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Unabated pollution and deteriorating air quality of Kathmandu has been in news for all the wrong reasons lately. Due to rapid urbanization, people from all over the country throng to the capital for of education, employment, entrepreneurship etc. With annual population growth rate of 4.7% and motorization rate of 12%, Kathmandu has fast become overpopulated as well as polluted. Contributors of environmental pollution are vehicle emission, open air waste burning, industrial smog, brick kiln smoke, river sewage, construction work, etc. Scarcity of natural sinks such as forests, ponds, grassland and greenery has catapulted this damage in the valley.

In 2017, Kathmandu ranked as 5th most polluted city in the world according to Pollution index survey. In 2018, Environment Performance Index(EPI) had Nepal at the bottom among 180 countries in the survey. EPI was measured considering various indicators such as household solid fuels, sanitation, heavy metal and lead exposure, air quality, water quality, etc. Air quality of Nepal was worse than its neighbouring countries India, China, Bangladesh, etc. Ultraviolet Index (UVI) of major cities such as Kathmandu and P0khara are usually at the worst daily, with scores of 9-10 every day. UV Index depends on ozone layer, cloud cover, environmental pollutants, etc. Pollutants in the air are nitrogen oxide, sulfur dioxide, carbon monoxide, particulate matter smaller than 2. 5 Microns(PM2.5), ground level ozone, hydrocarbons, methane, etc. Amount of particulate matter in the air (PM2.5) has reached more than four times that of WHO guidelines in Kathmandu.

So what are the health implications of such chemicals, indices and scores? Pollution is a major health hazard causing asthma respiratory difficulties, heart disease and cancers. WHO has reported death rate of 0.036% from air pollution in Nepal. Globally, more and more researches are attributed to links between pollution and health. In the same realm, skin health is hugely impacted by environmental pollution.

Skin is the largest and outermost organ of the body which acts as a barrier against external harm. It is the first line of defense that fights these chemicals, but ultimately succumbs to their detrimental effects in long term. Skin, hair and oil glands bear the brunt of environmental pollutants, which get absorbed into skin directly or indirectly, causing oxidative stress and inflammation.  Many studies show that skin quality is altered, leading to dry, rough, dull and reactive skin that has redness, itching, burning and stinging. Content of the skin changes. Major studies in Shanghai and Mexico showed decrease in vitamin C, Vitamin E, squalene and linolenic acid content. Pores get clogged causing acne. Decrease in oiliness of skin makes it dry and easily attacked by allergens leading to eczema, itching, sun allergy and rashes. Gases such as nitrous oxide coming from vehicle emission cause pigmentation and black spots. Increased humidity and temperature leads to excessive sweating, clothing dermatitis and flexural dermatitis. Environmental factors also trigger chronic skin diseases such as psoriasis and atopy. Interaction of sunlight with different pollutants cause pigmented spot, keratosis and skin cancers.  UV irradiation coming from the sun can have many effects on skin, most of which are harmful. UV rays reach the earth surface at various intensity during different time of the day and seasons. Compound effect of UV irradiation and toxic gases in atmosphere increase many skin diseases.
Depletion of ozone layer in atmosphere is another imminent threat. Photochemical smog, supersonic aircrafts and gases deplete ozone layer in the sky, increasing UV rays reaching earth surface. For every 1% decrease in ozone layer, there is 2% in UVB intensity and 2% increase in skin cancers.   
Cumulative effect of the pollutants, UV radiation and ozone layer depletion amount to an array of skin diseases that are exponentially rising. Hence urgent measures to curb the pollution and environmental damage in Kathmandu is of paramount importance.

Can we do anything to save ourselves and save our skin from the premature uninvited turmoil?? Skin is a large organ and it isn’t possible to completely cover all areas of skin. Wearing full sleeves can curb the direct exposure to some extent. Since these pollutants get absorbed through exposed skin, washing our face, hands and feet should be a regime. While outside, wearing protective moisturizers and sunscreen  act as barrier as well as fight sundamage. These products form films on the surface of skin and protect from instant damage but not long term protection. A medical study has revealed that Dead Sea minerals rich water (DSW) and Pollustop creams attenuates damage by UVB. They act as physical barrier and protect against carbon and heavy metals induced damage. But they are not readily available in common cosmetic market. Besides these, minimal endeavors can be done on personal front to control health implications of pollution. 

In summary, impact of global warming, pollution and sun damge can be seen on skin as pimples, sunallergy, rashes in short term while wrinkles and cancer in the long run.

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