Effects of fine particulate on heart rate variability in Beijing: a panel study of healthy elderly subjects

Application of Neuroscience Tools in Building Construction – An Interdisciplinary Analysis

Interdisciplinary integration is a new driving force in development of science and technology. Neuroscience, a powerful tool for studying human physiology and psychology that is greatly interconnected with the field of building construction, has attracted numerous research attention. In this paper, we systematically review the interdisciplinary applications of neuroscience tools using bibliometric methods. We report that the built environment, construction safety, architectural design, and occupational health are the main areas of research attention, while thermal comfort, air quality, hazard recognition, safety training, aesthetic design, and biophilic design, among others, comprise the most frequently studied topics with regards to application of neuroscience tools. Currently, eye tracking and the electroencephalogram are the most commonly used tools in the field of building construction, while functional near-infrared spectroscopy, functional magnetic resonance imaging and trigeminal nerve stimulation are still at their initial stage of application.

Association of urinary polycyclic aromatic hydrocarbon metabolites and cardiovascular disease among US population: A cross-sectional study

OBJECTIVE

The main aim of the study was to illustrate the association between urinary polycyclic aromatic hydrocarbons (PAHs) and their metabolites with cardiovascular diseases (CVDs), including congestive heart failure (CHF), coronary heart disease (CHD), angina, heart attack, and stroke among the US population.

METHODS

The National Health and Nutritional Examination Survey (NHANES) 2003-16, nationally representative data were utilized for this study. A cross-sectional observational study was designed to assess the strength of the association between urinary PAH and CVDs. The NHANES survey used a stratified multistage probability sample strategy for obtaining representative samples. Logistic regression analysis was performed to evaluate the association between PAH and the prevalence of CVDs.

RESULTS

In our study, the average ages of the three different PAHs tertiles were 42.56 ± 19.68, 42.21 ± 19.51, and 43.39 ± 17.99 years, respectively. A positive association was found between the second and third tertile of urinary PAH and increased prevalence of coronary heart disease (tertile-2: OR = 1.24, 95% CI = 1.09-1.42; tertile-3: OR = 1.97, 95% CI = 1.69-2.28), angina (tertile-2: OR = 1.3, 95% CI = 1.13-1.49; tertile-3: OR = 2.07, 95% CI = 1.76-2.42), heart attack (tertile-2: OR = 1.28, 95% CI = 1.12-1.47; tertile-3: OR = 1.71, 95% CI = 1.48-1.96) and stroke (tertile-2: OR = 1.17, 95% CI = 1.02-1.33; tertile-3: OR = 1.66, 95% CI = 1.43-1.93) in total participants, respectively, with p-values less than 0.05.

CONCLUSION

In conclusion, this study found a positive association between urinary PAHs and the prevalence of various CVDs among the US population.

Relationship Between Polycyclic Aromatic Hydrocarbons and Cardiovascular Diseases: A Systematic Review

Objective: The primary aim of this systematic review was to examine the relationship of polycyclic aromatic hydrocarbon (PAH) exposure with cardiovascular diseases (CVDs) and elaborate the current knowledge and recent advances in the area of PAH and its effects on CVDs and discuss the growing epidemiological evidence linking PAH to CVDs on the health of human populations. In this systematic review, the increased risk of cardiovascular diseases and their relationship with PAHs were discussed in detail.

Methods: On 05th April 2021, a systematic literature search was conducted using PubMed/Medline and Web of Science search engines in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The search was limited to articles that were written in English and dealt with human issues. All original peer-review publications were considered for inclusion. Comments, case reports, reviews, duplicated papers, and conference reports were excluded. Data was collected from included papers by two independent reviewers.

Results: Conclusively, 20 research articles published between 2005 and 2021 were chosen for the final analysis. The systemic review included 20 studies with a variety of geographical studies. The most common research category among the nominated studies were time-series studies followed by retrospective cohort, cross-sectional, quasi-experimental, panel, and case-control studies. Most of the studies were conducted in the United States, whereas others were showed in various geographical countries around the world, such as Denmark, Germany, Finland, Netherlands, France, China, Norway, Korea, Sweden, Saudi Arabia, and Belgium. Eight studies assessed the association between PAH exposure and CVDs, four articles observed this relationship with blood pressure (BP), two observed association between atherosclerotic CVD and PAH, one congenital heart disease, cardiovascular events, and two with obesity. Furthermore, in some investigations, a favorable association between PAH exposure and hypertension as well as PAH exposure and obesity was found.

Conclusion: In conclusion, this systematic review examined the relationship of PAH exposure with CVDs and CVD-related risk factors by searching several digital databases. After a comprehensive literature searches and summarizing findings from 20 articles, the authors concluded that a positive relationship was observed between PAH exposure and CVD risks.

Chemical constituents and sources of indoor PM2.5 and cardiopulmonary function in patients with chronic obstructive pulmonary disease: Estimation of individual and joint effects

BACKGROUND

The cardiopulmonary effects of chemical constituents and sources of indoor fine particulate matter (PM_2.5) remain unclear.

OBJECTIVES

To examine the individual and joint effects of constituents of indoor PM_2.5 on cardiopulmonary function of patients with chronic obstructive pulmonary disease (COPD) and the role of identified sources.

METHODS

This panel study recruited 43 stable COPD patients from November 2015 to May 2016 in Beijing, China. Daily indoor and outdoor PM_2.5 were collected for five consecutive days simultaneously. Twenty-four elements were measured and principal component analysis was used for source appointment. Pulmonary function and blood pressure (BP) were also measured at daily visit. The linear mixed-effect models were used to estimate the effect of each constituent and source. Bayesian kernel machine regression (BKMR) models were used to estimate the overall effect of all measured constituents.

RESULTS

The combustion, indoor soil/dust and road dust sources were identified as the main sources of indoor PM_2.5 and combustion sources contributed over 40% during the heating season. Most constituents were significantly associated with elevated BP of COPD patients and the joint effects of mixed exposures were also significant especially during the heating season. Most associations of chemical constituents with pulmonary function were negative but not statistically significant during the heating season, as was the joint effect. Few associations were observed during the non-heating season. Further, we observed combustion sources throughout the study period and road dust sources during the heating season were significantly associated with increased BP but not decreased pulmonary function.

CONCLUSION

The combustion and road dust sources and their related constituents of indoor PM_2.5 could cause adverse effects on cardiovascular function of COPD patients especially during the heating season, but the effect on pulmonary function still needs to be further studied.

Associations of Particulate Matter Sizes and Chemical Constituents with Blood Lipids: A Panel Study in Guangzhou, China

Existing evidence is scarce concerning the various effects of different PM sizes and chemical constituents on blood lipids. A panel study that involved 88 healthy college students with five repeated measurements (440 blood samples in total) was performed. We measured mass concentrations of particulate matter with diameters ≤ 2.5 μm (PM_2.5), ≤1.0 μm (PM_1.0), and ≤0.5 μm (PM_0.5) as well as number concentrations of particulate matter with diameters ≤ 0.2 μm (PN_0.2) and ≤0.1 μm (PN_0.1). We applied linear mixed-effect models to assess the associations between short-term exposure to different PM size fractions and PM_2.5 constituents and seven lipid metrics. We found significant associations of greater concentrations of PM in different size fractions within 5 days before blood collection with lower high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A (ApoA1) levels, higher apolipoprotein B (ApoB) levels, and lower ApoA1/ApoB ratios. Among the PM_2.5 constituents, we observed that higher concentrations of tin and lead were significantly associated with decreased HDL-C levels, and higher concentrations of nickel were associated with higher HDL-C levels. Our results suggest that short-term exposure to PM in different sizes was deleteriously associated with blood lipids. Some constituents, especially metals, might be the major contributors to the detrimental effects.

The relationship between exposure to PM2.5 and heart rate variability in older adults: A systematic review and meta-analysis

Ambient air pollution is recognized as a major threat to those with cardiovascular disease (CVD), especially among old adults within this high risk group. Heart rate variability (HRV) is a marker of cardiac autonomic system, which links air pollution and CVD. However, the relationship between PM and HRV has been inconsistently reported. To investigate the associations of PM_2.5 and HRV in old adults whose average age was 55 years old or above, we conducted a meta-analysis of nineteen longitudinal studies including nine short-term and ten long-term studies. In the short-term exposure group, per 10 μg/m³ increase of PM_2.5 was associated with decreases in the time-domain measurements, for SDNN -0.39% (95% CI: -0.72%, -0.06%) and for RMSSD -1.20% (95% CI: -2.17%, -0.23%) and in frequency-domain measurements, for LF -2.31% (95% CI: -3.85%, -0.77%) and for HF -1.87% (95% CI: -3.45%, -0.29%); In the long-term exposure group, per 10 μg/m³ increase of PM_2.5 was associated with decreases in the time-domain measurements, for SDNN -0.92% (95% CI: -2.14%, 0.31%) and for RMSSD -1.96% (95% CI: -3.48%, -0.44%) and in frequency-domain measurements, for LF -2.78% (95% CI: -4.02%, -1.55%) and for HF -1.61% (95% CI: -4.02%, 0.80%). Exposure to PM_2.5 is associated with decreased indicators of HRV in older adults suggesting an affected cardiac autonomic system upon exposure, which may explain the association between PM_2.5 and risk of CVD in older adults. Long-term exposure to PM_2.5 was more strongly associated with indicators of HRV than short-term exposure.

Acute effect of ambient fine particulate matter on heart rate variability: an updated systematic review and meta-analysis of panel studies

Background

Decreased heart rate variability (HRV) is a predictor of autonomic system dysfunction, and is considered as a potential mechanism of increased risk of cardiovascular disease (CVD) induced by exposure to particulate matter less than 2.5 μm in diameter (PM_2.5). Previous studies have suggested that exposure to PM_2.5 may lead to decreased HRV levels, but the results remain inconsistent.

Methods

An updated systematic review and meta-analysis of panel studies till November 1, 2019 was conducted to evaluate the acute effect of exposure to ambient PM_2.5 on HRV. We searched electronic databases (PubMed, Web of Science, and Embase) to identify panel studies reporting the associations between exposure to PM_2.5 and the four indicators of HRV (standard deviation of all normal-to-normal intervals (SDNN), root mean square of successive differences in adjacent normal-to-normal intervals (rMSSD), high frequency power (HF), and low frequency power (LF)). Random-effects model was used to calculate the pooled effect estimates.

Results

A total of 33 panel studies were included in our meta-analysis, with 16 studies conducted in North America, 12 studies in Asia, and 5 studies in Europe. The pooled results showed a 10 μg/m³ increase in PM_2.5 exposure which was significantly associated with a − 0.92% change in SDNN (95% confidence intervals (95%CI) − 1.26%, − 0.59%), − 1.47% change in rMSSD (95%CI − 2.17%, − 0.77%), − 2.17% change in HF (95%CI − 3.24%, − 1.10%), and − 1.52% change in LF (95%CI − 2.50%, − 0.54%), respectively. Overall, subgroup analysis suggested that short-term exposure to PM_2.5 was associated with lower HRV levels in Asians, healthy population, and those aged ≥ 40 years.

Conclusion

Short-term exposure to PM_2.5 was associated with decreased HRV levels. Future studies are warranted to clarity the exact mechanism of exposure to PM_2.5 on the cardiovascular system through disturbance of autonomic nervous function.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12199-020-00912-2.

Biomagnetic monitoring combined with support vector machine: a new opportunity for predicting particle-bound-heavy metals

Biomagnetic monitoring includes fast and simple methods to estimate airborne heavy metals. Leaves of Osmanthus fragrans Lour and Ligustrum lucidum Ait were collected simultaneously with PM₁₀ from a mega-city of China during one year. Magnetic properties of leaves and metal concentrations in PM₁₀ were analyzed. Metal concentrations were estimated using leaf magnetic properties and meteorological factors as input variables in support vector machine (SVM) models. The mean concentrations of many metals were highest in winter and lowest in summer. Hazard index for potentially toxic metals was 5.77, a level considered unsafe. The combined carcinogenic risk was higher than precautionary value (10^-4). Ferrimagnetic minerals were dominant magnetic minerals in leaves. Principal component analysis indicated iron & steel industry and soil dust were the common sources for many metals and magnetic minerals on leaves. However, the poor simulation results obtained with multiple linear regression confirmed strong nonlinear relationships between metal concentrations and leaf magnetic properties. SVM models including leaf magnetic variables as inputs yielded better simulation results for all elements. Simulations were promising for Ti, Cd and Zn, whereas relatively poor for Ni. Our study demonstrates the feasibility of prediction of airborne heavy metals based on biomagnetic monitoring of tree leaves.

Effects of Personal Exposures to Micro- and Nano-Particulate Matter, Black Carbon, Particle-Bound Polycyclic Aromatic Hydrocarbons, and Carbon Monoxide on Heart Rate Variability in a Panel of Healthy Older Subjects

As a non-invasive method, heart rate variability (HRV) has been widely used to study cardiovascular autonomous control. Environmental epidemiological studies indicated that the increase in an average concentration of particulate matter (PM) would result in a decrease in HRV, which was related to the increase of cardiovascular mortality in patients with myocardial infarction and the general population. With rapid economic and social development in Asia, how air pollutants, such as PM of different sizes and their components, affect the cardiovascular health of older people, still need to be further explored. The current study includes a 72 h personal exposure monitoring of seven healthy older people who lived in the Taipei metropolitan area. Mobile equipment, a portable electrocardiogram recorder, and the generalized additive mixed model (GAMM) were adopted to evaluate how HRV indices were affected by size-fractionated PM, particle-bound polycyclic aromatic hydrocarbons (p-PAHs), black carbon (BC), and carbon monoxide (CO). Other related confounding factors, such as age, sex, body mass index (BMI), temperature, relative humidity (RH), time, and monitoring week were controlled by fixed effects of the GAMM. Statistical analyses of multi-pollutant models showed that PM_2.5–10, PM₁, and nanoparticle (NP) could cause heart rate (HR), time-domain indices, and frequency-domain indices to rise; PM_1–2.5 and BC would cause the frequency-domain index to rise; p-PAHs would cause HR to rise, and CO would cause time-domain index and frequency-domain index to decline. In addition, the moving average time all fell after one hour and might appear at 8 h in HRVs’ largest percentage change caused by each pollutant, results of which suggested that size-fractionated PM, p-PAHs, BC, and CO exposures have delayed effects on HRVs. In conclusion, the results of the study showed that the increase in personal pollutant exposure would affect cardiac autonomic control function of healthy older residents in metropolitan areas, and the susceptibility of cardiovascular effects was higher than that of healthy young people. Since the small sample size would limit the generalizability of this study, more studies with larger scale are warranted to better understand the HRV effects of simultaneous PM and other pollution exposures for subpopulation groups.

Ambient Air Pollution and Biomarkers of Health Effect

Recently, the air pollution situation of our country is very serious along with the development of urbanization and industrialization. Studies indicate that the exposure of air pollution can cause a rise of incidence and mortality of many diseases, such as chronic obstructive pulmonary disease (COPD), asthma, myocardial infarction, and so on. However, there is now growing evidence showing that significant air pollution exposures are associated with early biomarkers in various systems of the body. In order to better prevent and control the damage effect of air pollution, this article summarizes comprehensively epidemiological studies about the bad effects on the biomarkers of respiratory system, cardiovascular system, and genetic and epigenetic system exposure to ambient air pollution.

Association of size-fractionated indoor particulate matter and black carbon with heart rate variability in healthy elderly women in Beijing

Associations between size-fractionated indoor particulate matter (PM) and black carbon (BC) and heart rate variability (HRV) and heart rate (HR) in elderly women remain unclear. Twenty-nine healthy elderly women were measured for 24-hour HRV/HR indices. Real-time size-fractionated indoor PM and BC were monitored on the same day and on the preceding day. Mixed-effects models were applied to investigate the associations between pollutants and HRV/HR indices. Increases in size-fractionated indoor PM were significantly associated with declines in power in the high-frequency band (HF), power in the low-frequency band (LF), and standard deviation of all NN intervals (SDNN). The largest decline in HF was 19% at 5-minute moving average for an interquartile range (IQR) increase (24 μg/m³ ) in PM_0.5 . The results showed that smaller particles could lead to greater reductions in HRV indices. The reported associations were modified by body mass index (BMI): Declines in HF at 5-minute average for an IQR increase in PM_0.5 were 34.5% and 1.0% for overweight (BMI ≥25 kg/m² ) and normal-weight (BMI <25 kg/m² ) participants, respectively. Moreover, negative associations between BC and HRV indices were found to be significant in overweight participants. Increases in size-fractionated indoor PM and BC were associated with compromised cardiac autonomic function in healthy elderly women, especially overweight ones.

Cardio-Respiratory Effects of Air Pollution in a Panel Study of Outdoor Physical Activity and Health in Rural Older Adults

Objective:

To examine cardio-respiratory effects of air pollution in rural older adults exercising outdoors.

Methods:

Adults 55 and over completed measurements of blood pressure, peak expiratory flow and oximetry daily, and of heart rate variability, endothelial function, spirometry, fraction of exhaled nitric oxide and urinary oxidative stress markers weekly, before and after outdoor exercise, for 10 weeks. Data were analyzed using linear mixed effect models.

Results:

Pooled estimates combining 2013 (n = 36 participants) and 2014 (n = 41) indicated that an interquartile increase in the air quality health index (AQHI) was associated with a significant (P < 0.05) increase in heart rate (2.1%) and significant decreases in high frequency power (−19.1%), root mean square of successive differences (−9.5%), and reactive hyperemia index (−6.5%).

Conclusions:

We observed acute subclinical adverse effects of air pollution in rural older adults exercising outdoors.

Acute particulate matter affects cardiovascular autonomic modulation and IFN-γ methylation in healthy volunteers

AIMS

Air particulate matter (PM) is associated with increased cardiovascular morbidity and mortality. Altered autonomic functions play a key role in PM-induced cardiovascular disease. However, previous studies have not address the impact of PM on sympathetic and parasympathetic control of heart function, independently, and using controlled conditions, i.e., increasing titration of PM of known composition, in absence of other potential confounding factors. To fill this gap, here we used symbolic analysis that is capable of detecting non-mutual changes of the two autonomic branches, thus considering them as independent, and concentrations of PM as they could be measured at peak levels in Milan during a polluted winter day.

METHODS AND RESULTS

In this randomized, cross-over study, we enrolled 12 healthy subjects who underwent two random sessions: inhalation of filtered air mixture or inhalation of filtered air containing particulate mixture (PM 10, PM 2.5, PM 1.0 and PM 0.5µm). ECG and respiration for autonomic analysis and blood sample for DNA Methylation were collected at baseline (T1), after air exposure (T2) and after 2h (T3). Spectral and symbolic analysis of heart rate variability (HRV) were performed for autonomic control of cardiac function, while alterations in DNA methylation of candidate genes were used to index pro-inflammatory modifications. In the PM expose group, autonomic analysis revealed a significant decrease of 2UV%, index of parasympathetic modulation (14% vs 9%, p = 0.0309), while DNA analysis showed a significant increase of interferon γ (IFN- γ) methylation, from T1 to T3. In a mixed model using T1, T2 and T3, fine and ultrafine PM fractions showed significant associations with IFN- γ methylation and parasympathetic modulation.

CONCLUSIONS

Our study shows, for the first time, that in healthy subjects, acute exposure to PM affects parasympathetic control of heart function and it increases methylation of a pro-inflammatory gene (i.e. methylation of interferon γ). Thus, our study suggests that, even in absence of other co-factors and in otherwise healthy individuals, PM per se is sufficient to trigger parasympathetic dysautonomia, independently from changes in sympathetic control, and inflammation, in a dose-dependent manner.

A Systematic Review on the Effects of Polycyclic Aromatic Hydrocarbons on Cardiometabolic Impairment

Background:

Various epidemiological studies have shown that exposure to environmental pollutants including polycyclic aromatic hydrocarbons (PAHs) might increase the risk of cardiovascular diseases (CVDs) and their risk factors. This study aims to systematically review the association of PAH exposure with metabolic impairment.

Methods:

Data were collected by searching for relevant studies in international databases using the following keywords: “polycyclic aromatic hydrocarbon” + “cardiovascular disease,” PAH + CVD, polycyclic aromatic hydrocarbon and “air pollutant” + “CVD,” and the desired data were extracted and included in the study according to the systematic review process.

Results:

From the 14 articles included in the present systematic review, eight articles were conducted on the relationship between PAH and CVDs, four articles were conducted to examine the association of PAH exposure with blood pressure (BP), and two articles investigated the link between PAH and obesity.

Conclusions:

Most studies included in this systematic review reported a significant positive association of PAH exposure with increased risk of CVDs and its major risk factors including elevated BP and obesity. These findings should be confirmed by longitudinal studies with long-term follow-up.

A structured review of panel studies used to investigate associations between ambient air pollution and heart rate variability

INTRODUCTION

Dysfunction of the autonomic nervous system is one of the postulated pathways linking short-term exposure to air pollution to adverse cardiovascular outcomes. A hypothesis is that exposure to air pollution decreases heart rate variability, a recognized independent predictor of poorer cardiovascular prognosis.

METHODS

We conducted a structured review of panel studies published between 1946 and July 2015 of the association between ambient air pollution and parameters of heart rate variability reflecting autonomic nervous function. We focused on exposure to mass concentrations of fine particles (PM2.5), nitrogen dioxide (NO2), and ozone (O3), and four commonly used indices of heart rate variability (HRV): standard deviation of all normal-to-normal intervals (SDNN); root mean square of successive differences in adjacent normal-to-normal intervals (RMSSD); high frequency power (HF); and low frequency power (LF). We searched bibliographic databases and references of identified articles and abstracted characteristics of their design and conduct, and synthesized the quantitative findings in graphic form according to health condition of the study population and the functional form of the HRV indices used in the regression analyses.

RESULTS

A total of 33 panel studies were included: 31, 12, and 13 studies were used to investigate ambient exposure to PM2.5, NO2 and O3, respectively. We found substantial variation across studies in terms of design characteristics and statistical methodologies, and we identified some studies that may have had methodological and statistical issues. Because many panel studies were not comparable to each other, meta-analyses were not generally possible, although we were able to pool the results obtained amongst older adults who had cardiovascular disease for the 24-h average concentrations of PM2.5 prior to the heart rate variability measurements. In studies of PM2.5 among older adults with cardiovascular disease, logarithmic transformations of the HRV indices were used in ten studies. Negative associations across all HRV indices were found in 60-86% of these studies for periods of exposures ranging from 5-min to 5-days. The pooled percent changes for an increase of 10μg/m(3) in the 24-h prior to the measurements of HRV were: -2.11% for SDNN (95% confidence interval (95%CI): -4.00, -0.23%), -3.29% for RMSSD (95%CI: -6.32, -0.25%), -4.76% for LF (95%CI: -12.10, 2.58%), and -1.74% for HF (95%CI: -7.79, 4.31%). No transformations were used in seven studies of PM2.5 among older adults with cardiovascular disease, and we found for absolute differences pooled changes in the HRV indices, for an increase of 10μg/m(3), of -0.31ms for SDNN (95%CI: -1.02, 0.41ms) and -1.22ms for RMSSD (95%CI: -2.37; -0.07ms). For gaseous pollutants, negative associations over periods of exposure ranging from 5-min or to 5-days prior to the heart rate variability measurements were reported in 71-83% of studies of NO2 and 57-100% of studies of O3, depending of the indices of heart rate variability. However, many of these studies had statistical or methodological issues, and in the few studies without these issues the confidence intervals were relatively wide and mostly included the null.

CONCLUSIONS AND DISCUSSION

We were not persuaded by the results that there was an association between PM2.5 and any of the four indices of heart rate variability. For NO2 and O3 the number of high-quality studies was insufficient to draw any definite conclusions. Further panel studies with improved design and methodologies are needed to help establish or refute an association between ambient exposure to air pollution and heart rate variability.

Role of autonomic reflex arcs in cardiovascular responses to air pollution exposure

The body responds to environmental stressors by triggering autonomic reflexes in the pulmonary receptors, baroreceptors, and chemoreceptors to maintain homeostasis. Numerous studies have shown that exposure to various gases and airborne particles can alter the functional outcome of these reflexes, particularly with respect to the cardiovascular system. Modulation of autonomic neural input to the heart and vasculature following direct activation of sensory nerves in the respiratory system, elicitation of oxidative stress and inflammation, or through other mechanisms is one of the primary ways that exposure to air pollution affects normal cardiovascular function. Any homeostatic process that utilizes the autonomic nervous system to regulate organ function might be affected. Thus, air pollution and other inhaled environmental irritants have the potential to alter both local airway function and baro- and chemoreflex responses, which modulate autonomic control of blood pressure and detect concentrations of key gases in the body. While each of these reflex pathways causes distinct responses, the systems are heavily integrated and communicate through overlapping regions of the brainstem to cause global effects. This short review summarizes the function of major pulmonary sensory receptors, baroreceptors, and carotid body chemoreceptors and discusses the impacts of air pollution exposure on these systems.

Framingham risk score modifies the effect of PM10 on heart rate variability

Health conditions may greatly modify the association between particulate matter (PM) and heart rate variability (HRV), but whether the modification of PM effect by coronary artery disease (CAD) risk status depends on the PM levels remains unknown. We investigated the associations between personal exposures to PM with aerodynamic diameter of ≤10μm (PM10) and ≤2.5μm (PM2.5) and concurrent HRV, and whether the effect of PM on HRV was modified by Framingham risk score (FRS) in healthy subjects with different PM exposure levels. Personal exposures to PM10 and PM2.5 were measured for 24h in 152 volunteers of community residents who were free of cardiovascular disease in two cities (Zhuhai and Wuhan) that differ in air quality. Simultaneously, 24h HRV indices were obtained from 3-channel Holter monitor. FRS was calculated based on age, sex, lipid profiles, blood pressure, diabetes, and smoking status. Linear regression models were constructed after adjusting for potential confounders. We found significant decrease in total power (TP) and low power (LF) with increased PM10 concentrations (P for trend<0.05) in the high PM levels city (Wuhan) and total population, but not in the low PM levels city (Zhuhai). We also observed significant modification of FRS on PM10 effect in Wuhan. Interestingly, elevated PM10 was associated in a greater decreased HRV in the low FRS subgroup, but not in the high FRS subgroup. However, we did not find any significant main effects of PM2.5 or PM2.5-FRS interactions on HRV in city-specified or city-combined analyses. Overall, the findings indicate that individual coronary risk profiles may modulate the association between particulate air pollution and HRV in high PM exposure levels.

Noninvasive effects measurements for air pollution human studies: methods, analysis, and implications

Human exposure studies, compared with cell and animal models, are heavily relied upon to study the associations between health effects in humans and air pollutant inhalation. Human studies vary in exposure methodology, with some work conducted in controlled settings, whereas other studies are conducted in ambient environments. Human studies can also vary in the health metrics explored, as there exists a myriad of health effect end points commonly measured. In this review, we compiled mini reviews of the most commonly used noninvasive health effect end points that are suitable for panel studies of air pollution, broken into cardiovascular end points, respiratory end points, and biomarkers of effect from biological specimens. Pertinent information regarding each health end point and the suggested methods for mobile collection in the field are assessed. In addition, the clinical implications for each health end point are summarized, along with the factors identified that can modify each measurement. Finally, the important research findings regarding each health end point and air pollutant exposures were reviewed. It appeared that most of the adverse health effects end points explored were found to positively correlate with pollutant levels, although differences in study design, pollutants measured, and study population were found to influence the magnitude of these effects. Thus, this review is intended to act as a guide for researchers interested in conducting human exposure studies of air pollutants while in the field, although there can be a wider application for using these end points in many epidemiological study designs.

The cardiopulmonary effects of ambient air pollution and mechanistic pathways: a comparative hierarchical pathway analysis

Previous studies have investigated the associations between exposure to ambient air pollution and biomarkers of physiological pathways, yet little has been done on the comparison across biomarkers of different pathways to establish the temporal pattern of biological response. In the current study, we aim to compare the relative temporal patterns in responses of candidate pathways to different pollutants. Four biomarkers of pulmonary inflammation and oxidative stress, five biomarkers of systemic inflammation and oxidative stress, ten parameters of autonomic function, and three biomarkers of hemostasis were repeatedly measured in 125 young adults, along with daily concentrations of ambient CO, PM2.5, NO2, SO2, EC, OC, and sulfate, before, during, and after the Beijing Olympics. We used a two-stage modeling approach, including Stage I models to estimate the association between each biomarker and pollutant over each of 7 lags, and Stage II mixed-effect models to describe temporal patterns in the associations when grouping the biomarkers into the four physiological pathways. Our results show that candidate pathway groupings of biomarkers explained a significant amount of variation in the associations for each pollutant, and the temporal patterns of the biomarker-pollutant-lag associations varied across candidate pathways (p<0.0001) and were not linear (from lag 0 to lag 3: p = 0.0629, from lag 3 to lag 6: p = 0.0005). These findings suggest that, among this healthy young adult population, the pulmonary inflammation and oxidative stress pathway is the first to respond to ambient air pollution exposure (within 24 hours) and the hemostasis pathway responds gradually over a 2-3 day period. The initial pulmonary response may contribute to the more gradual systemic changes that likely ultimately involve the cardiovascular system.

A community study of the effect of polycyclic aromatic hydrocarbon metabolites on heart rate variability based on the Framingham risk score

OBJECTIVES

To investigate the effects of the urinary metabolite profiles of background exposure to the atmospheric pollutants polycyclic aromatic hydrocarbon (PAH) and Framingham risk score (FRS), which assesses an individual's cardiovascular disease risk, on heart rate variability (HRV).

METHODS

The study conducted from April to May 2011 in Wuhan, China, included 1978 adult residents with completed questionnaires, physical examinations, blood and urine samples, and 5-min HRV indices (including SD of all normal to normal intervals (SDNN), root mean square successive difference (rMSSD), low frequency (LF), high frequency (HF) and their ratio (LF/HF), and total power) obtained from 3-channel Holter monitor. 12 urinary PAH metabolites were measured by gas chromatography-mass spectrometry. FRS was calculated by age, sex, lipid profiles, blood pressure, diabetes and smoking status. Linear regression models were constructed after adjusting for potential confounders.

RESULTS

Elevated total concentration of hydroxynaphthalene (ΣOHNa) was significantly associated, in a dose-responsive manner, with decreased SDNN and LF/HF (ptrend=0.014 and 0.007, respectively); elevated total concentration of hydroxyfluorene (ΣOHFlu) was significantly associated with reduced SDNN, LF and LF/HF (ptrend=0.027, 0.003, and <0.0001, respectively); and elevated total concentration of all PAH metabolites (ΣOH-PAHs) was associated with decreased LF and LF/HF (ptrend=0.005 and <0.0001, respectively). Moreover, increasing quartiles of FRS were significantly associated with decreased HRV indices, except LF/HF (all ptrend<0.0001). Interestingly, individuals in low-risk subgroups had greater decreases in SDNN, LF and LF/HF in relation to ΣOH-PAHs, ΣOHNa and ΣOHFlu than those in high-risk subgroups (all p<0.05).

CONCLUSIONS

Environmental PAH exposure may differentially affect HRV based on individual coronary risk profiles.

Satellite-based PM concentrations and their application to COPD in Cleveland, OH

A hybrid approach is proposed to estimate exposure to fine particulate matter (PM(2.5)) at a given location and time. This approach builds on satellite-based aerosol optical depth (AOD), air pollution data from sparsely distributed Environmental Protection Agency (EPA) sites and local time-space Kriging, an optimal interpolation technique. Given the daily global coverage of AOD data, we can develop daily estimate of air quality at any given location and time. This can assure unprecedented spatial coverage, needed for air quality surveillance and management and epidemiological studies. In this paper, we developed an empirical relationship between the 2 km AOD and PM(2.5) data from EPA sites. Extrapolating this relationship to the study domain resulted in 2.3 million predictions of PM(2.5) between 2000 and 2009 in Cleveland Metropolitan Statistical Area (MSA). We have developed local time-space Kriging to compute exposure at a given location and time using the predicted PM(2.5). Daily estimates of PM(2.5) were developed for Cleveland MSA between 2000 and 2009 at 2.5 km spatial resolution; 1.7 million (∼79.8%) of 2.13 million predictions required for multiyear and geographic domain were robust. In the epidemiological application of the hybrid approach, admissions for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) was examined with respect to time-space lagged PM(2.5) exposure. Our analysis suggests that the risk of AECOPD increases 2.3% with a unit increase in PM(2.5) exposure within 9 days and 0.05° (∼5 km) distance lags. In the aggregated analysis, the exposed groups (who experienced exposure to PM(2.5) >15.4 μg/m(3)) were 54% more likely to be admitted for AECOPD than the reference group. The hybrid approach offers greater spatiotemporal coverage and reliable characterization of ambient concentration than conventional in situ monitoring-based approaches. Thus, this approach can potentially reduce exposure misclassification errors in the conventional air pollution epidemiology studies.

The impacts of short-term exposure to noise and traffic-related air pollution on heart rate variability in young healthy adults

Traffic-related air pollution and noise are associated with cardiovascular diseases, and alternation of heart rate variability (HRV), which reflects cardiac autonomic function, is one of the mechanisms. However, few studies considered the impacts of noise when exploring associations between air pollution and HRV. We explored whether noise modifies associations between short-term exposure to traffic-related air pollution and HRV in young healthy adults. In this randomized, crossover study, 40 young healthy adults stayed for 2 h in a traffic center and, on a separate occasion, in a park. Personal exposure to traffic-related air pollutants and noise were measured and ambulatory electrocardiogram was performed. Effects were estimated using mixed-effects regression models. Traffic-related air pollution and noise were both associated with HRV, and effects of air pollutants were amplified at high noise level (>65.6 A-weighted decibels (dB[A])) compared with low noise level (≤ 65.6 dB[A]). High frequency (HF) decreased by -4.61% (95% confidence interval, -6.75% to-2.42%) per 10 μg/m(3) increment in fine particle (PM2.5) at 5-min moving average, but effects became insignificant at low noise level (P>0.05). Similar effects modification was observed for black carbon (BC) and carbon monoxide (CO). We conclude that noise is an important factor influencing the effects of air pollution on HRV.

Characteristics and popular topics of latest researches into the effects of air particulate matter on cardiovascular system by bibliometric analysis

In recent years, many epidemiological and toxicological studies have investigated the adverse effects of air particulate matter (PM) on the cardiovascular system. However, it is difficult for the researchers to have a timely and effective overall command of the latest characteristics and popular topics in such a wide field. Different from the previous reviews, in which the research characteristics and trends are empirically concluded by experts, we try to have a comprehensive evaluation of the above topics for the first time by bibliometric analysis, a quantitative tool in information exploration. This study aims to introduce the bibliometric method into the field of PM and cardiovascular system. The articles were selected by searching PubMed/MEDLINE (from 2007 to 2012) using Medical Subject Headings (MeSH) terms "particulate matter" and "cardiovascular system". A total of 935 eligible articles and 1895 MeSH terms were retrieved and processed by the software Thomson Data Analyzer (TDA). The bibliographic information and the MeSH terms of these articles were classified and analyzed to summarize the research characteristics. The top 200 high-frequency MeSH terms (the cumulative frequency percentage was 74.2%) were clustered for popular-topic conclusion. We summarized the characteristics of published articles, of researcher collaborations and of the contents. Ten clusters of MeSH terms are presented. Six popular topics are concluded and elaborated for reference. Our study presents an overview of the characteristics and popular topics in the field of PM and cardiovascular system in the past five years by bibliometric tools, which may provide a new perspective for future researchers.

Blood pressure changes and chemical constituents of particulate air pollution: results from the healthy volunteer natural relocation (HVNR) study

BACKGROUND

Elevated blood pressure (BP) has been associated with particulate matter (PM) air pollution, but associations with PM chemical constituents are still uncertain.

OBJECTIVES

We investigated associations of BP with various chemical constituents of fine PM (PM2.5) during 460 repeated visits among a panel of 39 university students.

METHODS

Resting BP was measured using standardized methods before and after the university students relocated from a suburban campus to an urban campus with different air pollution contents in Beijing, China. Air pollution data were obtained from central monitors close to student residences. We used mixed-effects models to estimate associations of various PM2.5 constituents with systolic BP (SBP), diastolic BP (DBP), and pulse pressure.

RESULTS

An interquartile range increase of 51.2 μg/m3 in PM2.5 was associated with a 1.08-mmHg (95% CI: 0.17, 1.99) increase in SBP and a 0.96-mmHg (95% CI: 0.31, 1.61) increase in DBP on the following day. A subset of PM2.5 constituents, including carbonaceous fractions (organic carbon and elemental carbon), ions (chloride and fluoride), and metals/metalloid elements (nickel, zinc, magnesium, lead, and arsenic), were found to have robust positive associations with different BP variables, though robust negative associations of manganese, chromium, and molybdenum with SBP or DBP also were observed.

CONCLUSIONS

Our results support relationships between specific PM2.5 constituents and BP. These findings have potential implications for the development of pollution abatement strategies that maximize public health benefits.

Temperature, traffic-related air pollution, and heart rate variability in a panel of healthy adults

BACKGROUND

Both ambient temperature and air pollution have been associated with alterations in cardiac autonomic function, but the responsive patterns associated with temperature exposure and the interactive effects of temperature and air pollution remain largely unclear.

OBJECTIVES

We investigated the associations between personal temperature exposure and cardiac autonomic function as reflected by heart rate variability (HRV) in a panel of 14 healthy taxi drivers in the context of traffic-related air pollution.

METHODS

We collected real-time data on study subjects' in-car exposures to temperature and traffic-related air pollutants including particulate matter with an aerodynamic diameter ≤2.5 μm (PM(2.5)) and carbon monoxide (CO) and HRV indices during work time (8:30-21:00) on 48 sampling days in the warm season (May-September) and cold season (October-March). We applied mixed-effects models and loess models adjusting for potential confounders to examine the associations between temperature and HRV indices.

RESULTS

We found nonlinear relationships between temperature and HRV indices in both the warm and cold seasons. Linear regression stratified by temperature levels showed that increasing temperature levels were associated with declines in standard deviation of normal-to-normal intervals over different temperature strata and increases in low-frequency power and low-frequency:high-frequency ratio in higher temperature range (>25 °C). PM(2.5) and CO modified these associations to various extents.

CONCLUSIONS

Temperature was associated with alterations in cardiac autonomic function in healthy adults in the context of traffic-related air pollution.