1
|
Revand R, Dontham A, Sarkar S, Patil A. Subacute Exposure to Gaseous Pollutants from Diesel Engine Exhaust Attenuates Capsaicin-Induced Cardio-Pulmonary Reflex Responses Involving Oxidant Stress Mechanisms in Adult Wistar Rats. Cardiovasc Toxicol 2024; 24:396-407. [PMID: 38451349 DOI: 10.1007/s12012-024-09842-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/12/2024] [Indexed: 03/08/2024]
Abstract
Intravenous injection of capsaicin produces vagal-mediated protective cardio-pulmonary (CP) reflexes manifesting as tachypnea, bradycardia, and triphasic blood pressure (BP) response in anesthetized rats. Particulate matter from diesel engine exhaust has been reported to attenuate these reflexes. However, the effects of gaseous constituents of diesel exhaust are not known. Therefore, the present study was designed to investigate the effects of gaseous pollutants in diesel exhaust, on capsaicin-induced CP reflexes in rat model. Adult male rats were randomly assigned to three groups: Non-exposed (NE) group, filtered diesel exhaust-exposed (FDE) group and N-acetyl cysteine (NAC)-treated FDE group. FDE group of rats (n = 6) were exposed to filtered diesel exhaust for 5 h a day for 5 days (D1-D5), and were taken for dissection on day 6 (D6), while NE group of rats (n = 6) remained unexposed. On D6, rats were anesthetized, following which jugular vein was cannulated for injection of chemicals, and femoral artery was cannulated to record the BP. Lead II electrocardiogram and respiratory movements were also recorded. Results show that intravenous injection of capsaicin (0.1 ml; 10 µg/kg) produced immediate tachypneic, hyperventilatory, hypotensive, and bradycardiac responses in both NE and FDE groups of rats. However, these capsaicin-induced CP responses were significantly attenuated in FDE group as compared to the NE group of rats. Further, FDE-induced attenuation of capsaicin-evoked CP responses were diminished in the N-acetyl cysteine-treated FDE rats. These findings demonstrate that oxidant stress mechanisms could possibly be involved in inhibition of CP reflexes by gaseous pollutants in diesel engine exhaust.
Collapse
Affiliation(s)
- Ravindran Revand
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Aditya Dontham
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Swarnabha Sarkar
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Asmita Patil
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, 110029, India.
| |
Collapse
|
2
|
He F, Yanosky JD, Fernandez‐Mendoza J, Chinchilli VM, Al‐Shaar L, Vgontzas AN, Bixler EO, Liao D. Acute Impact of Fine Particulate Air Pollution on Cardiac Arrhythmias in a Population‐Based Sample of Adolescents: The Penn State Child Cohort. J Am Heart Assoc 2022; 11:e026370. [DOI: 10.1161/jaha.122.026370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Fine particulate (fine particles with aerodynamic diameters ≤2.5 μm [PM
2.5
]) exposure has been associated with a risk of cardiac arrhythmias in adults. However, the association between PM
2.5
exposure and cardiac arrhythmias in adolescents remains unclear.
Methods and Results
To investigate the association and time course between PM
2.5
exposure with cardiac arrhythmias in adolescents, we analyzed the data collected from 322 adolescents who participated in the PSCC (Penn State Child Cohort) follow‐up examination. We obtained individual‐level 24‐hour PM
2.5
concentrations with a nephelometer. Concurrent with the PM
2.5
measure, we obtained 24‐hour ECG data using a Holter monitor, from which cardiac arrhythmias, including premature atrial contractions and premature ventricular contractions (PVCs), were identified. PM
2.5
concentration and numbers of premature atrial contractions/PVCs were summarized into 30‐minute‐based segments. Polynomial distributed lag models within a framework of a negative binomial model were used to assess the effect of PM
2.5
concentration on numbers of premature atrial contractions and PVCs. PM
2.5
exposure was associated with an acute increase in number of PVCs. Specifically, a 10 μg/m
3
increase in PM
2.5
concentration was associated with a 2% (95% CI, 0.4%–3.3%) increase in PVC counts 0.5 to 1.0, 1.0 to 1.5, and 1.5 to 2.0 hours after the exposure. Cumulatively, a 10 μg/m
3
increment in PM
2.5
was associated with a 5% (95% CI, 1%–10%) increase in PVC counts within 2 hours after exposure. PM
2.5
concentration was not associated with premature atrial contraction.
Conclusions
PM
2.5
exposure was associated with an acute increased number of ventricular arrhythmias in a population‐based sample of adolescents. The time course of the effect of PM
2.5
on ventricular arrhythmia is within 2 hours after exposure.
Collapse
Affiliation(s)
- Fan He
- Department of Public Health Sciences Pennsylvania State University College of Medicine Hershey PA
| | - Jeff D. Yanosky
- Department of Public Health Sciences Pennsylvania State University College of Medicine Hershey PA
| | - Julio Fernandez‐Mendoza
- Department of Psychiatry & Behavioral Health, Sleep Research and Treatment Center Pennsylvania State University College of Medicine Hershey PA
| | - Vernon M. Chinchilli
- Department of Public Health Sciences Pennsylvania State University College of Medicine Hershey PA
| | - Laila Al‐Shaar
- Department of Public Health Sciences Pennsylvania State University College of Medicine Hershey PA
| | - Alexandros N. Vgontzas
- Department of Psychiatry & Behavioral Health, Sleep Research and Treatment Center Pennsylvania State University College of Medicine Hershey PA
| | - Edward O. Bixler
- Department of Psychiatry & Behavioral Health, Sleep Research and Treatment Center Pennsylvania State University College of Medicine Hershey PA
| | - Duanping Liao
- Department of Public Health Sciences Pennsylvania State University College of Medicine Hershey PA
| |
Collapse
|
3
|
Fatima S, Ahlawat A, Mishra SK, Soni VK, Guleria R. Respiratory Deposition Dose of PM2.5 and PM10 Before, During and After COVID-19 Lockdown Phases in Megacity-Delhi, India. MAPAN 2022. [PMCID: PMC9081966 DOI: 10.1007/s12647-022-00548-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Considerable changes in particulate matter (PM) during COVID-19 lockdown in major cities around the World demand changes in exposure assessment studies of PM. The present study shows variations in respiratory deposition dose (RDD) of both fine (PM2.5) and coarse (PM10) particles before, during and after Covid-19 lockdown phases at three sites (with different pollution signatures) in Delhi—Alipur, Okhla and Pusa Road. Exposure assessment study showed mean PM2.5 RDD (± S.D.) (µg/min) for walk and sit mode during before lockdown (BL) as 2.41(± 1.20) and 0.84(± 0.42) for Alipur, 2.71(± 1.60) and 0.94(± 0.56) for Okhla, and 2.54(± 1.28) and 0.88(± 0.44) for Pusa road, which decreased drastically during Lockdown 1(L1) as 0.85(± 0.35) and 0.30(± 0.12) for Alipur, 0.83(± 0.33) and 0.29(± 0.11) for Okhla, and 0.68(± 0.28) and 0.23(± 0.10) for Pusa road, respectively. Mean PM10 RDD (± S.D.) (µg/min) for walk and sit mode during before lockdown (BL) as 3.90 (± 1.73) and 1.36 (± 0.60) for Alipur, 4.74 (± 2.04) and 1.65 (± 0.71) for Okhla, and 4.25 (± 1.69) and 1.48 (± 0.59) for Pusa Road, respectively which decreased drastically during Lockdown 1(L1) as 2.19 (± 0.95) and 0.76 (± 0.33) for Alipur, 1.73 (± 0.67) and 0.60 (± 0.23) for Okhla and, 1.45 (± 0.50) and 0.50 (± 0.17) for Pusa Road, respectively. Significant decrease in RDD concentrations (Both PM2.5 and PM10) than that of BL phase have been found during Lockdown 1(L1) phase and other successive lockdown and unlock phases—Lockdown 2(L2), Lockdown 3(L3), Lockdown 4(L4) and Unlock1 (UL1) phases. Changes in RDD values during lockdown phases were affected by lesser traffic emission, minimized industrial activities, biomass burning activities, precipitation activities, etc. Seasonal variations of RDD showed Delhites are found exposed to more fine and coarse particles’ RDD (walk and sit modes) before and after lockdown, i.e. during normal days than during lockdown phases showing potential health effects. People in sit condition found less exposed to fine and coarse RDD comparison to those in walk condition both during normal and lockdown days.
Collapse
Affiliation(s)
- Sadaf Fatima
- CSIR-National Physical Laboratory, New Delhi, 110012 India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002 India
| | - Ajit Ahlawat
- Leibniz Institute for Tropospheric Research (TROPOS), 04318 Permoserstraße, Leipzig, Germany
| | - Sumit Kumar Mishra
- CSIR-National Physical Laboratory, New Delhi, 110012 India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002 India
| | - Vijay Kumar Soni
- India Meteorological Department, Ministry of Earth Sciences, New Delhi, 110003 India
| | - Randeep Guleria
- All India Institute of Medical Sciences, New Delhi, 110029 India
| |
Collapse
|
4
|
Fang Y, Cheng H, Li X, Xu Y, Xu H, Chen Z, Cai W, Liu C, Cao J. Short-term exposure to ambient air pollution and atrial fibrillation hospitalization: A time-series study in Yancheng, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 228:112961. [PMID: 34773847 DOI: 10.1016/j.ecoenv.2021.112961] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/07/2021] [Accepted: 10/31/2021] [Indexed: 06/13/2023]
Abstract
Atrial fibrillation (AF) is an important cardiovascular disease that causes a great burden of disease. However, there is limited evidence of a link between air pollution exposure and AF. This study aimed to explore the short-term association between air pollution and AF. We obtained daily hospitalization of AF in two major hospitals of Yancheng, China from May, 2015 to May, 2020. Generalized additive models with quasi-Poisson regression were used to assess the associations between six criteria air pollutants and AF hospitalization. We explored the lag patterns, and visualized the concentration-response relationships. The robustness of the association was tested by two-pollutant model, and we explored potential effect modification by age, sex and season. A total of 15,171 inpatients from two hospitals were collected in this study with an average daily count of eight patients. We observed consistent and significant associations between six air pollutants and AF on lag 0-4 days. A 10 ug/m3 increase in PM2.5 was associated with 2.81% (95%CI: 1.44%, 4.20%) changes in AF, and the effect estimate was 1.67% (95%CI: 0.77%, 2.59%) for PM10, 4.90% (95%CI: 1.69%, 8.22%) for NO2, 6.81% (95%CI: 0.46%, 13.57%) for SO2, 1.82% (95%CI: 0.60%, 3.06%) for O3; a 0.1 mg/m3 increase in CO was associated with 2.55% (95%CI: 0.91%, 4.21%) increments in AF. Associations of PM2.5 and PM10 were robust after adjusting for SO2, NO2, CO, and O3, but not vice versa. Female patients and those aged less 70 years had larger risk of AF associated with air pollution exposure. The concentration-response curves of the six pollutants were almost linear and increasing with no obvious thresholds. This time-series study in Yancheng demonstrated increased risk of AF and a delayed effect over lag 0-4 days. Our findings suggested need of prevention and protection against these environmental risk factors for AF in health departments.
Collapse
Affiliation(s)
- Yan Fang
- Department of Cardiology, the Yancheng Clinical College of Xuzhou Medical University, Yancheng 224006, China; Department of Cardiology, the First People's Hospital of Yancheng, Yancheng 224006, China
| | - Hongyi Cheng
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xu Li
- Department of Cardiology, the Yancheng School of Clinical Medicine of Nanjing Medical University and Yancheng Third People 's Hospital, Yancheng 224006, China
| | - Yifan Xu
- Department of Radiology, the Fourth Affiliated Hospital of Nantong University, Yancheng 224006, China; Department of Radiology, the First People's Hospital of Yancheng, Yancheng 224006, China
| | - Hang Xu
- Department of Neurology, the Yancheng Clinical College of Xuzhou Medical University, Yancheng 224006, China; Department of Neurology, the First People's Hospital of Yancheng, Yancheng 224006, China
| | - Zhichao Chen
- Department of Cardiology, the Yancheng Clinical College of Xuzhou Medical University, Yancheng 224006, China; Department of Cardiology, the First People's Hospital of Yancheng, Yancheng 224006, China
| | - Weixin Cai
- Department of Hematology, the Yancheng Clinical College of Xuzhou Medical University, Yancheng 224006, China; Department of Hematology, the First People's Hospital of Yancheng, Yancheng 224006, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China.
| | - Jingyan Cao
- Department of Cardiology, the Yancheng Clinical College of Xuzhou Medical University, Yancheng 224006, China; Department of Cardiology, the First People's Hospital of Yancheng, Yancheng 224006, China.
| |
Collapse
|
5
|
Zhang Z, Kang J, Hong YS, Chang Y, Ryu S, Park J, Cho J, Guallar E, Shin HC, Zhao D. Long-Term Particulate Matter Exposure and Incidence of Arrhythmias: A Cohort Study. J Am Heart Assoc 2020; 9:e016885. [PMID: 33146044 PMCID: PMC7763729 DOI: 10.1161/jaha.120.016885] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background Studies have shown that short-term exposure to air pollution is associated with cardiac arrhythmia hospitalization and mortality. However, the relationship between long-term particulate matter air pollution and arrhythmias is still unclear. We evaluate the prospective association between particulate matter (PM) air pollution and the risk of incident arrhythmia and its subtypes. Methods and Results Participants were drawn from a prospective cohort study of 178 780 men and women who attended regular health screening exams in Seoul and Suwon, South Korea, from 2002 to 2016. Exposure to PM with an aerodynamic diameter of ≤10 and ≤2.5 μm (PM10 and PM2.5, respectively) was estimated using a land-use regression model. The associations between long-term PM air pollution and arrhythmia were examined using pooled logistic regression models with time-varying exposure and covariables. In the fully adjusted model, the odds ratios (ORs) for any arrhythmia associated with a 10 μg/m3 increase in 12-, 36-, and 60-month PM10 exposure were 1.15 (1.09, 1.21), 1.12 (1.06, 1.18), and 1.14 (1.08, 1.20), respectively. The ORs with a 10 μg/m3 increase in 12- and 36-month PM2.5 exposure were 1.27 (1.15, 1.40) and 1.10 (0.99, 1.23). PM10 was associated with increased risk of incident bradycardia and premature atrial contraction. PM2.5 was associated with increased risk of incident bradycardia and right bundle-branch block. Conclusions In this large cohort study, long-term exposure to outdoor PM air pollution was associated with increased risk of arrhythmia. Our findings indicate that PM air pollution may be a contributor to cardiac arrhythmia in the general population.
Collapse
Affiliation(s)
- Zhenyu Zhang
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Jeonggyu Kang
- Center for Cohort Studies Total Healthcare Center Kangbuk Samsung HospitalSungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Yun Soo Hong
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Yoosoo Chang
- Center for Cohort Studies Total Healthcare Center Kangbuk Samsung HospitalSungkyunkwan University School of Medicine Seoul Republic of Korea.,Department of Clinical Research Design and Evaluation SAIHST Seoul Republic of Korea.,Department of Occupational and Environmental Medicine Kangbuk Samsung HospitalSungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies Total Healthcare Center Kangbuk Samsung HospitalSungkyunkwan University School of Medicine Seoul Republic of Korea.,Department of Clinical Research Design and Evaluation SAIHST Seoul Republic of Korea.,Department of Occupational and Environmental Medicine Kangbuk Samsung HospitalSungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Jihwan Park
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Juhee Cho
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD.,Center for Cohort Studies Total Healthcare Center Kangbuk Samsung HospitalSungkyunkwan University School of Medicine Seoul Republic of Korea.,Department of Clinical Research Design and Evaluation SAIHST Seoul Republic of Korea
| | - Eliseo Guallar
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Ho Cheol Shin
- Department of Family Medicine Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Di Zhao
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| |
Collapse
|
6
|
Abstract
Air pollutants pose a serious worldwide health hazard, causing respiratory and cardiovascular morbidity and mortality. Pollutants perturb the autonomic nervous system, whose function is critical to cardiopulmonary homeostasis. Recent studies suggest that pollutants can stimulate defensive sensory nerves within the cardiopulmonary system, thus providing a possible mechanism for pollutant-induced autonomic dysfunction. A better understanding of the mechanisms involved would likely improve the management and treatment of pollution-related disease.
Collapse
Affiliation(s)
- Thomas E Taylor-Clark
- Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida
| |
Collapse
|
7
|
Peralta AA, Link MS, Schwartz J, Luttmann-Gibson H, Dockery DW, Blomberg A, Wei Y, Mittleman MA, Gold DR, Laden F, Coull BA, Koutrakis P. Exposure to Air Pollution and Particle Radioactivity With the Risk of Ventricular Arrhythmias. Circulation 2020; 142:858-867. [PMID: 32795087 PMCID: PMC7484430 DOI: 10.1161/circulationaha.120.046321] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/11/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Individuals are exposed to air pollution and ionizing radiation from natural sources through inhalation of particles. This study investigates the association between cardiac arrhythmias and short-term exposures to fine particulate matter (particulate matter ≤2.5 µm aerodynamic diameter; PM2.5) and particle radioactivity. METHODS Ventricular arrhythmic events were identified among 176 patients with dual-chamber implanted cardioverter-defibrillators in Boston, Massachusetts between September 2006 and June 2010. Patients were assigned exposures based on residential addresses. Daily PM2.5 levels were estimated at 1-km×1-km grid cells from a previously validated prediction model. Particle gross β activity was used as a surrogate for particle radioactivity and was measured from several monitoring sites by the US Environmental Protection Agency's monitoring network. The association of the onset of ventricular arrhythmias (VA) with 0- to 21-day moving averages of PM2.5 and particle radioactivity (2 single-pollutant models and a 2-pollutant model) before the event was examined using time-stratified case-crossover analyses, adjusted for dew point and air temperatures. RESULTS A total of 1,050 VA were recorded among 91 patients, including 123 sustained VA among 25 of these patients. In the single-pollutant model of PM2.5, each interquartile range increase in daily PM2.5 levels for a 21-day moving average was associated with 39% higher odds of a VA event (95% CI, 12%-72%). In the single-pollutant model of particle radioactivity, each interquartile range increase in particle radioactivity for a 2-day moving average was associated with 13% higher odds of a VA event (95% CI, 1%-26%). In the 2-pollutant model, for the same averaging window of 21 days, each interquartile range increase in daily PM2.5 was associated with an 48% higher odds of a VA event (95% CI, 15%-90%), and each interquartile range increase of particle radioactivity with a 10% lower odds of a VA event (95% CI, -29% to 14%). We found that with higher levels of particle radioactivity, the effect of PM2.5 on VAs is reduced. CONCLUSIONS In this high-risk population, intermediate (21-day) PM2.5 exposure was associated with higher odds of a VA event onset among patients with known cardiac disease and indication for implanted cardioverter-defibrillator implantation independently of particle radioactivity.
Collapse
Affiliation(s)
- Adjani A. Peralta
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Mark S. Link
- UTSouthwestern Medical Center, Department of Internal Medicine, Division of Cardiology, Cardiac Arrhythmia Service, Dallas, TX
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Heike Luttmann-Gibson
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Douglas W. Dockery
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Annelise Blomberg
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Murray A. Mittleman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA
| | - Diane R. Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Brent A. Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| |
Collapse
|
8
|
Seposo X, Ueda K, Sugata S, Yoshino A, Takami A. Short-term effects of air pollution on daily single- and co-morbidity cardiorespiratory outpatient visits. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 729:138934. [PMID: 32371210 DOI: 10.1016/j.scitotenv.2020.138934] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 04/14/2023]
Abstract
Several studies have noted that the existence of comorbidities lead to an increase in the risk of premature mortality and morbidity. Most of the studies examining the effects of air pollution on comorbidity visits were from Northern American countries, with scarce literature from Asia. This study contributes to existing, yet limited understanding of air pollution-comorbidity by examining the effects of daily air pollutants on outpatient single morbidity and comorbid cardiorespiratory visits in Japan. A total of 1,452,505 outpatient cardiorespiratory visits were recorded among the 21 Japanese cities from 2013 to 2016. Daily outpatient cardiorespiratory visit data were obtained from a health insurance claims database managed by the Japan Medical Data Center Co., Ltd. (JMDC). A time-stratified case crossover analysis coupled with Generalized Additive Mixed Model was used to analyze the association of daily air pollutants (particulate matter 2.5 μm or less in diameter, ozone and nitrogen dioxide) on daily single (respiratory and cardiovascular) and comorbidity health outcomes. We further examined single and cumulative effects for 0-3 and 0-14 lag periods. Ozone, NO2, and PM2.5 were positively associated with cardiorespiratory visits in either shorter or longer lags, with more apparent comorbidity associations with NO2 exposure. A 10-unit increase in NO2, after adjusting for ozone, was associated with a 2.24% (95% CI: 1.34-3.15) and 6.49% (95% CI: 5.00-8.01) increase in comorbidity visit at Lag 0 (of Lag 0-3) and cumulative lag 0-3, respectively. Our results contribute to existing evidence suggesting that short-term and extended exposure to air pollution elicit health risks on cardiovascular, respiratory and comorbid clinic visits. Exposure to NO2, in particular, was associated with increase in the risk of single and comorbidity cardiorespiratory visits. Results can be potentially utilized for both individual health (e.g. risk population health management) and health facility management (e.g. health visit influx determination).
Collapse
Affiliation(s)
- Xerxes Seposo
- School of Tropical Medicine and Global Health, Nagasaki University, Japan.
| | - Kayo Ueda
- Environmental Health Division, Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Japan; Environmental Health Sciences, Department of Global Ecology, Graduate School of Global Environmental Studies, Kyoto University, Japan
| | - Seiji Sugata
- Center for Regional Environmental Research, National Institute for Environmental Studies, Japan
| | - Ayako Yoshino
- Center for Regional Environmental Research, National Institute for Environmental Studies, Japan
| | - Akinori Takami
- Center for Regional Environmental Research, National Institute for Environmental Studies, Japan
| |
Collapse
|
9
|
Shahrbaf MA, Akbarzadeh MA, Tabary M, Khaheshi I. Air Pollution and Cardiac Arrhythmias: A Comprehensive Review. Curr Probl Cardiol 2020; 46:100649. [PMID: 32839041 DOI: 10.1016/j.cpcardiol.2020.100649] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/11/2020] [Indexed: 12/26/2022]
Abstract
Air pollution is the mixture of some chemical and environmental agents including dust, fumes, gases, particulate matters, and biological materials which can be harmful for the environment and the human body. The increasing trend of the air pollution, especially in developing countries, may exert its detrimental effects on human health. The potentially harmful effects of air pollution on the human health have been recognized and many epidemiological studies have clearly suggested the strong association between air pollution exposure and increased morbidities and mortalities. Air pollutants are classified into gaseous pollutants including carbon mono oxide, nitrogen oxides, ozone and sulfur dioxide, and particulate matters (PMs). All air pollutants have destructive effects on the health systems including cardiovascular system. Many studies have demonstrated the effect of air pollutant on the occurrence of ST elevation myocardial infarction, sudden cardiac death, cardiac arrythmias, and peripheral arterial disease. Recently, some studies suggested that air pollution may be associated with cardiac arrhythmias. In this study, we aimed to comprehensively review the last evidences related to the association of air pollutant and cardiac arrythmias. We found that particulate matters (PM10, PM2.5, and UFP) and gaseous air pollutants can exert undesirable effects on cardiac rhythms. Short-term and long-term exposure to the air pollutants can interact with the cardiac rhythms through oxidative stress, autonomic dysfunction, coagulation dysfunction, and inflammation. It seems that particulate matters, especially PM2.5 have stronger association with cardiac arrhythmias among all air pollutants. However, future studies are needed to confirm these results.
Collapse
|
10
|
Yang M, Zhou R, Qiu X, Feng X, Sun J, Wang Q, Lu Q, Zhang P, Liu B, Li W, Chen M, Zhao Y, Mo B, Zhou X, Zhang X, Hua Y, Guo J, Bi F, Cao Y, Ling F, Shi S, Li YG. Artificial intelligence-assisted analysis on the association between exposure to ambient fine particulate matter and incidence of arrhythmias in outpatients of Shanghai community hospitals. ENVIRONMENT INTERNATIONAL 2020; 139:105745. [PMID: 32334122 DOI: 10.1016/j.envint.2020.105745] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Recently, the impact of fine particulate matter pollution on cardiovascular system is drawing considerable concern worldwide. The association between ambient fine particulate and the cardiac arrhythmias is not clear now. OBJECTIVE To study associations of ambient fine particulate with incidence of arrhythmias in outpatients. METHODS Data was collected from the remote electrocardiogram (ECG) system covering 282 community hospitals in Shanghai from June 24th, 2014 to June 23rd, 2016. ECG was performed for patients admitted to above hospitals with complaining of chest discomfort or palpitation, or for regular check-ups. Air quality data during this time period was obtained from China National Environment Monitoring Center. A generalized additive quasi-Poisson model was established to examine the associations between PM2.5 and cardiac arrhythmias. RESULTS Cardiac arrhythmias were detected in 202,661 out of 1,016,579 outpatients (19.9%) and fine particulate matter ranged from 6 to 219 μg/m3 during this period. Positive associations were evidenced between fine particulate matter level and prevalence of cardiac arrhythmia by different lag models. Per 10 μg/m3 increase in fine particulate matter was associated with a 0.584%(95%CI:0.346-0.689%, p < 0.001) increase of cardiac arrhythmia detected in these patient cohort at lag0-2. For different types of cardiac arrhythmias, an immediate arrhythmogenic effect of fine particulate matter (increase of the estimates of cardiac arrhythmia prevalence detected in daily outpatient visits) was found with paroxysmal supraventricular tachycardia; a lag effect was found with atrial fibrillation; and both immediate and lag effect was found with premature atrial contractions or atrial tachycardia, atrioventricular block. Moreover, the impact of fine particulate matter on cardiac arrhythmias was significantly greater in women (lag3 and lag0-4), and in people aged <65 years (lag0). CONCLUSION Ambient exposure to fine particulate matter is linked with increased risk of arrhythmias in outpatients visiting Shanghai community hospitals, with an immediate or lag effect. The arrhythmogenic effect varies among different types of cardiac arrhythmias.
Collapse
Affiliation(s)
- Mei Yang
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Runze Zhou
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Department of Cardiology, East Hospital, Tongji University, Shanghai, China
| | | | - Xiangfei Feng
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jian Sun
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qunshan Wang
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qiufen Lu
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Pengpai Zhang
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bo Liu
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Li
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mu Chen
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Zhao
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Binfeng Mo
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xin Zhou
- Clinical Research Unit, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xi Zhang
- Clinical Research Unit, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yingxue Hua
- Pudong New Area Heqing Community Health Center, Shanghai, China
| | - Jin Guo
- Shanghai Huangpu Bund Subdistrict Community Health Center, Shanghai, China
| | - Fangfang Bi
- Changning Tianshan Community Health Center, Shanghai, China
| | - Yajun Cao
- Pudong New Area Sunqiao Community Health Center, Shanghai, China
| | - Feng Ling
- Shanghai Lingyun Community Health Center, Shanghai, China
| | - Shengming Shi
- Shangnail Xinhua Street Community Health Service Center, Shanghai, China
| | - Yi-Gang Li
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| |
Collapse
|
11
|
Lee HH, Pan SC, Chen BY, Lo SH, Guo YL. Atrial fibrillation hospitalization is associated with exposure to fine particulate air pollutants. Environ Health 2019; 18:117. [PMID: 31888649 PMCID: PMC6937716 DOI: 10.1186/s12940-019-0554-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 12/18/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND Although air pollutants have been associated with cardiopulmonary mortality, their effects on the occurrence of atrial fibrillation (Afib) remain unclear. This study examined the association between ambient air pollutants and Afib occurrence. METHODS Using a representative sample from the National Health Insurance Database of Taiwan, we applied a case-crossover study design to explore the associations between air pollutants and patients hospitalized with Afib from 2006 to 2011. The event day was when a patient was hospitalized with Afib, and the control days were the same days of the following weeks of the same month. The association between Afib occurrence and levels of ambient air pollutants (including particulate matter [PM] 2.5 PM10, NO2, SO2, and O3) was examined after adjusting for temperature and relative humidity. A two-pollutant model was used to examine the effect of the second pollutant when the first pollutant was determined to be significantly related to Afib. RESULTS During 2006-2011, 670 patients hospitalized with the first onset of Afib were identified. The occurrence of Afib was associated with PM2.5, in which a 22% (95% confidence interval = 3-44%) increase was related to an interquartile range increase (26.2 μg/m3) on the same day and a 19% (95% confidence interval = 0-40%) increase on the second day. A two-pollutant model was applied, and the results indicated that the effect of PM2.5 was significantly associated with the occurrence of Afib. Patients aged over 65 years with DM and with hyperlipidemia were more susceptible to the effect of PM2.5. CONCLUSIONS In conclusion, the occurrence of Afib was associated with short-term exposure to fine particulate air pollutants in the general population.
Collapse
Affiliation(s)
- Hsiu Hao Lee
- Department of Internal Medicine, Taipei City Hospital, Zhongxing Branch, No. 145, Zhengzhou Rd., Datong Dist, Taipei City, 10341, Taiwan
| | - Shih Chun Pan
- Institution of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Room 703, No. 17, Xu-Zhou Road, Taipei, 100, Taiwan
| | - Bing Yu Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, 10 F, Bldg F, 3 Yuanqu Street, Taipei, 11503, Taiwan
| | - Shih Hsiang Lo
- Department of Internal Medicine, Taipei City Hospital, Zhongxing Branch, No. 145, Zhengzhou Rd., Datong Dist, Taipei City, 10341, Taiwan
| | - Yue Leon Guo
- Institution of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Room 703, No. 17, Xu-Zhou Road, Taipei, 100, Taiwan.
- National Institute of Environmental Health Sciences, National Health Research Institutes, 10 F, Bldg F, 3 Yuanqu Street, Taipei, 11503, Taiwan.
- Environmental and Occupational Medicine, National Taiwan University and NTU Hospital, Taipei, 100, Taiwan.
| |
Collapse
|
12
|
Kim IS, Yang PS, Lee J, Yu HT, Kim TH, Uhm JS, Pak HN, Lee MH, Joung B. Long-term exposure of fine particulate matter air pollution and incident atrial fibrillation in the general population: A nationwide cohort study. Int J Cardiol 2019; 283:178-183. [DOI: 10.1016/j.ijcard.2018.12.048] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 12/04/2018] [Accepted: 12/17/2018] [Indexed: 12/30/2022]
|
13
|
Tsai T, Lo L, Liu S, Cheng W, Chou Y, Lin W, Shinya Y, Lin Y, Chang S, Hu Y, Chung F, Liao J, Chao T, Tuan T, Chen S. Ambient fine particulate matter (PM2.5) exposure is associated with idiopathic ventricular premature complexes burden: A cohort study with consecutive Holter recordings. J Cardiovasc Electrophysiol 2019; 30:487-492. [DOI: 10.1111/jce.13829] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/20/2018] [Accepted: 12/03/2018] [Indexed: 01/02/2023]
Affiliation(s)
- Tsung‐Ying Tsai
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
| | - Li‐Wei Lo
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang‐Ming UniversityTaipei Taiwan
| | - Shin‐Huei Liu
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
| | - Wen‐Han Cheng
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
| | - Yu‐Hui Chou
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
| | - Wei‐Lun Lin
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang‐Ming UniversityTaipei Taiwan
| | - Yamada Shinya
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
| | - Yenn‐Jiang Lin
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang‐Ming UniversityTaipei Taiwan
| | - Shih‐Lin Chang
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang‐Ming UniversityTaipei Taiwan
| | - Yu‐Feng Hu
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang‐Ming UniversityTaipei Taiwan
| | - Fa‐Po Chung
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang‐Ming UniversityTaipei Taiwan
| | - Jo‐Nan Liao
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang‐Ming UniversityTaipei Taiwan
| | - Tze‐Fan Chao
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang‐Ming UniversityTaipei Taiwan
| | - Ta‐Chuan Tuan
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang‐Ming UniversityTaipei Taiwan
| | - Shih‐Ann Chen
- Division of Cardiology, Department of MedicineTaipei Veterans General HospitalTaipei Taiwan
- Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang‐Ming UniversityTaipei Taiwan
| |
Collapse
|
14
|
Boovarahan SR, Kurian GA. Mitochondrial dysfunction: a key player in the pathogenesis of cardiovascular diseases linked to air pollution. REVIEWS ON ENVIRONMENTAL HEALTH 2018; 33:111-122. [PMID: 29346115 DOI: 10.1515/reveh-2017-0025] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 12/11/2017] [Indexed: 06/07/2023]
Abstract
Air pollution has become an environmental burden with regard to non-communicable diseases, particularly heart disease. It has been reported that air pollution can accelerate the development of heart failure and atrial fibrillation. Air pollutants encompass various particulate matters (PMs), which change the blood composition and heart rate and eventually leads to cardiac failure by triggering atherosclerotic plaque ruptures or by developing irreversible ischemia. A series of major epidemiological and observational studies have established the noxious effect of air pollutants on cardiovascular diseases (CVD), but the underlying molecular mechanisms of its susceptibility and the pathological disease events remain largely elusive and are predicted to be initiated in the cell organelle. The basis of this belief is that mitochondria are one of the major targets of environmental toxicants that can damage mitochondrial morphology, function and its DNA (manifested in non-communicable diseases). In this article, we review the literature related to air pollutants that adversely affect the progression of CVD and that target mitochondrial morphological and functional activities and how mitochondrial DNA (mtDNA) copy number variation, which reflects the airborne oxidant-induced cell damage, correlates with heart failure. We conclude that environmental health assessment should focus on the cellular/circulatory mitochondrial functional copy number status, which can predict the outcome of CVD.
Collapse
Affiliation(s)
- Sri Rahavi Boovarahan
- Vascular Biology Laboratory, School of Chemical and Biotechnology, SASTRA University, Thanjavur, Tamilnadu, India
| | - Gino A Kurian
- Vascular Biology Laboratory, School of Chemical and Biotechnology, SASTRA University, Thanjavur, Tamilnadu, India
| |
Collapse
|
15
|
Abstract
Air pollution is a significant environmental and health hazard. Earlier studies had examined the adverse health effects associated with short- and long-term exposure to particulate matter on respiratory disease. However, later studies demonstrated that was actually cardiovascular disease that accounted for majority of mortality. Furthermore, it was not gaseous pollutants like oxides of nitrate, sulfur, carbon mono-oxide or ozone but the particulate matter or PM, of fine or coarse size (PM2.5 and PM10) which was linearly associated with mortality; PM2.5 with long term and PM10 with short term. Several cardiovascular diseases are associated with pollution; acute myocardial infarction, heart failure, cardiac arrhythmias, atherosclerosis and cardiac arrest. The ideal way to address this problem is by adhering to stringent environmental standards of pollutants but some individual steps like choosing to stay indoors (on high pollution days), reducing outdoor air permeation to inside, purifying indoor air using air filters, and also limiting outdoor physical activity near source of air pollution can help. Nutritional anti-oxidants like statins or Mediterranean diet, and aspirin have not been associated with reduced risk but specific nutritional agents like broccoli, cabbage, cauliflower or brussels sprouts, fish oil supplement may help. Use of face-mask has been controversial but may be useful if particulate matter load is higher.
Collapse
|
16
|
Folino F, Buja G, Zanotto G, Marras E, Allocca G, Vaccari D, Gasparini G, Bertaglia E, Zoppo F, Calzolari V, Suh RN, Ignatiuk B, Lanera C, Benassi A, Gregori D, Iliceto S. Association between air pollution and ventricular arrhythmias in high-risk patients (ARIA study): a multicentre longitudinal study. Lancet Planet Health 2017; 1:e58-e64. [PMID: 29851582 DOI: 10.1016/s2542-5196(17)30020-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 02/18/2017] [Accepted: 03/15/2017] [Indexed: 05/27/2023]
Abstract
BACKGROUND Although the effects of air pollution on mortality have been clearly shown in many epidemiological and observational studies, the pro-arrhythmic effects remain unknown. We aimed to assess the short-term effects of air pollution on ventricular arrhythmias in a population of high-risk patients with implantable cardioverter-defibrillators (ICDs) or cardiac resynchronisation therapy defibrillators (ICD-CRT). METHODS In this prospective multicentre study, we assessed 281 patients (median age 71 years) across nine centres in the Veneto region of Italy. Episodes of ventricular tachycardia and ventricular fibrillation that were recorded by the diagnostic device were considered in this analysis. Concentrations of particulate matter of less than 10 μm (PM10) and less than 2·5 μm (PM2·5) in aerodynamic diameter, carbon monoxide, nitrogen dioxide, sulphur dioxide, and ozone were obtained daily from monitoring stations, and the 24 h median value was considered. Each patient was associated with exposure data from the monitoring station that was closest to their residence. Patients were followed up for 1 year and then scheduled to have a closing visit, within 1 more year. This study is registered with ClinicalTrials.gov, number NCT01723761. FINDINGS Participants were enrolled from April 1, 2011, to Sept 30, 2012, and follow-ups (completed on April 5, 2014) ranged from 637 to 1177 days (median 652 days). The incidence of episodes of ventricular tachycardia and ventricular fibrillation correlated significantly with PM2·5 (p<0·0001) but not PM10. An analysis of ventricular fibrillation episodes alone showed a significant increase in risk of higher PM2·5 (p=0·002) and PM10 values (p=0·0057). None of the gaseous pollutants were significantly linked to the occurrence of ventricular tachycardia or ventricular fibrillation. In a subgroup analysis of patients with or without a previous myocardial infarction, only the first showed a significant association between particulate matter and episodes of ventricular tachycardia or ventricular fibrillation. INTERPRETATION Particulate matter has acute pro-arrhythmic effects in a population of high-risk patients, which increase on exposure to fine particles and in patients who have experienced a previous myocardial infarction. The time sequence of the arrhythmic events suggests there is an underlying neurally mediated mechanism. From a clinical point of view, the results of our study should encourage physicians to also consider environmental risk when addressing the prevention of arrhythmic events, particularly in patients with coronary heart disease, advising them to avoid exposure to high levels of fine particulate matter. FUNDING There was no funding source for this study.
Collapse
Affiliation(s)
- Franco Folino
- Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
| | - Gianfranco Buja
- Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Gabriele Zanotto
- Department of Cardiology, Mater Salutis Hospital, Legnago, Italy
| | - Elena Marras
- Department of Cardiology, S Maria dei Battuti Hospital, Conegliano, Italy
| | - Giuseppe Allocca
- Department of Cardiology, S Maria dei Battuti Hospital, Conegliano, Italy
| | - Diego Vaccari
- Department of Cardiology, Civic Hospital, Montebelluna, Italy
| | | | - Emanuele Bertaglia
- Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Franco Zoppo
- Department of Cardiology, Civic Hospital, Mirano, Italy
| | | | - Rene Nangah Suh
- Department of Cardiology, Civic Hospital, Portogruaro, Italy
| | | | - Corrado Lanera
- Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Alessandro Benassi
- Regional Agency for Environmental Prevention and Protection of the Veneto Region, Padua, Italy
| | - Dario Gregori
- Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Sabino Iliceto
- Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| |
Collapse
|
17
|
O’Neal WT, Soliman EZ, Efird JT, Judd SE, Howard VJ, Howard G, McClure LA. Fine particulate air pollution and premature atrial contractions: The REasons for Geographic And Racial Differences in Stroke study. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2017; 27:271-275. [PMID: 27649843 PMCID: PMC5457811 DOI: 10.1038/jes.2016.46] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 05/26/2016] [Indexed: 05/03/2023]
Abstract
Several reports have suggested that particulate matter (PM) exposure increases the risk for atrial arrhythmias. However, data from large-scale epidemiologic studies supporting this hypothesis are lacking. We examined the association of PM <2.5 μm in diameter (PM2.5) concentration with premature atrial contractions (PACs) in 26,609 (mean age=65±9.4 years; 55% female; 41% black) participants from the REGARDS (REasons for Geographic And Racial Differences in Stroke) study. Estimates of short- (2 weeks) and long-term (1 year) PM2.5 exposure were computed before each participant's baseline visit using geographic information system data on the individual level at the coordinates of study participants' residences. PACs were identified from baseline electrocardiograms. A total of 2140 (8.2%) participants had evidence of PACs on the baseline electrocardiogram. Short-term PM2.5 (per 10 μg/m3) exposure was not associated with PACs (OR=1.09, 95% CI=0.98, 1.23). Increases in long-term PM2.5 (per 10 μg/m3) were associated with PACs (OR=1.40, 95% CI=1.10, 1.78). Interactions were not detected for short- and long-term PM2.5 exposure by age, sex, or race. Long- but not short-term PM2.5 exposure is associated with PACs. This suggests a role for long-term PM2.5 exposure in initiating supraventricular arrhythmias that are triggered by PACs.
Collapse
Affiliation(s)
- Wesley T. O’Neal
- Department of Medicine, Division of Cardiology, Emory University
School of Medicine, Atlanta, GA
| | - Elsayed Z. Soliman
- Department of Medicine, Section on Cardiology, Wake Forest School of
Medicine, Winston-Salem, NC
- Epidemiological Cardiology Research Center (EPICARE), Department of
Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC
| | - Jimmy T. Efird
- Department of Cardiovascular Sciences, East Carolina Heart
Institute, Brody School of Medicine, East Carolina University, Greenville, NC
| | - Suzanne E. Judd
- Department of Biostatistics, School of Public Health, University of
Alabama at Birmingham, Birmingham, AL
| | - Virginia J. Howard
- Department of Epidemiology, School of Public Health, University of
Alabama at Birmingham, Birmingham, AL
| | - George Howard
- Department of Biostatistics, School of Public Health, University of
Alabama at Birmingham, Birmingham, AL
| | - Leslie A. McClure
- Department of Epidemiology and Biostatistics, Dornsife School of
Public Health, Drexel University, Philadelphia, PA
| |
Collapse
|
18
|
O'Neal WT, Soliman EZ, Efird JT, Howard VJ, Howard G, McClure LA. Fine particulate air pollution and premature ventricular contractions: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study. ENVIRONMENTAL RESEARCH 2017; 154:115-119. [PMID: 28061370 PMCID: PMC5354125 DOI: 10.1016/j.envres.2016.12.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 12/26/2016] [Accepted: 12/27/2016] [Indexed: 06/01/2023]
Abstract
BACKGROUND It is unknown if higher levels of ambient particulate matter (PM) exposure increase the risk for premature ventricular contractions (PVC) in a population-based study of men and women, and if this relationship varies by race or sex. METHODS We examined the association of PM <2.5µm in diameter (PM2.5) concentration with PVCs in 26,121 (mean age=64±9.3 years; 55% female; 41% black) participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Estimates of short- (2-week) and long-term (1-year) PM2.5 exposures were computed prior to the baseline visit using geographic information system data on the individual level at the coordinates of study participants' residences. PVCs were identified from baseline electrocardiograms. RESULTS PVCs were detected in 1719 (6.6%) study participants. Short- (OR=1.08, 95%CI=1.03, 1.14) and long- (OR=1.06, 95%CI=1.01, 1.12) term PM2.5 exposures were associated with PVCs. Interactions were not detected by race or sex. An interaction between short-term PM2.5 exposure and PVCs was detected for those with cardiovascular disease (OR=1.16, 95%CI=1.06, 1.27) compared with those without cardiovascular disease (OR=1.05, 95%CI=0.99, 1.12; p-interaction=0.027). CONCLUSION Our findings suggest that PM2.5 exposure is associated with an increased risk for PVCs in a biracial population-based study of men and women. We also have identified persons with cardiovascular disease as an at-risk population for PVCs when increases in short-term PM2.5 concentration occur.
Collapse
Affiliation(s)
- Wesley T O'Neal
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Elsayed Z Soliman
- Department of Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, NC, USA; Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jimmy T Efird
- Department of Cardiovascular Sciences, East Carolina Heart Institute, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - George Howard
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| |
Collapse
|
19
|
Gany F, Bari S, Prasad L, Leng J, Lee T, Thurston GD, Gordon T, Acharya S, Zelikoff JT. Perception and reality of particulate matter exposure in New York City taxi drivers. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2017; 27:221-226. [PMID: 27168392 PMCID: PMC5547750 DOI: 10.1038/jes.2016.23] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 03/22/2016] [Indexed: 05/05/2023]
Abstract
Exposure to fine particulate matter (PM2.5) and black carbon (BC) have been linked to negative health risks, but exposure among professional taxi drivers is understudied. This pilot study measured drivers' knowledge, attitudes, and beliefs (KAB) about air pollution compared with direct measures of exposures. Roadside and in-vehicle levels of PM2.5 and BC were continuously measured over a single shift on each subject, and exposures compared with central site monitoring. One hundred drivers completed an air pollution KAB questionnaire, and seven taxicabs participated in preliminary in-cab air sampling. Taxicab PM2.5 and BC concentrations were elevated compared with nearby central monitoring. Average PM2.5 concentrations per 15-min interval were 4-49 μg/m3. BC levels were also elevated; reaching>10 μg/m3. Fifty-six of the 100 drivers surveyed believed they were more exposed than non-drivers; 81 believed air pollution causes health problems. Air pollution exposures recorded suggest that driver exposures would likely exceed EPA recommendations if experienced for 24 h. Surveys indicated that driver awareness of this was limited. Future studies should focus on reducing exposures and increasing awareness among taxi drivers.
Collapse
Affiliation(s)
- Francesca Gany
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine; Weill Cornell Medical College, Department of Public Health; 300 E. 66 St., New York, NY 10065
| | - Sehrish Bari
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences; 300 East 66 St., New York, NY 10065
| | - Lakshmi Prasad
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences; 300 East 66 St., New York, NY 10065
| | - Jennifer Leng
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine; Weill Cornell Medical College, Department of Public Health; 300 E. 66 St., New York, NY 10065
| | - Trevor Lee
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences; 300 East 66 St., New York, NY 10065
| | - George D Thurston
- New York University School of Medicine, Department of Environmental Medicine. 57 Old Forge Road, Tuxedo, NY 10987
| | - Terry Gordon
- New York University School of Medicine, Department of Environmental Medicine. 57 Old Forge Road, Tuxedo, NY 10987
| | - Sudha Acharya
- South Asian Council for Social Services, 143-06 45th Avenue, Flushing, NY 11355
| | - Judith T Zelikoff
- New York University School of Medicine, Department of Environmental Medicine. 57 Old Forge Road, Tuxedo, NY 10987
| |
Collapse
|
20
|
Buteau S, Goldberg MS. A structured review of panel studies used to investigate associations between ambient air pollution and heart rate variability. ENVIRONMENTAL RESEARCH 2016; 148:207-247. [PMID: 27085495 DOI: 10.1016/j.envres.2016.03.013] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/04/2016] [Accepted: 03/08/2016] [Indexed: 05/25/2023]
Abstract
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.
Collapse
Affiliation(s)
- Stephane Buteau
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Institut national de sante publique du Quebec (INSPQ), Montreal, Quebec, Canada.
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada
| |
Collapse
|
21
|
Wang F, Jia X, Wang X, Zhao Y, Hao W. Particulate matter and atherosclerosis: a bibliometric analysis of original research articles published in 1973-2014. BMC Public Health 2016; 16:348. [PMID: 27093947 PMCID: PMC4837518 DOI: 10.1186/s12889-016-3015-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 04/08/2016] [Indexed: 11/22/2022] Open
Abstract
Background Epidemiological and experimental studies have suggested that exposure to particulate air pollution may promote progression of atherosclerosis. Methods In the present study, the characteristics and trends of the research field of particulate matter (PM) and atherosclerosis were analyzed using bibliometric indicators. Bibliometric analysis was based on original papers obtained from PubMed/MEDLINE search results (from 1973 to 2014) using Medical Subject Headings (MeSH) terms. A fully-detailed search strategy was employed, and articles were imported into the Thomson Data Analyzer (TDA) software. Results The visualizing network of the collaborative researchers was analyzed by Ucinet 6 software. Main research topics and future focuses were explored by co-word and cluster analysis. The characteristics of these research articles were summarized. The number of published articles has increased from five for the period 1973–1978 to 89 for the period 2009–2014. Tobacco smoke pollution, smoke and air PM were the most studied targets in this research field. Coronary disease was the top health outcome posed by PM exposure. The aorta and endothelium vascular were the principal locations of atherosclerotic lesions, which were enhanced by PM exposure. Oxidative stress and inflammation were of special concern in the current mechanistic research system. The top high-frequency MeSH terms were clustered, and four popular topics were further presented. Conclusion Based on the quantitative analysis of bibliographic information and MeSH terms, we were able to define the study characteristics and popular topics in the field of PM and atherosclerosis. Our analysis would provide a comprehensive background reference for researchers in this field of study.
Collapse
Affiliation(s)
- Feifei Wang
- Department of Toxicology, School of Public Health, Peking University, Beijing, 100191, China.,State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China
| | - Xiaofeng Jia
- Institute of Medical Information & Library, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, 100020, China
| | - Xianliang Wang
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China
| | - Yongdong Zhao
- Department of Toxicology, Baotou Medical College of Public Health, Baotou, 014040, China
| | - Weidong Hao
- Department of Toxicology, School of Public Health, Peking University, Beijing, 100191, China.
| |
Collapse
|
22
|
Cavallari JM, Fang SC, Eisen EA, Mittleman MA, Christiani DC. Environmental and occupational particulate matter exposures and ectopic heart beats in welders. Occup Environ Med 2016; 73:435-41. [PMID: 27052768 DOI: 10.1136/oemed-2015-103256] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 03/18/2016] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Links between arrhythmias and particulate matter exposures have been found among sensitive populations. We examined the relationship between personal particulate matter ≤2.5 µm aerodynamic diameter (PM2.5) exposures and ectopy in a panel study of healthy welders. METHODS Simultaneous ambulatory ECG and personal PM2.5 exposure monitoring with DustTrak Aerosol Monitor was performed on 72 males during work and non-work periods for 5-90 h (median 40 h). ECGs were summarised hourly for supraventricular ectopy (SVE) and ventricular ectopy (VE). PM2.5 exposures both work and non-work periods were averaged hourly with lags from 0 to 7 h. Generalised linear mixed-effects models with a random participant intercept were used to examine the relationship between PM2.5 exposure and the odds of SVE or VE. Sensitivity analyses were performed to assess whether relationships differed by work period and among current smokers. RESULTS Participants had a mean (SD) age of 38 (11) years and were monitored over 2993 person-hours. The number of hourly ectopic events was highly skewed with mean (SD) of 14 (69) VE and 1 (4) SVE. We found marginally significant increases in VE with PM2.5 exposures in the sixth and seventh hour lags, yet no association with SVE. For every 100 μg/m(3) increase in sixth hour lagged PM2.5, the adjusted OR (95% CI) for VE was 1.03 (1.00 to 1.05). Results persisted in work or non-work exposure periods and non-smokers had increased odds of VE associated with PM2.5 as compared with smokers. CONCLUSIONS A small increase in the odds of VE with short-term PM2.5 exposure was observed among relatively healthy men with environmental and occupational exposures.
Collapse
Affiliation(s)
- Jennifer M Cavallari
- Division of Occupational and Environmental Medicine, UConn Health Center, Farmington, Connecticut, USA Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Shona C Fang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ellen A Eisen
- School of Public Health, University of California, Berkeley, California, USA
| | - Murray A Mittleman
- Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA Massachusetts General Hospital, Boston, Massachusetts, USA
| |
Collapse
|
23
|
Cakmak S, Kauri L, Shutt R, Liu L, Green MS, Mulholland M, Stieb D, Dales R. The association between ambient air quality and cardiac rate and rhythm in ambulatory subjects. ENVIRONMENT INTERNATIONAL 2014; 73:365-71. [PMID: 25226341 DOI: 10.1016/j.envint.2014.08.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 06/24/2014] [Accepted: 08/20/2014] [Indexed: 05/27/2023]
Abstract
BACKGROUND Acute increases in ambient air pollution have been associated with increased hospitalization for cardiac diseases and stroke. Triggering of cardiac arrhythmia by changes in air quality could theoretically predispose individuals to cardiac arrest or heart failure, or stroke through precipitation of atrial fibrillation. We investigated the association between air quality and cardiac rate and rhythm characteristics measured by ambulatory cardiac monitoring. METHODS AND RESULTS Daily ambient 3-h maximum concentrations of ozone, nitrogen dioxide and fine particulate matter, and an index summarizing these pollutants called the Air Quality Health Index (AQHI) were compared to the results of 24-h ambulatory cardiac monitoring performed for clinical purposes in 8662 patients and analyzed at the University of Ottawa Heart Institute, Canada, between 2004 and 2009. An interquartile increase in the daily 3 h- maximum AQHI was associated with a 0.9% (95% CI 0.3%, 1.5%) increase in the daily maximum heart rate and a 1.17% (95% CI 1.07%, 1.29%) increase in heart block frequency. An interquartile increase in NO2 was associated with an increase in the percentage of time in atrial fibrillation of 4.39% (-0.15, 9.15) among those ≤50 years old, and 7.1% (0.24, 14.5) among males. CONCLUSIONS We found evidence that air pollution may affect cardiac rate and rhythm. This may be one mechanism partially explaining the increase in strokes and cardiac events observed on days of higher air pollution.
Collapse
Affiliation(s)
- Sabit Cakmak
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, 50 Columbine Driveway, Ottawa, ON K1A 0K9, Canada.
| | - Lisa Kauri
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, 200 Eglantine Driveway, Ottawa, ON K1A 0K9, Canada.
| | - Robin Shutt
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, 200 Eglantine Driveway, Ottawa, ON K1A 0K9, Canada.
| | - Ling Liu
- Air Quality Health Effects Research Section, Biostatistics and Epidemiology Division, Environmental Health Sciences and Research Bureau, Health Canada, 200 Eglantine Driveway,Ottawa, ON K1A 0K9, Canada.
| | - Martin S Green
- Division of Cardiology at the University of Ottawa Heart Institute, 40 Ruskin St., Ottawa, ON K1Y 4W7, Canada.
| | - Marie Mulholland
- University of Ottawa Heart Institute, 40 Ruskin St., Ottawa, ON K1Y 4W7, Canada.
| | - Dave Stieb
- Risk Analysis and Modelling Section, Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada.
| | - Robert Dales
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
| |
Collapse
|
24
|
Langrish JP, Watts SJ, Hunter AJ, Shah ASV, Bosson JA, Unosson J, Barath S, Lundbäck M, Cassee FR, Donaldson K, Sandström T, Blomberg A, Newby DE, Mills NL. Controlled exposures to air pollutants and risk of cardiac arrhythmia. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:747-53. [PMID: 24667535 PMCID: PMC4080532 DOI: 10.1289/ehp.1307337] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 03/21/2014] [Indexed: 05/03/2023]
Abstract
BACKGROUND Epidemiological studies have reported associations between air pollution exposure and increases in cardiovascular morbidity and mortality. Exposure to air pollutants can influence cardiac autonomic tone and reduce heart rate variability, and may increase the risk of cardiac arrhythmias, particularly in susceptible patient groups. OBJECTIVES We investigated the incidence of cardiac arrhythmias during and after controlled exposure to air pollutants in healthy volunteers and patients with coronary heart disease. METHODS We analyzed data from 13 double-blind randomized crossover studies including 282 participants (140 healthy volunteers and 142 patients with stable coronary heart disease) from whom continuous electrocardiograms were available. The incidence of cardiac arrhythmias was recorded for each exposure and study population. RESULTS There were no increases in any cardiac arrhythmia during or after exposure to dilute diesel exhaust, wood smoke, ozone, concentrated ambient particles, engineered carbon nanoparticles, or high ambient levels of air pollution in either healthy volunteers or patients with coronary heart disease. CONCLUSIONS Acute controlled exposure to air pollutants did not increase the short-term risk of arrhythmia in participants. Research employing these techniques remains crucial in identifying the important pathophysiological pathways involved in the adverse effects of air pollution, and is vital to inform environmental and public health policy decisions.
Collapse
Affiliation(s)
- Jeremy P Langrish
- University of Edinburgh, University/BHF Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Bartell SM, Longhurst J, Tjoa T, Sioutas C, Delfino RJ. Particulate air pollution, ambulatory heart rate variability, and cardiac arrhythmia in retirement community residents with coronary artery disease. ENVIRONMENTAL HEALTH PERSPECTIVES 2013; 121:1135-41. [PMID: 23838152 PMCID: PMC3801451 DOI: 10.1289/ehp.1205914] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 07/08/2013] [Indexed: 05/03/2023]
Abstract
BACKGROUND Decreased heart rate variability (HRV) has been associated with future cardiac morbidity and mortality and is often used as a marker of altered cardiac autonomic balance in studies of health effects of airborne particulate matter. Fewer studies have evaluated associations between air pollutants and cardiac arrhythmia. OBJECTIVES We examined relationships between cardiac arrhythmias, HRV, and exposures to airborne particulate matter. METHODS We measured HRV and arrhythmia with ambulatory electrocardiograms in a cohort panel study for up to 235 hr per participant among 50 nonsmokers with coronary artery disease who were ≥ 71 years of age and living in four retirement communities in the Los Angeles, California, Air Basin. Exposures included hourly outdoor gases, hourly traffic-related and secondary organic aerosol markers, and daily size-fractionated particle mass. We used repeated measures analyses, adjusting for actigraph-derived physical activity and heart rate, temperature, day of week, season, and community location. RESULTS Ventricular tachycardia was significantly increased in association with increases in markers of traffic-related particles, secondary organic carbon, and ozone. Few consistent associations were observed for supraventricular tachycardia. Particulates were significantly associated with decreased ambulatory HRV only in the 20 participants using ACE (angiotensin I-converting enzyme) inhibitors. CONCLUSIONS Although these data support the hypothesis that particulate exposures may increase the risk of ventricular tachycardia for elderly people with coronary artery disease, HRV was not associated with exposure in most of our participants. These results are consistent with previous findings in this cohort for systemic inflammation, blood pressure, and ST segment depression.
Collapse
Affiliation(s)
- Scott M Bartell
- Program in Public Health, University of California, Irvine, Irvine, California, USA
| | | | | | | | | |
Collapse
|
26
|
Link MS, Luttmann-Gibson H, Schwartz J, Mittleman MA, Wessler B, Gold DR, Dockery DW, Laden F. Acute exposure to air pollution triggers atrial fibrillation. J Am Coll Cardiol 2013; 62:816-25. [PMID: 23770178 DOI: 10.1016/j.jacc.2013.05.043] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Revised: 05/22/2013] [Accepted: 05/28/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study sought to evaluate the association of air pollution with the onset of atrial fibrillation (AF). BACKGROUND Air pollution in general and more specifically particulate matter has been associated with cardiovascular events. Although ventricular arrhythmias are traditionally thought to convey the increased cardiovascular risk, AF may also contribute. METHODS Patients with dual chamber implantable cardioverter-defibrillators (ICDs) were enrolled and followed prospectively. The association of AF onset with air quality including ambient particulate matter <2.5 μm aerodynamic diameter (PM2.5), black carbon, sulfate, particle number, NO2, SO2, and O3 in the 24 h prior to the arrhythmia was examined utilizing a case-crossover analysis. In sensitivity analyses, associations with air pollution between 2 and 48 h prior to the AF were examined. RESULTS Of 176 patients followed for an average of 1.9 years, 49 patients had 328 episodes of AF lasting ≥ 30 s. Positive but nonsignificant associations were found for PM2.5 in the prior 24 h, but stronger associations were found with shorter exposure windows. The odds of AF increased by 26% (95% confidence interval: 8% to 47%) for each 6.0 μg/m(3) increase in PM2.5 in the 2 h prior to the event (p = 0.004). The odds of AF were highest at the upper quartile of mean PM2.5. CONCLUSIONS PM was associated with increased odds of AF onset within hours following exposure in patients with known cardiac disease. Air pollution is an acute trigger of AF, likely contributing to the pollution-associated adverse cardiac outcomes observed in epidemiological studies.
Collapse
Affiliation(s)
- Mark S Link
- Cardiac Arrhythmia Service, Division of Cardiology, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02459, USA.
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Čulić V, Silić N, Hodžić M. Triggering of supraventricular tachycardia by physical activity and meteorologic factors. Int J Cardiol 2013; 168:4295-300. [PMID: 23701934 DOI: 10.1016/j.ijcard.2013.04.195] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 04/20/2013] [Indexed: 11/25/2022]
Affiliation(s)
- Viktor Čulić
- Division of Cardiology, Department of Internal Medicine, University Hospital Centre Split, Split, Croatia; University of Split School of Medicine, Split, Croatia.
| | | | | |
Collapse
|
28
|
Kumar S, Verma MK, Srivastava AK. Ultrafine particles in urban ambient air and their health perspectives. REVIEWS ON ENVIRONMENTAL HEALTH 2013; 28:117-128. [PMID: 24192498 DOI: 10.1515/reveh-2013-0008] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 09/08/2013] [Indexed: 05/28/2023]
Abstract
Ultrafine particles (UfPs, PM<0.1) are constituents of urban ambient air aerosol. We have reviewed literature on UfPs in urban ambient air and their health perspectives. Generally traffic-linked and of anthropogenic origin, these are toxicants and a health risk factor for urban subjects. UfPs occur in single and agglomerate forms. Studies on the number concentrations of UfPs show tens of thousand times greater levels in urban aerosol than in nonurban aerosol. These nanosize pollutants seem to have more aggressive implications than other respirable fractions of urban aerosol. In literature, it is hypothesized that a chronic exposure to their high number concentrations and their vast surface area, transporting various toxicants, injure tissues or cells and induce inflammation or, eventually, adverse health effects. UfPs are deposited deep in the tissues, translocate, and skip the innate clearance mechanisms. After retention for a long time, these can infiltrate into the interstitium and permeate cells. Traffic-linked UfPs have been found to be toxic to the respiratory, cardiovascular, and nervous systems. At the molecular level, UfPs influence signaling cascade, actin-cytoskeleton pathway, immunoregulation, reactive oxygen species generation to trigger histaminic response, mast cell activation, and pro-inflammatory changes; their mutagenic and carcinogenic effects are also tacit in view of the carcinogenic potential of diesel exhaust in humans. The molecular changes are proposed to be the subclinical effects that manifest disease exacerbations or the predisposition of subjects to pathologies after exposure to UfP. A legislatively regulated monitoring of UfP-contaminated urban ambient air environment is also endorsed to reduce the disease load or its exacerbation that is growing in diesel exhaust (a human carcinogen)-polluted urban areas.
Collapse
|
29
|
Watkins A, Danilewitz M, Kusha M, Massé S, Urch B, Quadros K, Spears D, Farid T, Nanthakumar K. Air pollution and arrhythmic risk: the smog is yet to clear. Can J Cardiol 2012; 29:734-41. [PMID: 23219609 DOI: 10.1016/j.cjca.2012.09.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 09/11/2012] [Accepted: 09/11/2012] [Indexed: 11/24/2022] Open
Abstract
Epidemiologic evidence has demonstrated that air pollution may impair cardiovascular health, leading to potentially life-threatening arrhythmias. Efforts have been made, with the use of epidemiologic data and controlled exposures in diverse animal and human populations, to verify the relationship between air pollution and arrhythmias. The purpose of this review is to examine and contrast the epidemiologic and toxicologic evidence to date that relates airborne pollutants with cardiac arrhythmia. We have explored the potential biological mechanisms driving this association. Using the PubMed database, we conducted a literature search that included the terms "air pollution" and "arrhythmia" and eventually divergent synonyms such as "particulate matter," "bradycardia," and "atrial fibrillation." We reviewed epidemiologic studies and controlled human and animal exposures independently to determine whether observational conclusions were corroborated by toxicologic results. Numerous pollutants have demonstrated some arrhythmic capacity among healthy and health-compromised populations. However, some exposure studies have shown no significant correlation of air pollutants with arrhythmia, which suggests some uncertainty about the arrhythmogenic potential of air pollution and the mechanisms involved in arrhythmogenesis. While data from an increasing number of controlled exposures with human volunteers suggest a potential mechanistic link between air pollution and altered cardiac electrophysiology, definite conclusions regarding air pollution and arrhythmia are elusive as the direct arrhythmic effects of air pollutants are not entirely consistent across all studies.
Collapse
Affiliation(s)
- Alex Watkins
- Department of Environmental Services, University of Waterloo, Ontario, Canada
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Bunch TJ, Horne BD, Asirvatham SJ, Day JD, Crandall BG, Weiss JP, Osborn JS, Anderson JL, Muhlestein JB, Lappe DL, Pope CA. Atrial fibrillation hospitalization is not increased with short-term elevations in exposure to fine particulate air pollution. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2012; 34:1475-9. [PMID: 21895725 DOI: 10.1111/j.1540-8159.2011.03200.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Previous studies have observed that short-term exposure to elevated concentrations of particulate matter (PM) air pollution increases risk of acute ischemic heart disease events and heart failure hospitalization, alters cardiac autonomic function, and increases risk of arrhythmias. This study explored the potential associations between short-term elevations in PM exposure and atrial fibrillation (AF). METHODS AND RESULTS A case-crossover study design was used to explore associations between fine PM (PM2.5, particles with an aerodynamic diameter ≤2.5 μm) and 10,457 AF hospitalizations from 1993 to 2008 of patients who lived on Utah’s Wasatch Front. Patients were hospitalized at Intermountain Healthcare facilities with a primary diagnosis of AF. Concurrent day exposure and cumulative lagged exposures for up to 21 days were explored and the data were stratified by sex, age, and previous or subsequent admission for myocardial infarction. Although the estimated associations between PM2.5 and AF hospitalizations for the various lag structures and strata were consistently positive suggestive of risk, they were not statistically significant and they were extremely small compared to previously observed associations with ischemic heart disease events and heart failure hospitalizations. Further, we observed no additive risk between PM2.5 and AF hospitalization in those with respiratory disease or sleep apnea. CONCLUSIONS Unlike previously observed associations with ischemic heart disease events and heart failure hospitalizations using similar study design and approaches, this study found that hospitalization for AF was not significantly associated with elevations in short-term exposure to fine PM air pollution.
Collapse
Affiliation(s)
- T Jared Bunch
- Intermountain Heart Rhythm Specialists, Intermountain Medical Center, Murray, Utah 84107, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Ghio AJ, Bassett M, Montilla T, Chung EH, Smith CB, Cascio WE, Carraway MS. Case report: supraventricular arrhythmia after exposure to concentrated ambient air pollution particles. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:275-7. [PMID: 21896397 PMCID: PMC3279446 DOI: 10.1289/ehp.1103877] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Accepted: 09/06/2011] [Indexed: 05/15/2023]
Abstract
CONTEXT Exposure to air pollution can result in the onset of arrhythmias. CASE PRESENTATION We present a case of a 58-year-old woman who volunteered to participate in a controlled exposure to concentrated ambient particles. Twenty minutes into the exposure, telemetry revealed new onset of atrial fibrillation. The exposure was discontinued, and she reverted to normal sinus rhythm approximately 2 hr later. No abnormality was evident on the volunteer's laboratory examination or echocardiography that could explain an increased risk for supraventricular arrhythmia. DISCUSSION Epidemiologic evidence strongly supports a relationship between exposure to air pollutants and cardiovascular disease, but population-level data are not directly relevant to the clinical presentation of individual cases. To our knowledge, this is the only case report of an individual suffering an episode of atrial fibrillation after exposure to an air pollutant. The resolution of the arrhythmia with termination of the particle exposure further supports a causal relationship between the two. RELEVANCE TO CLINICAL PRACTICE Exposure to air pollution, including particulate matter, may cause supraventricular arrhythmias.
Collapse
Affiliation(s)
- Andrew J Ghio
- Environmental Public Health Division, National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Chapel Hill, North Carolina, USA.
| | | | | | | | | | | | | |
Collapse
|
32
|
Rückerl R, Schneider A, Breitner S, Cyrys J, Peters A. Health effects of particulate air pollution: A review of epidemiological evidence. Inhal Toxicol 2012; 23:555-92. [PMID: 21864219 DOI: 10.3109/08958378.2011.593587] [Citation(s) in RCA: 311] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Regina Rückerl
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany.
| | | | | | | | | |
Collapse
|
33
|
|
34
|
Lamb CM, Hazari MS, Haykal-Coates N, Carll AP, Krantz QT, King C, Winsett DW, Cascio WE, Costa DL, Farraj AK. Divergent electrocardiographic responses to whole and particle-free diesel exhaust inhalation in spontaneously hypertensive rats. Toxicol Sci 2011; 125:558-68. [PMID: 22052608 DOI: 10.1093/toxsci/kfr296] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Diesel exhaust (DE) is a major contributor to traffic-related fine particulate matter (PM)(2.5). Although inroads have been made in understanding the mechanisms of PM-related health effects, DE's complex mixture of PM, gases, and volatile organics makes it difficult to determine how the constituents contribute to DE's effects. We hypothesized that exposure to particle-filtered DE (fDE; gases alone) will elicit less cardiac effects than whole DE (wDE; particles plus gases). In addition, we hypothesized that spontaneously hypertensive (SH) rats will be more sensitive to the electrocardiographic effects of DE exposure than Wistar Kyoto rats (WKY; background strain with normal blood pressure). SH and WKY rats, implanted with telemeters to monitor electrocardiogram and heart rate (HR), were exposed once for 4 h to 150 μg/m(3) or 500 μg/m(3) of wDE (gases plus PM) or fDE (gases alone) DE, or filtered air. Exposure to fDE, but not wDE, caused immediate electrocardiographic alterations in cardiac repolarization (ST depression) and atrioventricular conduction block (PR prolongation) as well as bradycardia in SH rats. Exposure to wDE, but not fDE, caused postexposure ST depression and increased sensitivity to the pulmonary C fiber agonist capsaicin in SH rats. The only notable effect of DE exposure in WKY rats was a decrease in HR. Taken together, hypertension may predispose to the potential cardiac effects of DE and components of DE may have divergent effects with some eliciting immediate irritant effects (e.g., gases), whereas others (e.g., PM) trigger delayed effects potentially via separate mechanisms.
Collapse
Affiliation(s)
- Christina M Lamb
- Curriculum in Toxicology, University of North Carolina, Chapel Hill, North Carolina 27514, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
He F, Shaffer ML, Rodriguez-Colon S, Yanosky JD, Bixler E, Cascio WE, Liao D. Acute effects of fine particulate air pollution on cardiac arrhythmia: the APACR study. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:927-32. [PMID: 21398201 PMCID: PMC3222979 DOI: 10.1289/ehp.1002640] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Accepted: 03/11/2011] [Indexed: 05/19/2023]
Abstract
BACKGROUND The mechanisms underlying the relationship between particulate matter (PM) air pollution and cardiac disease are not fully understood. OBJECTIVES We examined the effects and time course of exposure to fine PM [aerodynamic diameter ≤ 2.5 μm (PM(2.5))] on cardiac arrhythmia in 105 middle-age community-dwelling healthy nonsmokers in central Pennsylvania. METHODS The 24-hr beat-to-beat electrocardiography data were obtained using a high-resolution Holter system. After visually identifying and removing artifacts, we summarized the total number of premature ventricular contractions (PVCs) and premature atrial contractions (PACs) for each 30-min segment. A personal PM(2.5) nephelometer was used to measure individual-level real-time PM(2.5) exposures for 24 hr. We averaged these data to obtain 30-min average time-specific PM(2.5) exposures. Distributed lag models under the framework of negative binomial regression and generalized estimating equations were used to estimate the rate ratio between 10-μg/m³ increases in average PM(2.5) over 30-min intervals and ectopy counts. RESULTS The mean ± SD age of participants was 56 ± 8 years, with 40% male and 73% non-Hispanic white. The 30-min mean ± SD for PM(2.5) exposure was 13 ± 22 μg/m³, and PAC and PVC counts were 0.92 ± 4.94 and 1.22 ± 7.18. Increases of 10 μg/m³ in average PM(2.5) concentrations during the same 30 min or the previous 30 min were associated with 8% and 3% increases in average PVC counts, respectively. PM(2.5) was not significantly associated with PAC count. CONCLUSION PM(2.5) exposure within approximately 60 min was associated with increased PVC counts in healthy individuals.
Collapse
Affiliation(s)
- Fan He
- Department of Public Health Sciences, the Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033, USA
| | | | | | | | | | | | | |
Collapse
|
36
|
Lessons From Air Pollution Epidemiology for Studies of Engineered Nanomaterials. J Occup Environ Med 2011; 53:S8-S13. [DOI: 10.1097/jom.0b013e31821ad5c0] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
37
|
Hampel R, Schneider A, Brüske I, Zareba W, Cyrys J, Rückerl R, Breitner S, Korb H, Sunyer J, Wichmann HE, Peters A. Altered cardiac repolarization in association with air pollution and air temperature among myocardial infarction survivors. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:1755-61. [PMID: 20846924 PMCID: PMC3002196 DOI: 10.1289/ehp.1001995] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Accepted: 09/15/2010] [Indexed: 05/18/2023]
Abstract
BACKGROUND Epidemiological studies have shown that ambient particulate matter (PM) and changes in air temperature are associated with increased cardiopulmonary events. OBJECTIVE We hypothesized that patients with previous myocardial infarction (MI) experience changes in heart rate (HR) and repolarization parameters, such as Bazett-corrected QT interval (QTc), and T-wave amplitude (Tamp), in association with increases in air pollution and temperature changes. METHODS Between May 2003 and February 2004, 67 MI survivors from the Augsburg KORA-MI registry repeatedly sent 16 sec electrocardiograms (ECGs) with a personal transmitter (Viapac) via telephone to the Philips Monitoring Center, where ECG parameters were immediately analyzed. Meteorological data and air pollutants were acquired from fixed monitoring sites on an hourly basis. Additive mixed models were used for analysis. Effect modification by patient characteristics was investigated. RESULTS The analysis of the 1,745 ECGs revealed an increased HR associated with interquartile range (IQR) increases in PM levels among participants not using beta-adrenergic receptor blockers and among those with body mass index ≥ 30 kg/m². We observed a 24- to 47-hr lagged QTc prolongation [0.5% change (95% confidence interval, 0.0-1.0%)] in association with IQR increases in levels of PM ≤ 2.5 µm in aerodynamic diameter, especially in patients with one [0.6% (0.1-1.0%)] or two [1.2% (0.4-2.1%)] minor alleles of the nuclear factor (erythroid-derived 2)-like 2 (NFE2L2) single-nucleotide polymorphism rs2364725. Positive immediate (0-23 hr) and inverse delayed (48-71 hr up to 96-119 hr) associations were evident between PM and Tamp. We detected an inverse U-shaped association between temperature and Tamp, with a maximum Tamp at 5°C. CONCLUSIONS Increased air pollution levels and temperature changes may lead to changes in HR and repolarization parameters that may be precursors of cardiac problems.
Collapse
Affiliation(s)
- Regina Hampel
- Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
He F, Shaffer ML, Rodriguez-Colon S, Bixler EO, Vgontzas AN, Williams RW, Wu R, Cascio WE, Liao D. Acute effects of fine particulate air pollution on ST segment height: a longitudinal study. Environ Health 2010; 9:68. [PMID: 21059260 PMCID: PMC2989950 DOI: 10.1186/1476-069x-9-68] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 11/08/2010] [Indexed: 05/23/2023]
Abstract
BACKGROUND The mechanisms for the relationship between particulate air pollution and cardiac disease are not fully understood. Air pollution-induced myocardial ischemia is one of the potentially important mechanisms. METHODS We investigate the acute effects and the time course of fine particulate pollution (PM2.5) on myocardium ischemic injury as assessed by ST-segment height in a community-based sample of 106 healthy non-smokers. Twenty-four hour beat-to-beat electrocardiogram (ECG) data were obtained using a high resolution 12-lead Holter ECG system. After visually identifying and removing all the artifacts and arrhythmic beats, we calculated beat-to-beat ST-height from ten leads (inferior leads II, III, and aVF; anterior leads V3 and V4; septal leads V1 and V2; lateral leads I, V5, and V6,). Individual-level 24-hour real-time PM2.5 concentration was obtained by a continuous personal PM2.5 monitor. We then calculated, on a 30-minute basis, the corresponding time-of-the-day specific average exposure to PM2.5 for each participant. Distributed lag models under a linear mixed-effects models framework were used to assess the regression coefficients between 30-minute PM2.5 and ST-height measures from each lead; i.e., one lag indicates a 30-minute separation between the exposure and outcome. RESULTS The mean (SD) age was 56 (7.6) years, with 41% male and 74% white. The mean (SD) PM2.5 exposure was 14 (22) μg/m3. All inferior leads (II, III, and aVF) and two out of three lateral leads (I and V6), showed a significant association between higher PM2.5 levels and higher ST-height. Most of the adverse effects occurred within two hours after PM2.5 exposure. The multivariable adjusted regression coefficients β (95% CI) of the cumulative effect due to a 10 μg/m3 increase in Lag 0-4 PM2.5 on ST-I, II, III, aVF and ST-V6 were 0.29 (0.01-0.56) μV, 0.79 (0.20-1.39) μV, 0.52 (0.01-1.05) μV, 0.65 (0.11-1.19) μV, and 0.58 (0.07-1.09) μV, respectively, with all p < 0.05. CONCLUSIONS Increased PM2.5 concentration is associated with immediate increase in ST-segment height in inferior and lateral leads, generally within two hours. Such an acute effect of PM2.5 may contribute to increased potential for regional myocardial ischemic injury among healthy individuals.
Collapse
Affiliation(s)
- Fan He
- Department of Public Health Sciences, Penn State University College of Medicine, A210, 600 Centerview Dr. Suite 2200, Hershey, PA, 17033, USA
| | - Michele L Shaffer
- Department of Public Health Sciences, Penn State University College of Medicine, A210, 600 Centerview Dr. Suite 2200, Hershey, PA, 17033, USA
| | - Sol Rodriguez-Colon
- Department of Public Health Sciences, Penn State University College of Medicine, A210, 600 Centerview Dr. Suite 2200, Hershey, PA, 17033, USA
| | - Edward O Bixler
- Sleep Research & Treatment Center, Department of Psychiatry, Penn State University College of Medicine, 500 University Dr., Hershey, PA, 17033, USA
| | - Alexandros N Vgontzas
- Sleep Research & Treatment Center, Department of Psychiatry, Penn State University College of Medicine, 500 University Dr., Hershey, PA, 17033, USA
| | - Ronald W Williams
- Exposure Measurements and Analysis Branch, Human Exposure and Atmospheric Sciences Division, U.S. EPA, MD-E205-04, Research Triangle Park, NC, 27711, USA
| | - Rongling Wu
- Department of Public Health Sciences, Penn State University College of Medicine, A210, 600 Centerview Dr. Suite 2200, Hershey, PA, 17033, USA
| | - Wayne E Cascio
- Department of Cardiovascular Sciences, Brody School of Medicine, and the East Carolina Heart Institute and East Carolina University, Ste C, 2315 Executive Cir, Greenville, NC, 27834, USA
| | - Duanping Liao
- Department of Public Health Sciences, Penn State University College of Medicine, A210, 600 Centerview Dr. Suite 2200, Hershey, PA, 17033, USA
| |
Collapse
|
39
|
Schneider A, Hampel R, Ibald-Mulli A, Zareba W, Schmidt G, Schneider R, Rückerl R, Couderc JP, Mykins B, Oberdörster G, Wölke G, Pitz M, Wichmann HE, Peters A. Changes in deceleration capacity of heart rate and heart rate variability induced by ambient air pollution in individuals with coronary artery disease. Part Fibre Toxicol 2010; 7:29. [PMID: 20929559 PMCID: PMC2958976 DOI: 10.1186/1743-8977-7-29] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 10/07/2010] [Indexed: 12/19/2022] Open
Abstract
Background and Objective Exposure to ambient particles has been shown to be responsible for cardiovascular effects, especially in elderly with cardiovascular disease. The study assessed the association between deceleration capacity (DC) as well as heart rate variability (HRV) and ambient particulate matter (PM) in patients with coronary artery disease (CAD). Methods A prospective study with up to 12 repeated measurements was conducted in Erfurt, Germany, between October 2000 and April 2001 in 56 patients with physician-diagnosed ischemic heart disease, stable angina pectoris or prior myocardial infarction at an age of at least 50 years. Twenty-minute ECG recordings were obtained every two weeks and 24-hour ECG recordings every four weeks. Exposure to PM (size range from 10 nm to 2.5 μm), and elemental (EC) and organic (OC) carbon was measured. Additive mixed models were used to analyze the association between PM and ECG recordings. Results The short-term recordings showed decrements in the high-frequency component of HRV as well as in RMSSD (root-mean-square of successive differences of NN intervals) in association with increments in EC and OC 0-23 hours prior to the recordings. The long-term recordings revealed decreased RMSSD and pNN50 (% of adjacent NN intervals that differed more than 50 ms) in association with EC and OC 24-47 hours prior to the recordings. In addition, highly significant effects were found for DC which decreased in association with PM2.5, EC and OC concurrent with the ECG recordings as well as with a lag of up to 47 hours. Conclusions The analysis showed significant effects of ambient particulate air pollution on DC and HRV parameters reflecting parasympathetic modulation of the heart in patients with CAD. An air pollution-related decrease in parasympathetic tone as well as impaired heart rate deceleration capacity may contribute to an increased risk for cardiac morbidity and sudden cardiac death in vulnerable populations.
Collapse
Affiliation(s)
- Alexandra Schneider
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Abstract
BACKGROUND Air pollution may increase the incidence of ventricular cardiac arrhythmias. We investigated this in patients with implantable cardioverter defibrillators attending London clinics. METHOD We explored associations between dates of activation of defibrillators and daily concentrations of various metrics of particulate matter and of pollutant gases at lags from 0 to 5 days, using a fixed-stratum case-crossover analysis controlling for confounding factors. RESULTS Over an average of 1200 days of observation, 705 patients experienced 5462 activation days. Of 11 pollutants considered, we found positive associations with particle sulfate, particulate matter with aerodynamic diameter less than 10 microm and less than 2.5 microm, ozone, and sulfur dioxide. Only the association for particle sulfate was not easily explainable by chance (for 1 microg/m, lag 0-1 day, odds ratio = 1.025 [95% confidence interval = 1.003 to 1.047]). There was little or no evidence of associations with markers of primary vehicle emissions (particle number concentration, black smoke, nitrogen oxides, and carbon monoxide). There was little evidence of interactions with clinical factors such as ischemic heart disease, frequency of activation, or cardiac drugs. CONCLUSION Overall there was little evidence of an association between air pollution and activation of implantable cardioverter defibrillators. The pollutants with positive associations tended to be those of secondary origin with a regional distribution, rather than primary pollutants emitted from transport sources.
Collapse
|
41
|
Brook RD, Rajagopalan S, Pope CA, Brook JR, Bhatnagar A, Diez-Roux AV, Holguin F, Hong Y, Luepker RV, Mittleman MA, Peters A, Siscovick D, Smith SC, Whitsel L, Kaufman JD. Particulate matter air pollution and cardiovascular disease: An update to the scientific statement from the American Heart Association. Circulation 2010; 121:2331-78. [PMID: 20458016 DOI: 10.1161/cir.0b013e3181dbece1] [Citation(s) in RCA: 3807] [Impact Index Per Article: 271.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In 2004, the first American Heart Association scientific statement on "Air Pollution and Cardiovascular Disease" concluded that exposure to particulate matter (PM) air pollution contributes to cardiovascular morbidity and mortality. In the interim, numerous studies have expanded our understanding of this association and further elucidated the physiological and molecular mechanisms involved. The main objective of this updated American Heart Association scientific statement is to provide a comprehensive review of the new evidence linking PM exposure with cardiovascular disease, with a specific focus on highlighting the clinical implications for researchers and healthcare providers. The writing group also sought to provide expert consensus opinions on many aspects of the current state of science and updated suggestions for areas of future research. On the basis of the findings of this review, several new conclusions were reached, including the following: Exposure to PM <2.5 microm in diameter (PM(2.5)) over a few hours to weeks can trigger cardiovascular disease-related mortality and nonfatal events; longer-term exposure (eg, a few years) increases the risk for cardiovascular mortality to an even greater extent than exposures over a few days and reduces life expectancy within more highly exposed segments of the population by several months to a few years; reductions in PM levels are associated with decreases in cardiovascular mortality within a time frame as short as a few years; and many credible pathological mechanisms have been elucidated that lend biological plausibility to these findings. It is the opinion of the writing group that the overall evidence is consistent with a causal relationship between PM(2.5) exposure and cardiovascular morbidity and mortality. This body of evidence has grown and been strengthened substantially since the first American Heart Association scientific statement was published. Finally, PM(2.5) exposure is deemed a modifiable factor that contributes to cardiovascular morbidity and mortality.
Collapse
|
42
|
Farraj AK, Hazari MS, Haykal-Coates N, Lamb C, Winsett DW, Ge Y, Ledbetter AD, Carll AP, Bruno M, Ghio A, Costa DL. ST depression, arrhythmia, vagal dominance, and reduced cardiac micro-RNA in particulate-exposed rats. Am J Respir Cell Mol Biol 2010; 44:185-96. [PMID: 20378750 DOI: 10.1165/rcmb.2009-0456oc] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Recently, investigators demonstrated associations between fine particulate matter (PM)-associated metals and adverse health effects. Residual oil fly ash (ROFA), a waste product of fossil fuel combustion from boilers, is rich in the transition metals Fe, Ni, and V, and when released as a fugitive particle, is an important contributor to ambient fine particulate air pollution. We hypothesized that a single-inhalation exposure to transition metal-rich PM will cause concentration-dependent cardiovascular toxicity in spontaneously hypertensive (SH) rats. Rats implanted with telemeters to monitor heart rate and electrocardiogram were exposed once by nose-only inhalation for 4 hours to 3.5 mg/m(3), 1.0 mg/m(3), or 0.45 mg/m(3) of a synthetic PM (dried salt solution), similar in composition to a well-studied ROFA sample consisting of Fe, Ni, and V. Exposure to the highest concentration of PM decreased T-wave amplitude and area, caused ST depression, reduced heart rate (HR), and increased nonconducted P-wave arrhythmias. These changes were accompanied by increased pulmonary inflammation, lung resistance, and vagal tone, as indicated by changes in markers of HR variability (increased root of the mean of squared differences of adjacent RR intervals [RMSSD], low frequency [LF], high frequency [HF], and decreased LF/HF), and attenuated myocardial micro-RNA (RNA segments that suppress translation by targeting messenger RNA) expression. The low and intermediate concentrations of PM had less effect on the inflammatory, HR variability, and micro-RNA endpoints, but still caused significant reductions in HR. In addition, the intermediate concentration caused ST depression and increased QRS area, whereas the low concentration increased the T-wave parameters. Thus, PM-induced cardiac dysfunction is mediated by multiple mechanisms that may be dependent on PM concentration and myocardial vulnerability (this abstract does not reflect the policy of the United States Environmental Protection Agency).
Collapse
Affiliation(s)
- Aimen K Farraj
- Environmental Public Health Division, United States Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Ye Y, Liu J, Chen M, Sun L, Lan M. In vitro toxicity of silica nanoparticles in myocardial cells. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2010; 29:131-7. [PMID: 21787594 DOI: 10.1016/j.etap.2009.12.002] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Revised: 12/14/2009] [Accepted: 12/19/2009] [Indexed: 05/20/2023]
Abstract
In the present study, toxicities of silica nanoparticles with sizes of 21 and 48nm were assessed in myocardial H9c2(2-1) cells using the methylthiazolyldiphenyl-tetrazolium bromide reduction and lactate dehydrogenase assays. Cell injuries were characterized by morphological changes using hematoxylin and eosin staining. Reactive oxygen species, malondialdehyde and glutathione were measured to evaluate the levels of oxidative stress. To elucidate mechanisms, cell cycle distributions and the expressions of p53, p21 and Bax were also analyzed. Results showed that silica nanoparticles produced cytotoxicities in size, dose (0.1-1.6mg/ml) and time (12, 24, 36 and 48h exposure) dependent manners. Moreover, the particles caused oxidative stress, induced G1 phase arrest and upregulated levels of p53 and p21. Taken together, these data suggested that cell injuries were triggered by the generation of oxidative stress; p53 and p21 mediated G1 phase arrest is a potential mechanistic pathway of silica nanoparticles induced damage in H9c2(2-1) cells.
Collapse
Affiliation(s)
- Yiyi Ye
- State Key Laboratory of Bioreactor Engineering and School of Pharmacy, East China University of Science and Technology, 130 Meilong Road, Shanghai 200237, China
| | | | | | | | | |
Collapse
|
44
|
Abstract
PURPOSE OF REVIEW The last 5 years have witnessed an explosion in interest regarding cardiac arrhythmias and air pollution. The data have been strongest with respect to ventricular arrhythmias but there is accumulating evidence that air pollution is also associated with supraventricular arrhythmias. RECENT FINDINGS There is clear epidemiological evidence linking air pollution and cardiac mortality. Whether the cardiac mortality was from myocardial ischemia, congestive heart failure or arrhythmic, or all of these pathways, is not clear from the epidemiological data. There is a large body of evidence that air pollution can modify autonomic tone. More recent data, utilizing patients with cardiac disease and implantable cardioverter defibrillators (ICDs), have clarified the association of air pollution and arrhythmias. Data are also accumulating that air pollution may be associated with atrial arrhythmias. SUMMARY The incremental risk of air pollution in triggering arrhythmias or other acute cardiac events is greatest for those patients with underlying cardiac disease. Cardiovascular patients and those at high risk of cardiovascular disease should be educated about the risks for triggering of arrhythmias and other cardiac events by air pollution. These patients should monitor the local forecasted Air Quality Index and follow the recommendations to reduce exposures and limit activities.
Collapse
|
45
|
Davoodi G, Sharif AY, Kazemisaeid A, Sadeghian S, Farahani AV, Sheikhvatan M, Pashang M. Comparison of heart rate variability and cardiac arrhythmias in polluted and clean air episodes in healthy individuals. Environ Health Prev Med 2010; 15:217-21. [PMID: 21432548 DOI: 10.1007/s12199-009-0130-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Accepted: 12/18/2009] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Pathophysiological mechanisms and pathways linking cardiovascular mortality and morbidity with air pollution were recently hypothesized. The present study evaluated association between air pollution and changes in heart rate variability as a marker of cardiac autonomic function in healthy individuals, and also determined the frequency of cardiac arrhythmias and QT interval changes on polluted compared to unpolluted days. METHODS Continuous Holter electrocardiography (ECG) monitoring was conducted on 21 young healthy individuals in the two episodes of clean air and elevated air pollution in Tehran. All subjects underwent a medical history review, a physical examination and echocardiography in order to rule out structural heart diseases. Measured pollutants and parameters included NO(2), CO(2), O(3), SO(2), and PM10, which all showed significantly higher concentrations on polluted days. Holter parameters were measured for 24-h time segments and compared. RESULTS Maximum heart rate was significantly lower in polluted air conditions in comparison with clean air conditions (115.1 ± 32.2 vs. 128.9 ± 17.7), and the square root of the mean of squared differences between adjacent NN intervals (r-MSSD) was higher in polluted air compared to clean air (99.0 ± 58.2 vs. 58.5 ± 26.4). Also, the occurrence of nonsustained supraventricular tachycardia was reported in 42.9% of participants in air pollution episodes, whereas this arrhythmia was not seen in clear air conditions (p = 0.001). CONCLUSION Changes in air pollution indices may lead to the occurrence of nonsustained supraventricular tachycardia, a slight reduction in maximum heart rate, and an increase in r-MSSD in healthy individuals. Air quality monitoring in cities associated with a high exposure to air pollutants is recommended in order to prevent such events.
Collapse
Affiliation(s)
- Gholamreza Davoodi
- Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Street, Tehran, 1411713138, Iran.
| | | | | | | | | | | | | |
Collapse
|
46
|
Knol AB, de Hartog JJ, Boogaard H, Slottje P, van der Sluijs JP, Lebret E, Cassee FR, Wardekker JA, Ayres JG, Borm PJ, Brunekreef B, Donaldson K, Forastiere F, Holgate ST, Kreyling WG, Nemery B, Pekkanen J, Stone V, Wichmann HE, Hoek G. Expert elicitation on ultrafine particles: likelihood of health effects and causal pathways. Part Fibre Toxicol 2009; 6:19. [PMID: 19630955 PMCID: PMC2731037 DOI: 10.1186/1743-8977-6-19] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Accepted: 07/24/2009] [Indexed: 11/10/2022] Open
Abstract
Background Exposure to fine ambient particulate matter (PM) has consistently been associated with increased morbidity and mortality. The relationship between exposure to ultrafine particles (UFP) and health effects is less firmly established. If UFP cause health effects independently from coarser fractions, this could affect health impact assessment of air pollution, which would possibly lead to alternative policy options to be considered to reduce the disease burden of PM. Therefore, we organized an expert elicitation workshop to assess the evidence for a causal relationship between exposure to UFP and health endpoints. Methods An expert elicitation on the health effects of ambient ultrafine particle exposure was carried out, focusing on: 1) the likelihood of causal relationships with key health endpoints, and 2) the likelihood of potential causal pathways for cardiac events. Based on a systematic peer-nomination procedure, fourteen European experts (epidemiologists, toxicologists and clinicians) were selected, of whom twelve attended. They were provided with a briefing book containing key literature. After a group discussion, individual expert judgments in the form of ratings of the likelihood of causal relationships and pathways were obtained using a confidence scheme adapted from the one used by the Intergovernmental Panel on Climate Change. Results The likelihood of an independent causal relationship between increased short-term UFP exposure and increased all-cause mortality, hospital admissions for cardiovascular and respiratory diseases, aggravation of asthma symptoms and lung function decrements was rated medium to high by most experts. The likelihood for long-term UFP exposure to be causally related to all cause mortality, cardiovascular and respiratory morbidity and lung cancer was rated slightly lower, mostly medium. The experts rated the likelihood of each of the six identified possible causal pathways separately. Out of these six, the highest likelihood was rated for the pathway involving respiratory inflammation and subsequent thrombotic effects. Conclusion The overall medium to high likelihood rating of causality of health effects of UFP exposure and the high likelihood rating of at least one of the proposed causal mechanisms explaining associations between UFP and cardiac events, stresses the importance of considering UFP in future health impact assessments of (transport-related) air pollution, and the need for further research on UFP exposure and health effects.
Collapse
Affiliation(s)
- Anne B Knol
- Dutch National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Farraj AK, Haykal-Coates N, Winsett DW, Hazari MS, Carll AP, Rowan WH, Ledbetter AD, Cascio WE, Costa DL. Increased non-conducted P-wave arrhythmias after a single oil fly ash inhalation exposure in hypertensive rats. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:709-15. [PMID: 19479011 PMCID: PMC2685831 DOI: 10.1289/ehp.0800129] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Accepted: 12/31/2008] [Indexed: 05/08/2023]
Abstract
BACKGROUND Exposure to combustion-derived fine particulate matter (PM) is associated with increased cardiovascular morbidity and mortality especially in individuals with cardiovascular disease, including hypertension. PM inhalation causes several adverse changes in cardiac function that are reflected in the electrocardiogram (ECG), including altered cardiac rhythm, myocardial ischemia, and reduced heart rate variability (HRV). The sensitivity and reliability of ECG-derived parameters as indicators of the cardiovascular toxicity of PM in rats are unclear. OBJECTIVE We hypothesized that spontaneously hypertensive (SH) rats are more susceptible to the development of PM-induced arrhythmia, altered ECG morphology, and reduced HRV than are Wistar Kyoto (WKY) rats, a related strain with normal blood pressure. METHODS We exposed rats once by nose-only inhalation for 4 hr to residual oil fly ash (ROFA), an emission source particle rich in transition metals, or to air and then sacrificed them 1 or 48 hr later. RESULTS ROFA-exposed SH rats developed non-conducted P-wave arrhythmias but no changes in ECG morphology or HRV. We found no ECG effects in ROFA-exposed WKY rats. ROFA-exposed SH rats also had greater pulmonary injury, neutrophil infiltration, and serum C-reactive protein than did ROFA-exposed WKY rats. CONCLUSIONS These results suggest that cardiac arrhythmias may be an early sensitive indicator of the propensity for PM inhalation to modify cardiovascular function.
Collapse
Affiliation(s)
- Aimen K Farraj
- Experimental Toxicology Division, National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Samet JM, Rappold A, Graff D, Cascio WE, Berntsen JH, Huang YCT, Herbst M, Bassett M, Montilla T, Hazucha MJ, Bromberg PA, Devlin RB. Concentrated ambient ultrafine particle exposure induces cardiac changes in young healthy volunteers. Am J Respir Crit Care Med 2009; 179:1034-42. [PMID: 19234105 DOI: 10.1164/rccm.200807-1043oc] [Citation(s) in RCA: 131] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Exposure to ambient ultrafine particles has been associated with cardiopulmonary toxicity and mortality. Adverse effects specifically linked to ultrafine particles include loss of sympathovagal balance and altered hemostasis. OBJECTIVES To characterize the effects of acute exposure to ambient ultrafine particles in young healthy humans. METHODS Nineteen healthy nonsmoking male and female subjects between the ages of 18 and 35 were exposed to filtered air or to an atmosphere in which captured ultrafine (<0.16 microm) particles were concentrated by a factor of up to 20-fold over ambient levels with the use of particle concentrators fitted with size-selective outlets (ultrafine concentrated ambient particles [UFCAPs]). Subjects underwent bronchoalveolar lavage 18 hours after each exposure. Cardiovascular endpoints measured included pulmonary function, clinical chemistry, and hematological parameters, as well as heart rate variability and repolarization indices. MEASUREMENTS AND MAIN RESULTS Exposure to UFCAPs was statistically associated with an increase in frequency domain markers of heart rate variability, specifically indicative of elevated vagal input to the heart. Consistent with this finding were increases in the variance associated with the duration of the QT interval. In addition, UFCAP exposure resulted in a significant increase in blood levels of the fibrin degradation product D-dimer as well as a modest elevation in the inflammatory chemokine IL-8 recovered in the lavage fluid. CONCLUSIONS These findings show mild inflammatory and prothrombic responses and are suggestive of alterations in cardiac repolarization induced by UFCAP inhalation.
Collapse
Affiliation(s)
- James M Samet
- Human Studies Division, National Health and Environmental Effects Research Laboratory, Research Triangle Park, Chapel Hill, NC 27599-7315, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Liao D, Whitsel EA, Duan Y, Lin HM, Quibrera PM, Smith R, Peuquet DJ, Prineas RJ, Zhang ZM, Anderson G. Ambient particulate air pollution and ectopy--the environmental epidemiology of arrhythmogenesis in Women's Health Initiative Study, 1999-2004. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2009; 72:30-8. [PMID: 18979352 PMCID: PMC2586923 DOI: 10.1080/15287390802445483] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The relationships between ambient PM(2.5) and PM(10) and arrhythmia and the effect modification by cigarette smoking were investigated. Data from U.S. Environmental Protection Agency (EPA) air quality monitors and an established national-scale, log-normal kriging method were used to spatially estimate daily mean concentrations of PM at addresses of 57,422 individuals from 59 examination sites in 24 U.S. states in 1999-2004. The acute and subacute exposures were estimated as mean, geocoded address-specific PM concentrations on the day of, 0-2 d before, and averaged over 30 d before the electrocardiogram (ECG) (Lag(0); Lag(1); Lag(2); Lag(1-30)). At the time of standard 12-lead resting ECG, the mean age (SD) of participants was 67.5 (6.9) yr (84% non-Hispanic White; 6% current smoker; 15% with coronary heart disease; 5% with ectopy). After the identification of significant effect modifiers, two-stage random-effects models were used to calculate center-pooled odds ratios and 95% confidence intervals (OR, 95% CI) of arrhythmia per 10 mug/m(3) increase in PM concentrations. Among current smokers, Lag(0) and Lag(1) PM concentrations were significantly associated ventricular ectopy (VE)-the OR (95% CI) for VE among current smokers was 2 (1.32-3.3) and 1.32 (1.07-1.65) at Lag(1) PM(2.5) and PM(10), respectively. The interactions between current smoking and acute exposures (Lag(0); Lag(1); Lag(2)) were significant in relationship to VE. Acute exposures were not significantly associated with supraventricular ectopy (SVE), or with VE among nonsmokers. Subacute (Lag(1-30)) exposures were not significantly associated with arrhythmia. Acute PM(2.5) and PM(10) exposure is directly associated with the odds of VE among smokers, suggesting that they are more vulnerable to the arrhythmogenic effects of PM.
Collapse
Affiliation(s)
- Duanping Liao
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Ljungman PLS, Berglind N, Holmgren C, Gadler F, Edvardsson N, Pershagen G, Rosenqvist M, Sjögren B, Bellander T. Rapid effects of air pollution on ventricular arrhythmias. Eur Heart J 2008; 29:2894-901. [PMID: 19004842 DOI: 10.1093/eurheartj/ehn463] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Air pollution has been associated with ventricular arrhythmias in patients with implantable cardioverter defibrillators (ICDs) for exposure periods of 24-48 h. Only two studies have investigated exposure periods <24 h. We aimed to explore such effects during the 2 and 24 preceding hours as well as in relation to distance from the place of the event to the air pollution monitor. METHODS AND RESULTS We used a case-crossover design to investigate the effects of particulate matter <10 microm in diameter (PM10) and nitrogen dioxide (NO2) in 211 patients with ICD devices in Gothenburg and Stockholm, Sweden. Events interpreted as ventricular arrhythmias were downloaded from the ICDs, and air pollution data were collected from urban background monitors. We found an association between 2 h moving averages of PM10 and ventricular arrhythmia [odds ratio (OR) 1.31, 95% confidence interval (CI) 1.00-1.72], whereas the OR for 24 h moving averages was 1.24 (95% CI 0.87-1.76). Corresponding ORs for events occurring closest to the air pollution monitor were 1.76 (95% CI 1.18-2.61) and 1.74 (95% CI 1.07-2.84), respectively. Events occurring in Gothenburg showed stronger associations than in Stockholm. CONCLUSION Moderate increases in air pollution appear to be associated with ventricular arrhythmias in ICD patients already after 2 h, although future studies including larger numbers of events are required to confirm these findings. Representative geographical exposure classification seems important in studies of these effects.
Collapse
Affiliation(s)
- Petter L S Ljungman
- Department of Cardiology, Karolinska Institutet, Stockholm South General Hospital, Stockholm, Sweden
| | | | | | | | | | | | | | | | | |
Collapse
|