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Peralta AA, Link MS, Schwartz J, Luttmann-Gibson H, Dockery DW, Blomberg A, Wei Y, Mittleman MA, Gold DR, Laden F, Coull BA, Koutrakis P. Exposure to Air Pollution and Particle Radioactivity With the Risk of Ventricular Arrhythmias. Circulation 2020; 142:858-867. [PMID: 32795087 PMCID: PMC7484430 DOI: 10.1161/circulationaha.120.046321] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/11/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Individuals are exposed to air pollution and ionizing radiation from natural sources through inhalation of particles. This study investigates the association between cardiac arrhythmias and short-term exposures to fine particulate matter (particulate matter ≤2.5 µm aerodynamic diameter; PM2.5) and particle radioactivity. METHODS Ventricular arrhythmic events were identified among 176 patients with dual-chamber implanted cardioverter-defibrillators in Boston, Massachusetts between September 2006 and June 2010. Patients were assigned exposures based on residential addresses. Daily PM2.5 levels were estimated at 1-km×1-km grid cells from a previously validated prediction model. Particle gross β activity was used as a surrogate for particle radioactivity and was measured from several monitoring sites by the US Environmental Protection Agency's monitoring network. The association of the onset of ventricular arrhythmias (VA) with 0- to 21-day moving averages of PM2.5 and particle radioactivity (2 single-pollutant models and a 2-pollutant model) before the event was examined using time-stratified case-crossover analyses, adjusted for dew point and air temperatures. RESULTS A total of 1,050 VA were recorded among 91 patients, including 123 sustained VA among 25 of these patients. In the single-pollutant model of PM2.5, each interquartile range increase in daily PM2.5 levels for a 21-day moving average was associated with 39% higher odds of a VA event (95% CI, 12%-72%). In the single-pollutant model of particle radioactivity, each interquartile range increase in particle radioactivity for a 2-day moving average was associated with 13% higher odds of a VA event (95% CI, 1%-26%). In the 2-pollutant model, for the same averaging window of 21 days, each interquartile range increase in daily PM2.5 was associated with an 48% higher odds of a VA event (95% CI, 15%-90%), and each interquartile range increase of particle radioactivity with a 10% lower odds of a VA event (95% CI, -29% to 14%). We found that with higher levels of particle radioactivity, the effect of PM2.5 on VAs is reduced. CONCLUSIONS In this high-risk population, intermediate (21-day) PM2.5 exposure was associated with higher odds of a VA event onset among patients with known cardiac disease and indication for implanted cardioverter-defibrillator implantation independently of particle radioactivity.
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Affiliation(s)
- Adjani A. Peralta
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Mark S. Link
- UTSouthwestern Medical Center, Department of Internal Medicine, Division of Cardiology, Cardiac Arrhythmia Service, Dallas, TX
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Heike Luttmann-Gibson
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Douglas W. Dockery
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Annelise Blomberg
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Murray A. Mittleman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA
| | - Diane R. Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Brent A. Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
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Nyhan MM, Coull BA, Blomberg AJ, Vieira CLZ, Garshick E, Aba A, Vokonas P, Gold DR, Schwartz J, Koutrakis P. Associations Between Ambient Particle Radioactivity and Blood Pressure: The NAS (Normative Aging Study). J Am Heart Assoc 2018; 7:e008245. [PMID: 29545261 PMCID: PMC5907574 DOI: 10.1161/jaha.117.008245] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 02/13/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND The cardiovascular effects of low-level environmental radiation exposures are poorly understood. Although particulate matter (PM) has been linked to cardiovascular morbidity and mortality, and elevated blood pressure (BP), the properties promoting its toxicity remain uncertain. Addressing a knowledge gap, we evaluated whether BP increased with higher exposures to radioactive components of ambient PM, herein referred to as particle radioactivity (PR). METHODS AND RESULTS We performed a repeated-measures analysis of 852 men to examine associations between PR exposure and BP using mixed-effects regression models. As a surrogate for PR, we used gross β activity, measured by the US Environmental Protection Agency's radiation monitoring network. Higher PR exposure was associated with increases in both diastolic BP and systolic BP, for exposures from 1 to 28 days. An interquartile range increase in 28-day PR exposure was associated with a 2.95-mm Hg increase in diastolic BP (95% confidence interval, 2.25-3.66; P<0.001) and a 3.94-mm Hg increase in systolic BP (95% confidence interval, 2.62-5.27; P<0.001). For models including both PR and PM ≤2.5 µm, the PR-BP associations remained stable and significant. For models including PR and black carbon or PR and particle number, the PR-BP associations were attenuated; however, they remained significant for many exposure durations. CONCLUSIONS This is the first study to demonstrate the potential adverse effects of PR on both systolic and diastolic BPs. These were independent and similar in magnitude to those of PM ≤2.5 µm, black carbon, and particle number. Understanding the effects of particle-bound radionuclide exposures on BP may have important implications for environmental and public health policy.
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Affiliation(s)
- Marguerite M Nyhan
- Harvard T.H. Chan School of Public Health Harvard University, Boston, MA
| | - Brent A Coull
- Harvard T.H. Chan School of Public Health Harvard University, Boston, MA
| | | | - Carol L Z Vieira
- Harvard T.H. Chan School of Public Health Harvard University, Boston, MA
| | - Eric Garshick
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, MA
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, MA
| | - Abdulaziz Aba
- Kuwait Institute for Scientific Research, Kuwait City, Kuwait
| | - Pantel Vokonas
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, MA
| | - Diane R Gold
- Harvard T.H. Chan School of Public Health Harvard University, Boston, MA
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, MA
| | - Joel Schwartz
- Harvard T.H. Chan School of Public Health Harvard University, Boston, MA
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, MA
| | - Petros Koutrakis
- Harvard T.H. Chan School of Public Health Harvard University, Boston, MA
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