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Raju S, Woo H, Koehler K, Fawzy A, Liu C, Putcha N, Balasubramanian A, Peng RD, Lin CT, Lemoine C, Wineke J, Berger RD, Hansel NN, McCormack MC. Indoor Air Pollution and Impaired Cardiac Autonomic Function in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2023; 207:721-730. [PMID: 36288428 PMCID: PMC10037475 DOI: 10.1164/rccm.202203-0523oc] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022] Open
Abstract
Rationale: Indoor air pollution represents a modifiable risk factor for respiratory morbidity in chronic obstructive pulmonary disease (COPD). The effects of indoor air pollution, as well as the impact of interventions to improve indoor air quality, on cardiovascular morbidity in COPD remain unknown. Objectives: To determine the association between indoor particulate matter (PM) and heart rate variability (HRV), a measure of cardiac autonomic function tied to cardiovascular morbidity and mortality, as well as the impact of household air purifiers on HRV. Methods: Former smokers with moderate-severe COPD were recruited from a 6-month randomized controlled trial of a portable air cleaner intervention to undergo paired assessment of both in-home PM and HRV using 24-hour Holter monitoring at up to five time points. Primary outcomes were HRV measures tied to cardiovascular morbidity (standard deviation of normal-to-normal intervals [SDNN] and root mean square of successive differences between normal-to-normal intervals [RMSSD]). Measurements and Results: Eighty-five participants contributed 317 HRV measurements. A twofold increase in household PM ⩽2.5 µm in aerodynamic diameter was associated with decreases in SDNN (β, -2.98% [95% confidence interval (CI), -5.12 to -0.78]) and RMSSD (β, -4.57% [95% CI, -10.1 to -1.60]). The greatest effects were observed with ultrafine particles (<100 nm) (RMSSD; β, -16.4% [95% CI, -22.3 to -10.1]) and among obese participants. Participants randomized to the active air cleaner saw improvements in RMSSD (β, 25.2% [95% CI, 2.99 to 52.1]), but not SDNN (β, 2.65% [95% CI, -10.8 to 18.1]), compared with the placebo group. Conclusions: This is the first U.S. study to describe the association between household PM and cardiac autonomic function among individuals with COPD, as well as the potential cardiovascular health benefits of household air cleaners.
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Affiliation(s)
| | | | - Kirsten Koehler
- Department of Environmental Health Sciences and Engineering and
| | | | | | | | | | - Roger D. Peng
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Cheng Ting Lin
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Chantal Lemoine
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and
| | - Jennifer Wineke
- Department of Psychiatry, University of Maryland Medical Center, Baltimore, Maryland
| | | | - Nadia N. Hansel
- Department of Medicine and
- Department of Environmental Health Sciences and Engineering and
| | - Meredith C. McCormack
- Department of Medicine and
- Department of Environmental Health Sciences and Engineering and
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Zong Z, Zhang M, Xu K, Zhang Y, Hu C. Association between Short-Term Exposure to Ozone and Heart Rate Variability: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11186. [PMID: 36141453 PMCID: PMC9517606 DOI: 10.3390/ijerph191811186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
At present, ambient air pollution poses a significant threat to patients with cardiovascular disease (CVD). The heart rate variability (HRV) is a marker of the cardiac autonomic nervous system, and it is related to air pollution and cardiovascular disease. There is, however, considerable disagreement in the literature regarding the association between ozone (O3) and HRV. To further investigate the effects of short-term exposure to O3 on HRV, we conducted the first meta-analysis of relevant studies. The percentage change of HRV indicator(s) is the effect estimate extracted for the quantitative analysis in this study. In our meta-analysis, per 10 ppb increase in O3 was significantly associated with decreases in the time-domain measurements, for standard deviation of the normal-to-normal (NN) interval (SDNN) -1.11% (95%CI: -1.35%, -0.87%) and for root mean square of successive differences (RMSSD) -3.26% (95%CI: -5.42%, -1.09%); in the frequency-domain measurements, for high frequency (HF) -3.01% (95%CI: -4.66%, -1.35%) and for low frequency (LF) -2.14% (95%CI: -3.83%, -0.45%). This study showed short-term exposure to O3 was associated with reduced HRV indicators in adults, which suggested that the cardiac autonomic nervous system might be affected after O3 exposure, contributing to the association between O3 exposure and CVD risk.
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Affiliation(s)
- Zhiqiang Zong
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Mengyue Zhang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Kexin Xu
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Yunquan Zhang
- School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Chengyang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
- Department of Epidemiology and Biostatistics, School of Public health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
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Mallah MA, Changxing L, Mallah MA, Naveed M, Liu Y, Noreen S, Xi H, Wang W, Feng F, Zhang Q. Association of urinary polycyclic aromatic hydrocarbon metabolites and cardiovascular disease among US population: A cross-sectional study. ENVIRONMENTAL RESEARCH 2022; 209:112775. [PMID: 35065070 DOI: 10.1016/j.envres.2022.112775] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The main aim of the study was to illustrate the association between urinary polycyclic aromatic hydrocarbons (PAHs) and their metabolites with cardiovascular diseases (CVDs), including congestive heart failure (CHF), coronary heart disease (CHD), angina, heart attack, and stroke among the US population. METHODS The National Health and Nutritional Examination Survey (NHANES) 2003-16, nationally representative data were utilized for this study. A cross-sectional observational study was designed to assess the strength of the association between urinary PAH and CVDs. The NHANES survey used a stratified multistage probability sample strategy for obtaining representative samples. Logistic regression analysis was performed to evaluate the association between PAH and the prevalence of CVDs. RESULTS In our study, the average ages of the three different PAHs tertiles were 42.56 ± 19.68, 42.21 ± 19.51, and 43.39 ± 17.99 years, respectively. A positive association was found between the second and third tertile of urinary PAH and increased prevalence of coronary heart disease (tertile-2: OR = 1.24, 95% CI = 1.09-1.42; tertile-3: OR = 1.97, 95% CI = 1.69-2.28), angina (tertile-2: OR = 1.3, 95% CI = 1.13-1.49; tertile-3: OR = 2.07, 95% CI = 1.76-2.42), heart attack (tertile-2: OR = 1.28, 95% CI = 1.12-1.47; tertile-3: OR = 1.71, 95% CI = 1.48-1.96) and stroke (tertile-2: OR = 1.17, 95% CI = 1.02-1.33; tertile-3: OR = 1.66, 95% CI = 1.43-1.93) in total participants, respectively, with p-values less than 0.05. CONCLUSION In conclusion, this study found a positive association between urinary PAHs and the prevalence of various CVDs among the US population.
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Affiliation(s)
- Manthar Ali Mallah
- Department of Toxicology, College of Public Health, Zhengzhou University, 100 Kexue Ave, Zhongyuan District, Zhengzhou, 450001, China
| | - Li Changxing
- Department of Human Anatomy, Medical College of Qinghai University, Xining, 81000, China
| | - Mukhtiar Ali Mallah
- Department of Chemical Engineering, Quaid-e-Awam University of Engineering, Science & Technology (QUEST), Nawabshah, 67480, Sindh, Pakistan
| | - Muhammad Naveed
- Department of Clinical Pharmacy, School of Pharmacy. Nanjing Medical University, Nanjing, 211166, China
| | - Yang Liu
- Department of Toxicology, College of Public Health, Zhengzhou University, 100 Kexue Ave, Zhongyuan District, Zhengzhou, 450001, China
| | - Sobia Noreen
- Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, 6300, Pakistan
| | - He Xi
- Department of Toxicology, College of Public Health, Zhengzhou University, 100 Kexue Ave, Zhongyuan District, Zhengzhou, 450001, China
| | - Wei Wang
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, 100 Kexue Ave, Zhongyuan District, Zhengzhou, 450001, China
| | - Feifei Feng
- Department of Toxicology, College of Public Health, Zhengzhou University, 100 Kexue Ave, Zhongyuan District, Zhengzhou, 450001, China
| | - Qiao Zhang
- Department of Toxicology, College of Public Health, Zhengzhou University, 100 Kexue Ave, Zhongyuan District, Zhengzhou, 450001, China.
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Frampton MW, Balmes JR, Bromberg PA, Arjomandi M, Hazucha MJ, Thurston SW, Alexis NE, Ganz P, Zareba W, Koutrakis P, Thevenet-Morrison K, Rich DQ. Effects of short-term increases in personal and ambient pollutant concentrations on pulmonary and cardiovascular function: A panel study analysis of the Multicenter Ozone Study in oldEr subjects (MOSES 2). ENVIRONMENTAL RESEARCH 2022; 205:112522. [PMID: 34919956 DOI: 10.1016/j.envres.2021.112522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/30/2021] [Accepted: 12/04/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The cardiovascular effects of ozone exposure are unclear. Using measurements from the 87 participants in the Multicenter Ozone Study of oldEr Subjects (MOSES), we examined whether personal and ambient pollutant exposures before the controlled exposure sessions would be associated with adverse changes in pulmonary and cardiovascular function. METHODS We used mixed effects linear regression to evaluate associations between increased personal exposures and ambient pollutant concentrations in the 96 h before the pre-exposure visit, and 1) biomarkers measured at pre-exposure, and 2) changes in biomarkers from pre-to post-exposure. RESULTS Decreases in pre-exposure forced expiratory volume in 1 s (FEV1) were associated with interquartile-range increases in concentrations of particulate matter ≤2.5 μm (PM2.5) 1 h before the pre-exposure visit (-0.022 L; 95% CI -0.037 to -0.006; p = 0.007), carbon monoxide (CO) in the prior 3 h (-0.046 L; 95% CI -0.076 to -0.016; p = 0.003), and nitrogen dioxide (NO2) in the prior 72 h (-0.030 L; 95% CI -0.052 to -0.008; p = 0.007). From pre-to post-exposure, increases in FEV1 were marginally significantly associated with increases in personal ozone exposure (0.010 L; 95% CI 0.004 to 0.026; p = 0.010), and ambient PM2.5 and CO at all lag times. Ambient ozone concentrations in the prior 96 h were associated with both decreased pre-exposure high frequency (HF) heart rate variability (HRV) and increases in HF HRV from pre-to post-exposure. CONCLUSIONS We observed associations between increased ambient PM2.5, NO2, and CO levels and reduced pulmonary function, and increased ambient ozone concentrations and reduced HRV. Pulmonary function and HRV increased across the exposure sessions in association with these same pollutant increases, suggesting a "recovery" during the exposure sessions. These findings support an association between short term increases in ambient PM2.5, NO2, and CO and decreased pulmonary function, and increased ambient ozone and decreased HRV.
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Affiliation(s)
- M W Frampton
- University of Rochester Medical Center, Rochester, NY, USA.
| | - J R Balmes
- University of California at San Francisco, San Francisco, CA, USA
| | - P A Bromberg
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M Arjomandi
- University of California at San Francisco, San Francisco, CA, USA
| | - M J Hazucha
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - S W Thurston
- University of Rochester Medical Center, Rochester, NY, USA
| | - N E Alexis
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - P Ganz
- University of California at San Francisco, San Francisco, CA, USA
| | - W Zareba
- University of Rochester Medical Center, Rochester, NY, USA
| | - P Koutrakis
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - D Q Rich
- University of Rochester Medical Center, Rochester, NY, USA
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Xu H, Jia Y, Sun Z, Su J, Liu QS, Zhou Q, Jiang G. Environmental pollution, a hidden culprit for health issues. ECO-ENVIRONMENT & HEALTH (ONLINE) 2022; 1:31-45. [PMID: 38078200 PMCID: PMC10702928 DOI: 10.1016/j.eehl.2022.04.003] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/26/2022] [Accepted: 04/23/2022] [Indexed: 12/12/2023]
Abstract
The environmental and health impacts from the massive discharge of chemicals and subsequent pollution have been gaining increasing public concern. The unintended exposure to different pollutants, such as heavy metals, air pollutants and organic chemicals, may cause diverse deleterious effects on human bodies, resulting in the incidence and progression of different diseases. The article reviewed the outbreak of environmental pollution-related public health emergencies, the epidemiological evidence on certain pollution-correlated health effects, and the pathological studies on specific pollutant exposure. By recalling the notable historical life-threatening disasters incurred by local chemical pollution, the damning evidence was presented to criminate certain pollutants as the main culprit for the given health issues. The epidemiological data on the prevalence of some common diseases revealed a variety of environmental pollutants to blame, such as endocrine-disrupting chemicals (EDCs), fine particulate matters (PMs) and heavy metals. The retrospection of toxicological studies provided illustrative clues for evaluating ambient pollutant-induced health risks. Overall, environmental pollution, as the hidden culprit, should answer for the increasing public health burden, and more efforts are highly encouraged to strive to explore the cause-and-effect relationships through extensive epidemiological and pathological studies.
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Affiliation(s)
- Hanqing Xu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
- National and Local Joint Engineering Research Center of Ecological Treatment Technology for Urban Water Pollution, and Zhejiang Provincial Key Lab for Subtropical Water Environment and Marine Biological Resources Protection, Wenzhou University, Wenzhou, 325035, China
| | - Yang Jia
- National and Local Joint Engineering Research Center of Ecological Treatment Technology for Urban Water Pollution, and Zhejiang Provincial Key Lab for Subtropical Water Environment and Marine Biological Resources Protection, Wenzhou University, Wenzhou, 325035, China
| | - Zhendong Sun
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, 310000, China
| | - Jiahui Su
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Qian S. Liu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
| | - Qunfang Zhou
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, 310000, China
- Institute of Environment and Health, Jianghan University, Wuhan, 430056, China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, 310000, China
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Yang Y, Li W, Kang Y, Guo Y, Yang K, Li Q, Liu Y, Yang C, Chen R, Chen H, Li X, Cheng L. A novel lung radiomics feature for characterizing resting heart rate and COPD stage evolution based on radiomics feature combination strategy. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2022; 19:4145-4165. [PMID: 35341291 DOI: 10.3934/mbe.2022191] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The resting HR is an upward trend with the development of chronic obstructive pulmonary disease (COPD) severity. Chest computed tomography (CT) has been regarded as the most effective modality for characterizing and quantifying COPD. Therefore, CT images should provide more information to analyze the lung and heart relationship. The relationship between HR variability and PFT or/and COPD has been fully revealed, but the relationship between resting HR variability and COPD radiomics features remains unclear. 231 sets of chest high-resolution CT (HRCT) images from "COPD patients" (at risk of COPD and stage I to IV) are segmented by the trained lung region segmentation model (ResU-Net). Based on the chest HRCT images and lung segmentation images, 231 sets of the original lung parenchyma images are obtained. 1316 COPD radiomics features of each subject are calculated by the original lung parenchyma images and its derived lung parenchyma images. The 13 selected COPD radiomics features related to the resting HR are generated from the Lasso model. A COPD radiomics features combination strategy is proposed to satisfy the significant change of the lung radiomics feature among the different COPD stages. Results show no significance between COPD stage Ⅰ and COPD stage Ⅱ of the 13 selected COPD radiomics features, and the lung radiomics feature Y1-Y4 (P > 0.05). The lung radiomics feature F2 with the dominant selected COPD radiomics features based on the proposed COPD radiomics features combination significantly increases with the development of COPD stages (P < 0.05). It is concluded that the lung radiomics feature F2 with the dominant selected COPD radiomics features not only can characterize the resting HR but also can characterize the COPD stage evolution.
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Affiliation(s)
- Yingjian Yang
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China
- Medical Health and Intelligent Simulation Laboratory, Medical Device Innovation Center, Shenzhen Technology University, Shenzhen 518118, China
| | - Wei Li
- Medical Health and Intelligent Simulation Laboratory, Medical Device Innovation Center, Shenzhen Technology University, Shenzhen 518118, China
| | - Yan Kang
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China
- Medical Health and Intelligent Simulation Laboratory, Medical Device Innovation Center, Shenzhen Technology University, Shenzhen 518118, China
- Engineering Research Centre of Medical Imaging and Intelligent Analysis, Ministry of Education, Shenyang 110169, China
| | - Yingwei Guo
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China
| | - Kai Yang
- Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital (the Second Clinical Medical College, Jinan University, Shenzhen 518001, China
- The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518001, China
| | - Qiang Li
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China
- Medical Health and Intelligent Simulation Laboratory, Medical Device Innovation Center, Shenzhen Technology University, Shenzhen 518118, China
| | - Yang Liu
- Medical Health and Intelligent Simulation Laboratory, Medical Device Innovation Center, Shenzhen Technology University, Shenzhen 518118, China
| | - Chaoran Yang
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China
| | - Rongchang Chen
- Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital (the Second Clinical Medical College, Jinan University, Shenzhen 518001, China
- The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518001, China
| | - Huai Chen
- Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Xian Li
- Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Lei Cheng
- Shenzhen Happy-Growing Intelligent CO., Ltd, Shenzhen 518118, China
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Susceptibility of patients with chronic obstructive pulmonary disease to heart rate difference associated with the short-term exposure to metals in ambient fine particles: A panel study in Beijing, China. SCIENCE CHINA. LIFE SCIENCES 2022; 65:387-397. [PMID: 34008166 DOI: 10.1007/s11427-020-1912-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/16/2021] [Indexed: 10/21/2022]
Abstract
Susceptibility of patients with chronic obstructive pulmonary disease (COPD) to cardiovascular autonomic dysfunction associated with exposure to metals in ambient fine particles (PM2.5, particulate matter with aerodynamic diameter ≤2.5 µm) remains poorly evidenced. Based on the COPDB (COPD in Beijing) panel study, we aimed to compare the associations of heart rate (HR, an indicator of cardiovascular autonomic function) and exposure to metals in PM2.5 between 53 patients with COPD and 82 healthy controls by using linear mixed-effects models. In all participants, the HR levels were significantly associated with interquartile range increases in the average concentrations of Cr, Zn, and Pb, but the strength of the associations differed by exposure time (from 1.4% for an average 9 days (d) Cr exposure to 3.5% for an average 9 d Zn exposure). HR was positively associated with the average concentrations of PM2.5 and certain metals only in patients with COPD. Associations between HR and exposure to PM2.5, K, Cr, Mn, Ni, Cu, Zn, As, and Se in patients with COPD significantly differed from those in health controls. Furthermore, association between HR and Cr exposure was robust in COPD patients. In conclusion, our findings indicate that COPD could exacerbate difference in HR following exposure to metals in PM2.5.
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Chen X, Luan M, Liu J, Yao Y, Li X, Wang T, Zhang H, Han Y, Lu X, Chen W, Hu X, Zheng M, Qiu X, Zhu T. Risk factors in air pollution exposome contributing to higher levels of TNFα in COPD patients. ENVIRONMENT INTERNATIONAL 2022; 159:107034. [PMID: 34906887 DOI: 10.1016/j.envint.2021.107034] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 11/30/2021] [Accepted: 12/05/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Air pollutants are found associated with various health effects in chronic obstructive pulmonary patients. Given the complicate chemical components of air pollutants, it is not clear which components are the main risk factors for these health effects. OBJECTIVES Based on the COPD in Beijing (COPDB) study and exposome concept, we examined comprehensively the air pollution components to screen out high-risk factors for systemic inflammation of COPD patients. METHODS Concentrations of PM with aerodynamic diameter ≤ 2.5 μm (PM2.5), ultrafine and accumulated-mode particles (UFPs and Acc), PM2.5-contained carbonaceous components/elements/water soluble ions, gaseous pollutants, temperature, and relative humidity (RH) were continuously monitored around participants. Urinary polycyclic aromatic hydrocarbons (PAHs) and cotinine, and serum tumor necrosis factor α (TNFα) were measured from 53 COPD and 82 non-COPD participants. Lifestyle variables were recorded using follow-up questionnaire. Linear mixed effects (LME) models were used to assess the associations of TNFα differences with exposure to air pollutants, meteorological variations, and lifestyle. RESULTS In COPD patients, the associations of TNFα differences with exposure to ozone, Cd, UFPs, Acc, 2-hydroxydibenzofuran, temperature and RH parameters, and several elements in PM2.5 were significant in certain time-windows. For example, per interquartile range (IQR) increase in average ozone concentration 14 d before visits was associated with 17.3% (95% confidence interval: 6.8%, 27.7%) TNFα difference. Associations between ozone, Cd, UFPs, Acc, the maximum value of RH, and 2-hydroxydibenzofuran exposure and TNFα differences remained robust in two-pollutant models, and contributed to 19.0%, 10.5%, 2.2%, 1.6%, 2.1%, and 1.5% TNFα differences, respectively. Among the high-risk factors for COPD patients, the responses to UFPs, Acc, and 2-hydroxydibenzofuran were not robust in non-COPD participants. DISCUSSION Ozone, Cd, UFPs, Acc, PAHs exposure and RH variation were high-risk factors of systemic inflammation for COPD patients, and the profile of high-risk factors were different from those in general population.
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Affiliation(s)
- Xi Chen
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China; Hebei Technology Innovation Center of Human Settlement in Green Building, Shenzhen Institute of Building Research Co., Ltd., Xiongan 071700, China
| | - Mengxiao Luan
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Jinming Liu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Yuan Yao
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Xiaoying Li
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Teng Wang
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Hanxiyue Zhang
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Yiqun Han
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China; Department of Epidemiology and Biostatistics, MRC Centre for Environmental and Health, Imperial College London, SW7 2AZ, UK
| | - Xinchen Lu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Wu Chen
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Xinyan Hu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Mei Zheng
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Xinghua Qiu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Tong Zhu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China.
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9
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Mallah MA, Mallah MA, Liu Y, Xi H, Wang W, Feng F, Zhang Q. Relationship Between Polycyclic Aromatic Hydrocarbons and Cardiovascular Diseases: A Systematic Review. Front Public Health 2021; 9:763706. [PMID: 34950626 PMCID: PMC8688693 DOI: 10.3389/fpubh.2021.763706] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 11/08/2021] [Indexed: 01/06/2023] Open
Abstract
Objective: The primary aim of this systematic review was to examine the relationship of polycyclic aromatic hydrocarbon (PAH) exposure with cardiovascular diseases (CVDs) and elaborate the current knowledge and recent advances in the area of PAH and its effects on CVDs and discuss the growing epidemiological evidence linking PAH to CVDs on the health of human populations. In this systematic review, the increased risk of cardiovascular diseases and their relationship with PAHs were discussed in detail. Methods: On 05th April 2021, a systematic literature search was conducted using PubMed/Medline and Web of Science search engines in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The search was limited to articles that were written in English and dealt with human issues. All original peer-review publications were considered for inclusion. Comments, case reports, reviews, duplicated papers, and conference reports were excluded. Data was collected from included papers by two independent reviewers. Results: Conclusively, 20 research articles published between 2005 and 2021 were chosen for the final analysis. The systemic review included 20 studies with a variety of geographical studies. The most common research category among the nominated studies were time-series studies followed by retrospective cohort, cross-sectional, quasi-experimental, panel, and case-control studies. Most of the studies were conducted in the United States, whereas others were showed in various geographical countries around the world, such as Denmark, Germany, Finland, Netherlands, France, China, Norway, Korea, Sweden, Saudi Arabia, and Belgium. Eight studies assessed the association between PAH exposure and CVDs, four articles observed this relationship with blood pressure (BP), two observed association between atherosclerotic CVD and PAH, one congenital heart disease, cardiovascular events, and two with obesity. Furthermore, in some investigations, a favorable association between PAH exposure and hypertension as well as PAH exposure and obesity was found. Conclusion: In conclusion, this systematic review examined the relationship of PAH exposure with CVDs and CVD-related risk factors by searching several digital databases. After a comprehensive literature searches and summarizing findings from 20 articles, the authors concluded that a positive relationship was observed between PAH exposure and CVD risks.
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Affiliation(s)
- Manthar Ali Mallah
- Department of Toxicology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Mukhtiar Ali Mallah
- Department of Chemical Engineering, Quaid-e-Awam University of Engineering, Science & Technology (QUEST), Nawabshah, Pakistan
| | - Yang Liu
- Department of Toxicology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - He Xi
- Department of Toxicology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wei Wang
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Feifei Feng
- Department of Toxicology, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Qiao Zhang
- Department of Toxicology, College of Public Health, Zhengzhou University, Zhengzhou, China
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10
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VERCELLI MARINA, LILLINI ROBERTO. Application of Socio-Economic and Health Deprivation Indices to study the relationships between socio-economic status and disease onset and outcome in a metropolitan area subjected to aging, demographic fall and socio-economic crisis. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E718-E727. [PMID: 34909500 PMCID: PMC8639118 DOI: 10.15167/2421-4248/jpmh2021.62.3.1890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 05/27/2021] [Indexed: 12/27/2022]
Abstract
Aims Genoa is a city affected by a deep economic, demographic and social involution. The association between disease onset and outcome and socioeconomic status (SES) was assessed in the mortality by cause in two periods, using indices referred to the distribution of deprivation in the population defined in a ten-years span (2001 to 2011). Material and Methods Two Socio-Economic and Health Deprivation Indices (SEHDIs), computed at census tract level (2001 and 2011 Censuses), were applied to analyse the SMRs by cause, age (0-64 and 65+ years) and gender of the five normalised groups of deprivation individuated in the two population distribution. The associations between SES and onset of disease was described in the mortality 2008-11 using the index referred to 2001 population. The second index, referred to 2011 population, described the associations between SES and disease outcomes in the mortality 2009-13. Two ANOVAs evaluated the statistical significance (p < 0.05) of differences in death distribution among groups. Results The population at medium-high deprivation increased in Genoa between 2001 and 2011. The mortality by age and gender showed different trends. Not significant trends (NS) in both periods regarded only the younger (respiratory diseases in both sexes, prostate cancer, diabetes in women). Linearly positives (L↑) trends in both periods were observed only in men (all cancers and lung cancers, overall mortality and cardiovascular diseases in younger, diabetes in older). Not linear trends (NL) in both periods interested both sexes for flu and pneumonia, women for lung cancer, old women for overall mortality and respiratory diseases, old men for colorectal cancers. Instead, L↑ trends in the final phases of disease interest all cancers in the elderly (NS trend at the disease onset), all cancers and breast cancer in young women, diabetes and colorectal cancers in young men (NL trends at the disease onset). On the contrary, L↑ trends at the disease onset and NL trends in the final phases regarded cardiovascular diseases in elderly, overall mortality, respiratory diseases and prostate cancer in old men, diabetes and colorectal cancers in old women. Finally, NL trends at the disease onset regarded colorectal cancers in young women (NS trend in the final phases) and breast cancer in the older (linearly negative trend, L↓, in the final phases). Discussion Deprivation trends confirmed the literature about populations shifting towards poverty. Aging-linked social risks were revealed, reflecting the weakening of social-health care, which worsened in elderly if alone. Serious problems in younger singles or in the single-parent families arose. Cardiovascular diseases, all cancers and colorectal cancers trends confirmed the advantage of less deprived when diseases are preventable and curable. Prostate and breast cancers trends reflected the rising incidence and increasing problems in care. The need of corrective interventions in social and health policies was emerging, aimed to support in a targeted way a population in an alarming condition of socio-economic deterioration.
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Affiliation(s)
- MARINA VERCELLI
- Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
| | - ROBERTO LILLINI
- Analytical Epidemiology & Health Impact Unit, Fondazione IRCCS “Istituto Nazionale Tumori”, Milan, Italy
- Correspondence: Roberto Lillini. Analytical Epidemiology & Health Impact, Fondazione IRCCS “Istituto Nazionale Tumori”, Milan, Italy - Tel: +390223903564 - E-mail:
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11
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Zhou L, Tao Y, Li H, Niu Y, Li L, Kan H, Xie J, Chen R. Acute effects of fine particulate matter constituents on cardiopulmonary function in a panel of COPD patients. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 770:144753. [PMID: 33515878 DOI: 10.1016/j.scitotenv.2020.144753] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/13/2020] [Accepted: 12/19/2020] [Indexed: 05/12/2023]
Abstract
BACKGROUND Exposure to fine particulate matter (PM2.5) has been linked with adverse cardiorespiratory health conditions. However, evidence for PM2.5 constituents is still scarce, especially among patients with chronic obstructive pulmonary disease (COPD). OBJECTIVE To investigate the associations of short-term exposure to different chemical constituents of PM2.5 with measures of cardiac and lung function in COPD patients. METHODS We conducted a retrospective panel study among 100 COPD patients who received repeated measures of left ventricular ejection fraction (LVEF), forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and peak expiratory flow (PEF) in Shanghai, China from August 2014 to September 2019. Daily PM2.5 and PM2.5 constituents were obtained from fixed-site monitoring station. Linear mixed-effects models were used to estimate the associations of PM2.5. RESULTS We found water-soluble ions of PM2.5, mainly NO3-, SO42-, and NH4+ were robustly associated with reduced LVEF, and the reductions in LVEF associated with an IQR increase of them ranged from 1.8% to 2.0% (lag 1 d). Metal constituents such as Cu and As were associated with FEV1, FVC and PEF. The corresponding reductions in lung function parameters for an IQR increase of them ranged from 1.4% to 2.3% (lag 0 or 1 d). These associations remained relatively robust after adjusting for total PM2.5 mass and gaseous pollutants. CONCLUSIONS Our results suggest that water-soluble ions and several metal/metalloid elements might be important constituents in PM2.5 that were associated with reduced cardiorespiratory function among COPD patients.
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Affiliation(s)
- Lu Zhou
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Yingmin Tao
- Division of General Practice, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China.
| | - Huichu Li
- Department of Environmental Health, Harvard T.H.Chan School of Public Health, Boston, MA, USA.
| | - Yue Niu
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Liang Li
- Division of General Practice, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China.
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Juan Xie
- Division of General Practice, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China.
| | - Renjie Chen
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200032, China.
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12
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Wang F, Liang Q, Sun M, Ma Y, Lin L, Li T, Duan J, Sun Z. The relationship between exposure to PM 2.5 and heart rate variability in older adults: A systematic review and meta-analysis. CHEMOSPHERE 2020; 261:127635. [PMID: 32768749 DOI: 10.1016/j.chemosphere.2020.127635] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/28/2020] [Accepted: 07/05/2020] [Indexed: 06/11/2023]
Abstract
Ambient air pollution is recognized as a major threat to those with cardiovascular disease (CVD), especially among old adults within this high risk group. Heart rate variability (HRV) is a marker of cardiac autonomic system, which links air pollution and CVD. However, the relationship between PM and HRV has been inconsistently reported. To investigate the associations of PM2.5 and HRV in old adults whose average age was 55 years old or above, we conducted a meta-analysis of nineteen longitudinal studies including nine short-term and ten long-term studies. In the short-term exposure group, per 10 μg/m3 increase of PM2.5 was associated with decreases in the time-domain measurements, for SDNN -0.39% (95% CI: -0.72%, -0.06%) and for RMSSD -1.20% (95% CI: -2.17%, -0.23%) and in frequency-domain measurements, for LF -2.31% (95% CI: -3.85%, -0.77%) and for HF -1.87% (95% CI: -3.45%, -0.29%); In the long-term exposure group, per 10 μg/m3 increase of PM2.5 was associated with decreases in the time-domain measurements, for SDNN -0.92% (95% CI: -2.14%, 0.31%) and for RMSSD -1.96% (95% CI: -3.48%, -0.44%) and in frequency-domain measurements, for LF -2.78% (95% CI: -4.02%, -1.55%) and for HF -1.61% (95% CI: -4.02%, 0.80%). Exposure to PM2.5 is associated with decreased indicators of HRV in older adults suggesting an affected cardiac autonomic system upon exposure, which may explain the association between PM2.5 and risk of CVD in older adults. Long-term exposure to PM2.5 was more strongly associated with indicators of HRV than short-term exposure.
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Affiliation(s)
- Fenghong Wang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Qingqing Liang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Mengqi Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Yuexiao Ma
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Lisen Lin
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Tianyu Li
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Junchao Duan
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China.
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China.
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13
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Niu Z, Liu F, Li B, Li N, Yu H, Wang Y, Tang H, Chen X, Lu Y, Cheng Z, Liu S, Chen G, Zhang Y, Xiang H. Acute effect of ambient fine particulate matter on heart rate variability: an updated systematic review and meta-analysis of panel studies. Environ Health Prev Med 2020; 25:77. [PMID: 33261557 PMCID: PMC7706193 DOI: 10.1186/s12199-020-00912-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/09/2020] [Indexed: 11/10/2022] Open
Abstract
Background Decreased heart rate variability (HRV) is a predictor of autonomic system dysfunction, and is considered as a potential mechanism of increased risk of cardiovascular disease (CVD) induced by exposure to particulate matter less than 2.5 μm in diameter (PM2.5). Previous studies have suggested that exposure to PM2.5 may lead to decreased HRV levels, but the results remain inconsistent. Methods An updated systematic review and meta-analysis of panel studies till November 1, 2019 was conducted to evaluate the acute effect of exposure to ambient PM2.5 on HRV. We searched electronic databases (PubMed, Web of Science, and Embase) to identify panel studies reporting the associations between exposure to PM2.5 and the four indicators of HRV (standard deviation of all normal-to-normal intervals (SDNN), root mean square of successive differences in adjacent normal-to-normal intervals (rMSSD), high frequency power (HF), and low frequency power (LF)). Random-effects model was used to calculate the pooled effect estimates. Results A total of 33 panel studies were included in our meta-analysis, with 16 studies conducted in North America, 12 studies in Asia, and 5 studies in Europe. The pooled results showed a 10 μg/m3 increase in PM2.5 exposure which was significantly associated with a − 0.92% change in SDNN (95% confidence intervals (95%CI) − 1.26%, − 0.59%), − 1.47% change in rMSSD (95%CI − 2.17%, − 0.77%), − 2.17% change in HF (95%CI − 3.24%, − 1.10%), and − 1.52% change in LF (95%CI − 2.50%, − 0.54%), respectively. Overall, subgroup analysis suggested that short-term exposure to PM2.5 was associated with lower HRV levels in Asians, healthy population, and those aged ≥ 40 years. Conclusion Short-term exposure to PM2.5 was associated with decreased HRV levels. Future studies are warranted to clarity the exact mechanism of exposure to PM2.5 on the cardiovascular system through disturbance of autonomic nervous function. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-020-00912-2.
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Affiliation(s)
- Zhiping Niu
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China.,Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, China
| | - Feifei Liu
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China.,Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, China
| | - Baojing Li
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18, Solna, SE-171 65, Stockholm, Sweden
| | - Na Li
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China.,Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, China
| | - Hongmei Yu
- School of Management, Chengdu University of Traditional Chinese Medicine, 37# Shierqiao Road, Chengdu, China
| | - Yongbo Wang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China
| | - Hong Tang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China.,Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, China
| | - Xiaolu Chen
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China.,Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, China
| | - Yuanan Lu
- Environmental Health Laboratory, Department of Public Health Sciences, University Hawaii at Manoa, Honolulu, HI, 96822, USA
| | - Zilu Cheng
- School of Chemistry, Chemical Engineering and Life Sciences, Wuhan University of Technology, 122# Luoshi Road, Wuhan, China
| | - Suyang Liu
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China.,Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, China
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment; Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuxiao Zhang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China. .,Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, China.
| | - Hao Xiang
- Department of Global Health, School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan, China. .,Global Health Institute, Wuhan University, 115# Donghu Road, Wuhan, China.
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14
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Hung CS, Huang CC, Pan SC, Ma HP, Huang CC, Guo YLL, Ho YL. Acute particulate matter exposure is associated with disturbances in heart rate complexity in patients with prior myocardial infarction. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 733:138842. [PMID: 32446047 DOI: 10.1016/j.scitotenv.2020.138842] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/14/2020] [Accepted: 04/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Ambient air pollutants can increase cardiovascular mortality. One possible mechanism is the effect on the autonomic balance of the cardiovascular system. Studies on acute effects of particulate matter (PM) exposure on heart rate variability (HRV), a surrogate marker for autonomic balance, in patients with prior myocardial infarction (MI) revealed inconsistent results. METHOD We prospectively enrolled participants with acute MI. These participants received a 24-hour Holter electrocardiography examination and echocardiography six months after the index MI. Linear [standard deviation of all normal to normal intervals, standard deviation of NN intervals (SDNN), and a low-frequency to high-frequency ratio (LF/HF)] and non-linear parameters of heart rate variability [multiscale entropy (MSE)] were calculated to show autonomic balance. Data for PM2.5, PM2.5-10, and PM10, were obtained from a fixed-site station in Taiwan. Linear mixed effect models were used to estimate acute effects (within 0-3 days) of PM exposure (per 10 μg/m3) on heart rate variability. RESULTS A total of 90 participants were enrolled in this study with a mean age of 58.7 (13.3) and 83 (92.2%) male participants. Traditional HRV parameters, SDNN and LF/HF, were positively correlated with two-day lagged PM2.5-10 and PM10 [adjusted beta coefficient: SDNN: 130.3 and 58.5; LH/HF: 0.32 and 0.21 (all p < or = 0.01)]. MSE slopes 1-5 were negatively correlated with same-day PM2.5-10 and PM10 (adjusted beta coefficient -0.011 (p = 0.01) and -0.005 (p = 0.02), respectively). The left ventricular ejection fraction was negatively correlated with one-day lagged PM2.5-10, and PM10 (adjusted beta coefficient -0.49 and -0.4, respectively; both p < 0.05), after adjusting for MI size. CONCLUSION Our results suggest that coarse PM may acutely affect cardiac autonomic balance. MSE is a sensitive marker for detecting changes in autonomic imbalance in patients with prior MI following acute PM exposure.
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Affiliation(s)
- Chi-Sheng Hung
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Chang Huang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Shih-Chun Pan
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan
| | - Hsi-Pin Ma
- Department of Electrical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Ching-Chun Huang
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and NTU Hospital, Taipei, Taiwan
| | - Yue-Liang Leon Guo
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and NTU Hospital, Taipei, Taiwan.
| | - Yi-Lwun Ho
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan.
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15
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Zhang J, Zhou Q, Su R, Sun Z, Zhang W, Jin X, Zheng Y. Cardiac dysfunction and metabolic remodeling due to seasonally ambient fine particles exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 721:137792. [PMID: 32182466 DOI: 10.1016/j.scitotenv.2020.137792] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 06/10/2023]
Abstract
Increasing epidemiological evidences have revealed the association between ambient fine particulate matter (PM2.5) pollution and cardiovascular disease's morbidity and mortality. However, how seasonal PM2.5 exposure influence cardiac function and the underlying mechanism converged in energy metabolic remodeling remain to be elucidated. This study focused on seasonal PM2.5-induced cardiac dysfunction and metabolic remodeling, and the toxicity differences of PM2.5 samples from different sampling seasons and different exposure dosages were discussed. The results showed that seasonal haze caused cardiac dysfunctions, including decreases in heart rate (HR) and heart rate variability (HRV), abnormal changes in hemodynamic and echocardiographic parameters. Concurrently, the energy production in myocardial tissues was evidently disturbed. In particular, low dose of PM2.5 exposure notably induced the elevation of beta oxidation (β-oxidation) and tricarboxylic acid cycle (TCA cycle) as the compensation for the disturbed energy metabolism in animals, whereas high dose of PM2.5 exposure attenuated this process and the glycolysis levels were strikingly promoted, thus causing the reduced energy production and cardiac dysfunction. Comparatively, winter PM2.5 exposure caused more severe cardiac toxicity than did summer haze samples, possibly due to the existence of different components and pollutant levels in seasonal hazes. The findings on seasonal PM2.5 induced cardiac dysfunction and myocardial metabolic remodeling provided new insights into cardiovascular disease risks from haze exposure.
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Affiliation(s)
- Jingxu Zhang
- School of Public Health, Qingdao University, Qingdao 266071, China
| | - Qunfang Zhou
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Ruijun Su
- Institute of Biomedical Science, Shanxi University, Taiyuan 030006, China
| | - Zhendong Sun
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Weifang Zhang
- Department of Physiology, Shanxi Medical University, Taiyuan 030001, China
| | - Xiaoting Jin
- School of Public Health, Qingdao University, Qingdao 266071, China.
| | - Yuxin Zheng
- School of Public Health, Qingdao University, Qingdao 266071, China
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16
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Rich DQ, Frampton MW, Balmes JR, Bromberg PA, Arjomandi M, Hazucha MJ, Thurston SW, Alexis NE, Ganz P, Zareba W, Koutrakis P, Thevenet-Morrison K. Multicenter Ozone Study in oldEr Subjects (MOSES): Part 2. Effects of Personal and Ambient Concentrations of Ozone and Other Pollutants on Cardiovascular and Pulmonary Function. Res Rep Health Eff Inst 2020; 2020:1-90. [PMID: 32239870 PMCID: PMC7325421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Abstract
INTRODUCTION The Multicenter Ozone Study of oldEr Subjects (MOSES) was a multi-center study evaluating whether short-term controlled exposure of older, healthy individuals to low levels of ozone (O3) induced acute changes in cardiovascular biomarkers. In MOSES Part 1 (MOSES 1), controlled O3 exposure caused concentration-related reductions in lung function with evidence of airway inflammation and injury, but without convincing evidence of effects on cardiovascular function. However, subjects' prior exposures to indoor and outdoor air pollution in the few hours and days before each MOSES controlled O3 exposure may have independently affected the study biomarkers and/or modified biomarker responses to the MOSES controlled O3 exposures. METHODS MOSES 1 was conducted at three clinical centers (University of California San Francisco, University of North Carolina, and University of Rochester Medical Center) and included healthy volunteers 55 to 70 years of age. Consented participants who successfully completed the screening and training sessions were enrolled in the study. All three clinical centers adhered to common standard operating procedures and used common tracking and data forms. Each subject was scheduled to participate in a total of 11 visits: screening visit, training visit, and three sets of exposure visits consisting of the pre-exposure day, the exposure day, and the post-exposure day. After completing the pre-exposure day, subjects spent the night in a nearby hotel. On exposure days, the subjects were exposed for 3 hours in random order to 0 ppb O3 (clean air), 70 ppb O3, and 120 ppm O3. During the exposure period the subjects alternated between 15 minutes of moderate exercise and 15 minutes of rest. A suite of cardiovascular and pulmonary endpoints was measured on the day before, the day of, and up to 22 hours after each exposure. In MOSES Part 2 (MOSES 2), we used a longitudinal panel study design, cardiopulmonary biomarker data from MOSES 1, passive cumulative personal exposure samples (PES) of O3 and nitrogen dioxide (NO2) in the 72 hours before the pre-exposure visit, and hourly ambient air pollution and weather measurements in the 96 hours before the pre-exposure visit. We used mixed-effects linear regression and evaluated whether PES O3 and NO2 and these ambient pollutant concentrations in the 96 hours before the pre-exposure visit confounded the MOSES 1 controlled O3 exposure effects on the pre- to post-exposure biomarker changes (Aim 1), whether they modified these pre- to post-exposure biomarker responses to the controlled O3 exposures (Aim 2), whether they were associated with changes in biomarkers measured at the pre-exposure visit or morning of the exposure session (Aim 3), and whether they were associated with differences in the pre- to post-exposure biomarker changes independently of the controlled O3 exposures (Aim 4). RESULTS Ambient pollutant concentrations at each site were low and were regularly below the National Ambient Air Quality Standard levels. In Aim 1, the controlled O3 exposure effects on the pre- to post-exposure biomarker differences were little changed when PES or ambient pollutant concentrations in the previous 96 hours were included in the model, suggesting these were not confounders of the controlled O3 exposure/biomarker difference associations. In Aim 2, effects of MOSES controlled O3 exposures on forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were modified by ambient NO2 and carbon monoxide (CO), and PES NO2, with reductions in FEV1 and FVC observed only when these concentrations were "Medium" or "High" in the 72 hours before the pre-exposure visit. There was no such effect modification of the effect of controlled O3 exposure on any other cardiopulmonary biomarker. As hypothesized for Aim 3, increased ambient O3 concentrations were associated with decreased pre-exposure heart rate variability (HRV). For example, high frequency (HF) HRV decreased in association with increased ambient O3 concentrations in the 96 hours before the pre-exposure visit (-0.460 ln[ms2]; 95% CI, -0.743 to -0.177 for each 10.35-ppb increase in O3; P = 0.002). However, in Aim 4 these increases in ambient O3 were also associated with increases in HF and low frequency (LF) HRV from pre- to post-exposure, likely reflecting a "recovery" of HRV during the MOSES O3 exposure sessions. Similar patterns across Aims 3 and 4 were observed for LF (the other primary HRV marker), and standard deviation of normal-to-normal sinus beat intervals (SDNN) and root mean square of successive differences in normal-to-normal sinus beat intervals (RMSSD) (secondary HRV markers). Similar Aim 3 and Aim 4 patterns were observed for FEV1 and FVC in association with increases in ambient PM with an aerodynamic diameter ≤ 2.5 μm (PM2.5), CO, and NO2 in the 96 hours before the pre-exposure visit. For Aim 3, small decreases in pre-exposure FEV1 were significantly associated with interquartile range (IQR) increases in PM2.5 concentrations in the 1 hour before the pre-exposure visit (-0.022 L; 95% CI, -0.037 to -0.006; P = 0.007), CO in the 3 hours before the pre-exposure visit (-0.046 L; 95% CI, -0.076 to -0.016; P = 0.003), and NO2 in the 72 hours before the pre-exposure visit (-0.030 L; 95% CI, -0.052 to -0.008; P = 0.007). However, FEV1 was not associated with ambient O3 or sulfur dioxide (SO2), or PES O3 or NO2 (Aim 3). For Aim 4, increased FEV1 across the exposure session (post-exposure minus pre-exposure) was marginally significantly associated with each 4.1-ppb increase in PES O3 concentration (0.010 L; 95% CI, 0.004 to 0.026; P = 0.010), as well as ambient PM2.5 and CO at all lag times. FVC showed similar associations, with patterns of decreased pre-exposure FVC associated with increased PM2.5, CO, and NO2 at most lag times, and increased FVC across the exposure session also associated with increased concentrations of the same pollutants, reflecting a similar recovery. However, increased pollutant concentrations were not associated with adverse changes in pre-exposure levels or pre- to post-exposure changes in biomarkers of cardiac repolarization, ST segment, vascular function, nitrotyrosine as a measure of oxidative stress, prothrombotic state, systemic inflammation, lung injury, or sputum polymorphonuclear leukocyte (PMN) percentage as a measure of airway inflammation. CONCLUSIONS Our previous MOSES 1 findings of controlled O3 exposure effects on pulmonary function, but not on any cardiovascular biomarker, were not confounded by ambient or personal O3 or other pollutant exposures in the 96 and 72 hours before the pre-exposure visit. Further, these MOSES 1 O3 effects were generally not modified, blunted, or lessened by these same ambient and personal pollutant exposures. However, the reductions in markers of pulmonary function by the MOSES 1 controlled O3 exposure were modified by ambient NO2 and CO, and PES NO2, with reductions observed only when these pollutant concentrations were elevated in the few hours and days before the pre-exposure visit. Increased ambient O3 concentrations were associated with reduced HRV, with "recovery" during exposure visits. Increased ambient PM2.5, NO2, and CO were associated with reduced pulmonary function, independent of the MOSES-controlled O3 exposures. Increased pollutant concentrations were not associated with pre-exposure or pre- to post-exposure changes in other cardiopulmonary biomarkers. Future controlled exposure studies should consider the effect of ambient pollutants on pre-exposure biomarker levels and whether ambient pollutants modify any health response to a controlled pollutant exposure.
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Affiliation(s)
- D Q Rich
- University of Rochester Medical Center, Rochester, New York
| | - M W Frampton
- University of Rochester Medical Center, Rochester, New York
| | - J R Balmes
- University of California at San Francisco
| | | | | | | | - S W Thurston
- University of Rochester Medical Center, Rochester, New York
| | - N E Alexis
- University of North Carolina at Chapel Hill
| | - P Ganz
- University of California at San Francisco
| | - W Zareba
- University of Rochester Medical Center, Rochester, New York
| | - P Koutrakis
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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LILLINI R, MASANOTTI G, BIANCONI F, GILI A, STRACCI F, LA ROSA F, VERCELLI M. Regional indices of socio-economic and health inequalities: a tool for public health programming. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E300-E310. [PMID: 31967087 PMCID: PMC6953449 DOI: 10.15167/2421-4248/jpmh2019.60.4.1257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 11/15/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The aim was to provide an affordable method of computing socio-economic (SE) deprivation indices at the regional level, in order to reveal the specific aspects of the relationship between SE inequalities and health outcomes. The Umbria Region Socio-Health Index (USHI) was computed and compared with the Italian National Deprivation Index at the Umbria regional level (NDI-U). METHODS The USHI was computed by applying factor analysis to census tract SE variables correlated with general mortality and validated through comparison with the NDI-U. RESULTS Overall mortality presented linear positive trends in USHI, while trends in NDI-U proved non-linear or non-significant. Similar results were obtained with regard to specific causes of death according to deprivation groups, gender and age. CONCLUSIONS The USHI better describes a local population in terms of health-related SE status. Policy-makers could therefore adopt this method in order to obtain a better picture of SE-associated health conditions in regional populations and to target strategies for reducing health inequalities.
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Affiliation(s)
- R. LILLINI
- Department of Health Sciences, University of Genoa. Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
- Correspondence: Roberto Lillini, Department of Health Sciences, University of Genoa. Analytical Epidemiology and Health, via Antonio Pastore 1, 16132 Genova (Italy) - Tel. +39 010 3538501 - E-mail:
| | - G. MASANOTTI
- Section of Public Health, Department of Experimental Medicine, University of Perugia, Italy
| | - F. BIANCONI
- Section of Public Health, Department of Experimental Medicine, University of Perugia, Italy
| | - A. GILI
- Section of Public Health, Department of Experimental Medicine, University of Perugia, Italy
| | - F. STRACCI
- Section of Public Health, Department of Experimental Medicine, University of Perugia, Italy
| | - F. LA ROSA
- Section of Public Health, Department of Experimental Medicine, University of Perugia, Italy
| | - M. VERCELLI
- Department of Health Sciences, University of Genova, Italy
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18
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Tang CS, Chuang KJ, Chang TY, Chuang HC, Chen LH, Lung SCC, Chang LT. Effects of Personal Exposures to Micro- and Nano-Particulate Matter, Black Carbon, Particle-Bound Polycyclic Aromatic Hydrocarbons, and Carbon Monoxide on Heart Rate Variability in a Panel of Healthy Older Subjects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234672. [PMID: 31771182 PMCID: PMC6926945 DOI: 10.3390/ijerph16234672] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 11/12/2019] [Accepted: 11/21/2019] [Indexed: 12/14/2022]
Abstract
As a non-invasive method, heart rate variability (HRV) has been widely used to study cardiovascular autonomous control. Environmental epidemiological studies indicated that the increase in an average concentration of particulate matter (PM) would result in a decrease in HRV, which was related to the increase of cardiovascular mortality in patients with myocardial infarction and the general population. With rapid economic and social development in Asia, how air pollutants, such as PM of different sizes and their components, affect the cardiovascular health of older people, still need to be further explored. The current study includes a 72 h personal exposure monitoring of seven healthy older people who lived in the Taipei metropolitan area. Mobile equipment, a portable electrocardiogram recorder, and the generalized additive mixed model (GAMM) were adopted to evaluate how HRV indices were affected by size-fractionated PM, particle-bound polycyclic aromatic hydrocarbons (p-PAHs), black carbon (BC), and carbon monoxide (CO). Other related confounding factors, such as age, sex, body mass index (BMI), temperature, relative humidity (RH), time, and monitoring week were controlled by fixed effects of the GAMM. Statistical analyses of multi-pollutant models showed that PM2.5–10, PM1, and nanoparticle (NP) could cause heart rate (HR), time-domain indices, and frequency-domain indices to rise; PM1–2.5 and BC would cause the frequency-domain index to rise; p-PAHs would cause HR to rise, and CO would cause time-domain index and frequency-domain index to decline. In addition, the moving average time all fell after one hour and might appear at 8 h in HRVs’ largest percentage change caused by each pollutant, results of which suggested that size-fractionated PM, p-PAHs, BC, and CO exposures have delayed effects on HRVs. In conclusion, the results of the study showed that the increase in personal pollutant exposure would affect cardiac autonomic control function of healthy older residents in metropolitan areas, and the susceptibility of cardiovascular effects was higher than that of healthy young people. Since the small sample size would limit the generalizability of this study, more studies with larger scale are warranted to better understand the HRV effects of simultaneous PM and other pollution exposures for subpopulation groups.
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Affiliation(s)
- Chin-Sheng Tang
- Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan
| | - Kai-Jen Chuang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Ta-Yuan Chang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung 40402, Taiwan
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
| | - Li-Hsin Chen
- Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan
| | | | - Li-Te Chang
- Department of Environmental Engineering and Science, Feng Chia University, Taichung 40724, Taiwan
- Correspondence: ; Tel.: +886-4-2451-7250
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19
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Warburton DER, Bredin SSD, Shellington EM, Cole C, de Faye A, Harris J, Kim DD, Abelsohn A. A Systematic Review of the Short-Term Health Effects of Air Pollution in Persons Living with Coronary Heart Disease. J Clin Med 2019; 8:E274. [PMID: 30813506 PMCID: PMC6406357 DOI: 10.3390/jcm8020274] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/13/2019] [Accepted: 02/21/2019] [Indexed: 01/27/2023] Open
Abstract
Persons living with chronic medical conditions (such as coronary artery disease (CAD)) are thought to be at increased risk when exposed to air pollution. This systematic review critically evaluated the short-term health effects of air pollution in persons living with CAD. Original research articles were retrieved systematically through searching electronic databases (e.g., Medical Literature Analysis and Retrieval System Online (MEDLINE)), cross-referencing, and the authors' knowledge. From 2884 individual citations, 26 eligible articles were identified. The majority of the investigations (18 of 22 (82%)) revealed a negative relationship between air pollutants and cardiac function or overall health. Heart rate variability (HRV) was the primary cardiovascular outcome measure, with 10 out of 13 studies reporting at least one index of HRV being significantly affected by air pollutants. However, there was some inconsistency in the relationship between HRV and air pollutants, mediated (at least in part) by the confounding effects of beta-blocker medications. In conclusion, there is strong evidence that air pollution can have adverse effects on cardiovascular function in persons living with CAD. All persons living with CAD should be educated on how to monitor air quality, should recognize the potential risks of excessive exposure to air pollution, and be aware of strategies to mitigate these risks. Persons living with CAD should minimize their exposure to air pollution by limiting outdoor physical activity participation when the forecast air quality health index indicates increased air pollution (i.e., an increased risk).
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Affiliation(s)
- Darren E R Warburton
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Shannon S D Bredin
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
- Laboratory for Knowledge Mobilization, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Erin M Shellington
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
- Laboratory for Knowledge Mobilization, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Christie Cole
- Department of Heart Wise Exercise, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.
| | - Amanda de Faye
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
- Laboratory for Knowledge Mobilization, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Jennifer Harris
- Department of Heart Wise Exercise, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada.
| | - David D Kim
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
- Laboratory for Knowledge Mobilization, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Alan Abelsohn
- Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada.
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20
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Ambient and controlled exposures to particulate air pollution and acute changes in heart rate variability and repolarization. Sci Rep 2019; 9:1946. [PMID: 30760868 PMCID: PMC6374365 DOI: 10.1038/s41598-019-38531-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/27/2018] [Indexed: 02/06/2023] Open
Abstract
Previous studies have reported increased risks of myocardial infarction in association with elevated ambient particulate matter (PM) in the previous hour(s). However, whether PM can trigger mechanisms that act on this time scale is still unclear. We hypothesized that increases in PM are associated with rapid changes in measures of heart rate variability and repolarization. We used data from panel studies in Augsburg, Germany, and Rochester, New York, USA, and two controlled human exposure studies in Rochester. Data included ECG recordings from all four studies, controlled exposures to (concentrated) ultrafine particles (UFP; particles with an aerodynamic diameter <100 nm) and ambient concentrations of UFP and fine PM (PM2.5, aerodynamic diameter <2.5 μm). Factor analysis identified three representative ECG parameters: standard deviation of NN-intervals (SDNN), root mean square of successive differences (RMSSD), and T-wave complexity. Associations between air pollutants and ECG parameters in the concurrent and previous six hours were estimated using additive mixed models adjusting for long- and short-term time trends, meteorology, and study visit number. We found decreases in SDNN in relation to increased exposures to UFP in the previous five hours in both of the panel studies (e.g. Augsburg study, lag 3 hours: −2.26%, 95% confidence interval [CI]: −3.98% to −0.53%; Rochester panel study, lag 1 hour: −2.69%; 95% CI: −5.13% to −0.26%) and one of the two controlled human exposure studies (1-hour lag: −13.22%; 95% CI: −24.11% to −2.33%). Similarly, we observed consistent decreases in SDNN and RMSSD in association with elevated PM2.5 concentrations in the preceding six hours in both panel studies. We did not find consistent associations between particle metrics and T-wave complexity. This study provided consistent evidence that recent exposures to UFP and PM2.5 can induce acute pathophysiological responses.
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21
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Diurnal cardiac sympathetic hyperactivity after exposure to acute particulate matter 2.5 air pollution. J Electrocardiol 2019; 52:112-116. [DOI: 10.1016/j.jelectrocard.2018.11.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 09/23/2018] [Accepted: 11/15/2018] [Indexed: 01/30/2023]
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22
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Pan L, Wu S, Li H, Xu J, Dong W, Shan J, Yang X, Chen Y, Shima M, Deng F, Guo X. The short-term effects of indoor size-fractioned particulate matter and black carbon on cardiac autonomic function in COPD patients. ENVIRONMENT INTERNATIONAL 2018; 112:261-268. [PMID: 29306794 DOI: 10.1016/j.envint.2017.12.037] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 11/25/2017] [Accepted: 12/27/2017] [Indexed: 05/06/2023]
Abstract
BACKGROUND Previous studies have reported adverse health effects of indoor air pollutants especially particulate matter (PM) and black carbon (BC). Patients with chronic obstructive pulmonary disease (COPD) have been shown to be more likely with cardiovascular comorbidities in which cardiac autonomic dysfunction plays an important role. However, there is little evidence for the effect of indoor PM and BC exposures on cardiac autonomic function in COPD patients. OBJECTIVES To evaluate the association between exposure to indoor size-fractioned PM and BC and changes in HRV and HR in COPD patients. METHODS Forty-three doctor diagnosed, stable COPD patients were recruited and measured for 24-h HRV and HR. Real-time indoor size-fractioned PM and BC were monitored on the day before and the day of performing health measurements. Mixed-effects models were used to estimate the associations between indoor PM and BC and HRV indices and HR after controlling for potential confounders. RESULTS Increasing levels of size-fractioned PM and BC were associated with decreased HRV indices and increased HR. An IQR (3.14μg/m3) increase in 8-h BC moving average and an IQR (20.72μg/m3) increase in 5-min PM0.5 moving average concentrations were associated with declines of 7.45% (95% CI: -10.89%, -3.88%) and 16.40% (95% CI: -21.06%, -11.41%) in LF, respectively. The smaller the particles size, the greater effects on HRV indices and HR. Patients' BMI modified the associations between size-fractioned PM and BC and their HRV and HR. For an IQR increase in PM0.5, there was decline in HF of 34.85% (95% CI: -39.08%, -30.33%) in overweight patients, compared to a 2.01% (95% CI: -6.44%, 11.19%) increase in normal-weight patients. CONCLUSIONS Exposures to indoor PM and BC were associated with altered cardiac autonomic function in COPD patients, and the associations for HRV measures of parasympathetic activity (e.g., HF) were more apparent in overweight patients.
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Affiliation(s)
- Lu Pan
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Hongyu Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Junhui Xu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Wei Dong
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Jiao Shan
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Xuan Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Yahong Chen
- Respiratory Department, Peking University Third Hospital, Beijing, China
| | - Masayuki Shima
- Department of Public Health, Hyogo College of Medicine, Hyogo, Japan
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
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Gorr MW, Falvo MJ, Wold LE. Air Pollution and Other Environmental Modulators of Cardiac Function. Compr Physiol 2017; 7:1479-1495. [PMID: 28915333 PMCID: PMC7249238 DOI: 10.1002/cphy.c170017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death in developed regions and a worldwide health concern. Multiple external causes of CVD are well known, including obesity, diabetes, hyperlipidemia, age, and sedentary behavior. Air pollution has been linked with the development of CVD for decades, though the mechanistic characterization remains unknown. In this comprehensive review, we detail the background and epidemiology of the effects of air pollution and other environmental modulators on the heart, including both short- and long-term consequences. Then, we provide the experimental data and current hypotheses of how pollution is able to cause the CVD, and how exposure to pollutants is exacerbated in sensitive states. Published 2017. Compr Physiol 7:1479-1495, 2017.
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Affiliation(s)
- Matthew W. Gorr
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner College of Medicine, Columbus, Ohio, USA
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | - Michael J. Falvo
- War Related Illness and Injury Study Center, Department of Veterans Affairs, New Jersey Health Care System, East Orange, New Jersey, USA
- New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA
| | - Loren E. Wold
- Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner College of Medicine, Columbus, Ohio, USA
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
- Department of Physiology and Cell Biology, The Ohio State University, Columbus, Ohio, USA
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24
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Poursafa P, Moosazadeh M, Abedini E, Hajizadeh Y, Mansourian M, Pourzamani H, Amin MM. A Systematic Review on the Effects of Polycyclic Aromatic Hydrocarbons on Cardiometabolic Impairment. Int J Prev Med 2017; 8:19. [PMID: 28479961 PMCID: PMC5404352 DOI: 10.4103/ijpvm.ijpvm_144_17] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 03/14/2017] [Indexed: 01/06/2023] Open
Abstract
Background: Various epidemiological studies have shown that exposure to environmental pollutants including polycyclic aromatic hydrocarbons (PAHs) might increase the risk of cardiovascular diseases (CVDs) and their risk factors. This study aims to systematically review the association of PAH exposure with metabolic impairment. Methods: Data were collected by searching for relevant studies in international databases using the following keywords: “polycyclic aromatic hydrocarbon” + “cardiovascular disease,” PAH + CVD, polycyclic aromatic hydrocarbon and “air pollutant” + “CVD,” and the desired data were extracted and included in the study according to the systematic review process. Results: From the 14 articles included in the present systematic review, eight articles were conducted on the relationship between PAH and CVDs, four articles were conducted to examine the association of PAH exposure with blood pressure (BP), and two articles investigated the link between PAH and obesity. Conclusions: Most studies included in this systematic review reported a significant positive association of PAH exposure with increased risk of CVDs and its major risk factors including elevated BP and obesity. These findings should be confirmed by longitudinal studies with long-term follow-up.
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Affiliation(s)
- Parinaz Poursafa
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahmood Moosazadeh
- Health Science Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ehsan Abedini
- Student Research Committee, Health Science Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Yaghoub Hajizadeh
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Mansourian
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Pourzamani
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad-Mehdi Amin
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Chen SY, Chan CC, Su TC. Particulate and gaseous pollutants on inflammation, thrombosis, and autonomic imbalance in subjects at risk for cardiovascular disease. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 223:403-408. [PMID: 28159399 DOI: 10.1016/j.envpol.2017.01.037] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 01/14/2017] [Accepted: 01/15/2017] [Indexed: 05/28/2023]
Abstract
This study examined effects of short-term urban air pollution exposures on inflammation, thrombosis, and autonomic imbalance in subjects at risk for cardiovascular disease (CVD). We enrolled 61 patients with multiple CVD risk factors and measured high sensitive C-reactive protein (hs-CRP), fibrinogen, D-dimer, and heart rate variability (HRV) indices. Two health examinations for each participant were performed during December 2002 through September 2003. Changes in inflammation and thrombotic markers and HRV indices with exposures to PM2.5, organic carbon (OC), elemental carbon (EC), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) at 1- to 3-day lags were analyzed using mixed models. The results showed inflammatory and thrombotic markers increased with 1- to 3-day lagged PM2.5 components and gaseous pollutants exposures. hs-CRP maximally increased 0.19 [95% confidence interval (CI): 0.07-0.31] and 0.15 (95% CI: 0.05-0.24) mg/L for an interquartile range (IQR) of 1-day lagged SO2 (2.3 ppb) and CO (0.5 ppm), respectively. D-dimer maximally increased 1.05 (95% CI: 0.13-1.75), 0.72 (95% CI: 0.09-1.21), 0.92 (95% CI: 0.13-1.50), and 0.90 (95% CI: 0.07-1.61) mg/dL for an IQR of 1-day lagged OC (3.9 μg/m3), EC (2.0 μg/m3), SO2, and NO2 (13.4 ppb), respectively. The HRV indices, including low frequency, very low frequency, and the ratio of low frequency to high frequency decreased 19.8 (95% CI: 4.4-32.7), 12.9 (95% CI: 0.8-23.4), and 17.6 (95% CI: 5.4-28.2)% for an IQR of 1-day lagged PM2.5 (20.2 μg/m3), respectively. Our findings demonstrated PM2.5 components and gaseous pollutants exert prolonged inflammatory and thrombotic reactions, while PM2.5 exert an immediate autonomic imbalance.
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Affiliation(s)
- Szu-Ying Chen
- Division of Surgical Intensive Care, Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; Department of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Chang-Chuan Chan
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ta-Chen Su
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan.
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Yang L, Hou XY, Wei Y, Thai P, Chai F. Biomarkers of the health outcomes associated with ambient particulate matter exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 579:1446-1459. [PMID: 27908628 DOI: 10.1016/j.scitotenv.2016.11.146] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 11/18/2016] [Accepted: 11/21/2016] [Indexed: 05/22/2023]
Abstract
Epidemiologic evidence supports the positive association of cardiopulmonary morbidity and mortality, and lung cancer risk with exposure to airborne particulate matter (PM). Oxidative stress and inflammation have been proposed to be the major causal factors involved in mediating PM effects on both cardiovascular and pulmonary health outcomes. However, the mechanism whereby PM causes the health effects is not fully elucidated. To evaluate and investigate human exposure to PM, it is essential to have a specific, sensitive and robust characterization of individual exposure to PM. Biomarkers may mark important intermediate steps leading to overt health effects after PM exposure. Thus biomarkers are promising indicators, which could serve as representative measures of the exposure to PM for assessing the health impacts and understanding the mechanism. Indeed, a number of biomarkers are already in use in the field of epidemiological studies and toxicological research. However, we are facing now the challenges to select robust, specific and sensitive biomarkers, which can be employed in large-scale of population to assess the health risk and to monitor the effectiveness of interventions. In this review, we describe a range of biomarkers that are associated with air pollution exposure, particularly markers of oxidative stress, inflammatory factors, and microRNAs, as well as markers of pollutants metabolites. Understanding the nature of the association of these biomarkers with PM exposure may shed some light on the process of selecting biomarkers for large-scale population studies, developing novel preventative and therapeutic strategies.
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Affiliation(s)
- Lixin Yang
- Department of Environmental Pollution and Health, State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, 100012 Beijing, China.
| | - Xiang-Yu Hou
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD 4001, Australia
| | - Yongjie Wei
- Department of Environmental Pollution and Health, State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, 100012 Beijing, China
| | - Phong Thai
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, QLD 4001, Australia
| | - Fahe Chai
- Chinese Research Academy of Environmental Sciences, 100012 Beijing, China.
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Buteau S, Goldberg MS. A structured review of panel studies used to investigate associations between ambient air pollution and heart rate variability. ENVIRONMENTAL RESEARCH 2016; 148:207-247. [PMID: 27085495 DOI: 10.1016/j.envres.2016.03.013] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/04/2016] [Accepted: 03/08/2016] [Indexed: 05/25/2023]
Abstract
INTRODUCTION Dysfunction of the autonomic nervous system is one of the postulated pathways linking short-term exposure to air pollution to adverse cardiovascular outcomes. A hypothesis is that exposure to air pollution decreases heart rate variability, a recognized independent predictor of poorer cardiovascular prognosis. METHODS We conducted a structured review of panel studies published between 1946 and July 2015 of the association between ambient air pollution and parameters of heart rate variability reflecting autonomic nervous function. We focused on exposure to mass concentrations of fine particles (PM2.5), nitrogen dioxide (NO2), and ozone (O3), and four commonly used indices of heart rate variability (HRV): standard deviation of all normal-to-normal intervals (SDNN); root mean square of successive differences in adjacent normal-to-normal intervals (RMSSD); high frequency power (HF); and low frequency power (LF). We searched bibliographic databases and references of identified articles and abstracted characteristics of their design and conduct, and synthesized the quantitative findings in graphic form according to health condition of the study population and the functional form of the HRV indices used in the regression analyses. RESULTS A total of 33 panel studies were included: 31, 12, and 13 studies were used to investigate ambient exposure to PM2.5, NO2 and O3, respectively. We found substantial variation across studies in terms of design characteristics and statistical methodologies, and we identified some studies that may have had methodological and statistical issues. Because many panel studies were not comparable to each other, meta-analyses were not generally possible, although we were able to pool the results obtained amongst older adults who had cardiovascular disease for the 24-h average concentrations of PM2.5 prior to the heart rate variability measurements. In studies of PM2.5 among older adults with cardiovascular disease, logarithmic transformations of the HRV indices were used in ten studies. Negative associations across all HRV indices were found in 60-86% of these studies for periods of exposures ranging from 5-min to 5-days. The pooled percent changes for an increase of 10μg/m(3) in the 24-h prior to the measurements of HRV were: -2.11% for SDNN (95% confidence interval (95%CI): -4.00, -0.23%), -3.29% for RMSSD (95%CI: -6.32, -0.25%), -4.76% for LF (95%CI: -12.10, 2.58%), and -1.74% for HF (95%CI: -7.79, 4.31%). No transformations were used in seven studies of PM2.5 among older adults with cardiovascular disease, and we found for absolute differences pooled changes in the HRV indices, for an increase of 10μg/m(3), of -0.31ms for SDNN (95%CI: -1.02, 0.41ms) and -1.22ms for RMSSD (95%CI: -2.37; -0.07ms). For gaseous pollutants, negative associations over periods of exposure ranging from 5-min or to 5-days prior to the heart rate variability measurements were reported in 71-83% of studies of NO2 and 57-100% of studies of O3, depending of the indices of heart rate variability. However, many of these studies had statistical or methodological issues, and in the few studies without these issues the confidence intervals were relatively wide and mostly included the null. CONCLUSIONS AND DISCUSSION We were not persuaded by the results that there was an association between PM2.5 and any of the four indices of heart rate variability. For NO2 and O3 the number of high-quality studies was insufficient to draw any definite conclusions. Further panel studies with improved design and methodologies are needed to help establish or refute an association between ambient exposure to air pollution and heart rate variability.
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Affiliation(s)
- Stephane Buteau
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Institut national de sante publique du Quebec (INSPQ), Montreal, Quebec, Canada.
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada
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Calderón-Garcidueñas L, Franco-Lira M, Torres-Jardón R, Henriquez-Roldán C, Barragán-Mejía G, Valencia-Salazar G, González-Maciel A, Reynoso-Robles R, Villarreal-Calderón R, Reed W. Pediatric Respiratory and Systemic Effects of Chronic Air Pollution Exposure: Nose, Lung, Heart, and Brain Pathology. Toxicol Pathol 2016; 35:154-62. [PMID: 17325984 DOI: 10.1080/01926230601059985] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Exposures to particulate matter and gaseous air pollutants have been associated with respiratory tract inflammation, disruption of the nasal respiratory and olfactory barriers, systemic inflammation, production of mediators of inflammation capable of reaching the brain and systemic circulation of particulate matter. Mexico City (MC) residents are exposed to significant amounts of ozone, particulate matter and associated lipopolysaccharides. MC dogs exhibit brain inflammation and an acceleration of Alzheimer’s-like pathology, suggesting that the brain is adversely affected by air pollutants. MC children, adolescents and adults have a significant upregulation of cyclooxygenase-2 (COX2) and interleukin-1β (IL-1β) in olfactory bulb and frontal cortex, as well as neuronal and astrocytic accumulation of the 42 amino acid form of β-amyloid peptide (Aβ42), including diffuse amyloid plaques in frontal cortex. The pathogenesis of Alzheimer’s disease (AD) is characterized by brain inflammation and the accumulation of Aβ42, which precede the appearance of neuritic plaques and neurofibrillary tangles, the pathological hallmarks of AD. Our findings of nasal barrier disruption, systemic inflammation, and the upregulation of COX2 and IL-1β expression and Aβ42 accumulation in brain suggests that sustained exposures to significant concentrations of air pollutants such as particulate matter could be a risk factor for AD and other neurodegenerative diseases.
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Lee MS, Eum KD, Rodrigues EG, Magari SR, Fang SC, Modest GA, Christiani DC. Effects of Personal Exposure to Ambient Fine Particulate Matter on Acute Change in Nocturnal Heart Rate Variability in Subjects Without Overt Heart Disease. Am J Cardiol 2016; 117:151-6. [PMID: 26552502 DOI: 10.1016/j.amjcard.2015.10.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 10/09/2015] [Accepted: 10/09/2015] [Indexed: 02/02/2023]
Abstract
The immediate effect within minutes to hours of personal exposure to ambient fine particulate matter (PM2.5) on cardiac autonomic function is limited, particularly at night. Our study aimed to assess the lagged association between personal exposure to PM2.5 and nocturnal heart rate variability. Repeated measures panel study among 21 community adults recruited from a local health clinic during the period of March 1, 2004, to August 31, 2004, in Boston, Massachusetts, in the United States. Ambulatory electrocardiogram and continuous monitoring of personal exposure to PM2.5 and were measured for up to 2 consecutive days. We calculated 5-minute time-specific average PM2.5 exposure for each participant. Mixed-effects models were fit for 5-minute SD of normal-to-normal intervals (SDNN) and 5-minute heart rate in relation to 5-minute PM2.5 exposure lagged in 5-minute intervals up to 4 hours. We found an 8.4% decrease in nocturnal SDNN (95% confidence interval [CI] -11.3% to -5.5%) and a 1.9% increase in nighttime heart rate (95% CI 1.1% to 2.7%) for an interquartile range increase in PM2.5 (13.6 μg/m(3)), after adjusting for confounders. Significant decreases in nocturnal SDNN associated with PM2.5 exposure occurred within 2.5 hours. The largest decrease in nocturnal SDNN of -12.8% (95% CI -16.4 to -9.1%) that was associated with PM2.5 exposure was found with a lag of 25 minutes. Rapid changes in nocturnal heart rate variability associated with personal PM2.5 exposure occurred within the previous 2.5 hours, with the largest effects at 25 minutes, suggesting immediate cardiac autonomic effects of fine particulate exposure.
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Affiliation(s)
- Mi-Sun Lee
- Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ki-Do Eum
- Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ema G Rodrigues
- Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Shannon R Magari
- Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Colden Corporation, New York, New York
| | - Shona C Fang
- Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; New England Research Institutes, Inc., Watertown, Massachusetts
| | - Geoffrey A Modest
- Upham's Corner Health Center, Boston University School of Medicine, Boston, Massachusetts
| | - David C Christiani
- Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
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Chen WL, Lin CY, Yan YH, Cheng KT, Cheng TJ. Alterations in rat pulmonary phosphatidylcholines after chronic exposure to ambient fine particulate matter. MOLECULAR BIOSYSTEMS 2015; 10:3163-9. [PMID: 25236678 DOI: 10.1039/c4mb00435c] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study elucidated the underlying pathophysiological changes that occur after chronic ambient fine particulate matter (PM2.5) exposure via a lipidomic approach. Five male Sprague-Dawley rats were continually whole-body exposed to ambient air containing PM2.5 at 16.7 ± 10.1 μg m(-3) from the outside of the building for 8 months, whereas a control group (n = 5) inhaled filtered air. Phosphorylcholine-containing lipids were extracted from lung tissue and profiled using ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The phosphatidylcholine (PC) signal features of the two groups were compared using partial least squares discriminant analysis (PLS-DA) and Wilcoxon rank sum tests. The PC profile of the exposure group differed from that of the control group; the R(2)Y and Q(2) were 0.953 and 0.677, respectively, in the PLS-DA model. In the exposure group, a significant 0.66- to 0.80-fold reduction in lyso-PC levels, which may have resulted from repeated inflammation, was observed. Decreased surfactant PCs by 16% at most may indicate injuries to alveolar type II cells. Cell function and cell signalling are likely to be altered because the decrease in unsaturated PCs may reduce membrane fluidity. Accompanied by the decline in plasmenylcholines, decreased unsaturated PCs may indicate the attack of reactive oxygen species generated by PM2.5 exposure. The physiological findings conformed to the histopathological changes in the exposed animals. PC profiling using UPLC-MS/MS-based lipidomics is sensitive for reflecting pathophysiological perturbations in the lung after long-term and low concentration PM2.5 exposure.
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Affiliation(s)
- Wen-Ling Chen
- Institute of Occupational Health and Industrial Hygiene, College of Public Health, National Taiwan University, No. 17, Xuzhou Rd., Zhongzheng Dist., Taipei City 100, Taiwan.
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Feng Y, Huang X, Sun H, Liu C, Zhang B, Zhang Z, Sharma Tengur V, Chen W, Wu T, Yuan J, Zhang X. Framingham risk score modifies the effect of PM10 on heart rate variability. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 523:146-151. [PMID: 25863505 DOI: 10.1016/j.scitotenv.2015.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/31/2015] [Accepted: 04/02/2015] [Indexed: 06/04/2023]
Abstract
Health conditions may greatly modify the association between particulate matter (PM) and heart rate variability (HRV), but whether the modification of PM effect by coronary artery disease (CAD) risk status depends on the PM levels remains unknown. We investigated the associations between personal exposures to PM with aerodynamic diameter of ≤10μm (PM10) and ≤2.5μm (PM2.5) and concurrent HRV, and whether the effect of PM on HRV was modified by Framingham risk score (FRS) in healthy subjects with different PM exposure levels. Personal exposures to PM10 and PM2.5 were measured for 24h in 152 volunteers of community residents who were free of cardiovascular disease in two cities (Zhuhai and Wuhan) that differ in air quality. Simultaneously, 24h HRV indices were obtained from 3-channel Holter monitor. FRS was calculated based on age, sex, lipid profiles, blood pressure, diabetes, and smoking status. Linear regression models were constructed after adjusting for potential confounders. We found significant decrease in total power (TP) and low power (LF) with increased PM10 concentrations (P for trend<0.05) in the high PM levels city (Wuhan) and total population, but not in the low PM levels city (Zhuhai). We also observed significant modification of FRS on PM10 effect in Wuhan. Interestingly, elevated PM10 was associated in a greater decreased HRV in the low FRS subgroup, but not in the high FRS subgroup. However, we did not find any significant main effects of PM2.5 or PM2.5-FRS interactions on HRV in city-specified or city-combined analyses. Overall, the findings indicate that individual coronary risk profiles may modulate the association between particulate air pollution and HRV in high PM exposure levels.
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Affiliation(s)
- Yingying Feng
- Department of Occupational and Environmental Health, Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiji Huang
- Department of Occupational and Environmental Health, Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Huizhen Sun
- Department of Occupational and Environmental Health, Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Chuanyao Liu
- Department of Occupational and Environmental Health, Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Bing Zhang
- Department of Occupational and Environmental Health, Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhihong Zhang
- Department of Occupational and Environmental Health, Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Vashish Sharma Tengur
- Department of Occupational and Environmental Health, Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Weihong Chen
- Department of Occupational and Environmental Health, Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Tangchun Wu
- Department of Occupational and Environmental Health, Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jing Yuan
- Department of Occupational and Environmental Health, Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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Buteau S, Goldberg MS. Methodological issues related to pooling results from panel studies of heart rate variability and its association with ambient air pollution. ENVIRONMENTAL RESEARCH 2015; 140:462-465. [PMID: 25984645 DOI: 10.1016/j.envres.2015.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 04/23/2015] [Accepted: 05/03/2015] [Indexed: 06/04/2023]
Abstract
Reviews of observational studies and subsequent meta-analyses are challenging to interpret because of potential methodological issues and biases inherent in studies. In reviewing panel studies of the association between heart rate variability and ambient air pollution we identified a number of methodological issues that make difficult interpreting and pooling findings from longitudinal studies, notably issues related to associations arising from different type of designs, differences in design characteristics, including study populations, measurements of heart rate variability (e.g., duration and condition of the electrocardiogram recordings), exposure assessment (e.g., types of monitoring), metrics of exposure used, and parameters estimated from regression models. We conclude that many panel studies of the association between heart rate variability and ambient air pollution may not be comparable to each other, and thus caution must be exercised to avoid misleading conclusions.
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Affiliation(s)
- Stephane Buteau
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Institut National de Sante Publique du Quebec (INSPQ), Montreal, Quebec, Canada.
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada
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Goodman JE, Prueitt RL, Sax SN, Lynch HN, Zu K, Lemay JC, King JM, Venditti FJ. Weight-of-evidence evaluation of short-term ozone exposure and cardiovascular effects. Crit Rev Toxicol 2015; 44:725-90. [PMID: 25257961 DOI: 10.3109/10408444.2014.937854] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
There is a relatively large body of research on the potential cardiovascular (CV) effects associated with short-term ozone exposure (defined by EPA as less than 30 days in duration). We conducted a weight-of-evidence (WoE) analysis to assess whether it supports a causal relationship using a novel WoE framework adapted from the US EPA's National Ambient Air Quality Standards causality framework. Specifically, we synthesized and critically evaluated the relevant epidemiology, controlled human exposure, and experimental animal data and made a causal determination using the same categories proposed by the Institute of Medicine report Improving the Presumptive Disability Decision-making Process for Veterans ( IOM 2008). We found that the totality of the data indicates that the results for CV effects are largely null across human and experimental animal studies. The few statistically significant associations reported in epidemiology studies of CV morbidity and mortality are very small in magnitude and likely attributable to confounding, bias, or chance. In experimental animal studies, the reported statistically significant effects at high exposures are not observed at lower exposures and thus not likely relevant to current ambient ozone exposures in humans. The available data also do not support a biologically plausible mechanism for CV effects of ozone. Overall, the current WoE provides no convincing case for a causal relationship between short-term exposure to ambient ozone and adverse effects on the CV system in humans, but the limitations of the available studies preclude definitive conclusions regarding a lack of causation. Thus, we categorize the strength of evidence for a causal relationship between short-term exposure to ozone and CV effects as "below equipoise."
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Weichenthal S, Hatzopoulou M, Goldberg MS. Exposure to traffic-related air pollution during physical activity and acute changes in blood pressure, autonomic and micro-vascular function in women: a cross-over study. Part Fibre Toxicol 2014; 11:70. [PMID: 25487431 PMCID: PMC4276095 DOI: 10.1186/s12989-014-0070-4] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 11/24/2014] [Indexed: 12/31/2022] Open
Abstract
Background Traffic-related air pollution may contribute to cardiovascular morbidity. In urban areas, exposures during physical activity are of interest owing to increased breathing rates and close proximity to vehicle emissions. Methods We conducted a cross-over study among 53 healthy non-smoking women in Montreal, Canada during the summer of 2013. Women were exposed to traffic pollutants for 2-hours on three separate occasions during cycling on high and low-traffic routes as well as indoors. Personal air pollution exposures (PM2.5, ultrafine particles (UFP), black carbon, NO2, and O3) were evaluated along each route and linear mixed-effects models with random subject intercepts were used to estimate the impact of air pollutants on acute changes in blood pressure, heart rate variability, and micro-vascular function in the hours immediately following exposure. Single and multi-pollutant models were examined and potential effect modification by mean regional air pollution concentrations (PM2.5, NO2, and O3) was explored for the 24-hour and 5-day periods preceding exposure. Results In total, 143 exposure routes were completed. Each interquartile increase (10,850/cm3) in UFP exposure was associated with a 4.91% (95% CI: -9.31, -0.512) decrease in reactive hyperemia index (a measure of micro-vascular function) and each 24 ppb increase in O3 exposure corresponded to a 2.49% (95% CI: 0.141, 4.84) increase in systolic blood pressure and a 3.26% (95% CI: 0.0117, 6.51) increase in diastolic blood pressure 3-hours after exposure. Personal exposure to PM2.5 was associated with decreases in HRV measures reflecting parasympathetic modulation of the heart and regional PM2.5 concentrations modified these relationships (p < 0.05). In particular, stronger inverse associations were observed when regional PM2.5 was higher on the days prior to the study period. Regional PM2.5 also modified the impact of personal O3 on the standard deviation of normal to normal intervals (SDNN) (p < 0.05): a significant inverse relationship was observed when regional PM2.5 was low prior to study periods and a significant positive relationship was observed when regional PM2.5 was high. Conclusion Exposure to traffic pollution may contribute to acute changes in blood pressure, autonomic and micro-vascular function in women. Regional air pollution concentrations may modify the impact of these exposures on autonomic function. Electronic supplementary material The online version of this article (doi:10.1186/s12989-014-0070-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Scott Weichenthal
- Air Health Science Division, Health Canada, 269 Laurier Avenue West, K1A 0K9, Ottawa, ON, Canada.
| | - Marianne Hatzopoulou
- Department of Civil Engineering, McGill University, Macdonald Engineering Building, 817 Sherbrooke Street West, H3A 0C3, Montreal, Quebec, Canada.
| | - Mark S Goldberg
- Division of Clinical Epidemiology, McGill University Health Center, 687 Pine Avenue West, H3A 1A1, Montreal, Quebec, Canada.
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Samoli E, Stafoggia M, Rodopoulou S, Ostro B, Alessandrini E, Basagaña X, Díaz J, Faustini A, Gandini M, Karanasiou A, Kelessis AG, Le Tertre A, Linares C, Ranzi A, Scarinzi C, Katsouyanni K, Forastiere F. Which specific causes of death are associated with short term exposure to fine and coarse particles in Southern Europe? Results from the MED-PARTICLES project. ENVIRONMENT INTERNATIONAL 2014; 67:54-61. [PMID: 24657768 DOI: 10.1016/j.envint.2014.02.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 01/29/2014] [Accepted: 02/27/2014] [Indexed: 06/03/2023]
Abstract
We investigated the short-term effects of particles with aerodynamic diameter less than 2.5μm (PM2.5), between 2.5 and 10μm (PM2.5-10) and less than 10μm (PM10) on deaths from diabetes, cardiac and cerebrovascular causes, lower respiratory tract infections (LRTI) and chronic obstructive pulmonary disease (COPD) in 10 European Mediterranean metropolitan areas participating in the MED-PARTICLES project during 2001-2010. In the first stage of the analysis, data from each city were analyzed separately using Poisson regression models, whereas in the second stage, the city-specific air pollution estimates were combined to obtain overall estimates. We investigated the effects following immediate (lags 0-1), delayed (lags 2-5) and prolonged exposure (lags 0-5) and effect modification patterns by season. We evaluated the sensitivity of our results to co-pollutant exposures or city-specific model choice. We applied threshold models to investigate the pattern of selected associations. For a 10μg/m(3) increase in two days' PM2.5 exposure there was a 1.23% (95% confidence interval (95% CI): -1.63%, 4.17%) increase in diabetes deaths, while six days' exposure statistically significantly increased cardiac deaths by 1.33% (95% CI: 0.27, 2.40%), COPD deaths by 2.53% (95% CI: -0.01%, 5.14%) and LRTI deaths by 1.37% (95% CI: -1.94%, 4.78%). PM2.5 results were robust to co-pollutant adjustments and alternative modeling approaches. Stronger effects were observed in the warm season. Coarse particles displayed positive, even if not statistically significant, associations with mortality due to diabetes and cardiac causes that were more variable depending on exposure period, co-pollutant and seasonality adjustment. Our findings provide support for positive associations between PM2.5 and mortality due to diabetes, cardiac causes, COPD, and to a lesser degree to cerebrovascular causes, in the European Mediterranean region, which seem to drive the particles short-term health effects.
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Affiliation(s)
- Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, 75 Mikras Asias Str, 115 27 Athens, Greece.
| | - Massimo Stafoggia
- Department of Epidemiology of Lazio Region, 53 Santa Costanza Str, 00198 Rome, Italy
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, 75 Mikras Asias Str, 115 27 Athens, Greece
| | - Bart Ostro
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona Biomedical Research Park, C/Doctor Aiguader, 88, E-08003 Barcelona, Spain
| | - Ester Alessandrini
- Department of Epidemiology of Lazio Region, 53 Santa Costanza Str, 00198 Rome, Italy
| | - Xavier Basagaña
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona Biomedical Research Park, C/Doctor Aiguader, 88, E-08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10-12, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 3-5 Melchor Fernández Almagro, 28029 Madrid, Spain
| | - Julio Díaz
- Carlos III Institute of Health, 5 Avda. Monforte de Lemos, 28029 Madrid, Spain
| | - Annunziata Faustini
- Department of Epidemiology of Lazio Region, 53 Santa Costanza Str, 00198 Rome, Italy
| | - Martina Gandini
- Department of Epidemiology and Environmental Health, Regional Environmental Protection Agency, Piedmont, 9 Pio VII Str, 10127 Turin, Italy
| | - Angeliki Karanasiou
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona Biomedical Research Park, C/Doctor Aiguader, 88, E-08003 Barcelona, Spain
| | - Apostolos G Kelessis
- Environmental Department, Municipality of Thessaloniki, 7 Paparigopoulou Str, 54630 Thessaloniki, Greece
| | - Alain Le Tertre
- Environmental Health Department, French Institute for Public Health Surveillance (InVS), 12 du Val d'Osne Str, 94415 Saint-Maurice Cedex, France
| | - Cristina Linares
- Carlos III Institute of Health, 5 Avda. Monforte de Lemos, 28029 Madrid, Spain
| | - Andrea Ranzi
- Regional Centre for Environment and Health, Regional Agency for Environmental Prevention of Emilia-Romagna, 13 Begarelli Str, 41121 Modena, Italy
| | - Cecilia Scarinzi
- Department of Epidemiology and Environmental Health, Regional Environmental Protection Agency, Piedmont, 9 Pio VII Str, 10127 Turin, Italy
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, 75 Mikras Asias Str, 115 27 Athens, Greece
| | - Francesco Forastiere
- Department of Epidemiology of Lazio Region, 53 Santa Costanza Str, 00198 Rome, Italy
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Feng Y, Sun H, Song Y, Bao J, Huang X, Ye J, Yuan J, Chen W, Christiani DC, Wu T, Zhang X. A community study of the effect of polycyclic aromatic hydrocarbon metabolites on heart rate variability based on the Framingham risk score. Occup Environ Med 2014; 71:338-45. [PMID: 24627303 DOI: 10.1136/oemed-2013-101884] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To investigate the effects of the urinary metabolite profiles of background exposure to the atmospheric pollutants polycyclic aromatic hydrocarbon (PAH) and Framingham risk score (FRS), which assesses an individual's cardiovascular disease risk, on heart rate variability (HRV). METHODS The study conducted from April to May 2011 in Wuhan, China, included 1978 adult residents with completed questionnaires, physical examinations, blood and urine samples, and 5-min HRV indices (including SD of all normal to normal intervals (SDNN), root mean square successive difference (rMSSD), low frequency (LF), high frequency (HF) and their ratio (LF/HF), and total power) obtained from 3-channel Holter monitor. 12 urinary PAH metabolites were measured by gas chromatography-mass spectrometry. FRS was calculated by age, sex, lipid profiles, blood pressure, diabetes and smoking status. Linear regression models were constructed after adjusting for potential confounders. RESULTS Elevated total concentration of hydroxynaphthalene (ΣOHNa) was significantly associated, in a dose-responsive manner, with decreased SDNN and LF/HF (ptrend=0.014 and 0.007, respectively); elevated total concentration of hydroxyfluorene (ΣOHFlu) was significantly associated with reduced SDNN, LF and LF/HF (ptrend=0.027, 0.003, and <0.0001, respectively); and elevated total concentration of all PAH metabolites (ΣOH-PAHs) was associated with decreased LF and LF/HF (ptrend=0.005 and <0.0001, respectively). Moreover, increasing quartiles of FRS were significantly associated with decreased HRV indices, except LF/HF (all ptrend<0.0001). Interestingly, individuals in low-risk subgroups had greater decreases in SDNN, LF and LF/HF in relation to ΣOH-PAHs, ΣOHNa and ΣOHFlu than those in high-risk subgroups (all p<0.05). CONCLUSIONS Environmental PAH exposure may differentially affect HRV based on individual coronary risk profiles.
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Affiliation(s)
- Yingying Feng
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Nyhan M, McNabola A, Misstear B. Comparison of particulate matter dose and acute heart rate variability response in cyclists, pedestrians, bus and train passengers. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 468-469:821-31. [PMID: 24076503 DOI: 10.1016/j.scitotenv.2013.08.096] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Revised: 08/22/2013] [Accepted: 08/28/2013] [Indexed: 05/04/2023]
Abstract
Exposure to airborne particulate matter (PM) has been linked to cardiovascular morbidity and mortality. Heart rate variability (HRV) is a measure of the change in cardiac autonomic function, and consistent links between PM exposure and decreased HRV have been documented in studies. This study quantitatively assesses the acute relative variation of HRV with predicted PM dose in the lungs of commuters. Personal PM exposure, HR and HRV were monitored in 32 young healthy cyclists, pedestrians, bus and train passengers. Inhaled and lung deposited PM doses were determined using a numerical model of the human respiratory tract which accounted for varying ventilation rates between subjects and during commutes. Linear mixed models were used to examine air pollution dose and HRV response relationships in 122 commutes sampled. Elevated PM2.5 and PM10 inhaled and lung deposited doses were significantly (p<0.05) associated with decreased HRV indices. Percent declines in SDNN (standard deviation of normal RR intervals) relative to resting, due to an inter-quartile range increase in PM10 lung deposited dose were stronger in cyclists (-6.4%, 95% CI: -11.7, -1.3) and pedestrians (-5.8%, 95% CI: -11.3, -0.5), in comparison to bus (-3.2%, 95% CI: -6.4, -0.1) and train (-1.8%, -7.5, 3.8) passengers. A similar trend was observed in the case of PM2.5 lung deposited dose and results for rMSSD (the square root of the squared differences of successive normal RR intervals) followed similar trends to SDNN. Inhaled and lung deposited doses accounting for varying ventilation rates between modes, individuals and during commutes have been neglected in other studies relating PM to HRV. The findings here indicate that exercise whilst commuting has an influence on inhaled PM and PM lung deposited dose, and these were significantly associated with acute declines in HRV, especially in pedestrians and cyclists.
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Affiliation(s)
- Marguerite Nyhan
- Civil, Structural and Environmental Engineering Department, Trinity College Dublin, Ireland.
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Huang YCT, Rappold AG, Graff DW, Ghio AJ, Devlin RB. Synergistic effects of exposure to concentrated ambient fine pollution particles and nitrogen dioxide in humans. Inhal Toxicol 2013; 24:790-7. [PMID: 23033993 DOI: 10.3109/08958378.2012.718809] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Exposure to single pollutants e.g. particulate matter (PM) is associated with adverse health effects, but it does not represent a real world scenario that usually involves multiple pollutants. OBJECTIVES Determine if simultaneous exposure to PM and NO₂ results in synergistic interactions. MATERIALS AND METHODS Healthy young volunteers were exposed to clean air, nitrogen dioxide (NO₂, 0.5 ppm), concentrated fine particles from Chapel Hill air (PM(2.5)CAPs, 89.5 ± 10.7 µg/m³), or NO₂+PM(2.5)CAPs for 2 h. Each subject performed intermittent exercise during the exposure. Parameters of heart rate variability (HRV), changes in repolarization, peripheral blood endpoints and lung function were measured before and 1 and 18 h after exposure. Bronchoalveolar lavage (BAL) was performed 18 h after exposure. RESULTS NO₂ exposure alone increased cholesterol and HDL 18 h after exposure, decreased high frequency component of HRV one and 18 h after exposure, decreased QT variability index 1 h after exposure, and increased LDH in BAL fluid. The only significant change with PM(2.5)CAPs was an increase in HDL 1 h after exposure, likely due to the low concentrations of PM(2.5)CAPs in the exposure chamber. Exposure to both NO₂ and PM(2.5)CAPs increased BAL α1-antitrypsin, mean t wave amplitude, the low frequency components of HRV and the LF/HF ratio. These changes were not observed following exposure to NO₂ or PM(2.5)CAPs alone, suggesting possible interactions between the two pollutants. DISCUSSION AND CONCLUSIONS NO₂ exposure may produce and enhance acute cardiovascular effects of PM(2.5)CAPs. Assessment of health effects by ambient PM should consider its interactions with gaseous copollutants.
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Affiliation(s)
- Yuh-Chin T Huang
- Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
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Shields KN, Cavallari JM, Hunt MJO, Lazo M, Molina M, Molina L, Holguin F. Traffic-related air pollution exposures and changes in heart rate variability in Mexico City: a panel study. Environ Health 2013; 12:7. [PMID: 23327098 PMCID: PMC3639920 DOI: 10.1186/1476-069x-12-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 12/10/2012] [Indexed: 05/09/2023]
Abstract
BACKGROUND While air pollution exposures have been linked to cardiovascular outcomes, the contribution from acute gas and particle traffic-related pollutants remains unclear. Using a panel study design with repeated measures, we examined associations between personal exposures to traffic-related air pollutants in Mexico City and changes in heart rate variability (HRV) in a population of researchers aged 22 to 56 years. METHODS Participants were monitored for approximately 9.5 hours for eight days while operating a mobile laboratory van designed to characterize traffic pollutants while driving in traffic and "chasing" diesel buses. We examined the association between HRV parameters (standard deviation of normal-to-normal intervals (SDNN), power in high frequency (HF) and low frequency (LF), and the LF/HF ratio) and the 5-minute maximum (or average in the case of PM(2.5)) and 30-, 60-, and 90-minute moving averages of air pollutants (PM(2.5), O(3), CO, CO(2), NO(2), NO(x), and formaldehyde) using single- and two-pollutant linear mixed-effects models. RESULTS Short-term exposure to traffic-related emissions was associated with statistically significant acute changes in HRV. Gaseous pollutants - particularly ozone - were associated with reductions in time and frequency domain components (α = 0.05), while significant positive associations were observed between PM(2.5) and SDNN, HF, and LF. For ozone and formaldehyde, negative associations typically increased in magnitude and significance with increasing averaging periods. The associations for CO, CO(2), NO(2), and NO(x) were similar with statistically significant associations observed for SDNN, but not HF or LF. In contrast, PM(2.5) increased these HRV parameters. CONCLUSIONS Results revealed an association between traffic-related PM exposures and acute changes in HRV in a middle-aged population when PM exposures were relatively low (14 μg/m(3)) and demonstrate heterogeneity in the effects of different pollutants, with declines in HRV - especially HF - with ozone and formaldehyde exposures, and increases in HRV with PM(2.5) exposure. Given that exposure to traffic-related emissions is associated with increased risk of cardiovascular morbidity and mortality, understanding the mechanisms by which traffic-related emissions can cause cardiovascular disease has significant public health relevance.
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Affiliation(s)
- Kyra Naumoff Shields
- Department of Environmental and Occupational Health, University of Pittsburgh, Bridgeside Point I, 100 Technology Drive, Suite 350, Pittsburgh, PA, 15219, USA
| | - Jennifer M Cavallari
- Division of Occupational and Environmental Medicine, University of Connecticut Health Center, 270 Farmington Ave., The Exchange, Suite 262, Farmington, Ct. 06032-6210, USA
| | - Megan J Olson Hunt
- Department of Biostatistics, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15261, USA
| | - Mariana Lazo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W6508, Baltimore, Maryland, 21205, USA
| | - Mario Molina
- Department of Chemistry and Biochemistry, University of San Diego, Science & Technology 374, 5998 Alcala Park, San Diego, CA, 92110, USA
| | - Luisa Molina
- Department of Earth, Atmospheric and Planetary Sciences Cambridge, Massachusetts Institute of Technology, MA 02139, 9500 Gilman Dr., MCO332, La Jolla, CA, 92093-0332, USA
| | - Fernando Holguin
- Montefiore Hospital, University of Pittsburgh Medical Center, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA
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Adam M, Felber Dietrich D, Schaffner E, Carballo D, Barthélémy JC, Gaspoz JM, Tsai MY, Rapp R, Phuleria HC, Schindler C, Schwartz J, Künzli N, Probst-Hensch NM. Long-term exposure to traffic-related PM(10) and decreased heart rate variability: is the association restricted to subjects taking ACE inhibitors? ENVIRONMENT INTERNATIONAL 2012; 48:9-16. [PMID: 22820680 DOI: 10.1016/j.envint.2012.06.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Revised: 06/25/2012] [Accepted: 06/26/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Alterations in heart rate variability (HRV) are a potential link between exposure to traffic-related air pollution and cardiovascular mortality. OBJECTIVES We investigated whether long-term exposure to traffic-related PM(10) (TPM(10)) is associated with HRV in older subjects and/or in participants taking specific cardiovascular treatment or with self-reported heart disease. METHODS We included 1607 subjects from the general population aged 50 to 72 years. These participants from the SAPALDIA cohort underwent ambulatory 24-hr electrocardiogram monitoring. Associations of average annual exposure to TPM(10) over 10 years with HRV parameters from time and frequency domains were estimated using multivariable mixed linear models. Effect estimates are expressed as percent changes in geometric means. RESULTS HRV was only associated with TPM(10) in participants under ACE inhibitor therapy (N=94). A 1 μg/m(3) increment, approximately equivalent to an interquartile range, in 10 year average TPM(10) was associated with decrements of 14.5% (95% confidence interval (CI), -25.9 to -1.3) in high frequency (HF) power, of 4.5% (-8.2 to -0.5) in the standard deviation of all normal-to-normal RR intervals (SDNN), of 10.6% (-18.5 to -1.9) in total power (TP) and an increase of 9.2% (0.8 to 20.2) in the LF/HF power ratio. CONCLUSIONS In the absence of an overall effect our results suggest that alterations in HRV, a measure of autonomic control of the cardiac rhythm, may not be a central mechanism by which long-term exposure to TPM(10) increases cardiovascular mortality. Novel evidence on an effect in persons under ACE inhibitor treatment needs to be confirmed in future studies.
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Affiliation(s)
- Martin Adam
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
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42
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Li X, Feng Y, Deng H, Zhang W, Kuang D, Deng Q, Dai X, Lin D, Huang S, Xin L, He Y, Huang K, He M, Guo H, Zhang X, Wu T. The dose-response decrease in heart rate variability: any association with the metabolites of polycyclic aromatic hydrocarbons in coke oven workers? PLoS One 2012; 7:e44562. [PMID: 23024753 PMCID: PMC3443084 DOI: 10.1371/journal.pone.0044562] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 08/09/2012] [Indexed: 12/19/2022] Open
Abstract
Background Air pollution has been associated with an increased risk of cardiopulmonary mortality and decreased heart rate variability (HRV). However, it is unclear whether coke oven emissions (COEs) and polycyclic aromatic hydrocarbons (PAHs) are associated with HRV. Objectives Our goal in the present study was to investigate the association of exposure to COEs and the urinary metabolite profiles of PAHs with HRV of coke oven workers. Methods We measured benzene soluble matter, carbon monoxide, sulfur dioxide, particulate matters, and PAHs at different workplaces of a coke oven plant. We determined 10 urinary PAH metabolites and HRV indices of 1333 workers using gas chromatography–mass spectrometry and a 3-channel digital Holter monitor, respectively. Results Our results showed that there was a significant COEs-related dose-dependent decrease in HRV, and an inverse relationship between the quartiles of urinary 2-hydroxynaphthalene and five HRV indices (ptrend<0.01 for all). After adjustment for potential confounders, elevation per interquartile range (IQR) (1.81 µg/mmol creatinine) of urinary 2-hydroxynaphthalene was associated with a 5.46% (95% CI, 2.50–8.32) decrease in standard deviation of NN intervals (SDNN). As workers worked more years, SDNN gradually declined in the same quartiles of 2-hydroxynaphthalene levels (ptrend = 1.40×10−4), especially in workers with the highest levels of 2-hydroxynaphthalene. Conclusions Occupational exposure to COEs is associated with a dose-response decrease in HRV. In particular, increased exposure to 2-hydroxynaphthalene is associated with significantly decreased HRV. Increase of working years and exposure levels has resulted in a gradual decline of HRV.
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Affiliation(s)
- Xiaohai Li
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yingying Feng
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huaxin Deng
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wangzhen Zhang
- Institute of Industrial Health, Wuhan Iron and Steel (Group) Corporation, Wuhan, China
| | - Dan Kuang
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qifei Deng
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiayun Dai
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dafeng Lin
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Suli Huang
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lili Xin
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yunfeng He
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Huang
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meian He
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huan Guo
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tangchun Wu
- Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- * E-mail:
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Wu CF, Li YR, Kuo IC, Hsu SC, Lin LY, Su TC. Investigating the association of cardiovascular effects with personal exposure to particle components and sources. THE SCIENCE OF THE TOTAL ENVIRONMENT 2012; 431:176-182. [PMID: 22683757 DOI: 10.1016/j.scitotenv.2012.05.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 05/06/2012] [Accepted: 05/06/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Few studies included information on components and sources when exploring the cardiovascular health effects from personal exposure to particulate matters (PM). We previously reported that exposure to PM between 1.0 and 2.5 μm (PM(2.5-1)) was associated with increased cardio-ankle vascular index (CAVI, an arterial stiffness index), while exposure to PM smaller than 0.25 μm (PM(0.25)) decreased the heart rate variability (HRV) indices. The purpose of this study was to investigate the association between PM elements and cardiovascular health effects and identify responsible sources. METHODS In a panel study of seventeen mail carriers, the subjects were followed for 5-6 days while delivering mail outdoors. Personal filter samples of PM(2.5-1) and PM(0.25) were analyzed for their elemental concentrations. The source-specific exposures were further estimated by using absolute principal factor analysis. We analyzed the component- and source-specific health effects on HRV indices and CAVI using mixed models. RESULTS Several elements in PM(2.5-1) (e.g., cadmium and strontium) were associated with the CAVI. Subsequent analyses showed that an interquartile range increase in exposure to PM from regional sources was significantly associated with a 3.28% increase in CAVI (95% confidence interval (CI), 1.47%-5.13%). This significant effect remained (3.35%, CI: 1.62%-5.11%) after controlling for the ozone exposures. For exposures to PM(0.25), manganese, calcium, nickel, and chromium were associated with the CAVI and/or the HRV indices. CONCLUSIONS Our study suggests that PM(2.5-1) and PM(0.25) components may be associated with different cardiovascular effects. Health risks from exposure to PM from sources other than vehicle exhaust should not be underappreciated.
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Affiliation(s)
- Chang-fu Wu
- Department of Public Health, National Taiwan University, Taipei 100, Taiwan.
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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.
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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.
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Rückerl R, Schneider A, Breitner S, Cyrys J, Peters A. Health effects of particulate air pollution: A review of epidemiological evidence. Inhal Toxicol 2012; 23:555-92. [PMID: 21864219 DOI: 10.3109/08958378.2011.593587] [Citation(s) in RCA: 311] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Regina Rückerl
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany.
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McCracken J, Smith KR, Stone P, Díaz A, Arana B, Schwartz J. Intervention to lower household wood smoke exposure in Guatemala reduces ST-segment depression on electrocardiograms. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:1562-8. [PMID: 21669557 PMCID: PMC3226487 DOI: 10.1289/ehp.1002834] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Accepted: 06/13/2011] [Indexed: 05/19/2023]
Abstract
BACKGROUND A large body of evidence suggests that fine particulate matter (PM) air pollution is a cause of cardiovascular disease, but little is known in particular about the cardiovascular effects of indoor air pollution from household use of solid fuels in developing countries. RESPIRE (Randomized Exposure Study of Pollution Indoors and Respiratory Effects) was a randomized trial of a chimney woodstove that reduces wood smoke exposure. OBJECTIVES We tested the hypotheses that the stove intervention, compared with open fire use, would reduce ST-segment depression and increase heart rate variability (HRV). METHODS We used two complementary study designs: a) between-groups comparisons based on randomized stove assignment, and b) before-and-after comparisons within control subjects who used open fires during the trial and received chimney stoves after the trial. Electrocardiogram sessions that lasted 20 hr were repeated up to three times among 49 intervention and 70 control women 38-84 years of age, and 55 control subjects were also assessed after receiving stoves. HRV and ST-segment values were assessed for each 30-min period. ST-segment depression was defined as an average value below -1.00 mm. Personal fine PM [aerodynamic diameter ≤ 2.5 μm (PM₂.₅] exposures were measured for 24 hr before each electrocardiogram. RESULTS PM₂.₅ exposure means were 266 and 102 μg/m³ during the trial period in the control and intervention groups, respectively. During the trial, the stove intervention was associated with an odds ratio of 0.26 (95% confidence interval, 0.08-0.90) for ST-segment depression. We found similar associations with the before-and-after comparison. The intervention was not significantly associated with HRV. CONCLUSIONS The stove intervention was associated with reduced occurrence of nonspecific ST-segment depression, suggesting that household wood smoke exposures affect ventricular repolarization and potentially cardiovascular health.
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Affiliation(s)
- John McCracken
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA.
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Jia X, Song X, Shima M, Tamura K, Deng F, Guo X. Acute effect of ambient ozone on heart rate variability in healthy elderly subjects. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2011; 21:541-7. [PMID: 21522190 DOI: 10.1038/jes.2011.18] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2010] [Accepted: 02/24/2011] [Indexed: 05/24/2023]
Abstract
Acute ambient ozone (O(3)) exposure is associated with the increased mortality and morbidity of cardiovascular diseases. The dysfunction of cardiac autonomic nervous system (ANS), indicated by the disturbed heart rate variability (HRV), may be the most important underlying mechanism. Previous studies reported the heterogeneous associations between O(3) within several hours' exposure and HRV on general elderly subjects, in which poor surrogate of exposure evaluation and different health status of the subjects may be responsible for the heterogeneous associations. No studies were found focusing on the O(3)-mediated HRV effects within several minutes' exposure on healthy older subjects until recently. We measured the real-time 5-min ambient O(3) concentration and HRV frequency indices in 20 healthy elderly subjects in two surveys, with the 1st and 2nd survey in summer and winter, respectively. Mixed-linear model was used to evaluate the associations between the ambient 5-min average O(3) and concurrent 5-min HRV frequency indices measured during the outdoor period. After adjusting the co-pollutants (ambient PM(2.5) and nitrogen oxides concentrations) and subject characteristics, high frequency (HF) changed -4.87% (95% CI -8.62 to -0.97%) per 10 ppb increment of O(3), whereas decreased low frequency (LF) and increased LFHFR were found to be marginally associated with the elevated O(3) (P values were 0.092 and 0.069). We concluded that the ambient O(3) exert transient decrease effects on HRV, which may induce acute cardiac events.
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Affiliation(s)
- Xiaofeng Jia
- Peking University School of Public Health, Beijing, China
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He F, Shaffer ML, Rodriguez-Colon S, Yanosky JD, Bixler E, Cascio WE, Liao D. Acute effects of fine particulate air pollution on cardiac arrhythmia: the APACR study. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:927-32. [PMID: 21398201 PMCID: PMC3222979 DOI: 10.1289/ehp.1002640] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Accepted: 03/11/2011] [Indexed: 05/19/2023]
Abstract
BACKGROUND The mechanisms underlying the relationship between particulate matter (PM) air pollution and cardiac disease are not fully understood. OBJECTIVES We examined the effects and time course of exposure to fine PM [aerodynamic diameter ≤ 2.5 μm (PM(2.5))] on cardiac arrhythmia in 105 middle-age community-dwelling healthy nonsmokers in central Pennsylvania. METHODS The 24-hr beat-to-beat electrocardiography data were obtained using a high-resolution Holter system. After visually identifying and removing artifacts, we summarized the total number of premature ventricular contractions (PVCs) and premature atrial contractions (PACs) for each 30-min segment. A personal PM(2.5) nephelometer was used to measure individual-level real-time PM(2.5) exposures for 24 hr. We averaged these data to obtain 30-min average time-specific PM(2.5) exposures. Distributed lag models under the framework of negative binomial regression and generalized estimating equations were used to estimate the rate ratio between 10-μg/m³ increases in average PM(2.5) over 30-min intervals and ectopy counts. RESULTS The mean ± SD age of participants was 56 ± 8 years, with 40% male and 73% non-Hispanic white. The 30-min mean ± SD for PM(2.5) exposure was 13 ± 22 μg/m³, and PAC and PVC counts were 0.92 ± 4.94 and 1.22 ± 7.18. Increases of 10 μg/m³ in average PM(2.5) concentrations during the same 30 min or the previous 30 min were associated with 8% and 3% increases in average PVC counts, respectively. PM(2.5) was not significantly associated with PAC count. CONCLUSION PM(2.5) exposure within approximately 60 min was associated with increased PVC counts in healthy individuals.
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Affiliation(s)
- Fan He
- Department of Public Health Sciences, the Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033, USA
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Sérgio Chiarelli P, Amador Pereira LA, Nascimento Saldiva PHD, Ferreira Filho C, Bueno Garcia ML, Ferreira Braga AL, Conceição Martins L. The association between air pollution and blood pressure in traffic controllers in Santo André, São Paulo, Brazil. ENVIRONMENTAL RESEARCH 2011; 111:650-5. [PMID: 21570068 DOI: 10.1016/j.envres.2011.04.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2010] [Revised: 04/12/2011] [Accepted: 04/18/2011] [Indexed: 05/02/2023]
Abstract
BACKGROUND Urban air pollutants are associated with cardiovascular events. Traffic controllers are at high risk for pollution exposure during outdoor work shifts. OBJECTIVE The purpose of this study was to evaluate the relationship between air pollution and systemic blood pressure in traffic controllers during their work shifts. METHODS This cross-sectional study enrolled 19 male traffic controllers from Santo André city (São Paulo, Brazil) who were 30-60 years old and exposed to ambient air during outdoor work shifts. Systolic and diastolic blood pressure readings were measured every 15 min by an Ambulatory Arterial Blood Pressure Monitoring device. Hourly measurements (lags of 0-5h) and the moving averages (2-5h) of particulate matter (PM(10)), ozone (O(3)) ambient concentrations and the acquired daily minimum temperature and humidity means from the São Paulo State Environmental Agency were correlated with both systolic and diastolic blood pressures. Statistical methods included descriptive analysis and linear mixed effect models adjusted for temperature, humidity, work periods and time of day. RESULTS Interquartile increases of PM(10) (33 μg/m(3)) and O(3) (49 μg/m(3)) levels were associated with increases in all arterial pressure parameters, ranging from 1.06 to 2.53 mmHg. PM(10) concentration was associated with early effects (lag 0), mainly on systolic blood pressure. However, O(3) was weakly associated most consistently with diastolic blood pressure and with late cumulative effects. CONCLUSIONS Santo André traffic controllers presented higher blood pressure readings while working their outdoor shifts during periods of exposure to ambient pollutant fluctuations. However, PM(10) and O(3) induced cardiovascular effects demonstrated different time courses and end-point behaviors and probably acted through different mechanisms.
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Affiliation(s)
- Paulo Sérgio Chiarelli
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, University of São Paulo Faculty of Medical Sciences, São Paulo, Brazil
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Air pollution, lung function, and physical symptoms in communities near concentrated Swine feeding operations. Epidemiology 2011; 22:208-15. [PMID: 21228696 DOI: 10.1097/ede.0b013e3182093c8b] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Concentrated animal feeding operations emit air pollutants that may affect health. We examined associations of reported hog odor and of monitored air pollutants with physical symptoms and lung function in people living within 1.5 miles of hog operations. METHODS Between September 2003 and September 2005, we measured hydrogen sulfide (H2S), endotoxin, and particulate matter (PM10, PM2.5, and PM2.5-10) for approximately 2-week periods in each of 16 eastern North Carolina communities. During the same time periods, 101 adults sat outside their homes twice a day for 10 minutes, reported hog odor and physical symptoms, and measured their lung function. Conditional fixed-effects logistic and linear regression models were used to derive estimates of associations. RESULTS The log odds (±1 standard error) of acute eye irritation following 10 minutes outdoors increased by 0.53 (±0.06) for every unit increase in odor, by 0.15 (±0.06) per 1 ppb of H2S, and by 0.36 (±0.11) per 10 μg/m of PM10. Odor and H2S were also associated with irritation and respiratory symptoms in the previous 12 hours. The log odds of difficulty breathing increased by 0.50 (±0.15) per unit of odor. A 10 μg/m increase in mean 12-hour PM2.5 was associated with increased log odds of wheezing (0.84 ± 0.29) and declines in forced expiratory volume in 1 second (-0.04 ± 0.02 L). A 10 EU/mg increase in endotoxin was associated with increased log odds of sore throat (0.10 ± 0.05), chest tightness (0.09 ± 0.04), and nausea (0.10 ± 0.05). CONCLUSIONS Pollutants measured near hog operations are related to acute physical symptoms in a longitudinal study using analyses that preclude confounding by time-invariant characteristics of individuals.
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