1
|
Soares AG, Teixeira SA, Thakore P, Santos LG, Filho WDRP, Antunes VR, Muscará MN, Brain SD, Costa SKP. Disruption of Atrial Rhythmicity by the Air Pollutant 1,2-Naphthoquinone: Role of Beta-Adrenergic and Sensory Receptors. Biomolecules 2023; 14:57. [PMID: 38254656 PMCID: PMC10813334 DOI: 10.3390/biom14010057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/24/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024] Open
Abstract
The combustion of fossil fuels contributes to air pollution (AP), which was linked to about 8.79 million global deaths in 2018, mainly due to respiratory and cardiovascular-related effects. Among these, particulate air pollution (PM2.5) stands out as a major risk factor for heart health, especially during vulnerable phases. Our prior study showed that premature exposure to 1,2-naphthoquinone (1,2-NQ), a chemical found in diesel exhaust particles (DEP), exacerbated asthma in adulthood. Moreover, increased concentration of 1,2-NQ contributed to airway inflammation triggered by PM2.5, employing neurogenic pathways related to the up-regulation of transient receptor potential vanilloid 1 (TRPV1). However, the potential impact of early-life exposure to 1,2-naphthoquinone (1,2-NQ) on atrial fibrillation (AF) has not yet been investigated. This study aims to investigate how inhaling 1,2-NQ in early life affects the autonomic adrenergic system and the role played by TRPV1 in these heart disturbances. C57Bl/6 neonate male mice were exposed to 1,2-NQ (100 nM) or its vehicle at 6, 8, and 10 days of life. Early exposure to 1,2-NQ impairs adrenergic responses in the right atria without markedly affecting cholinergic responses. ECG analysis revealed altered rhythmicity in young mice, suggesting increased sympathetic nervous system activity. Furthermore, 1,2-NQ affected β1-adrenergic receptor agonist-mediated positive chronotropism, which was prevented by metoprolol, a β1 receptor blocker. Capsazepine, a TRPV1 blocker but not a TRPC5 blocker, reversed 1,2-NQ-induced cardiac changes. In conclusion, neonate mice exposure to AP 1,2-NQ results in an elevated risk of developing cardiac adrenergic dysfunction, potentially leading to atrial arrhythmia at a young age.
Collapse
Affiliation(s)
- Antonio G. Soares
- Departamento de Farmacologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, Av. Prof Lineu Prestes, 1524, São Paulo 05508-000, SP, Brazil; (A.G.S.); (S.A.T.); (L.G.S.); (M.N.M.)
- Department of Integrative Biology and Pharmacology, University of Texas Health Science Center at Houston, 6431 Fannin St., Houston, TX 77030, USA
| | - Simone A. Teixeira
- Departamento de Farmacologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, Av. Prof Lineu Prestes, 1524, São Paulo 05508-000, SP, Brazil; (A.G.S.); (S.A.T.); (L.G.S.); (M.N.M.)
| | - Pratish Thakore
- Section of Vascular Biology and Inflammation, School of Cardiovascular Medicine and Sciences, BHF Cardiovascular Centre of Research Excellence, King’s College London, Franklin-Wilkins Building, London SE1 9NH, UK;
| | - Larissa G. Santos
- Departamento de Farmacologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, Av. Prof Lineu Prestes, 1524, São Paulo 05508-000, SP, Brazil; (A.G.S.); (S.A.T.); (L.G.S.); (M.N.M.)
| | - Walter dos R. P. Filho
- Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho, Ministério do Trabalho e Previdência Social, Rua Capote Valente, nº 710, São Paulo 05409-002, SP, Brazil;
| | - Vagner R. Antunes
- Departamento de Fisiologia e Biofísica, Instituto de Ciências Biomédicas, Universidade de São Paulo, Av. Prof Lineu Prestes, 1524, São Paulo 05508-000, SP, Brazil;
| | - Marcelo N. Muscará
- Departamento de Farmacologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, Av. Prof Lineu Prestes, 1524, São Paulo 05508-000, SP, Brazil; (A.G.S.); (S.A.T.); (L.G.S.); (M.N.M.)
| | - Susan D. Brain
- Section of Vascular Biology and Inflammation, School of Cardiovascular Medicine and Sciences, BHF Cardiovascular Centre of Research Excellence, King’s College London, Franklin-Wilkins Building, London SE1 9NH, UK;
| | - Soraia K. P. Costa
- Departamento de Farmacologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, Av. Prof Lineu Prestes, 1524, São Paulo 05508-000, SP, Brazil; (A.G.S.); (S.A.T.); (L.G.S.); (M.N.M.)
- Section of Vascular Biology and Inflammation, School of Cardiovascular Medicine and Sciences, BHF Cardiovascular Centre of Research Excellence, King’s College London, Franklin-Wilkins Building, London SE1 9NH, UK;
| |
Collapse
|
2
|
Han J, Zhang R, Guo J, Zheng Q, Chen X, Wu S, Tan J, Li Y. The association between air pollution and the daily hospital visits for atrial fibrillation recorded by ECG: a cross-sectional study. Eur J Med Res 2023; 28:201. [PMID: 37381047 PMCID: PMC10308751 DOI: 10.1186/s40001-023-01170-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/14/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND The relationship between air pollution and atrial fibrillation (AF) recorded by electrocardiograph (ECG) has not yet been illustrated which worsens AF precaution and treatment. This research evaluated the association between air pollution and daily hospital visits for AF with ECG records. METHODS The study enrolled 4933 male and 5392 female patients whose ECG reports indicated AF from 2015 to 2018 in our hospital. Such data were then matched with meteorological data, including air pollutant concentrations, collected by local weather stations. A case-crossover study was performed to assess the relationship between air pollutants and daily hospital visits for AF recorded by ECG and to investigate its lag effect. RESULTS Our analysis revealed statistically significant associations between AF occurrence and demographic data, including age and gender. This effect was stronger in female (k = 0.02635, p < 0.01) and in patients over 65 y (k = 0.04732, p < 0.01). We also observed a hysteretic effect that when exposed to higher nitrogen dioxide(NO2), counting AF cases recorded by ECG may elevate at lag 0 with a maximum odds ratio(OR) of 1.038 (95% CI 1.014-1.063), on the contrary, O3 reduced the risk of daily visits for AF and its maximum OR was at lag 2, and the OR value was 0.9869 (95% CI 0.9791-0.9948). Other air pollutants such as PM2.5, PM10, and SO2 showed no clear relationship with the recorded AF. CONCLUSION The associations between air pollution and AF recorded with ECG were preliminarily discovered. Short-term exposure to NO2 was significantly associated with daily hospital visits for AF management.
Collapse
Affiliation(s)
- Jiming Han
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Rd, Shanghai, 200233, People's Republic of China
| | - Rui Zhang
- Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Rd, Shanghai, People's Republic of China
| | - Jingyi Guo
- Department of Clinical Research Center, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Rd, Shanghai, People's Republic of China
| | - Qingfeng Zheng
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, 280 Caoxi North Rd, Shanghai, 200030, People's Republic of China
| | - Xin Chen
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Rd, Shanghai, 200233, People's Republic of China
| | - Shanmei Wu
- Shanghai Jiao Tong University School of Medicine, 227 Chungking South Rd, Shanghai, People's Republic of China
| | - Jianguo Tan
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, 280 Caoxi North Rd, Shanghai, 200030, People's Republic of China.
| | - Yongguang Li
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Rd, Shanghai, 200233, People's Republic of China.
| |
Collapse
|
3
|
Associations between Dust Exposure and Hospitalizations in El Paso, Texas, USA. ATMOSPHERE 2021. [DOI: 10.3390/atmos12111413] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The Southwestern USA has been identified as one of the most persistent dust-producing regions of North America, where exposure to inhalable particulate matter (PM10) originating from desertic landscape during dust events/dust exposures (DEs) can reach hazardous levels. El Paso, Texas’s ambient air has reached hazardous levels of PM10 from dust with near zero visibility due to these natural events originating in the surrounding Chihuahuan Desert. The aim of this study was to investigate whether dust exposures in El Paso (generally acute, short-term exposures from nearby source areas) are associated with significant increases in hospitalizations on the day of the exposure and up to seven days afterwards. Using a Poisson regression, it was found that the relative risks of hospitalizations due to a variety of conditions were associated with dust exposures (through increases of 100 μg/m3 maximum hourly PM10 and/or increases of 4.5 m/s maximum hourly wind speed) in El Paso County, Texas between 2010 and 2014. Valley fever, coronary atherosclerosis, genitourinary diseases, neurodegenerative diseases, injury and poisoning, circulatory system conditions, respiratory system diseases, births, septicemia, Associated Diseases (the aggregation of hospital admissions for all causes, each associated with at least 5% of hospitalizations), and all ICD-9 admissions were significantly positively associated with dust exposures, indicated from higher to lower significant risk, at different lag periods after exposure. These findings, showing that an association does exist between dust exposures and hospitalizations, have important implications for residents of the world’s dryland cities.
Collapse
|
4
|
Zhang Y, Ma Y, Feng F, Cheng B, Wang H, Shen J, Jiao H. Association between PM 10 and specific circulatory system diseases in China. Sci Rep 2021; 11:12129. [PMID: 34108571 PMCID: PMC8190074 DOI: 10.1038/s41598-021-91637-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/25/2021] [Indexed: 11/26/2022] Open
Abstract
Particulate matter (PM) has been proved to be a risk factor for the development of circulatory system diseases (CSDs) around the world. In this study, we collected daily air pollutants, emergency room (ER) visits for CSDs, and meteorological data from 2009 to 2012 in Beijing, China. After controlling for the long-term trend and eliminating the influence of confounding factors, the generalized additive model (GAM) was used to evaluate the short-term effects of PM10 on CSDs and cause-specific diseases. The results showed that for every 10 μg/m3 increase in PM10, the largest effect estimates in ER visits of total CSDs, arrhythmia, cerebrovascular diseases, high blood pressure, ischemic heart disease and other related diseases were 0.14% (95% CI: 0.06-0.23%), 0.37% (95% CI: - 0.23 to 0.97%), 0.20% (95% CI: 0.00-0.40%), 0.15% (95% CI: 0.02-0.27%), 0.18% (95% CI: 0.02-0.35%) and 0.35% (95% CI: - 0.04 to 0.79%), respectively. When NO2 or SO2 was added into the model, the effect estimates of PM10 were mostly attenuated, while in those models with PM2.5 added, the effect estimates of PM10 were mostly increased. Stratified analysis indicated that PM10 had a greater effect on males and the elderly.
Collapse
Affiliation(s)
- Yifan Zhang
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yuxia Ma
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Fengliu Feng
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bowen Cheng
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Hang Wang
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Jiahui Shen
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Haoran Jiao
- Key Laboratory of Semi-Arid Climate Change, College of Atmospheric Sciences, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| |
Collapse
|
5
|
Nejm M, Guimarães-Marques M, Scorza CA, Victorino DB, Finsterer J, Fiorini AC, Scorza FA. Air pollution and sudden death risk in patients with Parkinson’s disease: Assessing the evidence to date. PUBLIC HEALTH IN PRACTICE 2020; 1:100008. [PMID: 36101679 PMCID: PMC9461562 DOI: 10.1016/j.puhip.2020.100008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/30/2020] [Indexed: 11/05/2022] Open
|
6
|
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
|
7
|
Cui L, Shi L, Li D, Li X, Su X, Chen L, Jiang Q, Jiang M, Luo J, Ji A, Chen C, Wang J, Tang J, Pi J, Chen R, Chen W, Zhang R, Zheng Y. Real-Ambient Particulate Matter Exposure-Induced Cardiotoxicity in C57/B6 Mice. Front Pharmacol 2020; 11:199. [PMID: 32296328 PMCID: PMC7136766 DOI: 10.3389/fphar.2020.00199] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 02/14/2020] [Indexed: 12/14/2022] Open
Abstract
It is generally accepted that exposure to particulate matter (PM) increases the risk of cardiovascular-related morbidity and mortality, though the exact mechanism behind this has yet to be elucidated. Oxidative stress plays a potentially important role in the mechanism of toxicity, with Nrf2 serving as a major antioxidant gene. In the current study, a Nrf2 knockout mouse model was used in combination with an individual ventilated cage (IVC)-based real-ambient PM exposure system to assess the potential cardiotoxicity induced by real-ambient PM exposure and the potential role of Nrf2 and related signaling in this endpoint. After 6- or 11-weeks exposure to PM, ICP-mass spectrometry was used to assess the metal depositions in the heart tissue following PM exposure. Functional and morphological changes in the hearts were investigated with echocardiography and histopathology, and oxidative stress levels were assessed with a serum malondialdehyde content assay. In the further mechanistic study, an RNA-seq technique was utilized to assess the gene transcription status in the hearts of C57/B6 mice exposed to PM with or without Nrf2 knockout. The expression levels of genes of interest were then further investigated with quantitative real-time PCR and western blotting. The results indicated that PM exposure resulted in significant elevation of sodium, potassium, selenium, and ferrum levels in mouse heart tissue. Meanwhile, significantly altered heart function and morphology were observed. Interestingly, Nrf2 knockout led to abolishment of PM-induced effects in several functional parameters but not the morphological changes. Meanwhile, elevated malondialdehyde content was observed in Nrf2 knockout animals. RNA-seq results revealed thousands of genes altered by PM exposure and/or Nrf2 knockout, and this affected several pathways, such as MAPK, phagosome, calcium signaling, and JAK-STAT. In subsequent molecular studies, enhanced nuclear translocation of Nrf2 was also observed following PM exposure, while the MAPK signaling pathway along with related JAK-STAT and TGF-β1 pathway genes, such as p38MAPK, AKT, TAK1, JAK1, STAT3, GRB2, TGFb1, and SMAD2, were confirmed to be affected by PM exposure and/or Nrf2 knockout. The data suggested that PM may induce cardiotoxicity in C57/B6 mice in which Nrf2 plays both protective and detrimental roles involving cardiac-related pathways, such as MAPK, JAK-STAT, and TGF-β1.
Collapse
Affiliation(s)
- Lianhua Cui
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Limei Shi
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Daochuan Li
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaobo Li
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Xuan Su
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Liping Chen
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qixiao Jiang
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Menghui Jiang
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Jing Luo
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Andong Ji
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Chen Chen
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Jianxun Wang
- School of Basic Medicine, Qingdao University, Qingdao, China
| | - JingLong Tang
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| | - Jingbo Pi
- School of Public Health, China Medical University, Shenyang, China
| | - Rui Chen
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Wen Chen
- Department of Toxicology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Rong Zhang
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Yuxin Zheng
- Department of Toxicology, School of Public Health, Qingdao University, Qingdao, China
| |
Collapse
|
8
|
Gibelin P. Pollution et maladies cardiovasculaires. BULLETIN DE L'ACADÉMIE NATIONALE DE MÉDECINE 2019. [DOI: 10.1016/j.banm.2018.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
9
|
Machin AB, Nascimento LF, Mantovani K, Machin EB. Effects of exposure to fine particulate matter in elderly hospitalizations due to respiratory diseases in the South of the Brazilian Amazon. ACTA ACUST UNITED AC 2019; 52:e8130. [PMID: 30698228 PMCID: PMC6345358 DOI: 10.1590/1414-431x20188130] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 11/07/2018] [Indexed: 11/29/2022]
Abstract
Exposure to air pollution is an important cause of hospital admissions due to respiratory diseases. Nevertheless, few studies use pollutant concentration data estimated by mathematical models. A time-series ecological study was developed, using data from hospitalizations due to respiratory diseases in people over 60 years of age, residents of Cuiabá, Brazil, during 2012, obtained from the Brazilian Ministry of Health. The independent variables were the concentrations of fine particulate matter (PM2.5) and carbon monoxide (CO) estimated by mathematical modeling, minimum temperature, and relative humidity (obtained from the Brazilian Meteorological Agency), and the number of forest fires. The generalized linear regression model of Poisson was used, with lags of 0 to 7 days. The coefficients obtained were transformed into relative risk of hospitalization, with respective 95% confidence intervals; alpha=5% was adopted. In that year, 591 hospitalizations were evaluated, with a daily average of 1.61 (SD=1.49), the PM2.5 average concentration was 15.7 µg/m3, and the CO average concentration was 144.2 ppb. Significant associations between exposure to these contaminants and hospitalizations in lags 3 and 4 in 2012 were observed. There was a hospitalization risk increase of 31.8%, with an increase of 3.5 µg/m3 of PM2.5 concentrations and an increase of 188 in the total number of hospitalizations, with an expense of more than ≈US$ 96,000 for the Brazilian Public Health System. This study provided information on the cost of air pollution to the health system and the feasibility of using a mathematical model to estimate environmental concentration of air pollutants.
Collapse
Affiliation(s)
- A B Machin
- Faculdade de Engenharia de Guaratinguetá, Universidade Estadual Paulista Júlio de Mesquita Filho, Guaratinguetá, SP, Brasil
| | - L F Nascimento
- Faculdade de Engenharia de Guaratinguetá, Universidade Estadual Paulista Júlio de Mesquita Filho, Guaratinguetá, SP, Brasil.,Programa de Pós-Graduação em Ciências Ambientais, Universidade de Taubaté, Taubaté, SP, Brasil
| | - K Mantovani
- Faculdade de Tecnologia de Guaratinguetá (FATEC), Guaratinguetá, SP, Brasil
| | - E B Machin
- Departamento de Ingeniería Mecánica, Facultad de Ingeniería, Universidad de Concepción, Concepción, Chile
| |
Collapse
|
10
|
Association between Atmospheric Particulate Pollutants and Mortality for Cardio-Cerebrovascular Diseases in Chinese Korean Population: A Case-Crossover Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122835. [PMID: 30545115 PMCID: PMC6313322 DOI: 10.3390/ijerph15122835] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 12/05/2018] [Accepted: 12/08/2018] [Indexed: 11/23/2022]
Abstract
Background: Air pollution in large Chinese cities has led to recent studies that highlighted the relationship between particulate matters (PM) and elevated risk of cardio-cerebrovascular mortality. However, it is unclear as to whether: (1) The same adverse relations exist in cities with relatively low levels of air pollution; and (2) the relationship between the two are similar across ethnic groups. Methods: We collected data of PM2.5 (PM with an aerodynamic diameter ≤ 2.5 µm) and PM10 (aerodynamic diameter ≤ 10 µm) in the Yanbian Korean Autonomous Prefecture between 1 January 2015 and 31 December 2016. Using a time-stratified case-crossover design, we investigated whether levels of particulate pollutants influence the risk of cardio-cerebrovascular disease mortality among ethnic Korean vs. ethnic Han residents residing in the Yanbian Korean Autonomous Prefecture. Results: Under the single air pollutant model, the odds ratios (ORs) of cardio-cerebrovascular disease were 1.025 (1.024–1.026) for each 10 μg/m3 increase in PM2.5 at lag0 day, 1.012 (1.011–1.013) for each 10 μg/m3 increase in PM10 at lag1 day. In the multi-pollutant model adjusted by PM10, SO2, and NO2, the ORs of cardio-cerebrovascular disease were 1.150 (1.145–1.155) for ethnic Koreans and 1.154 (1.149–1.158) for ethnic Hans for each 10 μg/m3 increase in PM2.5. In the multi-pollutant model adjusted by PM2.5, SO2, and NO2, the ORs of cardio-cerebrovascular disease were 1.050 (1.047–1.053) for ethnic Koreans and 1.041 (1.039–1.043) for ethnic Hans for each 10 μg/m3 increase in PM10. Conclusion: This study showed that PM2.5 and PM10 were associated with increased risks of acute death events in residential cardio-cerebrovascular disease in Yanbian, China.
Collapse
|
11
|
Nirel R, Adar SD, Dayan U, Vakulenko-Lagun B, Golovner M, Levy I, Alon Z, Peretz A. Fine and Coarse Particulate Matter Exposures and Associations with Acute Cardiac Events among Participants in a Telemedicine Service: A Case-Crossover Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:97003. [PMID: 30203992 PMCID: PMC6375393 DOI: 10.1289/ehp2596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Subclinical cardiovascular changes have been associated with ambient particulate matter (PM) exposures within hours. Although the U.S. Environmental Protection Agency continues to look for additional evidence of effects associated with sub-daily PM exposure, this information is still limited because most studies of clinical events have lacked data on the onset time of symptoms to assess rapid increased risk. OBJECTIVE Our objective was to investigate associations between sub-daily exposures to PM and acute cardiac events using telemedicine data. METHODS We conducted a case-crossover study among telemedicine participants [Formula: see text] of age who called a service center for cardiac-related symptoms and were transferred to a hospital in Tel Aviv and Haifa, Israel (2002-2013). Ambient [Formula: see text] and [Formula: see text] measured by monitors located in each city during the hours before the patient called with symptoms were compared with matched control periods. We investigated the sensitivity of these associations to more accurate symptom onset time and greater certainty of diagnosis. RESULTS We captured 12,661 calls from 7,617 subscribers experiencing ischemic (19%), arrhythmic (31%), or nonspecific (49%) cardiac events. PM concentrations were associated with small increases in the odds of cardiac events. For example, odds ratios for any cardiac event in association with a [Formula: see text] increase in 6-h and 24-h average [Formula: see text] were 1.008 [95% confidence interval (CI): 0.998, 1.018] and 1.006 (95% CI: 0.995, 1.018), respectively, and for [Formula: see text] were 1.003 (95% CI: 1.001, 1.006) and 1.003 (95% CI: 1.000, 1.007), respectively. Associations were stronger when using exposures matched to the call time rather than calendar date and for events with higher certainty of the diagnosis. CONCLUSIONS Our analysis of telemedicine data suggests that risks of cardiac events in telemedicine participants [Formula: see text] of age may increase within hours of PM exposures. https://doi.org/10.1289/EHP2596.
Collapse
Affiliation(s)
- Ronit Nirel
- 1 Department of Statistics, Hebrew University of Jerusalem , Jerusalem, Israel
| | - Sara D Adar
- 2 Department of Epidemiology, University of Michigan , Ann Arbor, Michigan, USA
| | - Uri Dayan
- 3 Department of Geography, Hebrew University of Jerusalem , Jerusalem, Israel
| | | | | | - Ilan Levy
- 5 Center of Excellence in Exposure Science and Environmental Health, Technion , Haifa, Israel
| | - Zvi Alon
- 1 Department of Statistics, Hebrew University of Jerusalem , Jerusalem, Israel
| | - Alon Peretz
- 6 Occupational Medicine Clinic, Rabin Medical Center , Petah Tiqua, Israel
| |
Collapse
|
12
|
Zheng Q, Liu H, Zhang J, Chen D. The effect of ambient particle matters on hospital admissions for cardiac arrhythmia: a multi-city case-crossover study in China. Environ Health 2018; 17:60. [PMID: 30012150 PMCID: PMC6048711 DOI: 10.1186/s12940-018-0404-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 06/29/2018] [Indexed: 05/20/2023]
Abstract
BACKGROUND The relationship between particle matters (PMs) and cardiac arrhythmia has been investigated in numerous studies. However, evidence from developing countries is limited. The aim of this study was to evaluate the association between ambient PMs and hospital admissions for cardiac arrhythmia in China and to examine the potential effect modifiers. METHODS A time-stratified case-crossover analysis was conducted in 26 large Chinese cities. In total, we identified 175,265 hospital admissions for cardiac arrhythmia between January 2014 and December 2015 from electronic hospitalization summary reports. Conditional logistic regression was performed to estimate the percentage changes in cardiac arrhythmia admissions in relation to interquartile range increases in air pollutants. Age, gender and prespecified comorbid health conditions including hypertension, diabetes, congestive heart failure and hyperlipidemia were stratified to evaluate susceptibility factors. RESULTS PMs levels were positively associated with the number of hospital admissions for cardiac arrhythmia. Both PM2.5 and PM10 had the strongest impact on lag 2 days. An interquartile range increase in PM2.5 (47.5 μg/m3) and PM10 (76.9 μg/m3) concentrations on lag 2 days was associated with increments of 2.09% (95%CI, 1.58-2.60%) and 2.33% (95%CI, 1.68-2.97%) in hospital admission for cardiac arrhythmia, respectively. Evidence of effect modification by age and comorbid diabetes was observed. The elderly (> 65 years) and patients with comorbid diabetes were more likely to be hospitalized for cardiac arrhythmia following exposure to high levels of PMs. CONCLUSIONS This study found an increased risk of arrhythmia admissions associated with PM2.5 and PM10 levels among 26 Chinese cities. The associations of PMs with arrhythmia admissions were stronger in aged population and people with diabetes.
Collapse
Affiliation(s)
- Qiwen Zheng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Hui Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
- Medical Informatics Center, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jun Zhang
- Department of Neurology, Peking University People's Hospital, No.11 South Xizhimen Street, Xicheng District, Beijing, 100044, China.
| | - Dafang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China.
| |
Collapse
|
13
|
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
|
14
|
The Association between Air Pollution and Outpatient and Inpatient Visits in Shenzhen, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020178. [PMID: 29360738 PMCID: PMC5858253 DOI: 10.3390/ijerph15020178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 12/18/2017] [Accepted: 01/17/2018] [Indexed: 11/17/2022]
Abstract
Nowadays, air pollution is a severe environmental problem in China. To investigate the effects of ambient air pollution on health, a time series analysis of daily outpatient and inpatient visits in 2015 were conducted in Shenzhen (China). Generalized additive model was employed to analyze associations between six air pollutants (namely SO2, CO, NO2, O3, PM10, and PM2.5) and daily outpatient and inpatient visits after adjusting confounding meteorological factors, time and day of the week effects. Significant associations between air pollutants and two types of hospital visits were observed. The estimated increase in overall outpatient visits associated with each 10 µg/m3 increase in air pollutant concentration ranged from 0.48% (O3 at lag 2) to 11.48% (SO2 with 2-day moving average); for overall inpatient visits ranged from 0.73% (O3 at lag 7) to 17.13% (SO2 with 8-day moving average). Our results also suggested a heterogeneity of the health effects across different outcomes and in different populations. The findings in present study indicate that even in Shenzhen, a less polluted area in China, significant associations exist between air pollution and daily number of overall outpatient and inpatient visits.
Collapse
|
15
|
Collart P, Dubourg D, Levêque A, Sierra NB, Coppieters Y. Short-term effects of nitrogen dioxide on hospital admissions for cardiovascular disease in Wallonia, Belgium. Int J Cardiol 2017; 255:231-236. [PMID: 29288056 DOI: 10.1016/j.ijcard.2017.12.058] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 11/22/2017] [Accepted: 12/19/2017] [Indexed: 01/11/2023]
Abstract
Many studies have shown a short-term association between NO2 and cardiovascular disease. However, few data are available on the delay between exposure and a health-related event. The aim of the present study is to determine the strength of association between NO2 and cardiovascular health in Wallonia for the period 2008-2011. This study also seeks to evaluate the effects of age, gender, season and temperature on this association. The effect of the delay between exposure and health-related event was also investigated. The daily numbers of hospital admissions for arrhythmia, acute myocardial infarction, ischemic and haemorrhagic stroke were taken from a register kept by Belgian hospitals. Analyses were performed using the quasi-Poisson regression model adjusted for seasonality, long-term trend, day of the week, and temperature. Our study confirms the existence of an association between NO2 and cardiovascular disease. Apart from haemorrhagic stroke, the strongest association between NO2 concentrations and number of hospital admissions is observed at lag 0. For haemorrhagic stroke, the association is strongest with a delay of 2days. All associations calculated without stratification are statistically significant and range from an excess relative risk of 2.8% for myocardial infarction to 4.9% for haemorrhagic strokes. The results of this study reinforce the evidence of the short-term effects of NO2 on hospital admissions for cardiovascular disease. The different delay between exposure and health-related event for haemorrhagic stroke compared to ischemic stroke suggests different mechanisms of action.
Collapse
Affiliation(s)
- Philippe Collart
- Centre de recherche Epidémiologie, Biostatistiques, Recherche Clinique, School of Public Health, Université Libre de Bruxelles (U.L.B.), Route de Lennik 808, CP 596, 1070 Brussels, Belgium.
| | - Dominique Dubourg
- Agence pour une Vie de Qualité, Rue de la Rivelaine 21, 6061 Charleroi, Belgium
| | - Alain Levêque
- Centre de recherche Epidémiologie, Biostatistiques, Recherche Clinique, School of Public Health, Université Libre de Bruxelles (U.L.B.), Route de Lennik 808, CP 596, 1070 Brussels, Belgium
| | - Natalia Bustos Sierra
- Institut Scientifique de Santé Publique, Santé Publique et Surveillance, rue J. Wytsman 14, 1050 Brussels, Belgium
| | - Yves Coppieters
- Centre de recherche Epidémiologie, Biostatistiques, Recherche Clinique, School of Public Health, Université Libre de Bruxelles (U.L.B.), Route de Lennik 808, CP 596, 1070 Brussels, Belgium
| |
Collapse
|
16
|
Gouveia N, Corrallo FP, Leon ACPD, Junger W, Freitas CUD. Air pollution and hospitalizations in the largest Brazilian metropolis. Rev Saude Publica 2017; 51:117. [PMID: 29211200 PMCID: PMC5708266 DOI: 10.11606/s1518-8787.2017051000223] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 10/17/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the impact of air pollution on hospitalizations for respiratory and cardiovascular diseases in the largest Brazilian metropolis. METHODS This study was carried out at the Metropolitan Region of São Paulo, Brazil. Environmental data were obtained from the network of monitoring stations of nine municipalities. Air pollution exposure was measured by daily means of PM10 (particles with a nominal mean aerodynamic diameter ≤ 10 μm) per municipality, while daily counts of hospitalizations for respiratory and cardiovascular diseases within the Brazilian Unified Health System were the outcome. For each municipality a time series analysis was carried out in which a semiparametric Poisson regression model was the framework to explain the daily fluctuations on counts of hospitalizations over time. The results were combined in a meta-analysis to estimate the overall risk of PM10 in hospitalizations for respiratory and cardiovascular diseases at the Metropolitan Region of São Paulo. RESULTS Regarding hospitalizations for respiratory diseases, the effect estimates were statistically significant (p < 0.05) for all municipalities, except Santo André and Taboão da Serra. The RR (Relative Risk) of this outcome for an increase of 10 µg/m3 in the levels of PM10 ranged from 1.011 (95%CI 1.009–1.013) for São Paulo to 1.032 (95%CI 1.024–1.040) in São Bernardo do Campo. The RR of hospitalization for respiratory diseases in children for an increase of 10 µg/m3 of PM10 ranged from 1.009 (95%CI 1.001–1.017) in Santo André to 1.077 (95%CI 1.056–1.098) in Mauá. Only São Paulo and São Bernardo do Campo presented positive and statistically significant results for hospitalizations for cardiovascular diseases. CONCLUSIONS This is the first study to estimate the risk of illness from air pollution in the set of municipalities of the Metropolitan Region of São Paulo, Brazil. Global estimates of the effect of exposure to pollution in the region indicated associations only with respiratory diseases. Only São Paulo and São Bernardo do Campo showed an association between the levels of PM10 and hospitalizations for cardiovascular diseases.
Collapse
Affiliation(s)
- Nelson Gouveia
- Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Preventiva. São Paulo, SP, Brasil
| | - Flavia Prado Corrallo
- Coordenadoria de Vigilância a Saúde do Município de Diadema. Núcleo de Vigilância em Saúde Ambiental. Diadema, SP, Brasil
| | | | - Washington Junger
- Universidade Estadual do Rio de Janeiro. Instituto de Medicina Social. Rio de Janeiro, RJ, Brasil
| | - Clarice Umbelino de Freitas
- Universidade de São Paulo. Faculdade de Medicina. Hospital das Clinicas. Laboratório de Investigação Médica - LIM 39. São Paulo, SP, Brasil
| |
Collapse
|
17
|
Chovert AD, Alonso MF. Estimated evolution of total pollutant gas emissions associated with vehicle activity in the Metropolitan Region of Porto Alegre until 2030. AN ACAD BRAS CIENC 2017; 89:1971-1983. [PMID: 28746615 DOI: 10.1590/0001-3765201720160117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 05/15/2017] [Indexed: 11/22/2022] Open
Abstract
In recent years, the majority of economic sectors in Brazil have gone through processes of development and transformation. These processes have led to increases in environmental pollution of all kinds; air pollution being one of the most adverse. The Brazilian transportation sector, which heavily affects the air quality, experienced a significant increase in its vehicle fleet thus provoking larger emissions of pollutant gases, mainly in regions with high population density such as the Metropolitan Region of Porto Alegre (MRPA). Within this research, considering mainly the ozone precursor species and Carbon Monoxide and using the year 2001 as a base year, scenarios are obtained for vehicular emissions of pollutant gases in the MRPA until the year 2030. In addition, scenarios related to the evolution of the study region's vehicle fleet were estimated. The statistical tool LEAP (Long Range Energy Alternatives Planning System) was used. The scenario analysis shows that the vehicle fleet will grow exponentially until 2030, considering that the Light Flex vehicles category will mainly contribute to this increase. It is also noted that vehicle emissions of CO, NOx, and THC decrease in the region. The decrease is caused mainly by the renewal of technology in new vehicles and the implementation of emission control programs created by the government.
Collapse
Affiliation(s)
- Angel D Chovert
- Centro de Pesquisas e Previsões Meteorológicas, Universidade Federal de Pelotas, Avenida Engenheiro Ildefonso Simões Lopes, 2751, 96060-290 Pelotas, RS, Brazil
| | - Marcelo F Alonso
- Centro de Pesquisas e Previsões Meteorológicas, Universidade Federal de Pelotas, Avenida Engenheiro Ildefonso Simões Lopes, 2751, 96060-290 Pelotas, RS, Brazil
| |
Collapse
|
18
|
Vencloviene J, Babarskiene RM, Dobozinskas P, Dedele A, Lopatiene K, Ragaisyte N. The short-term associations of weather and air pollution with emergency ambulance calls for paroxysmal atrial fibrillation. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2017; 24:15031-15043. [PMID: 28493187 DOI: 10.1007/s11356-017-9138-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 04/27/2017] [Indexed: 06/07/2023]
Abstract
A circadian variation in the cardiovascular parameters has been detected. It is plausible that the influence of the environment varies during different periods of the day. We investigated the association between daily emergency ambulance calls (EC) for paroxysmal atrial fibrillation (AF) that occurred during the time intervals of 8:00-13:59, 14:00-21:59, and 22:00-7:59, and weather conditions and exposure to CO and PM10. We used Poisson regression to explore the association between the risk of EC for AF and environmental variables, adjusting for seasonal variation. Before noon, the risk was associated with an IQR (0.333 mg/m3) increase in CO at lag 2-6 days above the median (RR = 1.15, P = 0.002); a protective impact of CO on previous day was observed (RR = 0.91, P = 0.018). During 14:00-21:59, a negative effect of air temperature below 1.9 °C (lag 2-3 days) was detected (per 10 °C decrease: RR = 1.17, P = 0.044). At night, the elevated risk was associated with wind speed above the median (lag 2-4 days) (per 1-kt increase: RR = 1.07, P = 0.001) and with PM10 at lag 2-5 days below the median (per IQR (7.31 μg/m3) increase: RR = 1.21, P = 0.002). Individuals over 65 years of age were more sensitive to air pollution, especially at night (CO lag 2-3 days < median, per IQR (0.12 mg/m3) increase: RR = 1.14, P = 0.045; PM10 lag 2-5 days < median, per IQR increase: RR = 1.32, P = 0.001). The associations of air pollution and other environmental variables with acute events may be analyzed depending on the time of the event.
Collapse
Affiliation(s)
- Jone Vencloviene
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Donelaicio St. 58, 44248, Kaunas, Lithuania.
| | - Ruta Marija Babarskiene
- Department of Cardiology, Lithuanian University of Health Sciences, Eiveniu str. 2, 50028, Kaunas, Lithuania
| | - Paulius Dobozinskas
- Department of Disaster Medicine, Lithuanian University of Health Sciences, Eiveniu str. 4, 50028, Kaunas, Lithuania
| | - Audrius Dedele
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Donelaicio St. 58, 44248, Kaunas, Lithuania
| | - Kristina Lopatiene
- Department of Orthodontics, Lithuanian University of Health Sciences, Luksos-Daumanto str. 6, 50106, Kaunas, Lithuania
| | - Nijole Ragaisyte
- Department of Cardiology, Lithuanian University of Health Sciences, Eiveniu str. 2, 50028, Kaunas, Lithuania
| |
Collapse
|
19
|
Kim J, Kim H. Influence of ambient temperature and diurnal temperature range on incidence of cardiac arrhythmias. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:407-416. [PMID: 27568189 DOI: 10.1007/s00484-016-1221-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 07/26/2016] [Accepted: 07/27/2016] [Indexed: 06/06/2023]
Abstract
We investigated the association between ambient temperature and diurnal temperature range (DTR) and the exacerbation of arrhythmia symptoms, using data from 31,629 arrhythmia-related emergency department (ED) visits in Seoul, Korea. Linear regression analyses with allowances for over-dispersion were applied to temperature variables and ED visits, adjusted for various environmental factors. The effects were expressed as percentage changes in the risk of arrhythmia-related ED visits up to 5 days later, with 95 % confidence intervals (CI), per 1 °C increase in DTR and 1 °C decrease in mean temperature. The overall risk of ED visits increased by 1.06 % (95 % CI 0.39 %, 1.73 %) for temperature and by 1.84 % (0.34, 3.37 %) for DTR. A season-specific effect was detected for temperature during both fall (1.18 % [0.01, 2.37 %]) and winter (0.87 % [0.07, 1.67 %]), and for DTR during spring (3.76 % [0.34, 7.29 %]). Females were more vulnerable, with 1.57 % [0.56, 2.59 %] and 3.84 % [1.53, 6.20 %] for the changes in temperature and DTR, respectively. An age-specific effect was detected for DTR, with 3.13 % [0.95, 5.36 %] for age ≥ 65 years, while a greater increased risk with temperature decrease was observed among those aged <65 (1.08 % [0.17, 2.00 %]) than among those aged ≥65 (1.02 % [0.06, 1.99 %]). Cardiac arrest was inversely related with temperature (1.61 % [0.46, 2.79 %]), while other cardiac arrhythmias depended more on the change in DTR (4.72 % [0.37, 9.26 %]). These findings provide evidence that low-temperature and elevated DTR influence the occurrence of arrhythmia exacerbations or symptoms, suggesting a possible strategy for reducing risk by encouraging vulnerable populations to minimize exposure.
Collapse
Affiliation(s)
- Jayeun Kim
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Ho Kim
- Institute of Health and Environment, Seoul National University, Seoul, South Korea.
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, 1 Gwanak-Ro, Gwanak_Gu, Seoul, 151-752, South Korea.
| |
Collapse
|
20
|
Song X, Liu Y, Hu Y, Zhao X, Tian J, Ding G, Wang S. Short-Term Exposure to Air Pollution and Cardiac Arrhythmia: A Meta-Analysis and Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13070642. [PMID: 27367707 PMCID: PMC4962183 DOI: 10.3390/ijerph13070642] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 06/18/2016] [Accepted: 06/22/2016] [Indexed: 12/23/2022]
Abstract
The objective was to assess the transient association between air pollution and cardiac arrhythmia. Five databases were searched for studies investigating the association between daily increases in air pollutants (PM2.5, PM10, carbon monoxide, nitrogen dioxide, sulfur dioxide and ozone) and arrhythmia hospitalization or arrhythmia mortality. Two reviewers independently selected studies, extracted data, and assessed risk of bias. Outcomes were analyzed via a random-effects model and reported as relative risk and 95% confidence interval. 25 studies satisfied our inclusion criteria and 23 contributed to the meta-analysis. Arrhythmia hospitalization or mortality were associated with increases in PM2.5 (RR = 1.015 per 10 μg/m³, 95% CI: 1.006-1.024), PM10 (RR = 1.009 per 10 μg/m³, 95% CI: 1.004-1.014), carbon monoxide (RR = 1.041 per 1 ppm, 95% CI: 1.017-1.065), nitrogen dioxide (RR = 1.036 per 10 ppb, 95% CI: 1.020-1.053), and sulfur dioxide (RR = 1.021 per 10 ppb, 95% CI: 1.003-1.039), but not ozone (RR = 1.012 per 10 ppb, 95% CI: 0.997-1.027). Both particulate and gaseous components, with the exception of ozone, have a temporal association with arrhythmia hospitalization or mortality. Compared with Europe and North America, a stronger association was noted in Asia.
Collapse
Affiliation(s)
- Xuping Song
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
- Center for Meteorological Environment and Human Health, Lanzhou University, Lanzhou 730000, China.
| | - Yu Liu
- School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Yuling Hu
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
- Center for Meteorological Environment and Human Health, Lanzhou University, Lanzhou 730000, China.
| | - Xiaoyan Zhao
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
- Center for Meteorological Environment and Human Health, Lanzhou University, Lanzhou 730000, China.
| | - Jinhui Tian
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.
| | - Guowu Ding
- School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Shigong Wang
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
- Center for Meteorological Environment and Human Health, Lanzhou University, Lanzhou 730000, China.
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu 610225, China.
| |
Collapse
|
21
|
Bravo MA, Son J, de Freitas CU, Gouveia N, Bell ML. Air pollution and mortality in São Paulo, Brazil: Effects of multiple pollutants and analysis of susceptible populations. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:150-61. [PMID: 25586330 DOI: 10.1038/jes.2014.90] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 10/20/2014] [Accepted: 10/21/2014] [Indexed: 05/04/2023]
Abstract
Health impacts of air pollution may differ depending on sex, education, socioeconomic status (SES), location at time of death, and other factors. In São Paulo, Brazil, questions remain regarding roles of individual and community characteristics. We estimate susceptibility to air pollution based on individual characteristics, residential SES, and location at time of death (May 1996-December 2010). Exposures for particulate matter with an aerodynamic diameter ≤ 10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3) were estimated using ambient monitors. Time-stratified case-crossover analysis was used with individual-level health data. Increased risk of non-accidental, cardiovascular, and respiratory mortality were associated with all pollutants (P < 0.05), except O3 and cardiovascular mortality. For non-accidental mortality, effect estimates for those with > 11 years education were lower than estimates for those with 0 years education for NO2, SO2, and CO (1.66% (95% confidence interval: 0.23%, 3.08%); 1.51% (0.51%, 2.51%); and 2.82% (0.23%, 5.35%), respectively). PM10 cardiovascular mortality effects were (3.74% (0.044%, 7.30%)) lower for the high education group (> 11 years) compared with the no education group. Positive, significant associations between pollutants and mortality were observed for in-hospital deaths, but evidence of differences in air pollution-related mortality risk by location at time of death was not strong.
Collapse
Affiliation(s)
- Mercedes A Bravo
- School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA
| | - Jiyoung Son
- School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA
| | - Clarice Umbelino de Freitas
- Faculty of Medicine, Departament of Preventative Medicine, University of São Paulo, Cerqueira Cesar, São Paulo, Brazil
| | - Nelson Gouveia
- Faculty of Medicine, Departament of Preventative Medicine, University of São Paulo, Cerqueira Cesar, São Paulo, Brazil
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA
| |
Collapse
|
22
|
The Influence of Nitrogen Dioxide on Arrhythmias in Spain and Its Relationship with Atmospheric Circulation. Cardiovasc Toxicol 2016; 17:88-96. [DOI: 10.1007/s12012-016-9359-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
23
|
Short-term effects of fine particulate air pollution on cardiovascular hospital emergency room visits: a time-series study in Beijing, China. Int Arch Occup Environ Health 2015; 89:641-57. [DOI: 10.1007/s00420-015-1102-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 10/18/2015] [Indexed: 10/22/2022]
|
24
|
Fernandes EC, Silva CA, Braga ALF, Sallum AME, Campos LMA, Farhat SCL. Exposure to Air Pollutants and Disease Activity in Juvenile-Onset Systemic Lupus Erythematosus Patients. Arthritis Care Res (Hoboken) 2015; 67:1609-14. [DOI: 10.1002/acr.22603] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 02/20/2015] [Accepted: 04/14/2015] [Indexed: 11/06/2022]
Affiliation(s)
| | - Clovis A. Silva
- Faculdade de Medicina da Universidade de São Paulo; São Paulo Brazil
| | - Alfésio L. F. Braga
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, and Universidade Catolica de Santos; Santos Brazil
| | | | | | | |
Collapse
|
25
|
Cozza IC, Zanetta DMT, Fernandes FLA, da Rocha FMM, de Andre PA, Garcia MLB, Paceli RB, Prado GF, Terra-Filho M, do Nascimento Saldiva PH, de Paula Santos U. An approach to using heart rate monitoring to estimate the ventilation and load of air pollution exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 520:160-7. [PMID: 25813969 DOI: 10.1016/j.scitotenv.2015.03.049] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 01/30/2015] [Accepted: 03/13/2015] [Indexed: 05/22/2023]
Abstract
BACKGROUND The effects of air pollution on health are associated with the amount of pollutants inhaled which depends on the environmental concentration and the inhaled air volume. It has not been clear whether statistical models of the relationship between heart rate and ventilation obtained using laboratory cardiopulmonary exercise test (CPET) can be applied to an external group to estimate ventilation. OBJECTIVES To develop and evaluate a model to estimate respiratory ventilation based on heart rate for inhaled load of pollutant assessment in field studies. METHODS Sixty non-smoking men; 43 public street workers (public street group) and 17 employees of the Forest Institute (park group) performed a maximum cardiopulmonary exercise test (CPET). Regression equation models were constructed with the heart rate and natural logarithmic of minute ventilation data obtained on CPET. Ten individuals were chosen randomly (public street group) and were used for external validation of the models (test group). All subjects also underwent heart rate register, and particulate matter (PM2.5) monitoring for a 24-hour period. RESULTS For the public street group, the median difference between estimated and observed data was 0.5 (CI 95% -0.2 to 1.4) l/min and for the park group was 0.2 (CI 95% -0.2 to 1.2) l/min. In the test group, estimated values were smaller than the ones observed in the CPET, with a median difference of -2.4 (CI 95% -4.2 to -1.8) l/min. The mixed model estimated values suggest that this model is suitable for situations in which heart rate is around 120-140bpm. CONCLUSION The mixed effect model is suitable for ventilation estimate, with good accuracy when applied to homogeneous groups, suggesting that, in this case, the model could be used in field studies to estimate ventilation. A small but significant difference in the median of external validation estimates was observed, suggesting that the applicability of the model to external groups needs further evaluation.
Collapse
Affiliation(s)
- Izabela Campos Cozza
- Pulmonary Division, Heart Institute (Incor), Hospital das Clínicas, Medicine School, University of São Paulo, Brazil.
| | | | | | | | - Paulo Afonso de Andre
- Experimental Laboratory of Atmospheric Pollution, Pathology Department, Medicine School, University of São Paulo, Brazil
| | | | - Renato Batista Paceli
- Pulmonary Division, Heart Institute (Incor), Hospital das Clínicas, Medicine School, University of São Paulo, Brazil
| | - Gustavo Faibischew Prado
- Pulmonary Division, Heart Institute (Incor), Hospital das Clínicas, Medicine School, University of São Paulo, Brazil
| | - Mario Terra-Filho
- Pulmonary Division, Heart Institute (Incor), Hospital das Clínicas, Medicine School, University of São Paulo, Brazil
| | | | - Ubiratan de Paula Santos
- Pulmonary Division, Heart Institute (Incor), Hospital das Clínicas, Medicine School, University of São Paulo, Brazil
| |
Collapse
|
26
|
Barbosa SMDM, Farhat SCL, Martins LC, Pereira LAA, Saldiva PHN, Zanobetti A, Braga ALF. Air pollution and children's health: sickle cell disease. CAD SAUDE PUBLICA 2015; 31:265-75. [PMID: 25760161 DOI: 10.1590/0102-311x00013214] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 09/12/2014] [Indexed: 12/14/2022] Open
Abstract
The hallmarks of sickle cell disease are anemia and vasculopathy. The aim of this study was to assess the association between air pollution and children's emergency room visits of sickle cell patients. We adopted a case-crossover design. Daily counts of children's and adolescents' sickle cell disease emergency room visits from the pediatric emergency unit in São Paulo, Brazil, were evaluated from September 1999 to December 2004, matching by temperature, humidity and controlling for day of the week. Interquartile range increases of the four-day moving averages of PM10, NO2, SO2, CO, and O3 were associated with increases of 18.9% (95%CI: 11.2-26.5), 19% (95%CI: 8.3-29.6), 14.4% (95%CI: 6.5-22.4), 16,5% (95%CI: 8.9-24.0), and 9.8% (95%CI: 1.1-18.6) in total sickle cell emergency room visits, respectively. When the analyses were stratified by pain, PM10 was found to be 40.3% higher than in sickle cell patients without pain symptoms. Exposure to air pollution can affect the cardiovascular health of children and may promote a significant health burden in a sensitive group.
Collapse
|
27
|
Pereira BB, Limongi JE. Epidemiologia de desfechos na saúde humana relacionados à poluição atmosférica no Brasil: uma revisão sistemática. ACTA ACUST UNITED AC 2015. [DOI: 10.1590/1414-462x201400050103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ResumoO presente artigo revisa e discute aspectos da situação da pesquisa epidemiológica relacionados aos desfechos de saúde decorrentes da poluição atmosférica. Foi realizada uma revisão sistemática de estudos que avaliou os efeitos de poluentes do ar na saúde humana. A qualidade metodológica dos trabalhos também foi avaliada. A revisão identificou 432 estudos que abordaram a temática, dos quais 56 atendem aos critérios de inclusão previamente estabelecidos. Além de evidenciarem um cenário de pesquisa epidemiológica pautado na relação causa-efeito, os resultados apontam para a necessidade de revisão de parâmetros ambientais e expõem desafios e contribuições à pesquisa epidemiológica em saúde ambiental.
Collapse
|
28
|
Castner J, Gittere S, Seo JY. Criteria Air Pollutants and Emergency Nursing. J Emerg Nurs 2015; 41:186-92. [DOI: 10.1016/j.jen.2014.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 08/14/2014] [Accepted: 08/17/2014] [Indexed: 11/26/2022]
|
29
|
Hazari MS, Haykal-Coates N, Winsett DW, King C, Krantz QT, Gilmour MI, Farraj AK. The effects of B0, B20, and B100 soy biodiesel exhaust on aconitine-induced cardiac arrhythmia in spontaneously hypertensive rats. Inhal Toxicol 2015; 27:557-63. [PMID: 26514783 DOI: 10.3109/08958378.2015.1054967] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 05/19/2015] [Accepted: 05/20/2015] [Indexed: 11/13/2022]
Abstract
CONTEXT Diesel exhaust (DE) has been shown to increase the risk of cardiac arrhythmias. Although biodiesel has been proposed as a "safer" alternative to diesel, it is still uncertain whether it actually poses less threat. OBJECTIVE We hypothesized that exposure to pure or 20% soy biodiesel exhaust (BDE) would cause less sensitivity to aconitine-induced arrhythmia than DE in rats. METHODS Spontaneously hypertensive (SH) rats implanted with radiotelemeters were exposed once or for 5 d (4 h) to either 50 mg/m(3) (low), 150 mg/m(3) (medium), or 500 mg/m(3) (high) of DE (B0), 20% (B20) or 100% (B100) soy biodiesel exhaust. Arrhythmogenesis was assessed 24 h later by continuous infusion of aconitine, an arrhythmogenic drug, while heart rate (HR), and electrocardiogram (ECG) were monitored. RESULTS Rats exposed once or for 5 d to low, medium, or high B0 developed arrhythmia at significantly lower doses of aconitine than controls, whereas rats exposed to B20 were only consistently sensitive after 5 d of the high concentration. B100 caused mild arrhythmia sensitivity at the low concentration, only after 5 d of exposure at the medium concentration and after either a single or 5 d at the high concentration. DISCUSSION AND CONCLUSIONS These data demonstrate that exposure to B20 causes less sensitivity to arrhythmia than B0 and B100. This diminished effect may be due to lower irritant components such as acrolein and nitrogen oxides. Thus, in terms of cardiac health, B20 may be a safer option than both of the pure forms.
Collapse
Affiliation(s)
- Mehdi S Hazari
- a Environmental Public Health Division, NHEERL, U.S. Environmental Protection Agency, Research Triangle Park , NC , USA
| | - Najwa Haykal-Coates
- a Environmental Public Health Division, NHEERL, U.S. Environmental Protection Agency, Research Triangle Park , NC , USA
| | - Darrell W Winsett
- a Environmental Public Health Division, NHEERL, U.S. Environmental Protection Agency, Research Triangle Park , NC , USA
| | - Charly King
- a Environmental Public Health Division, NHEERL, U.S. Environmental Protection Agency, Research Triangle Park , NC , USA
| | - Q Todd Krantz
- a Environmental Public Health Division, NHEERL, U.S. Environmental Protection Agency, Research Triangle Park , NC , USA
| | - M Ian Gilmour
- a Environmental Public Health Division, NHEERL, U.S. Environmental Protection Agency, Research Triangle Park , NC , USA
| | - Aimen K Farraj
- a Environmental Public Health Division, NHEERL, U.S. Environmental Protection Agency, Research Triangle Park , NC , USA
| |
Collapse
|
30
|
Mu H, Otani S, Okamoto M, Yokoyama Y, Tokushima Y, Onishi K, Hosoda T, Kurozawa Y. Assessment of Effects of Air Pollution on Daily Outpatient Visits using the Air Quality Index. Yonago Acta Med 2014; 57:133-136. [PMID: 25901100 PMCID: PMC4404523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 10/09/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND The air quality index (AQI) is widely used to characterize the quality of ambient air. Chinese cities officially report the AQI on a daily basis. To assess the possible effects of air pollution on daily outpatient visits, we examined the association between AQI and the daily outpatient count. METHODS Daily data on outpatient visits to each clinical department were collected from the Z county hospital of Datong City, China. The collection period was between 5 April and 30 June, 2012. Daily AQI data and meteorological information were simultaneously recorded. We compared outpatient counts between the index days and comparison days, and calculated Pearson's product moment correlation coefficient between outpatient counts and AQI levels. RESULTS The average AQI level for index days was significantly higher than that for comparison days. No significant difference was observed in temperature or relative humidity between index days and comparison days. The outpatient counts for pediatrics were significantly higher on index days than on comparison days, and no significant difference was noted in other clinical departments. The outpatient counts for pediatrics positively correlated with the AQI level, and no correlation was noted in other clinical departments. CONCLUSION The present study assessed the association between daily outpatient visits and air pollution using AQI. The results obtained suggest that air pollution could increase the outpatient count for pediatrics.
Collapse
Affiliation(s)
- Haosheng Mu
- Division of Health Administration and Promotion, Department of Social Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan
| | - Shinji Otani
- †Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan
| | - Mikizo Okamoto
- ‡Cancer Center, Tottori University Hospital, Yonago 683-8504, Japan
| | - Yae Yokoyama
- Division of Health Administration and Promotion, Department of Social Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan
| | - Yasuko Tokushima
- §Department of Nursing Care Environment and Mental Health, School of Health Science, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Kazunari Onishi
- Division of Health Administration and Promotion, Department of Social Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan
| | - Takenobu Hosoda
- Division of Health Administration and Promotion, Department of Social Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan
| | - Youichi Kurozawa
- Division of Health Administration and Promotion, Department of Social Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan
| |
Collapse
|
31
|
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
|
32
|
Zhao A, Chen R, Kuang X, Kan H. Ambient air pollution and daily outpatient visits for cardiac arrhythmia in Shanghai, China. J Epidemiol 2014; 24:321-6. [PMID: 24835409 PMCID: PMC4074637 DOI: 10.2188/jea.je20140030] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background Cardiac arrhythmias are cardiac rhythm disorders that comprise an important public health problem. Few prior studies have examined the association between ambient air pollution and arrhythmias in general populations in mainland China. Methods We performed a time-series analysis to investigate the short-term association between air pollution (particulate matter with an aerodynamic diameter less than 10 µm [PM10], sulfur dioxide [SO2], and nitrogen dioxide [NO2]) and outpatient visits for arrhythmia in Shanghai, China. We applied the over-dispersed Poisson generalized additive model to analyze the associations after control for seasonality, day of the week, and weather conditions. We then stratified the analyses by age, gender, and season. Results We identified a total of 56 940 outpatient visits for cardiac arrhythmia. A 10-µg/m3 increase in the present-day concentrations of PM10, SO2, and NO2 corresponded to increases of 0.56% (95% CI 0.42%, 0.70%), 2.07% (95% CI 1.49%, 2.64%), and 2.90% (95% CI 2.53%, 3.27%), respectively, in outpatient arrhythmia visits. The associations were stronger in older people (aged ≥65 years) and in females. This study provides the first evidence that ambient air pollution is significantly associated with increased risk of cardiac arrhythmia in mainland China. Conclusions Our analyses provide evidence that the current air pollution levels have an adverse effect on cardiovascular health and strengthened the rationale for further limiting air pollution levels in the city.
Collapse
Affiliation(s)
- Ang Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Institute of Global Health, Fudan University
| | | | | | | |
Collapse
|
33
|
Franck U, Leitte AM, Suppan P. Multiple exposures to airborne pollutants and hospital admissions due to diseases of the circulatory system in Santiago de Chile. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 468-469:746-56. [PMID: 24064344 DOI: 10.1016/j.scitotenv.2013.08.088] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 07/23/2013] [Accepted: 08/27/2013] [Indexed: 05/27/2023]
Abstract
BACKGROUND High concentrations of various air pollutants have been associated with hospitalization due to development and exacerbation of cardiovascular diseases. OBJECTIVES We aimed to assess associations between airborne exposures by particulate matter as well as gaseous air pollutants and hospital admissions due to different cardiovascular disease groups in Santiago de Chile. METHODS The study was performed in the metropolitan area of Santiago de Chile during 2004-2007. We applied a time-stratified case-crossover analysis taking temporal variation, meteorological conditions and autocorrelation into account. We computed associations between daily ambient concentrations of carbon monoxide (CO), nitrogen dioxide (NO2), particulate matter (PM10 and PM2.5--particulate matter with aerodynamic diameters less than 10 or 2.5 μm, respectively) or ozone (O3) and hospital admissions for cardiovascular illnesses. RESULTS We found for CO, NO2, PM10 and PM2.5 adverse relationships to cardiovascular admissions while effect strength and lag depended on the pollutant and on the disease group. By trend, in 1-pollutant models most adverse pollutants were NO2 and particulate matter (PM10 and PM2.5) followed by CO, while in 2-pollutant models effects of PM10 persisted in most cases whereas other effects weakened. In addition the strongest effects seemed to be immediate or with a delay of up to 2 days. Adverse effects of ozone could not be detected. CONCLUSIONS Our results provided evidence for adverse health effects of combined exposure to airborne pollutants. Different pollutants accounted for varying adverse effects within different cardiovascular disease groups. Taking case numbers and effect strength of all cardiovascular diseases into account, mitigation measures should address all pollutants but especially NO2, PM10, and CO.
Collapse
Affiliation(s)
- Ulrich Franck
- Core Facility Studies, Helmholtz Centre for Environmental Research-UFZ, Leipzig, Germany.
| | | | | |
Collapse
|
34
|
Farhat SCL, Almeida MB, Silva-Filho LVRF, Farhat J, Rodrigues JC, Braga ALF. Ozone is associated with an increased risk of respiratory exacerbations in patients with cystic fibrosis. Chest 2014; 144:1186-1192. [PMID: 23493973 PMCID: PMC7172612 DOI: 10.1378/chest.12-2414] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background Tropospheric oxidant pollutants may injure the respiratory tract. Cystic fibrosis (CF) respiratory disease involves significant inflammation and excessive oxidative stress, and exposure to air pollutants can magnify the lung damage. The objective of this study was to investigate the association between the short-term variation in the concentration of air pollutants in metropolitan São Paulo, Brazil, and the occurrence of respiratory exacerbations in children and adolescents with CF. Methods A longitudinal panel of repeated measurements was obtained from 103 patients attending the outpatient center of our institution from September 6, 2006 through September 4, 2007. Daily concentrations of inhaled particulate matter, sulfur dioxide, nitrogen dioxide, ozone (O3), carbon monoxide, and meteorologic variables, such as the minimum temperature and relative humidity, were evaluated. The generalized estimation equation model for binomial distribution was used to assess the impact of these measurements on the occurrence of acute respiratory exacerbations. Results In total, 103 patients with CF (median age, 8.9 years) made 408 visits, with a mean ± SD of 4 ± 1.74 visits per patient (range, 2-9). A respiratory disease exacerbation was diagnosed on 142 visits (38.4%). An interquartile range increase in the O3 concentration (45.62 μg/m3) had a positive, delayed (2 days after exposure) effect on the risk of a respiratory exacerbation (relative risk = 1.86; 95% CI, 1.14-3.02). Conclusions This study demonstrates that exposure to short-term air pollution in a large urban center increases the risk of a pulmonary exacerbation in patients with CF.
Collapse
Affiliation(s)
- Sylvia C L Farhat
- Emergency Unit, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo; Children's Institute, Clinics Hospital and the Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo.
| | - Marina B Almeida
- Pulmonology Unit, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo
| | - Luiz Vicente R F Silva-Filho
- Pulmonology Unit, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo; Virology Laboratory, Tropical Medicine Institute, University of São Paulo, São Paulo
| | - Juliana Farhat
- Children's Institute, Clinics Hospital and the Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo
| | - Joaquim C Rodrigues
- Pulmonology Unit, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo
| | - Alfésio L F Braga
- Children's Institute, Clinics Hospital and the Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, University of São Paulo Medical School, São Paulo; Environmental Exposure and Risk Assessment, Collective Health Post-graduation Program, Catholic University of Santos, Santos, Brazil
| |
Collapse
|
35
|
Goldberg MS, Burnett RT, Stieb DM, Brophy JM, Daskalopoulou SS, Valois MF, Brook JR. Associations between ambient air pollution and daily mortality among elderly persons in Montreal, Quebec. THE SCIENCE OF THE TOTAL ENVIRONMENT 2013; 463-464:931-42. [PMID: 23872247 DOI: 10.1016/j.scitotenv.2013.06.095] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Revised: 06/12/2013] [Accepted: 06/24/2013] [Indexed: 05/22/2023]
Abstract
BACKGROUND Persons with underlying health conditions may be at higher risk for the short-term effects of air pollution. We have extended our original mortality time series study in Montreal, Quebec, among persons 65 years of age and older, for an additional 10 years (1990-2003) to assess whether these associations persisted and to investigate new health conditions. METHODS AND RESULTS We created subgroups of subjects diagnosed with major health conditions one year before death using billing and prescription data from the Quebec Health Insurance Plan. We used parametric log-linear Poisson models within the distributed lag non-linear models framework, that were adjusted for long-term temporal trends and daily maximum temperature, for which we assessed associations with NO2, O3, CO, SO2, and particles with aerodynamic diameters 2.5 μm in diameter or less (PM2.5). We found positive associations between daily non-accidental mortality and all air pollutants but O3 (e.g., for a cumulative effect over a 3-day lag, with a mean percent change (MPC) in daily mortality of 1.90% [95% confidence interval: 0.73, 3.08%] for an increase of the interquartile range (17.56 μg m(-3)) of NO2). Positive associations were found amongst persons having cardiovascular disease (cumulative MPC for an increase equal to the interquartile range of NO2=2.67%), congestive heart failure (MPC=3.46%), atrial fibrillation (MPC=4.21%), diabetes (MPC=3.45%), and diabetes and cardiovascular disease (MPC=3.50%). Associations in the warm season were also found for acute and chronic coronary artery disease, hypertension, and cancer. There was no persuasive evidence to conclude that there were seasonal associations for cerebrovascular disease, acute lower respiratory disease (defined within 2 months of death), airways disease, and diabetes and airways disease. CONCLUSIONS These data indicate that individuals with certain health conditions, especially those with diabetes and cardiovascular disease, hypertension, atrial fibrillation, and cancer, may be susceptible to the short-term effects of air pollution.
Collapse
Affiliation(s)
- Mark S Goldberg
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, 687 Pine Ave. W., R4.29, Montreal, Quebec H3A 1A1, Canada.
| | | | | | | | | | | | | |
Collapse
|
36
|
Scorza CA, Calderazzo L, Arida RM, Cavalheiro EA, Scorza FA. Environmental air pollution is an aggravating event for sudden unexpected death in epilepsy. ARQUIVOS DE NEURO-PSIQUIATRIA 2013; 71:807-10. [DOI: 10.1590/0004-282x20130092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 05/06/2013] [Indexed: 11/21/2022]
Abstract
It is extremely difficult to estimate the occurrence of sudden unexpected death in epilepsy (SUDEP). On the other hand, discovering and carefully evaluating new risk factors that may contribute to the onset of cardiovascular abnormalities in people with refractory epilepsy may prevent fatal events in these individuals. In this context, we should not ignore that urban air pollution is a leading problem for environmental health and is able to cause serious cardiovascular dysfunctions that culminate in sudden death. In this regard, we aimed to determine whether environmental exposure to air pollution is an aggravating event for SUDEP.
Collapse
|
37
|
Jia X, Guo X, Li H, An X, Zhao Y. Characteristics and popular topics of latest researches into the effects of air particulate matter on cardiovascular system by bibliometric analysis. Inhal Toxicol 2013; 25:211-8. [PMID: 23480197 DOI: 10.3109/08958378.2013.775196] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In recent years, many epidemiological and toxicological studies have investigated the adverse effects of air particulate matter (PM) on the cardiovascular system. However, it is difficult for the researchers to have a timely and effective overall command of the latest characteristics and popular topics in such a wide field. Different from the previous reviews, in which the research characteristics and trends are empirically concluded by experts, we try to have a comprehensive evaluation of the above topics for the first time by bibliometric analysis, a quantitative tool in information exploration. This study aims to introduce the bibliometric method into the field of PM and cardiovascular system. The articles were selected by searching PubMed/MEDLINE (from 2007 to 2012) using Medical Subject Headings (MeSH) terms "particulate matter" and "cardiovascular system". A total of 935 eligible articles and 1895 MeSH terms were retrieved and processed by the software Thomson Data Analyzer (TDA). The bibliographic information and the MeSH terms of these articles were classified and analyzed to summarize the research characteristics. The top 200 high-frequency MeSH terms (the cumulative frequency percentage was 74.2%) were clustered for popular-topic conclusion. We summarized the characteristics of published articles, of researcher collaborations and of the contents. Ten clusters of MeSH terms are presented. Six popular topics are concluded and elaborated for reference. Our study presents an overview of the characteristics and popular topics in the field of PM and cardiovascular system in the past five years by bibliometric tools, which may provide a new perspective for future researchers.
Collapse
Affiliation(s)
- Xiaofeng Jia
- Institute of Medical Information & Library, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing, China.
| | | | | | | | | |
Collapse
|
38
|
Zheng S, Wang M, Wang S, Tao Y, Shang K. Short-term effects of gaseous pollutants and particulate matter on daily hospital admissions for cardio-cerebrovascular disease in Lanzhou: evidence from a heavily polluted city in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:462-77. [PMID: 23358231 PMCID: PMC3635155 DOI: 10.3390/ijerph10020462] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Revised: 01/04/2013] [Accepted: 01/16/2013] [Indexed: 11/18/2022]
Abstract
Panel studies show a consistent association between increase in the cardiovascular hospitalizations with air pollutants in economically developed regions, but little evidence in less developed inland areas. In this study, a time-series analysis was used to examine the specific effects of major air pollutants [particulate matter less than 10 microns in diameter (PM10), sulfur dioxide (SO2), and nitrogen dioxides (NO2)] on daily hospital admissions for cardio-cerebrovascular diseases in Lanzhou, a heavily polluted city in China. We examined the effects of air pollutants for stratified groups by age and gender, and conducted the modifying effect of seasons on air pollutants to test the possible interaction. The significant associations were found between PM10, SO2 and NO2 and cardiac disease admissions, SO2 and NO2 were found to be associated with the cerebrovascular disease admissions. The elderly was associated more strongly with gaseous pollutants than younger. The modifying effect of seasons on air pollutants also existed. The significant effect of gaseous pollutants (SO2 and NO2) was found on daily hospital admissions even after adjustment for other pollutants except for SO2 on cardiac diseases. In a word, this study provides the evidence for the detrimental short-term health effects of urban gaseous pollutants on cardio-cerebrovascular diseases in Lanzhou.
Collapse
Affiliation(s)
- Shan Zheng
- College of Atmospheric Science, Center for Meteorological Environment and Human Health, Lanzhou University, the Gansu key Laboratory of Arid Climate Change and Reducing Disaster, Lanzhou 730000, China; E-Mails: (S.Z.); (M.W.); (K.S.)
| | - Minzhen Wang
- College of Atmospheric Science, Center for Meteorological Environment and Human Health, Lanzhou University, the Gansu key Laboratory of Arid Climate Change and Reducing Disaster, Lanzhou 730000, China; E-Mails: (S.Z.); (M.W.); (K.S.)
| | - Shigong Wang
- College of Atmospheric Science, Center for Meteorological Environment and Human Health, Lanzhou University, the Gansu key Laboratory of Arid Climate Change and Reducing Disaster, Lanzhou 730000, China; E-Mails: (S.Z.); (M.W.); (K.S.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel./Fax: +86-0931-8915-728
| | - Yan Tao
- College of Earth and Environmental Sciences, Lanzhou University, Lanzhou 730000, China; E-Mail:
| | - Kezheng Shang
- College of Atmospheric Science, Center for Meteorological Environment and Human Health, Lanzhou University, the Gansu key Laboratory of Arid Climate Change and Reducing Disaster, Lanzhou 730000, China; E-Mails: (S.Z.); (M.W.); (K.S.)
| |
Collapse
|
39
|
Chiu HF, Tsai SS, Weng HH, Yang CY. Short-term effects of fine particulate air pollution on emergency room visits for cardiac arrhythmias: a case-crossover study in Taipei. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2013; 76:614-23. [PMID: 23859081 DOI: 10.1080/15287394.2013.801763] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
This study was undertaken to determine whether there was an association between fine particles (PM₂.₅) levels and number of emergency room (ER) visits for cardiac arrhythmias in Taipei, Taiwan. ER visits for cardiac arrhythmias and ambient air pollution data for Taipei were obtained for the period 2006-2010. The relative risk (RR) of ER visits was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. For the single-pollutant model (without adjustment for other pollutants), increased numbers of ER cardiac arrhythmia visits were significantly associated with PM₂.₅ on both warm days (>23°C) and cool days (< 23°C), with an interquartile range rise associated with a 10% (95% CI = -15%) and 4% (95% CI = 0-8%) elevation in number of ER visits for cardiac arrhythmias, respectively. In the two-pollutant models, PM₂.₅ levels remained significant after inclusion of sulfur dioxide (SO₂) or ozone (O₃) on both warm and cool days. This study provides evidence that higher levels of PM₂.₅ increase the risk of number of ER visits for cardiac arrhythmias.
Collapse
Affiliation(s)
- Hui-Fen Chiu
- Department of Pharmacology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | | | | |
Collapse
|
40
|
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
|
41
|
Kusha M, Masse S, Farid T, Urch B, Silverman F, Brook RD, Gold DR, Mangat I, Speck M, Nair K, Poku K, Meyer C, Mittleman MA, Wellenius GA, Nanthakumar K. Controlled exposure study of air pollution and T-wave alternans in volunteers without cardiovascular disease. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:1157-1161. [PMID: 22552907 PMCID: PMC3440072 DOI: 10.1289/ehp.1104171] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 05/02/2012] [Indexed: 05/31/2023]
Abstract
BACKGROUND Epidemiological studies have assessed T-wave alternans (TWA) as a possible mechanism of cardiac arrhythmias related to air pollution in high-risk subjects and have reported associations with increased TWA magnitude. OBJECTIVE In this controlled human exposure study, we assessed the impact of exposure to concentrated ambient particulate matter (CAP) and ozone (O3) on T-wave alternans in resting volunteers without preexisting cardiovascular disease. METHODS Seventeen participants without preexisting cardiovascular disease were randomized to filtered air (FA), CAP (150 μg/m3), O3 (120 ppb), or combined CAP + O3 exposures for 2 hr. Continuous electrocardiograms (ECGs) were recorded at rest and T-wave alternans (TWA) was computed by modified moving average analysis with QRS alignment for the artifact-free intervals of 20 beats along the V2 and V5 leads. Exposure-induced changes in the highest TWA magnitude (TWAMax) were estimated for the first and last 5 min of each exposure (TWAMax_Early and TWAMax_Late respectively). ΔTWAMax (Late-Early) were compared among exposure groups using analysis of variance. RESULTS Mean ± SD values for ΔTWAMax were -2.1 ± 0.4, -2.7 ± 1.1, -1.9 ± 1.5, and -1.2 ± 1.5 in FA, CAP, O3, and CAP + O3 exposure groups, respectively. No significant differences were observed between pollutant exposures and FA. CONCLUSION In our study of 17 volunteers who had no preexisting cardiovascular disease, we did not observe significant changes in T-wave alternans after 2-hr exposures to CAP, O3, or combined CAP + O3. This finding, however, does not preclude the possibility of pollution-related effects on TWA at elevated heart rates, such as during exercise, or the possibility of delayed responses.
Collapse
Affiliation(s)
- Marjan Kusha
- Division of Cardiology, Toronto General Hospital, Toronto, Ontario, Canada
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Vidotto JP, Pereira LAA, Braga ALF, Silva CA, Sallum AM, Campos LM, Martins LC, Farhat SCL. Atmospheric pollution: influence on hospital admissions in paediatric rheumatic diseases. Lupus 2012; 21:526-33. [DOI: 10.1177/0961203312437806] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To investigate the lag structure effects from exposure to atmospheric pollution in acute outbursts in hospital admissions of paediatric rheumatic diseases (PRDs). Methods: Morbidity data were obtained from the Brazilian Hospital Information System in seven consecutive years, including admissions due to seven PRDs (juvenile idiopathic arthritis, systemic lupus erythematosus, dermatomyositis, Henoch–Schönlein purpura, polyarteritis nodosa, systemic sclerosis and ankylosing spondylitis). Cases with secondary diagnosis of respiratory diseases were excluded. Daily concentrations of inhaled particulate matter (PM10), sulphur dioxide (SO2) nitrogen dioxide (NO2), ozone (O3) and carbon monoxide (CO) were evaluated. Generalized linear Poisson regression models controlling for short-term trend, seasonality, holidays, temperature and humidity were used. Lag structures and magnitude of air pollutants’ effects were adopted to estimate restricted polynomial distributed lag models. Results: The total number of admissions due to acute outbursts PRD was 1,821. The SO2 interquartile range (7.79 µg/m3) was associated with an increase of 1.98% (confidence interval 0.25–3.69) in the number of hospital admissions due to outcome studied after 14 days of exposure. This effect was maintained until day 17. Of note, the other pollutants, with the exception of O3, showed an increase in the number of hospital admissions from the second week. Conclusion: This study is the first to demonstrate a delayed association between SO2 and PRD outburst, suggesting that oxidative stress reaction could trigger the inflammation of these diseases.
Collapse
Affiliation(s)
- JP Vidotto
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| | - LAA Pereira
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Universidade Catolica de Santos, Brazil
| | - ALF Braga
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Universidade Catolica de Santos, Brazil
| | - CA Silva
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Paediatric Rheumatology Unit, Children’s Institute, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Division of Rheumatology, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| | - AM Sallum
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Paediatric Rheumatology Unit, Children’s Institute, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| | - LM Campos
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Paediatric Rheumatology Unit, Children’s Institute, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| | - LC Martins
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Environmental Exposure and Risk Assessment Group, Collective Health Post-graduation Program, Universidade Catolica de Santos, Brazil
| | - SCL Farhat
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
- Paediatric Department, Hospital das Clínicas, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| |
Collapse
|
43
|
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
|
44
|
Toledo GIFMD, Nardocci AC. Poluição veicular e saúde da população: uma revisão sobre o município de São Paulo (SP), Brasil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2011; 14:445-54. [DOI: 10.1590/s1415-790x2011000300009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Accepted: 06/06/2011] [Indexed: 12/13/2022] Open
Abstract
INTRODUÇÃO: A poluição do ar é um problema importante para o município de São Paulo, cuja maior fonte são os veículos. Cerca de 11 milhões de habitantes estão expostos a essa poluição. OBJETIVO: Analisar os estudos realizados sobre a poluição do ar e seus efeitos na saúde da população do município de São Paulo e sobre métodos de avaliação da exposição à poluição relacionada ao tráfego. MÉTODOS: Foi realizado um levantamento bibliográfico com os descritores "air pollution", "São Paulo" e "traffic-related air pollution". RESULTADOS: Foram obtidos vários estudos que verificaram relações entre a poluição do ar no município de São Paulo e problemas respiratórios e cardiovasculares, crescimento fetal, aumento na mortalidade e hospitalizações, particularmente em idosos e crianças. Para estimativa da exposição, a maioria destes estudos considera a distribuição isotrópica dos poluentes para toda a área, o que impede a avaliação da influência do tráfego. Vários métodos têm sido utilizados para avaliação da exposição da população à poluição relacionada ao tráfego, os quais podem ser utilizados isoladamente ou em conjunto. Acredita-se que a associação de modelos para cálculo das concentrações de poluentes a métodos de georreferenciamento seja a abordagem adequada para o município de São Paulo. As vantagens do uso destes métodos são a capacidade de identificar situações e áreas prioritárias, obtenção de informações detalhadas para adoção de medidas ou políticas públicas e a simulação de diferentes cenários. CONCLUSÃO: A aplicação destes métodos, em estudos no município de São Paulo, depende da melhoria dos dados de entrada dos modelos, o aprimoramento da rede de monitoramento do ar e de condições meteorológicas e dados do volume de tráfego.
Collapse
|
45
|
Farhat SCL, Silva CA, Orione MAM, Campos LMA, Sallum AME, Braga ALF. Air pollution in autoimmune rheumatic diseases: a review. Autoimmun Rev 2011; 11:14-21. [PMID: 21763467 DOI: 10.1016/j.autrev.2011.06.008] [Citation(s) in RCA: 133] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 06/06/2011] [Indexed: 12/11/2022]
Abstract
Air pollution consists of a heterogeneous mixture of gasses and particles that include carbon monoxide, nitrates, sulfur dioxide, ozone, lead, toxic by-product of tobacco smoke and particulate matter. Oxidative stress and inflammation induced by inhaled pollutants may result in acute and chronic disorders in the respiratory system, as well as contribute to a state of systemic inflammation and autoimmunity. This paper reviews the mechanisms of air contaminants influencing the immune response and autoimmunity, and it focuses on studies of inhaled pollutants triggering and/or exacerbating rheumatic diseases in cities around the world. Remarkably, environmental factors contribute to the onset of autoimmune diseases, especially smoking and occupational exposure to silica in rheumatoid arthritis and systemic lupus erythematosus. Other diseases such as scleroderma may be triggered by the inhalation of chemical solvents, herbicides and silica. Likewise, primary vasculitis associated with anti-neutrophil cytoplasmic antibody (ANCA) may be triggered by silica exposure. Only few studies showed that air pollutants could trigger or exacerbate juvenile idiopathic arthritis and systemic lupus erythematosus. In contrast, no studies of tropospheric pollution triggering inflammatory myopathies and spondyloarthropathies were carried out. In conclusion, air pollution is one of the environmental factors involved in systemic inflammation and autoimmunity. Further studies are needed in order to evaluate air pollutants and their potentially serious effects on autoimmune rheumatic diseases and the mechanisms involved in the onset and the exacerbation of these diseases.
Collapse
Affiliation(s)
- Sylvia C L Farhat
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, University of Sao Paulo Faculty of Medical Sciences, Brazil
| | | | | | | | | | | |
Collapse
|
46
|
Sivagangabalan G, Spears D, Masse S, Urch B, Brook RD, Silverman F, Gold DR, Lukic KZ, Speck M, Kusha M, Farid T, Poku K, Shi E, Floras J, Nanthakumar K. The effect of air pollution on spatial dispersion of myocardial repolarization in healthy human volunteers. J Am Coll Cardiol 2011; 57:198-206. [PMID: 21211691 DOI: 10.1016/j.jacc.2010.08.625] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Revised: 07/28/2010] [Accepted: 08/10/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We tested the hypothesis that exposure to concentrated ambient particles (CAP) and/or ozone (O(3)) would increase dispersion of ventricular repolarization. BACKGROUND Elevated levels of air pollution are associated with cardiac arrhythmias through mechanisms yet to be elucidated. METHODS Each of 25 volunteers (18 to 50 years of age) had four 2-h exposures to 150 μg/m(3) CAP; 120 parts per billion O(3); CAP + O(3); and filtered air (FA). Exposure-induced changes (Δ = 5-min epochs at end-start) in spatial dispersion of repolarization were determined from continuous 12-lead electrocardiographic recording. RESULTS Spatial dispersion of repolarization assessed by corrected ΔT-wave peak to T-wave end interval increased significantly for CAP + O(3) (0.17 ± 0.03, p < 0.0001) exposure only, remaining significant when factoring FA (CAP + O(3) - FA) as control (0.11 ± 0.04, p = 0.013). The influence on repolarization was further verified by a significant increase in ΔQT dispersion (for CAP + O(3) compared with FA (5.7 ± 1.4, p = 0.0002). When the low-frequency to high-frequency ratio of heart rate variability (a conventional representation of sympathetic-parasympathetic balances) was included as a covariate, the effect estimate was positive for both corrected ΔT-wave peak to T-wave end interval (p = 0.002) and ΔQT dispersion (p = 0.038). When the high-frequency component (parasympathetic heart rate modulation) was included as a covariate with corrected ΔT-wave peak to T-wave end interval, the effect estimate for high frequency was inverse (p = 0.02). CONCLUSIONS CAP + O(3) exposure alters dispersion of ventricular repolarization in part by increasing sympathetic and decreasing parasympathetic heart rate modulation. Detection of changes in repolarization parameters, even in this small cohort of healthy individuals, suggests an underappreciated role for air pollutants in urban arrhythmogenesis.
Collapse
|
47
|
Olmo NRS, Saldiva PHDN, Braga ALF, Lin CA, Santos UDP, Pereira LAA. A review of low-level air pollution and adverse effects on human health: implications for epidemiological studies and public policy. Clinics (Sao Paulo) 2011; 66:681-90. [PMID: 21655765 PMCID: PMC3093800 DOI: 10.1590/s1807-59322011000400025] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 01/17/2011] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to review original scientific articles describing the relationship between atmospheric pollution and damage to human health. We also aimed to determine which of these studies mentioned public policy issues. Original articles relating to atmospheric pollution and human health published between 1995 and 2009 were retrieved from the PubMed database and analyzed. This study included only articles dealing with atmospheric pollutants resulting primarily from vehicle emissions. Three researchers were involved in the final selection of the studies, and the chosen articles were approved by at least two of the three researchers. Of the 84 non-Brazilian studies analyzed, 80 showed an association between atmospheric pollution and adverse effects on human health. Moreover, 66 showed evidence of adverse effects on human health, even at levels below the permitted emission standards. Three studies mentioned public policies aimed at changing emission standards. Similarly, the 29 selected Brazilian studies reported adverse associations with human health, and 27 showed evidence of adverse effects even at levels below the legally permitted emission standards. Of these studies, 16 mentioned public policies aimed at changing emission standards. Based on the Brazilian and non-Brazilian scientific studies that have been conducted, it can be concluded that, even under conditions that are compliant with Brazilian air quality standards, the concentration of atmospheric pollutants in Brazil can negatively affect human health. However, as little discussion of this topic has been generated, this finding demonstrates the need to incorporate epidemiological evidence into decisions regarding legal regulations and to discuss the public policy implications in epidemiological studies.
Collapse
Affiliation(s)
- Neide Regina Simoes Olmo
- Laboratory of Experimental Air Pollution, Department of Pathology, Faculdade de Medicina, Universidade de São Paulo, Brazil.
| | | | | | | | | | | |
Collapse
|
48
|
Bravo MA, Bell ML. Spatial heterogeneity of PM10 and O3 in São Paulo, Brazil, and implications for human health studies. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2011; 61:69-77. [PMID: 21305890 DOI: 10.3155/1047-3289.61.1.69] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Developing exposure estimates is a challenging aspect of investigating the health effects of air pollution. Pollutant levels recorded at centrally located ambient air quality monitors in a community are commonly used as proxies for population exposures. However, if ample intraurban spatial variation in pollutants exists, city-wide averages of concentrations may introduce exposure misclassification. We assessed spatial heterogeneity of particulate matter with an aerodynamic diameter < or = 10 microm (PM10) and ozone (O3) and evaluated implications for epidemiological studies in São Paulo, Brazil, using daily (24-hr) and daytime (12-hr) averages and 1-hr daily maximums of pollutant levels recorded at the regulatory monitoring network. Monitor locations were also analyzed with respect to a socioeconomic status index developed by the municipal government. Hourly PM10 and O3 data for the Sāo Paulo Municipality and Metropolitan Region (1999-2006) were used to evaluate heterogeneity by comparing distance between monitors with pollutants' correlations and coefficients of divergence (CODs). Both pollutants showed high correlations across monitoring sites (median = 0.8 for daily averages). CODs across sites averaged 0.20. Distance was a good predictor of CODs for PM10 (p < 0.01) but not O3, whereas distance was a good predictor of correlations for O3 (p < 0.01) but not PM10. High COD values and low temporal correlation indicate a spatially heterogeneous distribution of PM10. Ozone levels were highly correlated (r > or = 0.75), but high CODs suggest that averaging over O3 levels may obscure important spatial variations. Of municipal districts in the highest of five socioeconomic groups, 40% have > or = 1 monitor, whereas districts in the lowest two groups, representing half the population, have no monitors. Results suggest that there is a potential for exposure misclassification based on the available monitoring network and that spatial heterogeneity depends on pollutant metric (e.g., daily average vs. daily 1-hr maximum). A denser monitoring network or alternative exposure methods may be needed for epidemiological research. Findings demonstrate the importance of considering spatial heterogeneity and differential exposure misclassification by subpopulation.
Collapse
Affiliation(s)
- Mercedes A Bravo
- School of Forestry and Environmental Studies, Yale University, New Haven, CT 06511, USA.
| | | |
Collapse
|
49
|
Guo Y, Tong S, Li S, Barnett AG, Yu W, Zhang Y, Pan X. Gaseous air pollution and emergency hospital visits for hypertension in Beijing, China: a time-stratified case-crossover study. Environ Health 2010; 9:57. [PMID: 20920362 PMCID: PMC2972268 DOI: 10.1186/1476-069x-9-57] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 10/05/2010] [Indexed: 05/18/2023]
Abstract
BACKGROUND A number of epidemiological studies have been conducted to research the adverse effects of air pollution on mortality and morbidity. Hypertension is the most important risk factor for cardiovascular mortality. However, few previous studies have examined the relationship between gaseous air pollution and morbidity for hypertension. METHODS Daily data on emergency hospital visits (EHVs) for hypertension were collected from the Peking University Third Hospital. Daily data on gaseous air pollutants (sulfur dioxide (SO2) and nitrogen dioxide (NO2)) and particulate matter less than 10 μm in aerodynamic diameter (PM10) were collected from the Beijing Municipal Environmental Monitoring Center. A time-stratified case-crossover design was conducted to evaluate the relationship between urban gaseous air pollution and EHVs for hypertension. Temperature and relative humidity were controlled for. RESULTS In the single air pollutant models, a 10 μg/m3 increase in SO2 and NO2 were significantly associated with EHVs for hypertension. The odds ratios (ORs) were 1.037 (95% confidence interval (CI): 1.004-1.071) for SO2 at lag 0 day, and 1.101 (95% CI: 1.038-1.168) for NO2 at lag 3 day. After controlling for PM10, the ORs associated with SO2 and NO2 were 1.025 (95% CI: 0.987-1.065) and 1.114 (95% CI: 1.037-1.195), respectively. CONCLUSION Elevated urban gaseous air pollution was associated with increased EHVs for hypertension in Beijing, China.
Collapse
Affiliation(s)
- Yuming Guo
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland 4059, Australia
| | - Shilu Tong
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland 4059, Australia
| | - Shanshan Li
- Department of Child and Maternal Health and Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, PR China
| | - Adrian G Barnett
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland 4059, Australia
| | - Weiwei Yu
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland 4059, Australia
| | - Yanshen Zhang
- Department of Environmental Pollution and Health, Chinese Research Academy of Environmental Sciences, Beijing 100012, PR China
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing 100191, PR China
| |
Collapse
|
50
|
Guo Y, Tong S, Zhang Y, Barnett AG, Jia Y, Pan X. The relationship between particulate air pollution and emergency hospital visits for hypertension in Beijing, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2010; 408:4446-50. [PMID: 20638709 DOI: 10.1016/j.scitotenv.2010.06.042] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Revised: 06/08/2010] [Accepted: 06/17/2010] [Indexed: 04/15/2023]
Abstract
BACKGROUND A number of epidemiological studies have examined the adverse effect of air pollution on mortality and morbidity. Also, several studies have investigated the associations between air pollution and specific-cause diseases including arrhythmia, myocardial infarction, and heart failure. However, little is known about the relationship between air pollution and the onset of hypertension. OBJECTIVE To explore the risk effect of particulate matter air pollution on the emergency hospital visits (EHVs) for hypertension in Beijing, China. METHODS We gathered data on daily EHVs for hypertension, fine particulate matter less than 2.5 microm in aerodynamic diameter (PM(2.5)), particulate matter less than 10 microm in aerodynamic diameter (PM(10)), sulfur dioxide, and nitrogen dioxide in Beijing, China during 2007. A time-stratified case-crossover design with distributed lag model was used to evaluate associations between ambient air pollutants and hypertension. Daily mean temperature and relative humidity were controlled in all models. RESULTS There were 1,491 EHVs for hypertension during the study period. In single pollutant models, an increase in 10 microg/m(3) in PM(2.5) and PM(10) was associated with EHVs for hypertension with odds ratios (overall effect of five days) of 1.084 (95% confidence interval (CI): 1.028, 1.139) and 1.060% (95% CI: 1.020, 1.101), respectively. CONCLUSION Elevated levels of ambient particulate matters are associated with an increase in EHVs for hypertension in Beijing, China.
Collapse
Affiliation(s)
- Yuming Guo
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland 4059, Australia.
| | | | | | | | | | | |
Collapse
|