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Wass SY, Hahad O, Asad Z, Li S, Chung MK, Benjamin EJ, Nasir K, Rajagopalan S, Al-Kindi SG. Environmental Exposome and Atrial Fibrillation: Emerging Evidence and Future Directions. Circ Res 2024; 134:1029-1045. [PMID: 38603473 PMCID: PMC11060886 DOI: 10.1161/circresaha.123.323477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
There has been increased awareness of the linkage between environmental exposures and cardiovascular health and disease. Atrial fibrillation is the most common sustained cardiac arrhythmia, affecting millions of people worldwide and contributing to substantial morbidity and mortality. Although numerous studies have explored the role of genetic and lifestyle factors in the development and progression of atrial fibrillation, the potential impact of environmental determinants on this prevalent condition has received comparatively less attention. This review aims to provide a comprehensive overview of the current evidence on environmental determinants of atrial fibrillation, encompassing factors such as air pollution, temperature, humidity, and other meteorologic conditions, noise pollution, greenspace, and the social environment. We discuss the existing evidence from epidemiological and mechanistic studies, critically evaluating the strengths and limitations of these investigations and the potential underlying biological mechanisms through which environmental exposures may affect atrial fibrillation risk. Furthermore, we address the potential implications of these findings for public health and clinical practice and identify knowledge gaps and future research directions in this emerging field.
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Affiliation(s)
- Sojin Youn Wass
- Heart, Vascular and Thoracic Institute, Cleveland Clinic, OH (M.K.C., S.Y.W.)
| | - Omar Hahad
- Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Germany (O.H.)
| | - Zain Asad
- Division of Cardiovascular Medicine, University of Oklahoma Medical Center, Oklahoma City (Z.A.)
| | - Shuo Li
- Biomedical Engineering, Case Western Reserve University, Cleveland, OH (S.L.)
| | - Mina K Chung
- Heart, Vascular and Thoracic Institute, Cleveland Clinic, OH (M.K.C., S.Y.W.)
| | - Emelia J Benjamin
- Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine and Department of Epidemiology, Boston University School of Public Health, MA (E.J.B.)
| | - Khurram Nasir
- Cardiovascular Prevention and Wellness, DeBakey Heart and Vascular Center, Houston Methodist, TX (K.N., S.G.A.-K.)
| | - Sanjay Rajagopalan
- Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH (S.R.)
- Case Western Reserve University School of Medicine, Cleveland, OH (S.R.)
| | - Sadeer G Al-Kindi
- Cardiovascular Prevention and Wellness, DeBakey Heart and Vascular Center, Houston Methodist, TX (K.N., S.G.A.-K.)
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Faherty T, Badri H, Hu D, Voliotis A, Pope FD, Mudway I, Smith J, McFiggans G. HIPTox-Hazard Identification Platform to Assess the Health Impacts from Indoor and Outdoor Air Pollutant Exposures, through Mechanistic Toxicology: A Single-Centre Double-Blind Human Exposure Trial Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:284. [PMID: 38541284 PMCID: PMC11154498 DOI: 10.3390/ijerph21030284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/14/2024] [Accepted: 02/24/2024] [Indexed: 06/09/2024]
Abstract
Over the past decade, our understanding of the impact of air pollution on short- and long-term population health has advanced considerably, focusing on adverse effects on cardiovascular and respiratory systems. There is, however, increasing evidence that air pollution exposures affect cognitive function, particularly in susceptible groups. Our study seeks to assess and hazard rank the cognitive effects of prevalent indoor and outdoor pollutants through a single-centre investigation on the cognitive functioning of healthy human volunteers aged 50 and above with a familial predisposition to dementia. Participants will all undertake five sequential controlled exposures. The sources of the air pollution exposures are wood smoke, diesel exhaust, cleaning products, and cooking emissions, with clean air serving as the control. Pre- and post-exposure spirometry, nasal lavage, blood sampling, and cognitive assessments will be performed. Repeated testing pre and post exposure to controlled levels of pollutants will allow for the identification of acute changes in functioning as well as the detection of peripheral markers of neuroinflammation and neuronal toxicity. This comprehensive approach enables the identification of the most hazardous components in indoor and outdoor air pollutants and further understanding of the pathways contributing to neurodegenerative diseases. The results of this project have the potential to facilitate greater refinement in policy, emphasizing health-relevant pollutants and providing details to aid mitigation against pollutant-associated health risks.
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Affiliation(s)
- Thomas Faherty
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK;
| | - Huda Badri
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, 2nd Floor Education and Research Centre, Wythenshawe Hospital, Southmoor Rd., Manchester M23 9LT, UK; (H.B.); (J.S.)
- Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
| | - Dawei Hu
- Centre for Atmospheric Sciences, Department of Earth and Environmental Science, School of Natural Sciences, University of Manchester, Manchester M13 9PL, UK; (D.H.); (A.V.); (G.M.)
| | - Aristeidis Voliotis
- Centre for Atmospheric Sciences, Department of Earth and Environmental Science, School of Natural Sciences, University of Manchester, Manchester M13 9PL, UK; (D.H.); (A.V.); (G.M.)
- National Centre for Atmospheric Science, Department of Earth and Environmental Science, University of Manchester, Manchester M13 9PL, UK
| | - Francis D. Pope
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK;
| | - Ian Mudway
- MRC Centre for Environment and Health, Imperial College London, London W12 0BZ, UK;
- NIHR Health Protection Research Unit in Environmental Exposures and Health, Imperial College London, London W12 0BZ, UK
- NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Imperial College London, London W12 0BZ, UK
| | - Jacky Smith
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, 2nd Floor Education and Research Centre, Wythenshawe Hospital, Southmoor Rd., Manchester M23 9LT, UK; (H.B.); (J.S.)
- Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
| | - Gordon McFiggans
- Centre for Atmospheric Sciences, Department of Earth and Environmental Science, School of Natural Sciences, University of Manchester, Manchester M13 9PL, UK; (D.H.); (A.V.); (G.M.)
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Millen AE, Dighe S, Kordas K, Aminigo BZ, Zafron ML, Mu L. Air Pollution and Chronic Eye Disease in Adults: A Scoping Review. Ophthalmic Epidemiol 2024; 31:1-10. [PMID: 36864662 DOI: 10.1080/09286586.2023.2183513] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 02/18/2023] [Indexed: 03/04/2023]
Abstract
PURPOSE We conducted a scoping review of studies examining ambient air pollution as a risk factor for chronic eye disease influencing the lens, retina, and intraocular pressure in adults. METHODS Terms related to air pollution and eye disease outcomes were used to search for publications on Embase, Web of Science Core Collection, Global Health, PubMed, and the Cochrane Central Register of Controlled Trials from January 1, 2010, through April 11, 2022. RESULTS We identified 27 articles, focusing on the following non-mutually exclusive outcomes: cataract (n = 9), presbyopia (n = 1), retinal vein occlusion or central retinal arteriolar and venular equivalents (n = 5), intraocular pressure (IOP) (n = 3), glaucoma (n = 5), age-related macular degeneration (AMD) (n = 5), diabetic retinopathy (n = 2), and measures of retinal morphology (n = 3). Study designs included cross-sectional (n = 16), case-control (n = 4), and longitudinal (n = 7). Air pollutants were measured in 50% and 95% of the studies on lens and retina or IOP, respectively, and these exposures were assigned to geographic locations. Most research was conducted in global regions with high exposure to air pollution. Consistent associations suggested a possibly increased risk of cataract and retina-associated chronic eye disease with increasing exposure to particulate matter (PM2.5-PM10), NO2, NOx, and SO2. Associations with O3 were less consistent. CONCLUSIONS Accumulating research suggests air pollution may be a modifiable risk factor for chronic eye diseases of the lens and retina. The number of studies on each specific lens- or retina-related outcome is limited. Guidelines regarding the role of air pollution in chronic eye disease do not exist.
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Affiliation(s)
- Amy E Millen
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Shruti Dighe
- Department of Family Medicine, Allegheny Health Network Saint Vincent, Erie, PA, USA
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Boma Zelma Aminigo
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Michelle L Zafron
- Health Sciences at Abbott Library, University Libraries, University at Buffalo, Buffalo, New York, USA
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
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Hahad O, Rajagopalan S, Lelieveld J, Sørensen M, Kuntic M, Daiber A, Basner M, Nieuwenhuijsen M, Brook RD, Münzel T. Noise and Air Pollution as Risk Factors for Hypertension: Part II-Pathophysiologic Insight. Hypertension 2023; 80:1384-1392. [PMID: 37073733 PMCID: PMC10330112 DOI: 10.1161/hypertensionaha.123.20617] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Traffic noise and air pollution are environmental stressors found to increase risk for cardiovascular events. The burden of disease attributable to environmental stressors and cardiovascular disease globally is substantial, with a need to better understand the contribution of specific risk factors that may underlie these effects. Epidemiological observations and experimental evidence from animal models and human controlled exposure studies suggest an essential role for common mediating pathways. These include sympathovagal imbalance, endothelial dysfunction, vascular inflammation, increased circulating cytokines, activation of central stress responses, including hypothalamic and limbic pathways, and circadian disruption. Evidence also suggests that cessation of air pollution or noise through directed interventions alleviates increases in blood pressure and intermediate surrogate pathways, supporting a causal link. In the second part of this review, we discuss the current understanding of mechanisms underlying and current gaps in knowledge and opportunities for new research.
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Affiliation(s)
- Omar Hahad
- Department of Cardiology – Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Sanjay Rajagopalan
- Harrington Heart and Vascular Institute, University Hospitals and Case Western Reserve University, Cleveland, OH, USA
| | - Jos Lelieveld
- Atmospheric Chemistry Department, Max Planck Institute for Chemistry, Mainz, Germany
| | - Mette Sørensen
- Environment and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
| | - Marin Kuntic
- Department of Cardiology – Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology – Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Mathias Basner
- Department of Psychiatry, Unit for Experimental Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark Nieuwenhuijsen
- Institute for Global Health (ISGlobal), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiolog ´ıa y Salud Pu ´blica (CIBERESP), Madrid, Spain
- Center for Urban Research, RMIT University, Melbourne VIC, Australia
| | - Robert D. Brook
- Division of Cardiovascular Diseases, Department of Internal Medicine, Wayne State University, Detroit, MI, USA
| | - Thomas Münzel
- Department of Cardiology – Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
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Singh N, Nagar E, Arora N. Diesel exhaust exposure impairs recovery of lung epithelial and cellular damage in murine model. Mol Immunol 2023; 158:1-9. [PMID: 37254294 DOI: 10.1016/j.molimm.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/07/2023] [Accepted: 04/04/2023] [Indexed: 06/01/2023]
Abstract
Studies have investigated the relationship between diesel exhaust (DE) exposure and lung health, highlighting the potential for DE to induce pulmonary inflammation and oxidative stress. However, the resolution of inflammation upon withdrawal of DE exposure needs further investigation. Therefore, resolution of diesel exhaust-induced lung damage was studied in the murine model. Mice (6 weeks) were divided into three groups. Group 1 (control) mice were exposed to filtered air, Group 2 (DE) mice were exposed to DE (5.1 ± 0.7 mg/m3) & Group 3 (DE-FA) mice were exposed to DE followed by filtered air exposure. Airway hyper-responsiveness was recorded after 24 h of the last exposure. BALF and lung samples were collected for cytokine estimation, immunobiological assays, and western blot analysis. DE exposure showed an increase in lung resistance thereby causing alteration in lung function parameters (p < 0.05) which was restored in the DE-FA group. BALF analysis showed a significant increase in total cell count and protein content in DE with no resolution in DE-FA groups (p < 0.05). Lung histology showed no reduction in the bronchiolar thickness and damage in the DE-FA group suggesting irreversible lung damage (p < 0.05). The significant increase in inflammatory cytokine levels, and collagen deposition showed persistent inflammatory phase and lung damage in the DE-FA group(p < 0.05). ZO-1 was significantly decreased in both test groups indicating disintegrated lung epithelium where in claudin-5 expression showed increased lung permeability. A significant increase in neutrophil elastase activity and decreased expression of, Elafin, resulted in lung epithelial damage in the DE-FA group. Lung injury marker alpha1-antitrypsin was increased in DE-FA groups indicating an immune defense mechanism against neutrophil elastase. The study showed that DE exposure causes persistent lung damage via neutrophil elastase-associated disruption of the epithelial barrier integrity and membrane dysfunction.
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Affiliation(s)
- Naresh Singh
- Allergy and Immunology Section, CSIR-Institute of Genomics and Integrative Biology, Delhi 110007, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Ekta Nagar
- Allergy and Immunology Section, CSIR-Institute of Genomics and Integrative Biology, Delhi 110007, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Naveen Arora
- Allergy and Immunology Section, CSIR-Institute of Genomics and Integrative Biology, Delhi 110007, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India.
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Gupta K, Ananthasubramaniam K. If you don't kill pollution it could kill you: pathophysiologic insights into pollution mediated cardiovascular risk through FDG PET imaging. J Nucl Cardiol 2023; 30:680-683. [PMID: 35859225 PMCID: PMC9299402 DOI: 10.1007/s12350-022-03022-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Kartik Gupta
- Division of General Internal Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Karthik Ananthasubramaniam
- Henry Ford West Bloomfield Hospital, Heart and Vascular Institute, 6777 W Maple, West Bloomfield, MI, 48322, USA.
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Zheng L, Birch ME, Johnson B, Breitenstein M, Snawder J, Kulkarni P. Correlation between Graphitic Carbon and Elemental Carbon in Diesel Particulate Matter in Workplace Atmospheres. Anal Chem 2023; 95:3283-3290. [PMID: 36724111 DOI: 10.1021/acs.analchem.2c04261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We investigated the suitability of the graphitic carbon (GC) content of diesel particulate matter (DPM), measured using Raman spectroscopy, as a surrogate measure of elemental carbon (EC) determined by thermal optical analysis. The Raman spectra in the range of 800-1800 cm-1 (including the D mode at ∼1322 cm-1 and the G mode at ∼1595 cm-1) were used for GC identification and quantification. Comparison of the Raman spectra for two certified DPM standards (NIST SRM 1650 and SRM 2975), two types of diesel engine exhaust soot, and three types of DPM-enriched workplace aerosols show that the uncertainty of GC quantification based on the D peak height, G peak height, and the total peak area below D and G peaks was about 6.0, 6.7, and 6.9%, respectively. The low uncertainty for different aerosol types suggested possible use of GC as a surrogate measure of EC in workplace atmospheres. A calibration curve was constructed using two laboratory-aerosolized DPM standards to describe the relationship between GC measured by a portable Raman spectrometer and the EC concentration determined by NIOSH Method 5040. The calibration curve was then applied to determine GC-based estimates of the EC contents of diesel engine exhaust samples from two vehicles and seven air samples collected at a hydraulic fracturing worksite. The GC-EC estimates obtained through Raman measurements agreed well with those found by NIOSH Method 5040 for the same samples at EC filter loadings below 2.86 μg/cm2. The study shows that using an appropriate sample collection method that avoids high filter mass loadings, onsite measurement of GC by a portable or hand-held Raman spectrometer can provide a useful indicator of EC in workplace aerosol.
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Affiliation(s)
- Lina Zheng
- Jiangsu Engineering Research Center for Dust Control and Occupational Protection, China University of Mining and Technology, Xuzhou 221116, Jiangsu, P.R. China.,Department of Occupational Hygiene Engineering, School of Safety Engineering, China University of Mining and Technology, Xuzhou 221116, Jiangsu, P.R. China
| | - M Eileen Birch
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, Ohio 45226, United States
| | - Belinda Johnson
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, Ohio 45226, United States
| | - Michael Breitenstein
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, Ohio 45226, United States
| | - John Snawder
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, Ohio 45226, United States
| | - Pramod Kulkarni
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, Ohio 45226, United States
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Body Mass Index Modulates the Impact of Short-Term Exposure to Air Particulate Matter on High-Density Lipoprotein Function. Antioxidants (Basel) 2022; 11:antiox11101938. [PMID: 36290661 PMCID: PMC9598765 DOI: 10.3390/antiox11101938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/19/2022] [Accepted: 09/24/2022] [Indexed: 11/21/2022] Open
Abstract
Air particulate matter (PM) exposure has been associated with increased cardiovascular risk, especially in obesity. By triggering inflammation and oxidative stress, PM could impact atheroprotection by high-density lipoproteins (HDL). The aim of the study was to assess the relationship between short-term exposure to PM and HDL function, and the modifying effect of body mass index (BMI). Daily exposures to PM10 and PM2.5 of 50 subjects with overweight/obesity and 41 healthy volunteers with BMI < 30 kg/m2 were obtained from fixed monitoring stations. HDL function was assessed as promotion of nitric oxide (NO) release by endothelial cells and reduction in cholesterol in macrophages. HDL-induced NO release progressively declined with the increase in BMI. No association was found between HDL function and PM exposure, but a modifying effect of BMI was observed. The positive association between PM10 exposure at day −1 and NO production found at normal BMI values was lost in participants with higher BMI. Similar results were obtained for the reduction in macrophage cholesterol. The loss of the compensatory response of HDL function to PM exposure at increasing BMI levels could contribute to the endothelial dysfunction induced by PM and help to explain the susceptibility of subjects with obesity to air pollution.
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Parenteau AM, Alen NV, La J, Luck AT, Teichrow DJ, Daang EM, Nissen AT, Deer LK, Hostinar CE. Associations of air pollution with peripheral inflammation and cardiac autonomic physiology in children. New Dir Child Adolesc Dev 2022; 2022:125-154. [PMID: 35921508 DOI: 10.1002/cad.20474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Climate change-related disasters have drawn increased attention to the impact of air pollution on health. 122 children ages 9-11 years old, M(SD) = 9.91(.56), participated. Levels of particulate matter (PM2.5) near participants' homes were obtained from the Environmental Protection Agency. Cytokines were assayed from 100 child serum samples: IL-6, IL-8, IL-10, and TNFα. Autonomic physiology was indexed by pre-ejection period (PEP), respiratory sinus arrhythmia (RSA), cardiac autonomic regulation (CAR), and cardiac autonomic balance (CAB). IL-6 was positively related to daily PM2.5 (r = .26, p = .009). IL-8 was negatively associated with monthly PM2.5 (r = -.23, p = .02). PEP was positively related to daily (r = .29, p = .001) and monthly PM2.5 (r = .18, p = .044). CAR was negatively associated with daily PM2.5 (r = -.29, p = .001). IL-10, TNFα, RSA, and CAB were not associated with PM2.5. Air pollution may increase risk of inflammation in children.
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Affiliation(s)
| | | | - Jennifer La
- University of California-San Francisco, San Francisco, California, USA
| | | | | | - Enya M Daang
- University of California-Davis, Davis, California, USA
| | - Adam T Nissen
- University of California-Davis, Davis, California, USA
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Joshi SS, Miller MR, Newby DE. Air pollution and cardiovascular disease: the Paul Wood Lecture, British Cardiovascular Society 2021. Heart 2022; 108:1267-1273. [PMID: 35074847 DOI: 10.1136/heartjnl-2021-319844] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/22/2021] [Indexed: 11/04/2022] Open
Abstract
Air pollution is associated with up to 8.8 million excess deaths worldwide each year and is a major contributor to the global burden of disease. Cardiovascular conditions are the predominant cause for air pollution-related deaths and there is an urgent need to address the silent pandemic of air pollution on cardiovascular health. Air pollution exposure is associated with acute events like acute coronary syndrome and stroke, and with chronic conditions, such as atherosclerosis and heart failure. Several potential mechanisms have been proposed that link particle inhalation to cardiovascular disease including oxidative stress and inflammation, changes in autonomic balance and neuroendocrine regulation and the particle translocation into the circulation itself. This, in turn, can cause endothelial, vasomotor and fibrinolytic dysfunction and increased thrombogenicity and blood pressure which are implicated in the mediation of adverse cardiovascular events. Certain interventions can help mitigate these adverse effects. At an individual level, this includes the use of a facemask and indoor air purification systems. At an environmental level, interventions reducing the generation or release of combustion-derived pollutants are key and include public health policies to facilitate active transport, cleaner sources of energy and reductions in vehicular and fossil fuel emissions. In this review, we summarise the key pathways and mechanisms that draw together how air pollution can lead to adverse cardiovascular effects, as well as explore potential interventions to reduce the burden of air pollution-induced cardiovascular morbidity and mortality.
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Affiliation(s)
- Shruti S Joshi
- BHF Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Mark R Miller
- BHF Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - David E Newby
- BHF Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
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11
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Keswani A, Akselrod H, Anenberg SC. Health and Clinical Impacts of Air Pollution and Linkages with Climate Change. NEJM EVIDENCE 2022; 1:EVIDra2200068. [PMID: 38319260 DOI: 10.1056/evidra2200068] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Air Pollution Impacts and Climate Change LinksAs part of the NEJM Group series on climate change, Keswani and colleagues review the linkages between climate change and air pollution and suggest strategies that clinicians may use to mitigate the adverse health impacts of air pollution.
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Affiliation(s)
- Anjeni Keswani
- Division of Allergy/Immunology, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Hana Akselrod
- Division of Infectious Diseases, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Susan C Anenberg
- George Washington University Milken Institute School of Public Health, Washington, DC
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12
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Faridi S, Brook RD, Yousefian F, Hassanvand MS, Nodehi RN, Shamsipour M, Rajagopalan S, Naddafi K. Effects of respirators to reduce fine particulate matter exposures on blood pressure and heart rate variability: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 303:119109. [PMID: 35271952 PMCID: PMC10411486 DOI: 10.1016/j.envpol.2022.119109] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 06/14/2023]
Abstract
Particulate-filtering respirators (PFRs) have been recommended as a practical personal-level intervention to protect individuals from the health effects of particulate matter exposure. However, the cardiovascular benefits of PFRs including improvements in key surrogate endpoints remain unclear. We performed a systematic review and meta-analysis of randomized studies (wearing versus not wearing PFRs) reporting the effects on blood pressure (BP) and heart rate variability (HRV). The search was performed on January 3, 2022 to identify published papers until this date. We queried three English databases, including PubMed, Web of Science Core Collection and Scopus. Of 527 articles identified, eight trials enrolling 312 participants (mean age ± standard deviation: 36 ± 19.8; 132 female) met our inclusion criteria for analyses. Study participants wore PFRs from 2 to 48 h during intervention periods. Wearing PFRs was associated with a non-significant pooled mean difference of -0.78 mmHg (95% confidence interval [CI]: -2.06, 0.50) and -0.49 mmHg (95%CI: -1.37, 0.38) in systolic and diastolic BP (SBP and DBP). There was a marginally significant reduction of mean arterial pressure (MAP) by nearly 1.1 mmHg (95%CI: -2.13, 0.01). The use of PFRs was associated with a significant increase of 38.92 ms2 (95%CI: 1.07, 76.77) in pooled mean high frequency (power in the high frequency band (0.15-0.4 Hz)) and a reduction in the low (power in the low frequency band (0.04-0.15Hz))-to-high frequency ratio [-0.14 (95%CI: -0.27, 0.00)]. Other HRV indices were not significantly changed. Our meta-analysis demonstrates modest or non-significant improvements in BP and many HRV parameters from wearing PFRs over brief periods. However, these findings are limited by the small number of trials as well as variations in experimental designs and durations. Given the mounting global public health threat posed by air pollution, larger-scale trials are warranted to elucidate more conclusively the potential health benefits of PFRs.
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Affiliation(s)
- Sasan Faridi
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fatemeh Yousefian
- Department of Environmental Health Engineering, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Sadegh Hassanvand
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nabizadeh Nodehi
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Kazem Naddafi
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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13
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Wyatt L, Kamat G, Moyer J, Weaver AM, Diaz-Sanchez D, Devlin RB, Di Q, Schwartz JD, Cascio WE, Ward-Caviness CK. Associations between short-term exposure to PM 2.5 and cardiomyocyte injury in myocardial infarction survivors in North Carolina. Open Heart 2022; 9:openhrt-2021-001891. [PMID: 35750420 PMCID: PMC9234784 DOI: 10.1136/openhrt-2021-001891] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 05/23/2022] [Indexed: 12/20/2022] Open
Abstract
Objective Short-term ambient fine particulate matter (PM2.5) is associated with adverse cardiovascular events including myocardial infarction (MI). However, few studies have examined associations between PM2.5 and subclinical cardiomyocyte damage outside of overt cardiovascular events. Here we evaluate the impact of daily PM2.5 on cardiac troponin I, a cardiomyocyte specific biomarker of cellular damage. Methods We conducted a retrospective cohort study of 2924 patients identified using electronic health records from the University of North Carolina Healthcare System who had a recorded MI between 2004 and 2016. Troponin I measurements were available from 2014 to 2016, and were required to be at least 1 week away from a clinically diagnosed MI. Daily ambient PM2.5 concentrations were estimated at 1 km resolution and assigned to patient residence. Associations between log-transformed troponin I and daily PM2.5 were evaluated using distributed lag linear mixed effects models adjusted for patient demographics, socioeconomic status and meteorology. Results A 10 µg/m3 elevation in PM2.5 3 days before troponin I measurement was associated with 0.06 ng/mL higher troponin I (95% CI=0.004 to 0.12). In stratified models, this association was strongest in patients that were men, white and living in less urban areas. Similar associations were observed when using 2-day rolling averages and were consistently strongest when using the average exposure over the 5 days prior to troponin I measurement. Conclusions Daily elevations in PM2.5 were associated with damage to cardiomyocytes, outside of the occurrence of an MI. Poor air quality may cause persistent damage to the cardiovascular system leading to increased risk of cardiovascular disease and adverse cardiovascular events.
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Affiliation(s)
- Lauren Wyatt
- Center for Public Health and Environmental Assessment, US Environmental Protection Agency Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina, USA
| | - Gauri Kamat
- Brown University, Providence, Rhode Island, USA
| | - Joshua Moyer
- US Environmental Protection Agency Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina, USA
| | - Anne M Weaver
- US Environmental Protection Agency Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina, USA
| | - David Diaz-Sanchez
- US Environmental Protection Agency Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina, USA
| | - Robert B Devlin
- US Environmental Protection Agency Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina, USA
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Joel D Schwartz
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Harvard University, Boston, Massachusetts, USA
| | - Wayne E Cascio
- US Environmental Protection Agency Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina, USA
| | - Cavin K Ward-Caviness
- US Environmental Protection Agency Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina, USA
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14
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Adrenergic and Glucocorticoid Receptors in the Pulmonary Health Effects of Air Pollution. TOXICS 2021; 9:toxics9060132. [PMID: 34200050 PMCID: PMC8226814 DOI: 10.3390/toxics9060132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 01/16/2023]
Abstract
Adrenergic receptors (ARs) and glucocorticoid receptors (GRs) are activated by circulating catecholamines and glucocorticoids, respectively. These receptors regulate the homeostasis of physiological processes with specificity via multiple receptor subtypes, wide tissue-specific distribution, and interactions with other receptors and signaling processes. Based on their physiological roles, ARs and GRs are widely manipulated therapeutically for chronic diseases. Although these receptors play key roles in inflammatory and cellular homeostatic processes, little research has addressed their involvement in the health effects of air pollution. We have recently demonstrated that ozone, a prototypic air pollutant, mediates pulmonary and systemic effects through the activation of these receptors. A single exposure to ozone induces the sympathetic–adrenal–medullary and hypothalamic–pituitary–adrenal axes, resulting in the release of epinephrine and corticosterone into the circulation. These hormones act as ligands for ARs and GRs. The roles of beta AR (βARs) and GRs in ozone-induced pulmonary injury and inflammation were confirmed in a number of studies using interventional approaches. Accordingly, the activation status of ARs and GRs is critical in mediating the health effects of inhaled irritants. In this paper, we review the cellular distribution and functions of ARs and GRs, their lung-specific localization, and their involvement in ozone-induced health effects, in order to capture attention for future research.
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15
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Affiliation(s)
- Ajay K Gupta
- William Harvey Research Institute Barts and the London School of Medicine and Dentistry Queen Mary University of London United Kingdom.,Barts Blood Pressure Centre of Excellence Barts Heart Centre London United Kingdom.,Royal London and St Bartholomew's Hospital Barts Health NHS Trust London United Kingdom
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16
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Rankin GD, Kabéle M, Brown R, Macefield VG, Sandström T, Bosson JA. Acute Exposure to Diesel Exhaust Increases Muscle Sympathetic Nerve Activity in Humans. J Am Heart Assoc 2021; 10:e018448. [PMID: 33942621 PMCID: PMC8200707 DOI: 10.1161/jaha.120.018448] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Diesel exhaust (DE) emissions are a major contributor to ambient air pollution and are strongly associated with cardiovascular morbidity and mortality. Exposure to traffic‐related particulate matter is linked with acute adverse cardiovascular events; however, the mechanisms are not fully understood. We examined the role of the autonomic nervous system during exposure to DE that has previously only been indirectly investigated. Methods and Results Using microneurography, we measured muscle sympathetic nerve activity (MSNA) directly in the peroneal nerve of 16 healthy individuals. MSNA, heart rate, and respiration were recorded while subjects rested breathing filtered air, filtered air with an exposure mask, and standardized diluted DE (300 µg/m3) through the exposure mask. Heart rate variability was assessed from an ECG. DE inhalation rapidly causes an increase in number of MSNA bursts as well as the size of bursts within 10 minutes, peaking by 30 minutes (P<0.001), compared with baseline filtered air with an exposure mask. No significant changes occurred in heart rate variability indices during DE exposure; however, MSNA frequency correlated negatively with total power (r2=0.294, P=0.03) and low frequency (r2=0.258, P=0.045). Heart rate correlated positively with MSNA frequency (r2=0.268, P=0.04) and the change in percentage of larger bursts (burst amplitude, height >50% of the maximum burst) from filtered air with an exposure mask (r2=0.368, P=0.013). Conclusions Our study provides direct evidence for the rapid modulation of the autonomic nervous system after exposure to DE, with an increase in MSNA. The quick increase in sympathetic outflow may explain the strong epidemiological data associating traffic‐related particulate matter to acute adverse cardiovascular events such as myocardial infarction. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02892279.
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Affiliation(s)
- Gregory D Rankin
- Department of Public Health and Clinical Medicine Section of Medicine/Respiratory Umeå University Umeå Sweden
| | - Mikael Kabéle
- Department of Public Health and Clinical Medicine Section of Medicine/Respiratory Umeå University Umeå Sweden
| | - Rachael Brown
- School of Medicine Western Sydney University Sydney NSW Australia
| | - Vaughan G Macefield
- Human Autonomic Neurophysiology Laboratory School of Medicine Baker Heart and Diabetes Institute Melbourne Vic. Australia.,Department of Physiology School of Biomedical Sciences The University of Melbourne Melbourne Vic. Australia
| | - Thomas Sandström
- Department of Public Health and Clinical Medicine Section of Medicine/Respiratory Umeå University Umeå Sweden
| | - Jenny A Bosson
- Department of Public Health and Clinical Medicine Section of Medicine/Respiratory Umeå University Umeå Sweden
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17
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Affiliation(s)
- Robert D Brook
- Division of Cardiovascular Diseases Wayne State University Detroit MI
| | - Sanjay Rajagopalan
- University Hospitals, Harrington Heart and Vascular InstituteCase Western Reserve University Cleveland OH
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