Original article By J. Reis, P.S. Spencer, M. Wasay, W. Grisold, W.M. Carroll

DOI: https://doi.org/10.1016/j.jns.2018.12.015

  • Nine in ten persons in the world are exposed to polluted air
  • Air pollution contributes to 29.2% of the global burden of stroke
  • WFN has chosen to emphasize the impact of the environment, notably air pollution, on the brain
  • There is a need for collaboration between physician professional societies and environmental experts at a global level for increased awareness and advocacy.


The latest estimate of attributable deaths to pollution worldwide is extraordinary: 9 million deaths annually. Deaths are related to cardiovascular disorders (myocardial infarction, congestive heart failure and stroke), lung diseases and cancers. The recent Global Burden of Disease study, based on 1990–2013 data from 188 countries demonstrated that air pollution contributes to 29.2% of the global burden of stroke. However, the burden varies between 10% in high-income countries and 34% in low- and middle-income countries.

The effects of air pollution on the developing and adult brain have received increased interest in recent years, with studies suggesting relationships with autism, attention deficit disorder, dementia and Parkinson's disease. However, these issues are still debated. 

Air pollution is a global and diffuse contamination of air by noxious bio-aerosols (pollen, germs, particulates and other toxicants) and chemical compounds (manmade or of natural origin). Airborne contamination differs quantitatively and qualitatively between indoor (household) and outdoor (atmospheric or ambient) air, urban versus rural areas, local versus regional, or atmospheric contamination (atmospheric brown clouds). The chemical nature of environmental pollutants is complex and variable. 

Global chemical airborne contamination is a critical issue because air pollution is a major environmental risk factor for neurological health. In 2014, only about one in ten people breathed clean air, as defined by the World Health Organization Air quality guidelines. That means that 9 in 10 persons are exposed to polluted air. Although air pollution is a global hazard, citizens of Africa, South Asia and the Middle East breathe much higher and increasing levels of air pollutants that those in living other parts of the world.

The WFN has actively adopted an advocacy role during the last five years. The World Brain day 2018 is an expression of WFN interest and role in global advocacy for environmental and neurological health. For the first time, WFN has chosen World Brain Day to emphasize the impact of the environment, notably air pollution, on the brain. The World Health Organization (WHO) has acknowledged the issue with the First Global Conference on Air Pollution and Health organized at WHO Headquarters in Geneva in November 2018 with brain and neurological health as an important area.


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