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Potential Cardiovascular and Total Mortality Benefits of Air Pollution Control in Urban China.

ABSTRACT: BACKGROUND:Outdoor air pollution ranks fourth among preventable causes of China's burden of disease. We hypothesized that the magnitude of health gains from air quality improvement in urban China could compare with achieving recommended blood pressure or smoking control goals. METHODS:The Cardiovascular Disease Policy Model-China projected coronary heart disease, stroke, and all-cause deaths in urban Chinese adults 35 to 84 years of age from 2017 to 2030 if recent air quality (particulate matter with aerodynamic diameter ?2.5 µm, PM2.5) and traditional cardiovascular risk factor trends continue. We projected life-years gained if urban China were to reach 1 of 3 air quality goals: Beijing Olympic Games level (mean PM2.5, 55 ?g/m3), China Class II standard (35 ?g/m3), or World Health Organization standard (10 ?g/m3). We compared projected air pollution reduction control benefits with potential benefits of reaching World Health Organization hypertension and tobacco control goals. RESULTS:Mean PM2.5 reduction to Beijing Olympic levels by 2030 would gain ?241,000 (95% uncertainty interval, 189?000-293?000) life-years annually. Achieving either the China Class II or World Health Organization PM2.5 standard would yield greater health benefits (992?000 [95% uncertainty interval, 790?000-1?180?000] or 1?827?000 [95% uncertainty interval, 1?481?00-2?129?000] annual life-years gained, respectively) than World Health Organization-recommended goals of 25% improvement in systolic hypertension control and 30% reduction in smoking combined (928?000 [95% uncertainty interval, 830?000-1?033?000] life-years). CONCLUSIONS:Air quality improvement in different scenarios could lead to graded health benefits ranging from 241?000 life-years gained to much greater benefits equal to or greater than the combined benefits of 25% improvement in systolic hypertension control and 30% smoking reduction.

SUBMITTER: Huang C

PROVIDER: S-EPMC5665369 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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Potential Cardiovascular and Total Mortality Benefits of Air Pollution Control in Urban China.

Huang Chen C Moran Andrew E AE Coxson Pamela G PG Yang Xueli X Liu Fangchao F Cao Jie J Chen Kai K Wang Miao M He Jiang J Goldman Lee L Zhao Dong D Kinney Patrick L PL Gu Dongfeng D

Circulation 20170907 17

<h4>Background</h4>Outdoor air pollution ranks fourth among preventable causes of China's burden of disease. We hypothesized that the magnitude of health gains from air quality improvement in urban China could compare with achieving recommended blood pressure or smoking control goals.<h4>Methods</h4>The Cardiovascular Disease Policy Model-China projected coronary heart disease, stroke, and all-cause deaths in urban Chinese adults 35 to 84 years of age from 2017 to 2030 if recent air quality (par ...[more]

PMID: 28882886

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Project description:Zinc (Zn) is a major elemental component of respirable ambient particulate matter (PM) detected often at alarming levels in urban air. Exposure to PM has been widely associated with increased cardiovascular morbidity and mortality, however, it is not known what components or sources of PM are causative. We recently demonstrated that long-term episodic inhalation of combustion PM, having similar amount of Zn found in urban PM, caused myocardial lesions in rats. We further demonstrated that a single pulmonary exposure to Zn at high concentration is associated with disturbances in cardiac mitochondrial function, ion channel regulation, calcium homeostasis, and cell signaling. Therefore, in this study we investigated the role of PM-associated Zn in cardiac injury using multiple exposure scenarios. Male Wistar-Kyoto (WKY) rats of 12-14 wks age were intratracheally exposed (once per wk x 8 or16 wks) to either (1) saline (control); (2) PM having no soluble Zn; (3) combustion PM suspension containing 14.5 ug/mg water-soluble Zn at high and (4) low dose levels, (5) the aqueous fraction of this suspension devoid of solid insoluble particulate fraction (14.5 ug/mg soluble Zn), or (6) Zn sulfate. Zn concentrations were identical in groups 3, 5 and 6. Pulmonary toxicity was apparent in all exposure groups when compared to saline as determined by recovery of cells in bronchoalveolar lavage fluid. Long-term exposure to PM with or without soluble Zn, or Zn sulfate caused distinct myocardial lesions characterized by subepicardial and randomly distributed myocardial inflammation, degeneration, and fibrosis. The lesion severity was higher in those groups receiving Zn PM. Because cardiac mitochondria are likely the primary target of inhaled metal or other absorbed PM components, we analyzed mitochondrial DNA damage using QPCR and found that all exposure groups except those exposed to PM without Zn caused variable degree of damage. Aconitase activity, sensitive to inhibition by oxidative stress was inhibited slightly but significantly in rats receiving zinc sulfate. Although modest, microarray (Affymetrix) analysis revealed expression changes in the heart reflective of effects on cell signaling, inflammation/oxidative stress, mitochondrial fatty acid metabolisms and cell cycle regulation in rats exposed to zinc sulfate. However, these changes were minimal following exposure to PM devoid of soluble metals. We demonstrate that episodic subchronic pulmonary exposure to zinc sulfate causes cardiac injury and mitochondrial DNA damage. Thus, water-soluble PM-associated zinc may be one of the PM components responsible for cardiovascular morbidity. Keywords: Pulmonary exposure, Cardiac gene expression

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Potential Cardiovascular and Total Mortality Benefits of Air Pollution Control in Urban China.

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Potential Cardiovascular and Total Mortality Benefits of Air Pollution Control in Urban China.

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