproductive organs," according to the Environmental Committee of the Forum of International Respiratory Societies.
However, as Haryanto pointed out, the exact nature of this "exposure" requires more research. And given that the particles enter through the nose, Haryanto raised the issue of a "relatively small number of gender-based research related to the health effects of air pollution in Indonesia."
Haryanto described the term "relative" because "the amount of research cannot be measured quantitatively. But imagine this; when I want to look up research sources on pollution, it's rare to find studies that specifically focus on men or women."
Bondan Andriyanu, Greenpeace Indonesia's climate and energy campaigner, concurred with Haryanto's statement. He stated that he had never come across research on the impact of gender-based air pollution in Indonesia. "I read such abroad-based research on the subject. But not on the Indonesian-based research."
Andriyanu claimed to be more competent in research focusing on women. He noted that "women's organs are more than that of men. Of course, the impact [of air pollution on women] would be bigger than men."
Haryanto agreed it was "difficult to find gender-based research of this kind." He was fortunate enough to have assisted his students who had listed women as one of their research subjects. Her name is Eky Pramitha Dwi Putri.
Putri's research, guided by Haryanto, found a significant association between air pollution and decreased lung function in adult women around the Pulo Gadung industrial area in North Jakarta.
She discovered that 31.2 percent of 109 adult women experienced decreased lung function, while the rest had stable lung function.
Interestingly, the analysis showed no significant correlation between age or length of time lived in the area and decreased lung function. Still, a significant relationship was found between the length of time spent indoors and reduced lung function.
Female adults who spend more time at home around the Pulo Gadung industrial "have a 3.56 times greater risk of decreasing lung function compared to female adults who spend less time at home," Eky wrote in her thesis.
Putri's research highlights the importance of studying lung function in relation to the impact of air pollution, particularly in women.
This is because exposure to particulate matter, toxic metals, organic compounds, and gases can cause inflammation with systemic effects affecting the respiratory organs and those located far from the lungs, including the reproductive organs.
According to data provided by AirNow, a US government-supported service that monitors air quality, the air quality in Central Jakarta, which is located south of North Jakarta, frequently reaches unhealthy levels between August and September. AirNow does not have sensors installed in North Jakarta to provide data on air quality in that area.
A Not-So-Silent Killer?
Air pollution particles settle in the lungs, which is crucial for proper breathing as they facilitate air exchange. "All air pollution particles stop in [human] lungs," said Haryanto.
The metabolic level of individuals determines whether their lung function remains or decreases after exposure to air pollution particles.
Children are at a higher risk of inhaling air pollution particles due to their faster breathing frequency, but there is a lack of research on the impact of air pollution on children's lungs. Similarly, there is also a lack of research examining the effects of air pollution on the lungs of adult men or women.
Exposure to air pollution is associated with an increased risk of lung cancer, the second most common cancer worldwide and the most common cancer in men.
According to the World Cancer Research Fund International, lung cancer is the second most common cancer globally and the most common cancer in men, and the second most common cancer in women.
However, it is not clear from international literature how exposure to air pollution ultimately causes human cancer.
Research by the National Center for Biotechnology Information shows that outdoor air pollution causes roughly 1 in 10 lung cancer cases, but this should be kept in perspective. Nearly 30 percent of new lung cancer cases are associated with air pollution, more evident in major cities.
Recent evidence also suggests that exposure to air pollution may increase the risk of breast cancer in women, but there are inconsistencies among previous studies on this topic.
In Indonesia, research and researchers specializing in the impact of air pollution on women are relatively few. "We have not yet reached the 'inconsistency' stage," Hariyanto said.
He also noted country's rapid growth has led to an increase in pollutants and shifting sources of pollution in big cities, which can bring unknown harm to human health, especially to women.
During the interview at his home in Pasar Minggu, Jakarta, Haryanto looked at a painting of mountains and tall trees behind him and remarked, "Breathing in a big city like Jakarta is very different from breathing in a place like this painting."
This story was produced with the support of Internews' Earth Journalism Network through the Clean Air Catalyst (Catalyst), a flagship program launched by the U.S. Agency for International Development (USAID).