The long term effects of outdoor air pollution in urban environments on cardiovascular health: a global review (original) (raw)
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Journal of the American Heart Association, 2017
Studies have shown that long-term exposure to air pollution such as fine particulate matter (≤2.5 μm in aerodynamic diameter [PM]) increases the risk of all-cause and cardiovascular mortality. To date, however, there are limited data on the impact of air pollution on specific cardiovascular diseases. This study aimed to evaluate cardiovascular effects of long-term exposure to air pollution among residents of Seoul, Korea. Healthy participants with no previous history of cardiovascular disease were evaluated between 2007 and 2013. Exposure to air pollutants was estimated by linking the location of outdoor monitors to the ZIP code of each participant's residence. Crude and adjusted analyses were performed using Cox regression models to evaluate the risk for composite cardiovascular events including cardiovascular mortality, acute myocardial infarction, congestive heart failure, and stroke. A total of 136 094 participants were followed for a median of 7.0 years (900 845 person-year...
Air Pollution and Cardiovascular Disease
Circulation, 2004
Air pollution is a heterogeneous, complex mixture of gases, liquids, and particulate matter. Epidemiological studies have demonstrated a consistent increased risk for cardiovascular events in relation to both short- and long-term exposure to present-day concentrations of ambient particulate matter. Several plausible mechanistic pathways have been described, including enhanced coagulation/thrombosis, a propensity for arrhythmias, acute arterial vasoconstriction, systemic inflammatory responses, and the chronic promotion of atherosclerosis. The purpose of this statement is to provide healthcare professionals and regulatory agencies with a comprehensive review of the literature on air pollution and cardiovascular disease. In addition, the implications of these findings in relation to public health and regulatory policies are addressed. Practical recommendations for healthcare providers and their patients are outlined. In the final section, suggestions for future research are made to ad...
Ambient air pollution and cardiovascular diseases: From bench to bedside
European Journal of Preventive Cardiology, 2018
Air pollution has a great impact on health, representing one of the leading causes of death worldwide. Previous experimental and epidemiological studies suggested the role of pollutants as risk factors for cardiovascular diseases. For this reason, international guidelines included specific statements regarding the contribution of particulate matter exposure to increase the risk of these events. In this review, we summarise the main evidence concerning the mechanisms involved in the processes linking air pollutants to the development of cardiovascular diseases.
Short-term effects of air pollution on cardiovascular diseases: outcomes and mechanisms
Journal of Thrombosis and Haemostasis, 2007
The short-term effects of air pollution on cardiovascular mortality in elderly were investigated in Niš, during the 2001-2005. Daily measurements of black smoke (BS) and sulphur dioxide (SO 2), as well as the daily number of cardiovascular death among person ≥ 65 yrs of age, were collected. Generalized linear model extending Poisson regression was applied. The effects of time trend, seasonal variations, day of week, temperature, relative humidity and barometric pressure were analysed. The results did not support findings from previous studies that had shown an increase in the number of cardiovascular death in elderly in association with air pollution.
Short-term effects of particulate air pollution on cardiovascular diseases in eight European cities
2002
Study objective: As part of the APHEA project this study examined the association between airborne particles and hospital admissions for cardiac causes in eight European cities (Barcelona, Birmingham, London, Milan, the Netherlands, Paris, Rome, and Stockholm). All admissions were studied, as well as admissions stratified by age. The association for ischaemic heart disease (ICD9 410-413) and stroke (ICD9 430-438) was also studied, also stratified by age. Design: Autoregressive Poisson models were used that controlled for long term trend, season, influenza epidemics, and meteorology to assess the short-term effects of particles in each city. The study also examined confounding by other pollutants. City specific results were pooled in a second stage regression to obtain more stable estimates and examine the sources of heterogeneity. Main results: The pooled percentage increases associated with a 10 µg/m 3 increase in PM 10 and black smoke were respectively 0.5% (95% CI: 0.2 to 0.8) and 1.1% (95% CI: 0.4 to 1.8) for cardiac admissions of all ages, 0.7% (95% CI: 0.4 to 1.0) and 1.3% (95% CI: 0.4 to 2.2) for cardiac admissions over 65 years, and, 0.8% (95% CI: 0.3 to 1.2) and 1.1% (95% CI: 0.7 to 1.5) for ischaemic heart disease over 65 years. The effect of PM 10 was little changed by control for ozone or SO 2 , but was substantially reduced (CO) or eliminated (NO 2 ) by control for other traffic related pollutants. The effect of black smoke remained practically unchanged controlling for CO and only somewhat reduced controlling for NO 2 . Conclusions: These effects of particulate air pollution on cardiac admissions suggest the primary effect is likely to be mainly attributable to diesel exhaust. Results for ischaemic heart disease below 65 years and for stroke over 65 years were inconclusive.
Effects of air pollution on the incidence of myocardial infarction
Heart, 2009
Short-term fluctuations in air pollution have been associated with changes in both overall and cardiovascular mortality. Objective: To consider the effects of air pollution on myocardial infarction (MI) risk by systematically reviewing studies looking at this specific outcome. Data sources: Medline, Embase and TOXNET publication databases, as well as reference lists and the websites of relevant public organisations. Study selection: Studies presenting original data with MI as a specific outcome and one or more of the following as an exposure of interest were included: particulate matter (PM), black carbon/black smoke, ozone, carbon monoxide, nitrogen oxides, sulphur dioxide and traffic exposure. Data extraction: The effects of each pollutant on risk of MI, including effect sizes and confidence intervals, were recorded where possible. Methodological details were also extracted including study population, location and setting, ascertainment of MI events, adjustment for potential confounders and consideration of lagged effects. Results: 26 studies were identified: 19 looked at the shortterm effects of pollution on a daily timescale; the remaining 7 at longer-term effects. A proportion of studies reported statistically significant detrimental effects of PM with diameter ,2.5 mm (3/5 studies, risk increase estimates ranging from 5 to 17% per 10 mg/m 3 increase), PM ,10 mm (3/10, 0.7-11% per 10 mg/m 3), CO (6/14, 2-4% per ppm), SO 2 (6/13, effect estimates on varied scales) and NO 2 (6/13, 1-9% per 10 ppb). Increasing ozone levels were associated with a reduction in MI risk in 3/12 studies. A number of differences in location, population and demographics and study methodology between studies were identified that might have affected results. Conclusion: There is some evidence that short-term fluctuations in air pollution affect the risk of MI. However, further studies are needed to clarify the nature of these effects and identify vulnerable populations and individuals.
Scientific Reports, 2022
As an independent risk factor, ambient air pollution can assume a considerable part in mortality and worsening of cardiovascular disease. We sought to investigate the association between longterm exposure to ambient air pollution and cardiovascular disease mortality and their risk factors in Iranian's elderly population. This inquiry was conducted ecologically utilizing recorded data on cardiovascular disease mortality from 1990 to 2019 for males and females aged 50 years or more from the Global Burden of Disease dataset. Data was interned into Joinpoint software 4.9.0.0 to present Annual Percent Change (APC), Average Annual Percent Change (AAPC), and its confidence intervals. The relationship between recorded data on ambient air pollution and cardiovascular disease' mortality, the prevalence of high systolic blood pressure, high LDL cholesterol levels, high body mass index, and diabetes mellitus type2 was investigated using the Spearman correlation test in R 3.5.0 software. Our finding demonstrated that cardiovascular diseases in elderly males and females in Iran had a general decreasing trend (AAPC = −0.77% and −0.65%, respectively). The results showed a positive correlation between exposure to ambient ozone pollution (p ≤ 0.001, r = 0.94) ambient particulate and air pollution (p < 0.001, r = 0.99) and mortality of cardiovascular disease. Also, ambient air pollution was positively correlated with high systolic blood pressure (p < 0.001, r = 0.98), high LDL cholesterol levels (p < 0.001, r = 0.97), high body mass index (p < 0.001, r = 0.91), diabetes mellitus type2 (p < 0.001, r = 0.77). Evidence from this study indicated that ambient air pollution, directly and indirectly, affects cardiovascular disease mortality in two ways by increasing the prevalence of some traditional cardiovascular disease risk factors. Evidence-based clinical and public health methodologies are necessary to decrease the burden of death and disability associated with cardiovascular disease. Exposure to air pollution increments morbidity and mortality of cardiovascular disease (CVD) 1 , especially exposure to emissions from traffic and industrial sources 2. Even lower concentrations of exposure to particulate matter (PM) caused by combustion, as a significant component of urban pollution, are involved in the pathogenesis of CVD 3. Some researchers have shown a relationship between intense or persistent exposure to PM and the rate of cardiopulmonary occasions 4. Increased ambient air pollution (AAP) can be considered a risk factor for heart failure 5 , myocardial infarction, cardiovascular stroke 6 , and death 7,8. These effects can be due to intense daily variation in air pollutant levels just as lifelong exposure to them 1. Long-term exposure to PM air pollution per 10 μg/m 3 is estimated to increase the overall mortality rate by 2-4%, with the highest mortality rate from CVD 2. Although the etiology underlying this long-term relationship is unknown 9 , Some pathways are considered as possible biological mechanisms for increased risk of CVD incidence due to air pollution exposure. Disorders of the autonomic nervous system of the heart, pulmonary and systemic oxidative stress and inflammatory responses that impair endothelial function, atherosclerosis, and thrombosis have been reported as direct effects of AAP 10. Long-term air pollutants exposure at low levels participates in hypertension 11 , obesity 12,13 , and diabetes 14 , which are involved in the CVD epidemiology 15. Hence, AAP indirectly affects CVD risk through changes in blood pressure, triglyceride, blood sugar, and vascular functions 16 .