Short-term exposure to ambient fine particulate matter (PM2,5 and PM10) and the risk of heart rhythm abnormalities and stroke

COMMENTARY ON THE LAW

Short-term exposure to ambient fine particulate matter (PM2,5 and PM10) and the risk of heart rhythm abnormalities and stroke

Małgorzata Kowalska 1 , Krzysztof Kocot 2

1. Katedra i Zakład Epidemiologii, Wydział Lekarski w Katowicach, Śląski Uniwersytet Medyczny
2. Koło Naukowe przy Katedrze i Zakładzie Epidemiologii, Wydział Lekarski w Katowicach, Śląski Uniwersytet Medyczny

Published: 2016-09-28
DOI: 10.5604/17322693.1220389
GICID: 01.3001.0009.6880
Available language versions: en pl
Issue: Postepy Hig Med Dosw 2016; 70 : 1017-1025

 

Abstract

Results of epidemiological studies suggest a significant impact of ambient particulate matter air pollution (PM10 and PM2,5) on the health of the population. Increased level of these pollutants is connected with increased rate of daily mortality and hospitalizations due to cardiovascular diseases. Among analyzed health effects, heart arrhythmias and stroke are mentioned most frequently. The aim of the study was to present the current knowledge of potential influence of the exposure to fine particulate matter on the presence of arrhythmias and strokes. Subject literature review suggests, that there is a link between short-term exposure to fine dust and the occurrence of arrhythmias. Results of previous studies indicates that this exposure may lead to significant electrophysiological changes in heart, resulting in higher susceptibility to cardiac rhythm abnormalities. In case of stroke, a stronger correlation between number of hospitalizations and death cases and exposure to fine dust was seen for ischaemic stroke than for haemorhhagic stroke. In addition, a significantly more harmful impact of the exposure to ultra particles (particles of aerodynamic diameter below 2,5 μm) has been confirmed. Among important mechanisms responsible for observed health impact of particulate matter there are: induction and intensification of inflammation, increased oxidative stress, increased autonomic nervous system activity, vasoconstriction, rheological changes and endothelial dysfunction. Among people of higher susceptibility to fine dust negative health impact are: elderly (over 65 years old), obese people, patients with respiratory and cardiovascular diseases, patients with diabetes and those with coagulation disorders. For further improvement of general health status, actions aimed at reducing the risk associated with fine dust and at the same time at continuing studies to clarify the biological mechanisms explaining the influence of fine dust on human health are necessary.

References

  • 1. Berger A., Zareba W., Schneider A., Rückerl R., Ibald-Mulli A.,Cyrys J., Wichmann H.E., Peters A.: Runs of ventricular and supraventriculartachycardia triggered by air pollution in patientswith coronary heart disease. J. Occup. Environ. Med., 2006; 48:1149-1158
    Google Scholar
  • 2. Brook R.D., Rajagopalan S., Pope C.A 3rd., Brook J.R., BhatnagarA., Diez-Roux A.V., Holguin F., Hong Y., Luepker R.V., MittlemanM.A., Peters A., Siscovick D., Smith S.C. Jr., Whitsel L., KaufmanJ.D.: Particulate matter air pollution and cardiovascular disease:An update to the scientific statement from the American HeartAssociation. Circulation, 2010; 121: 2331-2378
    Google Scholar
  • 3. Bunch T.J., Horne B.D., Asirvatham S.J., Day J.D., Crandall B.G.,Weiss J.P., Osborn J.S., Anderson J.L., Muhlestein J.B., Lappe D.L.,Pope C.A. 3rd.: Atrial fibrillation hospitalization is not increasedwith short-term elevations in exposure to fine particulate air pollution.Pacing Clin. Electrophysiol., 2011; 34: 1475-1479
    Google Scholar
  • 4. Cakmak S., Kauri L., Shutt R., Liu L., Green M.S., MulhollandM., Stieb D., Dales R.: The association between ambient air qualityand cardiac rate and rhythm in ambulatory subjects. Environ.Int., 2014; 73: 365-371
    Google Scholar
  • 5. Chen S.Y., Lin Y.L., Chang W.T., Lee C.T., Chan C.C.: Increasingemergency room visits for stroke by elevated levels of fine particulateconstituents. Sci. Total Environ., 2014; 473-474: 446-450
    Google Scholar
  • 6. Chiu H.F., Tsai S.S., Weng H.H., Yang C.Y.: Short-term effectsof fine particulate air pollution on emergency room visits forcardiac arrhythmias: a case-crossover study in Taipei. J. Toxicol.Environ. Health A., 2013; 76: 614-623
    Google Scholar
  • 7. Chlebus K., Gąsior M., Gierlotka M., Kalarus Z., KoziarkiewiczA., Opolski G., Poloński L., Rabczenko D., Stokwiszewski J.,Wojtyniak B., Wysocki M., Zdrojewski T.: Raport: Występowanie,leczenie i prewencja wtórna zawałów serca w Polsce. Ocena napodstawie Narodowej Bazy Danych Zawałów Serca AMI-PL 2009- 2012 Narodowy Instytut Zdrowia Publicznego – PZH. Warszawa,Zabrze, Gdańsk 2014
    Google Scholar
  • 8. European Environment Agency.: Air quality In Europe – 2014report. Luxembourg: Publications Office of the European Union;2014: 8-13
    Google Scholar
  • 9. Hoffman B., Weinmayr G., Hennig F., Fuks K., Moebus S., WeimarC., Dragano N., Hermann D.M., Kälsch H., Mahabadi A.A.,Erbel R., Jöckel K.H.: Air quality, stroke, and coronary events:results of the Heinz Nixdorf Recall Study from the Ruhr Region.Dtsch. Arztebl. Int., 2015; 112: 195-201
    Google Scholar
  • 10. Huang Y.C., Rappold A.G., Graff D.W., Ghio A.J., Devlin R.B.:Synergistic effects of exposure to concentrated ambient finepollution particles and nitrogen dioxide in humans. Inhal. Toxicol.,2012; 24: 790-797
    Google Scholar
  • 11. Kowalska M.: Wpływ krótkoterminowych zmian stężeń drobnegopyłu zawartego w powietrzu atmosferycznym na dobowąumieralność i chorobowość z przyczyn krążeniowo-oddechowychw populacji mieszkańców aglomeracji miejsko-przemysłowej(aglomeracja katowicka): rozprawa habilitacyjna. ŚUM,Katowice 2011
    Google Scholar
  • 12. Kowalska M., Kowalski M.: Wpływ zanieczyszczeń powietrzana zdrowie, Podręcznik nauczyciela tom II. Zespół Wydawnictwi Usług Poligraficznych Głównego Instytutu Górniczego. Katowice2014
    Google Scholar
  • 13. Liao D., Shaffer M.L., He F., Rodriguez-Colon S., Wu R., WhitselEA., Bixler EO., Cascio WE.: Fine particulate air pollution is associatedwith higher vulnerability to atrial fibrillation – the APACRstudy. J. Toxicol. Environ. Health A, 2011; 74: 693-705
    Google Scholar
  • 14. Liao D., Shaffer M.L., Rodriguez-Colon S., He F., Li X., WolbretteD.L., Yanosky J., Cascio W.E.: Acute adverse effects of fine particulate air pollution on ventricular repolarization. Environ.Health Perspect., 2010; 118: 1010-1015
    Google Scholar
  • 15. Link M.S., Dockery D.W.: Air pollution and the triggering ofcardiac arrhythmias. Curr. Opin. Cardiol., 2010; 25: 16-22
    Google Scholar
  • 16. Link M.S., Luttmann-Gibson H., Schwartz J., Mittleman M.A.,Wessler B., Gold D.R., Dockery D.W., Laden F.: Acute exposureto air pollution triggers atrial fibrillation. J. Am. Coll. Cardiol.,2013; 62: 816-825
    Google Scholar
  • 17. Ljungman P.L., Berglind N., Holmgren C., Gadler F., EdvardssonN., Pershagen G., Rosenqvist M., Sjögren B., Bellander T.:Rapid effects of air pollution on ventricular arrhythmias. Eur.Heart J., 2008; 29: 2894-2901
    Google Scholar
  • 18. Metzger K.B., Klein M., Flanders W.D., Peel J.L., MulhollandJ.A., Langberg J.J., Tolbert P.E.: Ambient air pollution and cardiacarrhythmias in patients with implantable defibrillators. Epidemiology,2007; 18: 585-592
    Google Scholar
  • 19. Milojevic A., Wilkinson P., Armstrong B., Bhaskaran K., SmeethL., Hajat S.: Short-term effects of air pollution on a range ofcardiovascular events in England and Wales: case-crossover analysisof the MINAP database, hospital admissions and mortality.Heart, 2014; 100: 1093-1098
    Google Scholar
  • 20. O’Donnell M.J., Fang J., Mittleman M.A., Kapral M.K., WelleniusG.A.: Fine particulate air pollution (PM2.5) and the risk ofacute ischemic stroke. Epidemiology, 2011; 22: 422-431
    Google Scholar
  • 21. Pope C.A. 3rd., Dockery D.W.: Health effects of fine particulateair pollution: lines that connect. J. Air. Waste Manag. Assoc.,2006; 56: 709-742
    Google Scholar
  • 22. Santos U.P., Terra-Filho M., Lin C.A., Pereira L.A., Vieira T.C.,Saldiva P.H., Braga A.L.: Cardiac arrhythmia emergency room visitsand environmental air pollution in Sao Paulo, Brazil. J. Epidemiol.Community Health., 2008; 62: 267-272
    Google Scholar
  • 23. Schneider A., Neas L.M., Graff D.W., Herbst M.C., Cascio W.E.,Schmitt M.T., Buse J.B., Peters A., Devlin R.B.: Association of cardiacand vascular changes with ambient PM2.5 in diabetic individuals.Part. Fibre. Toxicol., 2010; 7: 14
    Google Scholar
  • 24. Shah A.S., Lee K.K., McAllister DA., Hunter A., Nair H., WhiteleyW., Langrish J.P., Newby D.E., Mills N.L.: Short term exposureto air pollution and stroke: systematic review and meta-analysis.BMJ, 2015; 350: h1295
    Google Scholar
  • 25. Valavanidis A., Fiotakis K., Vlachogianni T.: Airborne particulatematter and human health: toxicological assessment andimportance of size and composition of particles for oxidativedamage and carcinogenic mechanisms. J. Environ. Sci. Health C.Environ. Carcinog. Ecotoxicol. Rev., 2008; 26: 339-362
    Google Scholar
  • 26. Van Hee V.C., Szpiro A.A., Prineas R., Neyer J., Watson K., SiscovickD., Kyun Park S., Kaufman J.D.: Association of long-termair pollution with ventricular conduction and repolarization abnormalities.Epidemiology, 2011; 22: 773-780
    Google Scholar
  • 27. Wellenius G.A., Boyle L.D., Wilker E.H., Sorond F.A., Coull B.A.,Koutrakis P., Mittleman M.A., Lipsitz L.A.: Ambient fine particulatematter alters cerebral hemodynamics in the elderly. Stroke,2013; 44: 1532-1536
    Google Scholar
  • 28. Wojtyniak B., Goryński P., Moskalewicz B.: Sytuacja zdrowotnaludności Polski i jej uwarunkowania. Raport NarodowegoInstytutu Zdrowia Publicznego – PZH. Warszawa 2012: 149-150
    Google Scholar
  • 29. Yang W.S., Wang X., Deng Q., Fan W.Y., Wang W.Y.: An evidence-basedappraisal of global association between air pollution andrisk of stroke. Int. J. Cardiol., 2014; 175: 307-313
    Google Scholar
  • 30. Yitshak Sade M., Novack V., Ifergane G., Horev A., Kloog I.:Air pollution and ischemic stroke among young adults. Stroke, 2015; 46: 3348-3353
    Google Scholar
  • 31. Yu X.B., Su J.W., Li X.Y., Chen G.: Short-term effects of particulatematter on stroke attack: meta-regression and meta- analyses.PLoS One, 2014; 9: e95682
    Google Scholar
  • 32. Zanobetti A., Coull B.A., Gryparis A., Kloog I., Sparrow D.,Vokonas P.S., Wright R.O., Gold D.R., Schwartz J.: Associationsbetween arrhythmia episodes and temporally and spatially resolvedblack carbon and particulate matter in elderly patients.Occup. Environ. Med., 2014; 71: 201-207
    Google Scholar
  • 33. Zhang Z.M., Whitsel E.A., Quibrera P.M., Smith R.L., Liao D.,Anderson G.L., Prineas R.J.: Ambient fine particulate matter exposureand myocardial ischemia in the Environmental Epidemiologyof Arrhythmogenesis in the Women’s Health Initiative (EEAWHI)study. Environ. Health Perspect., 2009; 117: 751-756
    Google Scholar
  • 34. Zhao A., Chen R., Kuang X., Kan H.: Ambient air pollutionand daily outpatient visits for cardiac arrhythmia in Shanghai,China. J. Epidemiol., 2014; 24: 321-326
    Google Scholar

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