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Ghazihosseini S, De Rosa C, Trimarco V, Izzo R, Morisco C, Esposito G. The Environmental Pollution and Cardiovascular Risk: The Role of Health Surveillance and Legislative Interventions in Cardiovascular Prevention. High Blood Press Cardiovasc Prev 2023; 30:533-538. [PMID: 38070034 PMCID: PMC10721657 DOI: 10.1007/s40292-023-00612-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023] Open
Abstract
Environmental pollution in considered an established determinant of non-communicable illness, including cardiovascular diseases (CVDs). Air pollution is the result of a complex combination of chemical, physical, and biological agents, and represents one of the main causes of mortality and morbidity in the world population. It is responsible for 7.6% of global mortality. In this regard, it has been documented that it increases the risk of CVDs and major adverse cardiovascular and cerebrovascular events. In northern regions of China, long-term exposures to the particulate matter < 2.5 µm (PM2.5) increase in the risk of ischemic heart disease by almost two-folds. Similarly, the additional risk for stroke, increases by almost 10% for long-term exposure to PM2.5. The detrimental effects of air pollution on cardiovascular system are particularly manifest in vulnerable subjects, such as the elderly, patients with heart disease, and obese individuals. Therefore, nowadays, cardiovascular prevention strategies, in addition to controlling traditional risk factors, should also include measures to improve the environment. This goal can be achieved by the implementation of the health surveillance in occupational medicine and by the extensive application of the national and international legislative measures. In fact, the health surveillance represents a crucial preventive measure for workers exposed to health risks (chemical, physical agents, etc.) that may lead to occupational diseases after long-term exposure. On the other hand, since environmental pollution does not recognize well-defined boundaries, only the implementation of regulations among large territorial areas can be useful to improve the quality of environment.
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Affiliation(s)
- Seyedali Ghazihosseini
- Dipartimento di Scienze Biomediche Avanzate, Università FEDERICO II, Napoli, Via S. Pansini, 80131, Naples, Italy
| | - Carlo De Rosa
- Medicina Legale Università della Tuscia, Viterbo, Italy
| | - Valentina Trimarco
- Dipartimento di Scienze Biomediche Avanzate, Università FEDERICO II, Napoli, Via S. Pansini, 80131, Naples, Italy
| | - Raffaele Izzo
- Dipartimento di Scienze Biomediche Avanzate, Università FEDERICO II, Napoli, Via S. Pansini, 80131, Naples, Italy
| | - Carmine Morisco
- Dipartimento di Scienze Biomediche Avanzate, Università FEDERICO II, Napoli, Via S. Pansini, 80131, Naples, Italy.
| | - Giovanni Esposito
- Dipartimento di Scienze Biomediche Avanzate, Università FEDERICO II, Napoli, Via S. Pansini, 80131, Naples, Italy
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Ma Y, Li D, Xie J, Hu Y, Su B, Tian Y. Exposure to various ambient air pollutants and 9 cardiovascular conditions among individuals with diabetes: A prospective analysis of the UK Biobank. Atherosclerosis 2023; 369:1-8. [PMID: 36822029 DOI: 10.1016/j.atherosclerosis.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 01/16/2023] [Accepted: 02/03/2023] [Indexed: 02/13/2023]
Abstract
BACKGROUND AND AIMS The adverse effects of air pollutants on the risk of most cardiovascular diseases (CVDs) are well-established, but the risk of CVDs such as deep vein thrombosis, pulmonary embolism, or aortic valve stenosis have been underappreciated, especially in the diabetic population. This study aimed to evaluate associations between long-term air pollutants exposure and the risk of incident CVDs among participants with diabetes. METHODS This study included 27,827 participants with baseline diabetes from the UK Biobank. We then estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for CVDs associated with chronic air pollutant exposure in the diabetic population by fitting the Cox proportional hazards model. Moreover, we investigated the cardiovascular effects of air pollutants at concentrations below WHO guideline limits. RESULTS After multivariable adjustment, long-term NO2 and NOx exposures were positively associated with the development of 8 and 6 types of CVDs in participants with diabetes, respectively. In term of particulate matters, the effect estimates ranged from 1.51 (1.13, 2.03) (coronary artery disease) to 4.65 (2.73, 7.92) (peripheral arterial disease) per 10 μg/m3 increase in PM2.5. Whereas, the effect estimates ranged from 1.15 (1.04, 1.27) (arterial hypertension) to 2.28 (1.40, 3.69) (pulmonary embolism) per 10 μg/m3 increase in PM10. In addition, our study discovered that for most of the cardiovascular events (8 of 9), the deleterious effects of air pollutants persisted even when participants were exposed to air pollutants concentrations below WHO guideline limits. CONCLUSIONS Long-term exposure to ambient NO2, NOx, PM2.5, and PM10, either at normal or low level, increased risk of various cardiovascular outcomes in the diabetic population.
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Affiliation(s)
- Yudiyang Ma
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, People's Republic of China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, People's Republic of China
| | - Dankang Li
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, People's Republic of China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, People's Republic of China
| | - Junqing Xie
- Center for Statistics in Medicine, NDORMS, University of Oxford, The Botnar Research Centre, Oxford, UK
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, People's Republic of China
| | - Binbin Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, No.31, Beijige-3, Dongcheng District, Beijing, 100730, People's Republic of China.
| | - Yaohua Tian
- Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, People's Republic of China; Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, People's Republic of China.
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