World Pneumonia Day: 2021 Focus on Air Pollution

November 9, 2021

Most people know someone who has had pneumonia, if they’ve not had it themselves. But did you know that the respiratory infection led to the deaths of  2.5 million people worldwide in 2019? And that over half a million of these people were children? November 12 is World Pneumonia Day, a time to put a spotlight on this common illness that causes sepsis and septic shock in so many people.

This year’s World Pneumonia Day focus is on air pollution and its role in pneumonia deaths around the world, particularly among the very old and the very young. The Asian Pacific Society for Respirology points out that increased risk is also caused by malnutrition, low or no access to hand washing, low birth weight, and suboptimal breastfeeding.

Poor air quality is not just a problem in other parts of the world. It also an issue in many places in the United States. The Respiratory Health Association reports that almost 140 million people in the U.S. are exposed to unhealthy air pollution levels. Air pollution includes obvious issues like smog, but also soot, car exhaust, and even smoke from fireplaces, wood-burning stoves and wildfires, which can send particulates hundreds of miles away.

What is pneumonia?

Simply put, pneumonia is an infection that affects your lungs. The right lung is divided into three lobes and the left has two. You can have infection in one lobe or in the whole lung, in one lung or both. It can range from mild (often called “walking pneumonia”) to severe. People who have mild cases still need to be careful because they can still be contagious, depending on the cause. The infection can also become more severe, particularly if you have a chronic illness, such as diabetes.

Pneumonia can occur on its own, or it can be a complication of another illness, such as COVID-19. Pneumonia contracted in a hospital or another healthcare facility is called healthcare-acquired pneumonia or nosocomial pneumonia. Although any kind of pneumonia can be serious, healthcare-acquired pneumonia is especially concerning because it occurs in people who are already sick or compromised, which is why they are in the hospital in the first place. Healthcare facilities also have the increased risk of antibiotic resistant bacteria, making infections harder to treat.

Pneumonia contracted outside of a healthcare facility is called community-acquired pneumonia. One of the most common causes of pneumonia in the community is influenza, the flu. Viruses and bacteria, especially Streptococcus pneumoniae, cause most cases but fungi can as well.

Air pollution and respiratory illnesses

When we breathe in particles that cause air pollution, this affects how our lungs function. One study, from 2009, looked at seniors and year-long exposure to higher levels of some pollutants. The researchers found that those who were exposed to nitrogen dioxide (largely in the air from burning fossil fuels) and fine particulate matter (mostly from burning wood and fuel) had twice the risk of developing pneumonia than those who were not exposed. But, it’s not just long-term exposure that is dangerous. Short-term exposure, starting at just one week, also causes more respiratory infections, particularly among children. The wildfires is a good example of where this may be the case.

The particles carried in the air can cause the lungs to become inflamed and irritated, making them vulnerable to infection. Some particles also affect the lung wall cells, making it harder for the body to pull out the oxygen after taking in a breath of air.

Air pollution can also contribute to illnesses such as:

  • Asthma
  • COPD
  • Heart disease
  • Cancer

Pneumonia and COVID-19

We have been hearing more about pneumonia since the COVID-19 pandemic began in early 2020, because pneumonia is a complication of the virus. Healthcare professionals and researchers quickly learned that COVID-19–related pneumonia causes more damage to the lungs and is harder to treat than what they are used to seeing.

The researchers found one reason why COVID-19 pneumonia is so dangerous. Typically, pneumonia infects large areas of the lung, but COVID-19 pneumonia appears to latch on to one small area and then moves slowly throughout the lung, damaging the lung tissue along the way. This makes the illness last longer than non-COVID-19 pneumonias. The longer you are sick, the higher the chances of more complications.

Pneumonia and sepsis

Respiratory infections, including pneumonia, are one of the leading causes of sepsis. Any kind of infection can trigger sepsis, which is the body’s toxic response to the infection. Instead of the immune system fighting the infection, it starts to attack the body itself.

Sepsis is usually treatable when recognized and treated in the early stages. Anyone who is at risk of developing pneumonia and other infections should know the signs of sepsis: fever or temperature below normal, changes in mental status, signs of an infection, and extreme feelings of pain or discomfort, as well as difficulty breathing.

Preventing pneumonia

Cleaning up the environment is the biggest challenge we have today. By reducing air pollution, we can reduce respiratory illnesses, like pneumonia. Eliminating sources of air pollution does require people around the world to work together, but we can all play a small role ourselves. Every little bit helps. Here are just a few ideas:

  • Consider using public transportation or cycling rather than using a car when possible.
  • Buy cars that are the most fuel efficient.
  • Don’t idle your car while waiting.
  • Limit or eliminate use of fossil fuels, such as coal, gas, and oil.
  • Use energy-efficient appliances and light bulbs.
  • Switch from a wood-burning stove to more efficient heating systems.
  • Avoid using plastic bags and single-use plastics.
  • Don’t smoke or vape.
  • Reuse and recycle whenever possible.

And to reduce the risk of contracting the infection:

  • Get vaccinated against viral illnesses, such as the flu and COVID-19, which can lead to pneumonia
  • Get vaccinated against pneumonia caused by pneumococcal bacteria.
  • Don’t smoke or vape.
  • Wash your hands frequently and thoroughly.

If you do get pneumonia, watch for signs of sepsis. Sepsis is a medical emergency.


Learn more about sepsis here.