Air Pollution

by Robert L, Jan 4, 2022

Air pollution is something few of us think about, especially if we don’t live in an industrial zone.  But my first, slow remission from cervical dystonia started one month after the COVID-19 shutdown, which reduced nearby freeway pollution to negligible levels, and shut down the train which runs behind my house.  Two months after restart, my cervical dystonia slowly came back, but only around 80% as bad as previously.  I’ll attribute the “not as bad as previously” due to other changes I had made, especially raising my serum vitamin D levels to what was recommended by my NDs.

I was heartbroken by my relapse, but it taught me something big.  I needed to get away from air pollution, especially since I lived next to train tracks, industry, and heavy traffic.  My family temporarily moved away from our home to a cleaner area.  Within 3 weeks I could walk without involuntary movement of my head.  The neck muscle that was originally tight stayed pretty tight and painful for the next few weeks, but then gradually loosened over the next 3 months or so.  I started taking more and longer walks during this period, which probably increased my vitamin D levels even higher.  My sense of balance also slowly improved.

Due to my improvement, we extended our time away and only came back home after 9 months.  At home, the trains run and the traffic pollution has returned to pre-COVID-19 levels. But after a year of living at home, I am still able to move my neck, and can sit up all day with little pain.  We have many HEPA air filters running in the house, shut the windows before the train gets here, and I never dig or play in the soils around our house.  Also, we monitor the air quality and I never go out when the air pollution in the area is bad.

Who knew that reducing air pollution exposure could be one of the “natural cures” for neck spasms and pain??  But recent scientific research shows that exposure to certain types of air pollution can drive neurologic and almost all systemic disease:

  • It is estimated that 8 million people worldwide died in 2018 from fossil fuel (coal, gasoline, oil burning) PM2.5 (small particulate) pollution.  This accounts for around 1 out of 5 deaths worldwide, generally from systemic disease [1].
  • In another study, for each 5 microgram per cubic meter of air (μg/m³) increase in annual PM2.5 concentrations, there was a 13% increased risk for first-time hospital admissions both for Parkinson’s disease and for Alzheimer’s disease and related dementias [5].
    • To put this 5 μg/m³ number in context, the PM2.5 concentration in my area is currently 43 μg/m³, likely mostly from trapped traffic pollution.  In the US EPA standard, this level of PM2.5 gives an AQI (Air Quality Index) of 120, color coded orange, or “Unhealthy for Sensitive Groups”.  There is no detectable smell or visual indication of this pollution, but the EPA has sensors nearby.  At this level, I choose not go outside without an N95 mask. 
    • In some countries, such as India [10], 43 μg/m³ still falls into the “Satisfactory” range, so if you have signs of neurologic disease, you have to understand the scaling standards for your conutry, and decide on how much risk you’re willing to take based on scientific research.
    • Residents of Mexico City, which is one of the most polluted metropolitan areas in the world, showed evidence of dangerous levels of neuroinflammation, and early accumulation of alpha-synuclein (a PD precursor) [2].
  • Evidence of early PD pathology in the olfactory bulb of PD patients, which may precede brain pathology, suggests a potential role of inhaled toxins as a risk factor for PD (and dystonia) [2].  This could be why hyposmia (reduced sense of smell) often precedes Parkinson’s disease, cervical dystonia, and Alzheimer’s disease by years.
  • In New York City, seven railroad workers developed PD at a relatively young age, likely linked to exposure to metal dusts, paraquat (a herbicide), and other toxic exposures [3].  In particular, the metals iron and manganese have been linked to PD, Parkinsonism, and dystonias, depending on exposure levels.  Paraquat, an herbicide, is also a risk factor for PD, but is highly genetics dependent [4].
  • In some studies, airborne manganese in the less than 0.2 μg/m³ range (from heavy traffic pollution) is associated with Parkinson’s disease risk [8].  This is not a consistent finding across studies, and I believe the reason why is that only a very small percentage of people cannot detox small amounts of manganese, which I’ll explain in the science section.  Note that manganese is present in wildfire, traffic, train tracks, and especially metalworking, welding, and battery manufacturing air pollution.

According to my research, most people can stay apparently healthy even if they have been exposed to high levels of pollution.  The main risk for neurodegenerative disease occurs when our natural detoxification systems are not operating quickly enough to remove certain toxins. For example, when metals such as manganese, iron, lead, and mercury build up, they can cause excessive reactive oxygen species (ROS) generation. The resulting chain of chemical reactions are collectively termed oxidative stress, which is a big driver of neurodegenerative disease, partially due to the high oxygen consumption in the brain [6]. 

Therefore reducing pollution-induced oxidative stress is important if we want to maximize our chances of achieving remission.   We can either improve our detox rate, or breathe toxins in more slowly.  I did both to achieve my remission.

Perhaps a reasonable question is, “Can reducing my air pollution exposure after I have developed cervical dystonia or Parkinson’s disease symptoms really help me?”  The answer, found from my nearly two years of research, is a definitive yes!  But we have to work at it, and start as early as possible.  As an example of what we can achieve: In a study on rats, exposure to manganese reduced tyrosine hydroxylase positive (dopamine-expressing) neurons in the substantia nigra and decreased the level of Park2 mRNA (Park2 is necessary to avoid PD).  After removal of exposure and 5 months of recovery, blood and brain Mn returned to normal, the reduction of tyrosine hydroxylase positive dopaminergic neurons ameliorated, and the level of Park2 mRNA returned to normal [9]. 

Note that these were otherwise healthy rats, without unusual genetics, years of toxin exposure, vitamin D deficiency, poor diets, poor sleep, or dysbiosis.  In contrast, my research shows that roughly 1-2% of adults exposed to airborne manganese do not return to normal manganese blood levels for potentially years after exposure.  This causes risk of dopamine and dopaminergic neuron damage, among other things.  In the science section, I will summarize some research findings that show there’s hope for detoxification in those people, just like there was for me.

The Science of Air Pollution Detoxification

Metal Air Pollution

Manganese: There have been a number of studies on the effects of airborne manganese, a metal, on dystonias and Parkinsonian disorders.  Manganese, unlike lead or mercury, has an important purpose in the body.  However, in excess, free manganese atoms act much like heavy metals.  Therefore the body has tight homeostasis (control) mechanism for manganese levels in the blood, body, and brain.

Manganese is present in varying proportions in almost all air pollution. When inhaled, manganese can travel directly to the basal ganglia region of the brain via the olfactory nerve, or deposit in the lungs to be absorbed into the bloodstream.  These inhaled routes bypass virtually all of the body’s normal homeostasis mechanisms.  Therefore, this route is considered roughly 50 times more toxic than eating the same amount of manganese.   

In the basal ganglia, the excess manganese can cause unintended release of dopamine from storage (high dopamine levels), and then oxidize the dopamine.  High dopamine levels, along with oxidation destruction, if at high enough levels, can contribute to dystonias and Parkinsonism. Over many years, the long-term oxidation of dopamine into o-quinones can contribute to a cascade of effects and Parkinson’s Disease [11].  In research, excess manganese is also often related to tics, sleep disturbance, memory loss, anxiety, and hyposmia – many things that we consider part of the Parkinson’s disease prodrome.

Other Essential Metals: Other airborne essential metals, such as iron and copper, can participate in neurologic disease.  However, in my research, manganese is still usually the most problematic for a few reasons.  For example, iron consumption in the body is much higher than manganese so it appears to have more homeostasis mechanisms.  Also, iron is often tested as part of health checkups and routine testing, where manganese is not. 

Lead and Mercury:  Airborne “heavy metals” such as lead and mercury from industrial pollution are much harder to detoxify.  The body has no mechanisms to do so except put them slowly into hair, nails, feces, and urine.  But the process is so slow that it is really important to reduce as much heavy metal exposure as possible.  European residents are lucky because the European Union has moved to reduce heavy metals and other toxins from manufacturing processes since 2003, starting with ROHS legislation [12]. 

Gasoline: Up until 1994, lead was used as a cheap “anti-knock” additive to gasoline worldwide.  After 1994, it was replaced with a “safer” alternative… manganese!  Unfortunately, metals cannot be broken down by clean combustion; the designation “Ultra-Low Emissions” vehicle is meaningless to manganese emissions.  Manganese emissions are instead directly related to amount of fuel consumed, so living near a freeway or heavy traffic will cause higher manganese levels in some people.  This can translate to increased aggression in children.  Luckily, many countries have recognized the airborne manganese toxicity issue, and restricted MMT usage in gasoline [13].  Note that it’s difficult to keep track of actual regulations around the world so you may want to search where you live.

Detoxification Rate

Historically, 1-2% of unprotected manganese miners would get Parkinsonism and disabling dystonias of their most-used muscles (legs and arms), while others appeared to be relatively unaffected except for some tics or small fine motor deficiencies.  So it’s important to understand how some people can detoxify manganese much quicker than others.

The chart below comes from the study of adult workers (Control) vs. office workers in a manganese smelter business (Low) vs. manganese smelter furnace workers (High) [7].  The geometric mean of Mn dust exposure for the control, low- and high- exposure groups was 3 μg/m3, 30 μg/m3, and 180 μg/m3

Each red dot indicates the 

Treatment Options


Additional Links

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2. Palacios, Natalia. “Air pollution and Parkinson’s disease – evidence and future directions” Reviews on Environmental Health, vol. 32, no. 4, 2017, pp. 303-313.


4. Tran, J., Anastacio, H. & Bardy, C. Genetic predispositions of Parkinson’s disease revealed in patient-derived brain cells. npj Parkinsons Dis. 6, 8 (2020).

5. Significant link found between air pollution and neurological disorders,

6. Liguori I, Russo G, Curcio F, et al. Oxidative stress, aging, and diseases. Clin Interv Aging. 2018;13:757-772. Published 2018 Apr 26. doi:10.2147/CIA.S158513

7. Cowan DM, Fan Q, Zou Y, et al. Manganese exposure among smelting workers: blood manganese-iron ratio as a novel tool for manganese exposure assessment. Biomarkers. 2009;14(1):3-16. doi:10.1080/13547500902730672

8. Finkelstein MM, Jerrett M. A study of the relationships between Parkinson’s disease and markers of traffic-derived and environmental manganese air pollution in two Canadian cities. Environ Res. 2007 Jul;104(3):420-32. doi: 10.1016/j.envres.2007.03.002. Epub 2007 Apr 18. PMID: 17445792.

9. Cao YM, Fan XM, Xu J, Liu J, Fan QY. Manganese Intoxication Recovery and the Expression Changes of Park2/Parkin in Rats. Neurochem Res. 2021 Nov 28. doi: 10.1007/s11064-021-03493-w. Epub ahead of print. PMID: 34839452.


11. Segura-Aguilar J, Paris I, Muñoz P, Ferrari E, Zecca L, Zucca FA. Protective and toxic roles of dopamine in Parkinson’s disease. J Neurochem. 2014 Jun;129(6):898-915. doi: 10.1111/jnc.12686. Epub 2014 Mar 18. PMID: 24548101.



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