Tuesday, April 19, 2011

From Gridlock to Brain Damage (A Study from Lagos, Nigeria)

From 234Next, April 17th, 2011

Ifeanyi Okosi closed his eyes, reclined on the head rest, and waited for a flicker of movement from the vehicle in front.

It would take another two hours to wriggle out of the barely 200 metres distance between Eric Moore and Orile bus stop.

For years, the snail motion traffic at that part of the Badagry expressway had become part of his daily experience on the way home from work.

"Some days, it takes up to three or four hours to drive out of that traffic," said Mr. Okosi, who runs an import agency in Lagos Island.

Such traffic escapades spread across the metropolis have been revealed to have detrimental effects on the brain.

A new study in the journal ‘Environmental Health Perspectives' by researchers at the University of Southern California has shown that the kind of pollution motorists are exposed to when they sit in gridlocks could impact on the brain.

This study adds to the list of previous studies that had linked pollution to other harmful effects on the body, including damaging the pulmonary system, causing cardiovascular problems, and even heart attacks.

The US researchers, led by Caleb Finch, a neurobiologist, exposed both live mice brain cells in vitro to the kind of air one might breathe in a gridlock - a mixture of particles from burning fossil fuels, bits of car parts, and weathered pavements.

Pollution and the brain

According to the research which was published by the US based Time magazine, both the in vitro brain cells and the neurons in the live mice showed the same problems - signs of inflammation associated with Alzheimer's disease (a disease which affects the functioning of the brain) and damage to cells associated with learning and memory.

The particulates used for the study are too tiny to be trapped by car filtration systems, about one-thousandth the width of a human hair, and the mice were exposed for 150 hours over ten weeks.

Mr. Finch hinted that frequent commuters, who might be exposed to the bad highway air over an even longer period than the mice were in the study, could be at risk.

According to the Lagos Metropolitan Area Transport Authority, the current vehicular density in Lagos is about 224 vehicles per kilometre. This is 15 times the national average.

"The reality about this study is that we don't have such study in Nigeria presently or probably, even the whole of Africa, but it could be explained based on the fact that in a congested area you are bound to have a lot of pollution and the brain is very sensitive to the amount of oxygen available to it," said Saliu Oseni, a surgeon at the Lagos State University Teaching Hospital.

"Besides if you deprive the brain of oxygen for five minutes, you can end up with a brain damage. So if the percentage of the oxygen in the available air is reduced, it can give what is called a sub-clinical injury to the brain - a case where you may not really have a clinical presentation on the patient having a brain damage but it may accumulate over time and eventually present clinically as a pathologic problem; one that you can see," Dr. Oseni added.

Shedding more light on the impact of pollution on the brain, the surgeon said gaseous emissions can compete for space with the oxygen present in the body.

"Like when they are available in the lungs, they will reduce the amount of oxygen that is available to the body and the body will see it as what we call ipoxia - reduced oxygen.

"And if the available oxygen in the body is not enough, part of the body that is affected the most is the brain. Some other parts of the body can be affected too, even the heart, but primarily the brain cells are more sensitive to things like this," said Dr. Oseni.

"However, the body system has a way of preventing immediate injury to the brain because they make available everything to the brain until they are, probably, not available again in the body, in terms of oxygen, food, and nutrients," he added.

The study also suggested that the highway pollution can have a profound effect on the development of neurons and brain health in children, particularly those who attend schools built close to highways.

"When you talk about pollution, it goes beyond gas or not feeling well. Noise is also pollution. If you have a child that lives or in a school close to the highway, either honking of cars, every time you have a lot of noise, it affects the hearing. And part of the brain takes care of hearing," said Dr. Oseni.

"If the school is sighted close to the highway, you have more of smoke from the exhaust of the vehicles available to the children to inhale. They have a growing brain which needs a lot of oxygen, so they can easily be affected," he added.

The medical doctor, however, noted that studies are yet to be carried out to determine the extent at which children are affected.

Dearth of specialists

During a conference to mark this year's brain awareness week in Abuja, Biodun Ogungbo, one of the participants, stated that there are 25 brain specialists available for 140 million Nigerians.

"There are only 25 neurosurgeons for 140 million Nigerians and most of them are found only in city centres, and only the universities of Lagos, Ibadan and Sokoto are authorized to train doctors in the area of neurosurgeon," said Dr. Ogungbo, a consultant neurosurgeon.

With a country ratio of one doctor to 4, 000 patients, according to NMA statistics, analysts say brain injuries are best prevented than allowed to occur.

"We have a significant number of neurologists, but where you need a neurosurgeon's attention, the number of neurosurgeons is very limited. In the whole of Lagos we have two here and two at LUTH (Lagos University Teaching Hospital), that means we have four to serve the whole of Lagos State," said Dr. Oseni.

"Generally, it (shortage of specialists) is something that translates all over. Because the truth of the matter is that we still don't have enough number of doctors available. In LASUTH here, we have about one-quarter or less the number of doctors that is needed to run LASUTH at the level that it is now," he said.

Not really important

Opinions of commuters on the study were divided. While some called it an "alarmist" theory of western scientists, others said they were not surprised.

"I think people should channel their energies on important things like how to reduce the sufferings of the masses, instead of coming up with these alarmist theories," said Tunde Aro, a member of the National Union of Road Transport Workers at Mile 2.

"We are exposed to dangers every time we leave our houses, so this one should not be a new thing," he added.

But Rawlings Ebele, a banker, said that he was not surprised at the findings of the study.

"Really, this shouldn't come as a surprise to anyone," said Mr. Ebele.

"If you take into consideration the amount of smoke discharged by all the substandard vehicles in this city and the large volume of people and vehicles; then one shouldn't be surprised," he said.

Finding solutions

Dr. Oseni called for a strict enforcement of traffic rules as a way to mitigate the effects of air pollution on residents.

"There are laws in place but, unfortunately, in Nigeria we have a situation whereby laws are just there; there is no implementation. For example, vehicles that are smoking excessively are supposed to be off the road," said Dr. Oseni.

"Part of the luck we have is that we have a very wide sea around us here in Lagos. Gas tends to move from where they are more to where they are less, so we have a sort of escape route into the Atlantic," he added.

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