Carbon monoxide is an asphyxiant.

An accumulation of this odorless,

colorless gas may result in a varied constellation of symptoms deriving from
the compound's affinity for and combination with hemoglobin, forming
carboxyhemoglobin (COHb) and disrupting oxygen transport. The elderly,
the fetus, and persons with cardiovascular and pulmonary diseases are
particularly sensitive to elevated CO levels. Methylene chloride, found in
some common household products, such as paint strippers, can be
metabolized to form carbon monoxide which combines with hemoglobin to
form COHb. The following chart shows the relationship between CO
concentrations and COHb levels in blood.

Tissues with the highest oxygen needs -- myocardium, brain, and exercising
muscle -- are the first affected. Symptoms may mimic influenza and include
fatigue, headache, dizziness, nausea and vomiting, cognitive impairment,
and tachycardia. Retinal hemorrhage on funduscopic examination is an
important diagnostic sign19, but COHb must be present before this finding
can be made, and the diagnosis is not exclusive. Studies involving controlled
exposure have also shown that CO exposure shortens time to the onset of
angina in exercising individuals with ischemic heart disease and decreases
exercise tolerance in those with chronic obstructive pulmonary disease
(COPD)20.

Note: Since CO poisoning can mimic influenza, the health care provider
should be suspicious when an entire family exhibits such symptoms at the
start of the heating season and symptoms persist with medical treatment and
time.
Relationship between carbon monoxide (CO) concentrations and
carboxyhemoglobin (COHb) levels in blood

Predicted COHb levels resulting from 1- and 8-hour exposures to carbon

monoxide at rest (10 l/min) and with light exercise (20 l/min) are based on the
Coburn-Foster-Kane equation using the following assumed parameters for
nonsmoking adults: altitude = 0 ft; initial COHb level = 0.5%; Haldane constant =
218; blood volume = 5.5 l; hemoglobin level = 15 g/100ml; lung diffusivity = 30
ml/torr/min; endogenous rate = 0.007 ml/min.

Source: Raub, J.A. and Grant, L.D. 1989. "Critical health issues associated with
review of the scientific criteria for carbon monoxide." Presented at the 82nd
Annual Meeting of the Air Waste Management Association. June 25-30. Anaheim,
CA. Paper No. 89.54.1, Used with permission.

Carboxyhemoglobin levels and related health effects

%
COHb in Effects Assocated with this COHb Level
blood
80 Deatha
Loss of consciousness; death if exposure
60
continuesa
 40 Confusion; collapse on exercisea
30 Headache; fatigue; impaired judgementa
Statistically significant decreased maximal
7-20 oxygen consumption during strenuous exercise
in healthy young menb
Statistically significant diminution of visual
perception, manual dexterity, ability to learn, or
5-17
performance in complex sensorimotor tasks
(such as driving)b
Statistically significant decreased maximal
5-5.5 oxygen consumption and exercise time during
strenuous exercise in young healthy menb
No statistically significant vigilance decrements
Below 5
after exposure to COb
Statistically significant decreased exercise
capacity (i.e., shortened duration of exercise
2.9-4.5 before onset of pain) in patients with angina
pectoris and increased duration of angina
attacksb
Statistically significant decreased (about 3-7%)
2.3-4.3 work time to exhaustion in exercising healthy
menb

SOURCE: aU.S. EPA (1979); bU.S. EPA (1985)

Nitrogen dioxide (NO) and sulfur dioxide (SO2) act mainly as irritants,
affecting the mucosa of the eyes, nose, throat, and respiratory tract. Acute
S02-related bronchial constriction may also occur in people with asthma or
as a hypersensitivity reaction. Extremely high-dose exposure (as in a
building fire) to N02 may result in pulmonary edema and diffuse lung injury.
Continued exposure to high N02 levels can contribute to the development of
acute or chronic bronchitis.

The relatively low water solubility of N02 results in minimal mucous

membrane irritation of the upper airway. The principal site of toxicity is the
lower respiratory tract. Recent studies indicate that low-level N02 exposure
may cause increased bronchial reactivity in some asthmatics, decreased lung
function in patients with chronic obstructive pulmonary disease, and an
increased risk of respiratory infections, especially in young children.

The high water solubility of S02 causes it to be extremely irritating to the

eyes and upper respiratory tract. Concentrations above six parts per million
produce mucous membrane irritation. Epidemiologic studies indicate that
chronic exposure to S02 is associated with increased respiratory symptoms
and decrements in pulmonary function21. Clinical studies have found that
some asthmatics respond with bronchoconstriction to even brief exposure to
S02 levels as low as 0.4 parts per million22.
 CLEAN AIR 101

Prepared by:
Donato de la Cruz
Technical Advisor
Energy and Clean Air Project (ECAP)

AIR POLLUTANTS AND THEIR HEALTH AND

ENVIROMENTAL IMPACTS

PRIMARY SOURCE OF AIR POLLUTION

COMBUSTION of:

GASOLINE

DIESEL

FUEL OIL

FUEL WOOD

GARBAGE

INCOMPLETE COMBUSTION RESULTS TO:

CO

CARBON MONOXIDE

HC

HYDROCARBONS

PM

PARTICULATE MATTERS (TSP, PM<sub>10, PM2.5)

 BUSES, JEEPNEYS, TRU
are major sources

BUSES ,
JEEPNEYS, TRUCKS and OTHER DIESEL VEHICLES are major
sources of

HEALTH EFFECTS OF
PARTICULATE MATTER (PM)

• May impair respiratory

function leading to acute
respiratory morb May impair
respiratory function leading
to acute respiratory
morbidity and mortality.

• Irritates the respiratory tract,

constrict airways,
exacerbate asthma and
bronchitis, and increase
rates of respiratory infection.

• Children and infants appear

to be particularly sensitive.
Children and infants appear to be
particularly sensitive.
 Cars and tricycles that burn gasoline are the primary
sources of hydrocarbon (HC) at carbon monoxide (CO).

CO CO CO
HC HC HC HC HC HC
HC HC HC HC HC HC
HC CO CO CO CO HC CO CO
HC
CO HC CO HC CO
HC HC HC HC HC
HC HC HC HC HC HC HC
HC
HC CO CO HC CO CO
HC CO CO
HC HC HC

CO
HC HC HC
HC
HC CO CO
HC

HC - HYDROCARBON
CO - CARBON MONOXIDE

HYDROCARBONS HC (benzene)

eye irritation

bronchitis

respiratory infection

headache

throat problem, cough

EFFECTS OF CARBON MONOXIDE

DEATH

VISION PROBLEM

DIZZINESS

HEADACHE

REDUCTION IN MENTAL AND PHYSICAL FUNCTIONS

CO (carbon monoxide) combines with haemoglobin to lessen the

amount of oxygen tha CO (carbon monoxide) combines with
haemoglobin to lessen the amount of oxygen that enters our blood
through our lungs. It can impair our concentration, slow our reflexes,
and make us confused and sleepy.

SULFUR OXIDES (SOx)

SULFUR
(MULA SA DIESEL AT FUEL OIL)

OXYGEN
(MULA SA HANGIN)

O<sub>2

SULFUR OXIDES

SO2

SO2 - colorless, nonflammable gas with a penetrating odor that irritates the eyes and air passages.

HEALTH EFFECTS OF SOx

 • SO</sub></span><span style=" font-family: 'Arial'; font-size: 16pt; font-weight: normal; font-style: normal; text-
decoration: none; color: #003399;"><sub>2 can cause irritation to the moist surfaces of the nose, mouth,
pharynx and major bronchi.

• SO</sub></span><span style=" font-family: 'Arial'; font-size: 16pt; font-weight: normal; font-style: normal; text-
decoration: none; color: #003399;"><sub>2 irritates the respiratory tract, reducing lung capacity, and causes
wheezing, shortness of breath and chest tightness.

NITROGEN OXIDES

NITROGEN
(IN AIR AND FUEL)

HIGH TEMPERATURE

HIGH PRESSURE

OXYGEN
(IN AIR)

NITROGEN OXIDES
(NO, NO<sub>2)

Nitric oxide (NO) is an odorless, colorless gas

Nitrogen dioxide (NO2) - a reddish brown, nonflammable, gas with a detectable smell.

EFFECTS OF NITROGEN OXIDES

• increased incidence of lower respiratory tract infection in

children and decreased airway responsiveness in asthmatics.

• Children, the elderly, asthmatics and individuals with chronic

obstructive pulmonary disease are more responsive to nitrogen
dioxide than others in the community (WHO, 1995).
 • In significant concentrations it is highly toxic, causing serious
lung damage with a delayed effect. Other health effects of
exposure to nitrogen dioxide include shortness of breath and
chest pains.

Sulfur Oxides (SO<sub>x)

Nitrogen Oxides (NOx)

SOx + WATER
NOx + WATER

SULFURIC ACID
NITRIC ACID

RAIN

ACID RAIN FORMATION

ACID RAIN

DAMAGE TO PLANTS, BUILDINGS, RIVERS, LAKES

ACID RAIN

SMOG, PM, DUST, SMOKE

ENVIRONMENTAL EFFECTS

HEALTH COST of PM<sub>10 EXPOSURE

Health costs due to exposure to particulate matter (PM10) in Metro Manila, Baguio City, Cebu City and Davao City,
2001.
 HEALTH COST of PM10 EXPOSURE

Health costs due to exposure to particulate matter (PM10 ) in Metro

Manila, Baguio City, Cebu City and Davao City, 2001.

Cause

Premature death
Source: World Bank. Philippine Environment Monitor 2002. Philippines.

Chronic bronchitis
Respiratory
Source: World Bank. Philippine Environment Monitor 2002. Philippines.

symptom days
WHAT CAN WE DO?

DO NOT ALLOW JEEPNEYS, BUSES, TRUCKS AND OTHER

TOTAL
DIESEL VEHICLES THA DO NOT ALLOW JEEPNEYS, BUSES,
TRUCKS AND OTHER DIESEL VEHICLES THAT EMIT BLACK
SMOKE ON OUR ROADS.

STOP SMOKE BELCHING

DO NOT ALLOW DO NOT ALLOW TRICYCLES EMITTING HIGH

LEVELS OF HYDROCARBON (HC) ON OUR STREETS.
 TRICYCLES EMITTING HIGH LEVELS OF HYDROCARBON (HC)
ON OUR STREETS.

USE CLEANER ENGINES/FUELS

PROPERLY IMPLEMENT THE CLEAN AIR ACT

All motor vehicles must pass emission test prior to registration at

LTO.

EMISSION TEST before registration

PROPERLY IMPLEMENT THE CLEAN AIR ACT

ROADSIDE INSPECTION AND APPREHENSION

USE CLEAN (ALTERNATIVE) FUELS SUCH AS COCO-METHYL

ESTERS (CME) O BIODIESEL

• Adding 1 to 5 % CME to diesel fuel results to reduction in

emission of black smoke.

• Since July 2004, all government diesel vehicles are required to

use diesel blended with 1% CME.
(Malacañang Memorandum Circular No. 55 - Directing all
Departments, Bureaus, Offices, Agencies and Instrumentalities
of the Government to Use 1% by Volume "Coco Methyl Ester"
in their fuel requirements for the Diesel Vehicles)

USE CLEANER ENGINES SUCH AS 4-STROKE MOTORCYCLES.

PRACTICE PREVENTIVE MAINTENANCE OF MOTOR VEHICLES

• Regular oil change.

Aside from lesser smo Aside from lesser smoke emission, preventive
maintenance results to fuel saving.

• Regular cleaning/change of air filter.

 DRIVE PROPERLY

Avoid jackrabbit start

Overloading and jack rabbit start results to higher emission of

pollutants.

Do not overload