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Effects of particulate air pollution on cardiovascular health: a population health risk assessment.

ABSTRACT: Particulate matter (PM) air pollution is increasingly recognized as an important and modifiable risk factor for adverse health outcomes including cardiovascular disease (CVD). However, there are still gaps regarding large population risk assessment. Results from the nationwide Behavioral Risk Factor Surveillance System (BRFSS) were used along with air quality monitoring measurements to implement a systematic evaluation of PM-related CVD risks at the national and regional scales. CVD status and individual-level risk factors were collected from more than 500,000 BRFSS respondents across 2,231 contiguous U.S. counties for 2007 and 2009. Chronic exposures to PM pollutants were estimated with spatial modeling from measurement data. CVD outcomes attributable to PM pollutants were assessed by mixed-effects logistic regression and latent class regression (LCR), with adjustment for multicausality. There were positive associations between CVD and PM after accounting for competing risk factors: the multivariable-adjusted odds for the multiplicity of CVD outcomes increased by 1.32 (95% confidence interval: 1.23-1.43) and 1.15 (1.07-1.22) times per 10 µg/m(3) increase in PM(2.5) and PM(10) respectively in the LCR analyses. After controlling for spatial confounding, there were moderate estimated effects of PM exposure on multiple cardiovascular manifestations. These results suggest that chronic exposures to ambient particulates are important environmental risk factors for cardiovascular morbidity.

SUBMITTER: Feng J

PROVIDER: S-EPMC3303831 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Effects of particulate air pollution on cardiovascular health: a population health risk assessment.

Feng Jing J Yang Wei W

PloS one 20120314 3

Particulate matter (PM) air pollution is increasingly recognized as an important and modifiable risk factor for adverse health outcomes including cardiovascular disease (CVD). However, there are still gaps regarding large population risk assessment. Results from the nationwide Behavioral Risk Factor Surveillance System (BRFSS) were used along with air quality monitoring measurements to implement a systematic evaluation of PM-related CVD risks at the national and regional scales. CVD status and i ...[more]

PMID: 22432017

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Project description:BackgroundAir pollution exposure increases cardiovascular morbidity and mortality and is a major global public health concern.ObjectivesWe investigated the benefits of reducing personal exposure to urban air pollution in patients with coronary heart disease.MethodsIn an open randomized crossover trial, 98 patients with coronary heart disease walked on a predefined route in central Beijing, China, under different conditions: once while using a highly efficient face mask, and once while not using the mask. Symptoms, exercise, personal air pollution exposure, blood pressure, heart rate, and 12-lead electrocardiography were monitored throughout the 24-hr study period.ResultsAmbient air pollutants were dominated by fine and ultrafine particulate matter (PM) that was present at high levels [74 μg/m³ for PM(2.5) (PM with aerodynamic diamater <2.5 µm)]. Consistent with traffic-derived sources, this PM contained organic carbon and polycyclic aromatic hydrocarbons and was highly oxidizing, generating large amounts of free radicals. The face mask was well tolerated, and its use was associated with decreased self-reported symptoms and reduced maximal ST segment depression (-142 vs. -156 μV, p = 0.046) over the 24-hr period. When the face mask was used during the prescribed walk, mean arterial pressure was lower (93 ± 10 vs. 96 ± 10 mmHg, p = 0.025) and heart rate variability increased (high-frequency power: 54 vs. 40 msec², p = 0.005; high-frequency normalized power: 23.5 vs. 20.5 msec, p = 0.001; root mean square successive differences: 16.7 vs. 14.8 msec, p = 0.007). However, mask use did not appear to influence heart rate or energy expenditure.ConclusionsReducing personal exposure to air pollution using a highly efficient face mask appeared to reduce symptoms and improve a range of cardiovascular health measures in patients with coronary heart disease. Such interventions to reduce personal exposure to PM air pollution have the potential to reduce the incidence of cardiovascular events in this highly susceptible population.

Project description:BackgroundTo mitigate air pollution-related health risks and target interventions towards the populations bearing the greatest risks, the City Health Outlook (CHO) project aims to establish multi-scale, long-lasting, real-time urban environment and health monitoring networks. A major goal of CHO is to collect data of personal exposure to particulate air pollution through a full profile that consists of a matrix of activities and micro-environments. As the first paper of a series, this paper is targeted at illustrating the characteristics of the participants and examining the effects of different covariates on personal exposure at various air pollution exposure levels.MethodsIn the first campaign, volunteers are recruited to wear portable environmental sensors to record their real-time personal air pollution exposure and routes. After a web-based social media recruitment strategy, 50 eligible subjects joined the first campaign in Beijing from January 8 to January 20, 2018. The mean personal exposures were measured at 19.36, 37.65, and 43.45 μg/m3 for particulate matter (PM) with a diameter less than 1, 2.5, and 10 μm, respectively, albeit with the high spatial-temporal variations.ResultsUnequal distribution of exposures was observed in the subjects with different sociodemographic status, travel behavior, living and health conditions. Quantile regression analysis reveals that subjects who are younger, less educated, exposed to passive smoking, low to middle household income, overweight, without ventilation system at home or office, and do not possess private vehicles, are more susceptible to PM pollution. The differences, however, are generally insignificant at low exposure levels and become evident on bad air quality days.ConclusionsThe heterogeneity in personal exposure found in this the first CHO campaign highlighted the importance of studying the pollution exposure at the individual scale. It is at the critical stage to bridge the knowledge gap of environmental inequality in different populations, which can lead to great health implications.

Dataset Information

Effects of particulate air pollution on cardiovascular health: a population health risk assessment.

Publications

Effects of particulate air pollution on cardiovascular health: a population health risk assessment.

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