“Gem membership” (Crystal healing)

CF

Despite being one of the oldest substances on the planet, crystals have a futuristic sci-fi look and this may partially explain some persons embracing them as an elixir, though gullibility is a more pronounced factor.

Good Morning America profiled persons who believe crystals are imbued with healing properties. This included Taryn Toomey, whose New York City studio features crystal-lined floors intended to “clear the energy and renew balance and confidence.” Unexplained were what type of energy it is, what it is being balanced with, and how standing on them raises one’s self-esteem.

Energy means “measurable work capability,” and Skeptoid’s Brian Dunning suggests replacing that definition with the word “energy” to see if a claim makes sense. When saying “Measurable work capability equals mass times the speed of light squared,” it’s understood what is being asserted. By contrast, “Clear the measurable work capability and renew balance and confidence,” takes a meandering sentence and leaves it even more muddled.

I once stopped by a mall kiosk once where two ladies were hawking healing crystals. It was a learning experience for all, as I was told amethyst works for backaches, anxiety, and rosacea, and they learned what a double blind study was. There have been many such peddlers over the years, but new spins are still being put on the notion of crystal power. For example, the GMA piece featured Mariah Lyons, who is likely the first person to imbed these structures in shoes. She did so after getting tired of carrying crystals in her pocket. Yes, I could see how that would get annoying.

But regardless of the method of transport, what is the owner getting out of possessing apatite and citrine? Lyons told GMA, “Crystals balance your energy.” Oh that’s right, Toomey already explained that. Me and my spotty memory, maybe there’s a gem to help with that.

Then there’s the question of how crystals access the energy and transmit it to a biological entity. For that, we look to crystalline.com, which states: “How do we access it? Crystals and other tools of transformation are just one way to get that rock star centeredness. They’re just waiting to be put to use to help us create the life of our dreams and our spirits to GLOW!” That didn’t even attempt to answer the question they posted – although the exclamation point and all caps shows that what they lack in evidence they make up for in enthusiasm.

With that, let’s go to the third crystal consumer connoisseur interviewed by GMA, Jennifer Salness, and she if she can explain how crystals transfer energy to people. She said, “Having the energy of the crystals around you transfers the vibrations of the stone to you. The longer we have it around us, our bodies can retain that same vibration as the crystal.” That wasn’t any better and we didn’t even get distinctive punctuation and lettering out of the deal. Salness just said crystals transfer energy by having the energy transferred. She prefers bottles that are embedded with crystals, saying, “I think because the water gets infused with the crystal energy and then you’re drinking that, it comes into our system.” I won’t drink to that.

Next, she said, “I think if you believe it will have some effect to it, then it will. I’ve seen the results in my life and others.” But no amount of belief makes anything true and she is also falling prey to subjective validation and preferring anecdotes over data, which is rife in the alternative medicine community. For instance, another crystal merchant, Colleen McCann, told GMA, “I had to experience a whole bunch of really mystical things to get on board with this.”

But a whole bunch of things does not equal one piece of data. Perceptions are prone to error, people experience good, bad, and indifferent days, and most illnesses fluctuate. Because of this, double blind studies are required to find out what is effective. Without any guidelines, certification, standards, or reliable data, there’s no way to determine what crystal would work for what malady, or whether they work at all.

McCann, who is releasing a book this fall entitled Crystal Rx, described herself as skeptic who fought the notion of healing crystals “tooth and nail.” In that case, she would have been better off buying dentures and metal fasteners than quartz and jasmine.

 

 

 

 

 

 

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“Internal combustion” (Concentrated hydrogen peroxide)

CORPSETEETH

Online, there are tantalizing testimonials and awesome anecdotes about concentrated hydrogen peroxide’s amazing ability to slay a number of serious conditions. These include Lyme disease, cancer, heart ailments, brain tumors, diabetes, HIV, and Parkinson’s. This long string of anonymous praise does not have a corresponding lengthy list of studies cited by PubMed, which ascribes no power to the fizzy concoction’s efficiency, outside of an ability to whiten teeth.

In fact, when ingested in enough quantity and at a high enough concentration, hydrogen peroxide results in mucosal burns, ER trips, permanent disabilities, and even death. In an article for Undark, Karen Savage interviewed Dr. Brendan Byrne, who has seen patients who overdosed on hydrogen peroxide, necessitating that he give them hyperbaric oxygen treatment. This is normally reserved for scuba divers who surface too fast. Not that any concentration should be considered safe for consumption, he warned.

“Hydrogen peroxide at any concentration, if drank, reacts with a natural enzyme in the body and produces very high volumes of oxygen,” Byrne said. “That oxygen has to go somewhere. It crosses the membrane of the gastrointestinal tract into the blood vessels and those resultant bubbles block up the blood vessels, leading to heart attacks, strokes, and other complications.”

At concentrations under 10 percent, hydrogen peroxide is used to disinfect scrapes and as a cleaning solution. Higher concentrations are employed in wastewater treatment and sometimes in swimming pools. Extremely high concentrations can be used as rocket fuel. Often, Food Babe will issue an alarm about a certain food ingredient also being used is something like, well, rocket fuel. She ignores or is ignorant of the fact that what a substance is mixed with will change its properties. But in the case of gulping hydrogen peroxide at a high enough concentration, the person IS downing a rocket fuel, yet Food Babe is silent on this since it’s an alternative medicine treatment. Hydrogen peroxide in drink form has another element that alt-med proponents normally eschew, as it is an oxidant.

Our bodies produce hydrogen peroxide and this promotes health, but Scott Gavura at Science-Based Medicine wrote that ingesting it for still more benefit is futile:  “Consuming or injecting peroxide and hoping for some sort of medicinal effect is the medical equivalent to spraying gasoline all over your car’s engine and interior and then wondering why it doesn’t make the car run better. Like gasoline in an engine, you need the right substance in the right place at the right time and under the right conditions in order to have a useful effect.”

Not all proponents favor drinking it; some think it should be sent straight into the veins. Advocates of this approach mistakenly believe that a lack of oxygen in the tissues allows toxins, viruses, and bacteria to accumulate, and that the release of oxygen from intravenously administering hydrogen peroxide is beneficial.

While they are wrong about the lack of oxygen having the specific deleterious effects they mention, Dr. Saul Green at Quackwatch explained that shooting up  hydrogen peroxide wouldn’t help even if they were right. He wrote, “When arterial blood leaves the lungs it is 98 percent saturated with oxygen and so it becomes impossible for the intravenous infusion of hydrogen peroxide to further increase the amount of oxygen carried to the tissues.”

Misuse of this product is partially associated with the notion that humans need to regularly cleanse and purify ourselves. This mindset acts as a secular version of exorcising demons and atoning for our sins. But as noted, internal use at high concentrations can kill you, although you will be laid to rest with immaculate teeth.

 

“What’s up with that, Doc?” (Vitamin D intake)

DPIC

My physician is pure mainstream: Recommending all the age-appropriate tests and an annual checkup; being solidly pro-vaccine and pro-antibiotics; well-versed in Germ Theory and even sporting the white coat and ever-present stethoscope, plus placing lollipops at the check-in desk.

So when he recommended a vitamin D supplement for me during winter and told me he popped the same pills, I headed from his office to the pharmacy. To get to those supplements, I passed the bandages, antiseptic, and pain medication I would normally purchase and ended up in the aisle of herbs, homeopathic tablets, flaxseed oil, and all manner of lotions and potions intended to complete the alt-med trifecta of detoxing, immune boosting, and increasing circulation. There was even something called soothing bath tea. I prefer that beverage for drinking, not dousing, so I passed on it, but did pick up the vitamin D tablets. It felt funny grabbing something from that section of the store, but my trusted doctor recommended it so I didn’t much question doing so.

Later, I learned my wife’s doctor, who coincidentally is married to my physician, had made the same suggestion to her. Hence, we both made the purchase and our previously supplement-free medicine cabinet was now overloaded with vitamin D goodies.

But according to a pair of New York Times articles, this was likely all for naught. Both sales of vitamin D supplements and testing for vitamin D deficiency have increased exponentially in the last two decades. According to the Times’ Liz Szabo, sales have shot up nine-fold since 2010, meaning it has nonupled if there’s such a word. Meanwhile, lab tests for vitamin D deficiency have seen a 547 percent increase since 2007 and the number of blood tests for vitamin D levels among seniors increased a staggering 8,300 percent from 2000 to 2010.

These Everest-like ascents stem from the embrace and promotion of vitamin D intake by Dr. Michael Holick, a Boston University endocrinologist. He has had authored books which extol increased intake and has sounded the alarm about a “vitamin D deficiency pandemic.”

Most prominent among his treatises was a 2011 paper in the peer-reviewed publication, Journal of Clinical Endocrinology & Metabolism. This was done at the behest of the Endocrine Society, whose guidelines are followed by hospitals, physicians, and laboratories. The authors’ conclusions were that “vitamin D deficiency is very common in all age groups,” and that there should be a large increase in vitamin D testing. Further, it recommended a 50 percent increase in daily vitamin D ingestion, which put 80 percent of the population out of compliance.

These exhortations led to an endorsement of D supplements from an anomalous mix of mainstream and alternative practitioners, from our family’s husband-wife physician team down to Dr. Oz and Goop.

But a Kaiser Health News investigation for The New York Times found that Holick uses his prominent position to promote these practices that benefit pharmaceutical companies, indoor tanning salons, and testing labs. In return, he has received hundreds of thousands of dollars from these industries. While acknowledging this, Horlick insists it doesn’t influence his interpretation of the evidence and said his money from these groups is the same whether vitamin D supplement sales are zero or a zillion.

In my time blogging, I have seen that talk of “Follow the money,” “He’s a shill,” and “Drug companies funnel money to doctors if you recommend their product” are ad hominem and red herrings that deflect from the issue of whether a product or treatment is beneficial, neutral, or harmful. Such lines are normally directed at the likes of Kevin Folta, Y’vette d’Entremon, and Kavin Senapathy, and launched  by alt-med proponents and conspiracy theorists.

But could it all be true in this case? Very possibly, but the central point remains the same. Whether Holick is getting money from these industries (which he admits), we still have to look at whether his claims are valid.

To be sure, vitamin D is crucial to good health. It is necessary for strong bones and deficiencies in it can result in rickets and osteomalacias. Another important point is that human bodies produce very little of it on their own. Further, it is available in only a tiny number of foods, such as oily fish. That leaves sunlight as one of the few natural sources for vitamin D, and exposure to this brings a host of issues, plus those in cold-weather climates get little of it in the winter.

This could seem to add up to solid supplement soundbite. However, vitamin D is available through foods fortified with it, such as milk, orange juice, and yogurt. Now to the central point of are humans getting enough vitamin D? At what level is a body deficient?

The year before the Endocrinology & Metabolism journal article, the National Academy of Medicine concluded that the vast majority of Americans get plenty of vitamin D naturally, and suggested doctors only test only patients at high risk of certain disorders. If Holick was right in about 80 percent of persons having a D deficit, there should have been a steady stream of brittle bones, rickets, and osteomalacias cases.

That this was not happening indicates most of us were getting enough of the vitamin through sunlight and fortified breakfast drinks. Indeed, an Institute of Medicine report concluded that very few people were deficient. The report stated that a sufficient amount would be 20 nanograms per milliliter. The increase to 30 nanograms per milliliter championed by Horlick would leave most of us wanting for vitamin D if that were a legitimate standard, but the report found no benefit to this additional amount. The study by the National Academy of Medicine reached the same conclusion.

As to the testing for vitamin D levels, Excellus BlueCross BlueShield published an analysis which found that 40 percent of its patients tested for D levels had no medical reason to be screened.

The Endocrine Society’s seemingly faulty conclusions manufactured the appearance of an epidemic since it decreed four persons in five had insufficient amounts of a key nutrient. And since it appeared in a respected publication and was associated with an esteemed doctor, many persons who would have otherwise dismissed the notion embraced it. This perhaps included my physician, which led to my flummoxed flaxseed frolic.

Repeat this recommendation and extraneous lab tests a few million times over and one gets the drastic increase in sales and testing. It also means there are hordes of healthy people popping a superfluous supplement tablet. One per day would be OK, though likely not beneficial, but going over that can lead to health issues. Hey, maybe that’s it! Maybe the recommendations are being made to get people sick from an overdose and give the doctors more sick patients and more money!

On a serious note, this does highlight the irony of the situation. Alt-med proponents and conspiracy theorists routinely allege that labs gain from unnecessary testing and that drug companies profit from unnecessary products, and that it’s all directed by persons with conflicts of interest who sit on the payroll of the benefited entities. The one time this seems to be happening, these groups embrace it.

“Take a pill chill” (Vitamins)

vitburger

There are lots of vitamins out there, in multiple forms. But in one survey, just three percent of respondents reporting using them for what would presumably be their intended use: Addressing suspected dietary deficiencies.

Whatever the other 97 percent are hoping to get out of it, there is scant evidence to suggest consumption of vitamins and mineral supplements will have substantial positive health effects. Timothy Caulfield, a health law and policy chair at the University of Alberta, cited a systemic review this year which concluded that proof “for the benefit of any supplement across all dietary backgrounds was not demonstrated.”

The American Heart Association advises against taking antioxidant vitamin supplements, as no research suggests these can reduce blood pressure, lower cholesterol, or have any similar benefit. To the contrary, excess consumption can cause harm. One study showed that 20 percent liver toxicity incidents are caused by supplements. Another paper attributed 23,000 ER visits a year to adverse reactions to these potions.  

Part of the reason may be lack of regulatory oversight. One study showed that two-thirds of herbal products contained ingredients different from what was on the label.

For those taking them, there are various ways to get vitamins and minerals to their innards: Traditional tablets, liquids, sprays, mists, patches, injections, and even vitamin-infused e-cigarettes and beer for those ambiguous about getting healthy.

But barring a clinically-identified deficiency, there is little reason to consume any of these. Some of them would make sense for those needing a specific benefit, such as women who require extra folic acid during pregnancy. Or, once the baby is born, formula fortified with iron would be advisable for infants low on this vital element.

While vitamins and minerals are necessary to good health, the AHA states that the best way to ingest them is via a balanced diet. On the AHA website, nutrition professor Penny Kris-Etherton writes this is because foods provide bioactive compounds and dietary fiber unavailable in supplements. That, plus some supplements inhibit the full absorption of vitamins. 

While diet is the key to getting the right amount of vitamins and minerals, not all bodies process food equally. So if a healthy, balanced diet leaves one still deficient in the potassium department, a supplement of this mineral to aid in heart and kidney health would be logical. Another example: Per the AHA, heart disease patients should consume a daily gram of omega-3 fatty acids. Fish would help with this, but it can still be hard to get this acid through diet alone, so an omega-3 supplement would be beneficial.

The key is that these are called supplements, not replacements or the end-all, and they are specific augmentations treating identified conditions.

A good diet is one that is balanced, nutritious, and which limits calories, sweets, saturated fat, trans fat, sodium, and cholesterol. Do all that and there’s not much need to pop a Fred Flintstone.

“Feat of clay” (Ionithermie)

CLAY

There are many forms of alternative medicine, most of them cheaper than ionithermie, since it is primarily available on ocean cruise liners. Wherever one receives the treatment, it is touted as a means of removing cellulite, toning skin, and slimming waistlines.

In these sessions, customers are wrapped in a mix of herbs and seaweed before having a dry brush applied to their skin. Next they shower, then lay on a pad covered with algae-infused clay. The skin to be treated is then covered with this clay, which acts as conductor when a current is applied to it.

Jeff Wagg of Skeptoid queried an ionithermie practitioner about the cellulite claims. She wrote that through galvanism, which is the contracting of muscles being stimulated by an electrical current, clay will be forced into the body. There, the clay makes a beeline for cellulite and commences to zapping it. In truth, the dermis keeps most foreign substances out of the body. Any clay will almost certainly stay on the outside. Further, misusing a genuine scientific word, in this case galvanism, is a typical ploy in alt-med circles.

As for slimming, if you wrap any part of your body tight enough that it sweats for a prolonged period, that particular part will shrink, but revert to its normal size the next day.

Wagg found another practitioner who wrote that ionithermie will “detoxify the body at the cellular level. Over one million treatments are performed annually worldwide and it is offered on more than 100 cruise liners around the world.”

That last sentence is the ad populum fallacy. Perhaps that many customers are receiving the treatment, but what are they getting out of it? And the only detoxing taking place is what the liver and kidneys are doing and this applies whether or not one is enveloped in fine-grain earthy material while floating toward Bora Bora.

The practitioner further proclaimed that, “Just one session and your favorite dress fits perfectly again,” and that the product is “100 percent chemical-free and enriched by the healing powers of natural amber and silver that can make your skin look delicious!”

Thinking it is chemical-free reveals scientific ignorance and the references to amber and silver represent the naturalist fallacy. Anything you put into your body or on your skin is going to contain chemicals, regardless of how natural, organic, silky, or sweet-smelling it is. Often times, the claims of being natural are false since mankind has improved the product in the field or in a laboratory. More importantly, nature merely means occurring in nature and this distinction has no bearing on safety. On a positive note for the practitioners, the “delicious-looking skin” imagery may help them with the cannibal demographic.

 

  

“Lotion notion” (Sunscreen dangers)

sunny

I have my parenting flaws. For instance, a lack of patriarchal oversight and an overreliance on Velcro sneakers means my children are usually about 8 years old before they can tie their shoes. But none of them have ever been sunburned. We carry sunscreen in our minivan so that we can never forget it and in case we launch an impromptu outdoor adventure. As unpleasant as sunburns are, excess exposure to ultraviolet radiation can also lead to prematurely aging skin and cancer.

However, some reports, most notably one from the Environmental Working Group,  warn that the sunscreens we use for protection may actually be doing harm. Most of the worry centers on the chemical oxybenzone. This mouthful of an ingredient serves as an ultraviolet filter which absorbs the sun’s rays so our skin doesn’t have to.

The challenge in determining a chemical’s dangers or lack thereof was addressed by Popular Science. (Incidentally, it doesn’t matter if science is popular, what matters is if it’s right). The article noted that cyanide will cause an exposed person to expire within 10 minutes, while asbestos could take years to unleash its fatal effects. From the story: “The gap between exposure and the emergence of disease is called latency and it’s just one of many issues that make it tough to determine a chemical’s safety.”

Adding to the challenge is that exposure to a certain chemical doesn’t take place in isolation. Popular Science envisioned an asbestos-removing chain smoker who develops lung cancer. Did the disease result from his habit, his employment, both, or neither? His exposure to toxins at his work and in his cigarette made the man’s risk higher, but did not guarantee cancer any more than a regimen of vitamins, minerals, vegetables, and cross training will ensure freedom from the disease. So trying to figure out the roles that exposure plays requires repeated research.

Dosage also matters. In one study, young rats ingested large amounts of oxybenzone and developed large uteruses (all test subjects were female, otherwise this would have been quite a result). This occurence suggested the lab rats experienced hormonal effects, which in humans can increase cancer risk. However, these findings are not without limitations. The dose was extremely high, no people are rats, and humans don’t consume vast quantities of sunscreen, though my 3-year-old son has tried. J.R. Thorpe at bustle.com noted that scientists have determined that persons would need to pile on inches-deep levels of oxybenzone over their entire body for 36 years to have an exposure equivalent to what was forced on the rodents.

Another study on human cells found that oxybenzone can mimic estrogen and block testosterone, especially in breast cells. Buy this result again comes with a caveat. Cellular studies are often a poor indicator of what will happens inside a person. The body may have mechanisms that counteract the goings-on inside a petri dish.  

There are other worries about a second sunscreen ingredient, retinal palmitate. These concerns stem from a study which shows that, when exposed to UV light, the chemical can produce free radicals, which are tied to cancer development. However, the Skin Cancer Foundation points out this study was also done on lab rats, not human skin. Further, it was never published and thus not peer-reviewed or replicated, and antioxidants inherent in people can tame the effects of free radicals.

Other studies have linked regular sunscreen use to melanoma, but this may be a result of inefficient use, specifically not applying the lotion often enough throughout the day. 

The American Academy of Dermatology recommends everyone wear a water-resistant, broad-spectrum, SPF 30 minimum sunscreen. This is especially vital for children since early sunburns increase the likelihood of skin cancer later in life. No published studies conclusively show that sunscreen is deleterious to human health. To the contrary, research indicates that wearing sunscreen reduces the risk of risk of skin cancer and prematurely aging skin. There is insufficient research to declare oxybenzone unquestionably safe, but if having such concerns, putting on long-sleeve shirts, full-length pants, and the millinery wear of your choice is better than trying an unproven sunscreen alternative.

I especially discourage eschewing sunscreen for coconut oil, a technique touted by alt-med types. Wellness Mama offers precisely this tip in her post, “How to make natural homemade sunscreen,” an oxymoronic suggestion since if you have to make it, it’s not natural. More importantly, the Mayo Clinic states that coconut oil blocks a negligible 20 percent of UV rays and it has an SPF of 7, less than a quarter of the minimum recommendation. The only way to safely use this product is indoors.

 

  

“The chemical druthers” (Multiple Chemical Sensitivity)


SCARY

Over the last year, I have experienced more frequent instances of muscle pain. Over the same time, my wife has had more headaches and my son has battled eczema. While the first two maladies could be seen as regular signs of aging and the third an understood medical condition, some persons would consider all of us to be victims of Multiple Chemical Sensitivity. It may even be to blame for my cats shedding so much fur.   

Multiple Chemical Sensitivity purportedly results from modern developments, be they positive ones like treated water, negative one like air pollution, or neutral ones like synthetic clothing. Other possible culprits include cleaning products, paints, perfumes, tobacco smoke, tar, construction materials, gas stoves, pesticides, news print, and felt-tip markers. However, as there is no identifiable organic basis for this sensitivity, it so far has been impossible to test for, diagnose, treat, or even confirm the existence of.

Allergist Theron Randolph first championed the idea of Multiple Chemical Sensitivity, and he posited that it developed from humans’ inability to evolve a defense to synthetic chemicals. Were this true, however, nearly everyone would be suffering from it.

For those who do think it’s afflicting them, the anguish is real. The reactions range from mild annoyances to crushing disabilities. A highly-truncated list of symptoms would include fatigue, memory loss, muscle and joint aches, shortness of breath, asthma, skin conditions, seizures, blurred vision, sleep disruption, nausea, vertigo and dry mouth. More extensive lists created by those who purport to treat the condition will run for several dozen items. This is a strong indication that, rather than being a diagnosable medical condition, MCS is a catch-all phrase that can be considered the source of any discomfort. Even when a condition doesn’t have a known cause, as is the usually the case with Alzheimer’s or ALS, the conditions and treatment are generally the same for each patient. No one is going to consider a lingering cough to be an Alzheimer’s sign, nor will auditory hallucinations be interpreted as a consequence of ALS.

Further, treatment and end-of-life care for those with these diseases is going to be largely similar, though it will vary some by patient. By contrast, the treatment for MCS will vary by practitioner. Since there is no way to identify MCS or understand what causes it, there could be as many treatment plans as there are planners. As such, the recommendation can be as simple as eating more vegetables, as moderate as emptying the home of perfumes, sprays, and oils, or as extreme as fumigating one’s house and staying indoors with a filtered charcoal mask. Other suggested remedies are colon flushes, dietary supplements, dental amalgam removal, saline nasal rinses, and just about any other whim that hits the provider.

For those preferring a more evidenced-based approach, there have been controlled studies to try and determine a chemical basis for the symptoms associated with MCS. Through such trials, researchers learned that persons diagnosed with MCS were as likely to react to placebos as to the actual chemical. MCS is reported to occur at doses so low they are imperceptible to the senses. But when exposed to these negligible amounts in studies, subjects experienced no triggering of symptoms, nor a change in their vital signs.

Contrast this to amateur diagnoses of MCS, in which almost anything in the immediate environment can qualify as a trigger, and what it can trigger can likewise be voluminous. MCS has no consistent characteristics, uniform cause, or measurable feature. 

Dr. Stephen Barrett at Quackwatch, while careful to emphasize that the patients are genuinely suffering, thinks signs point to the afflicted experiencing “a psychosomatic disorder in which they develop multiple symptoms in response to stress. Many of these patients suffer from somatization disorder, an emotional problem characterized by persistent symptoms that cannot be fully explained by any known medical condition, yet are severe enough to require medical treatment or cause alterations in lifestyle. Some are paranoids who are prone to believe that their problems have outside causes. Others suffer from depression, panic disorder, agoraphobia, or other anxiety states that induce bodily reactions to stress.”

As such, those convinced they are suffering from MCS are highly susceptible to post hoc reasoning, subjective validation, and self-diagnosis. They should seek care from the likes of Barrett, who will compassionately lead them through what they need to hear, as opposed to riding on a perpetual carousel of a regimen that involves removing bodily fluids and gas stoves, overloading on vitamins, yoga, and intravenous infusions, avoiding pesticides, carpets, and gasoline, and opening windows while paradoxically avoiding the ubiquitous polluted air.