AHA Scientific Statement

Air Pollution and Cardiovascular Disease

A Statement for Healthcare Professionals From the Expert Panel on Population and Prevention Science of the American Heart Association

Epidemiological studies have demonstrated a consistent increased risk for cardiovascular events in relation to both short- and long-term exposure to present-day concentrations of ambient particulate matter. Several plausible mechanistic pathways have been described, including enhanced coagulation/thrombosis, a propensity for arrhythmias, acute arterial vasoconstriction, systemic inflammatory responses, and the chronic promotion of atherosclerosis…

…Over the last decade, however, a growing body of epidemiological and clinical evidence has led to a heightened concern about the potential deleterious effects of ambient air pollution on health and its relation to heart disease and stroke….

…The most recent analysis of the National Mortality and Morbidity Air Pollution Study (NMMAPS), based on data from 90 of the largest cities in the United States, estimated that daily total and cardiopulmonary mortality increased in the short term by 0.21% (±0.06 standard error [SE]) and 0.31% (±0.09 SE), respectively, for each 10-μg/m³ increase in PM₁₀ (measured over a 24-hour period)  American Heart Association Journal

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Health Effects of Fine Particulate Air
Pollution: Lines that Connect
Journal of Air and Waste Management Association

There has also been emerging evidence of PM-related cardiovascular health effects and growing knowledge regarding interconnected general pathophysiological pathways that link PM exposure with cardiopulmonary morbidity and mortality.

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J. bras. pneumol. vol.30 no.2 São Paulo Mar./Apr. 2004
Biomass burning and its effects on health

The first thought that comes to mind concerning air pollution is related to urban centers where automotive exhausts and the industrial chimneys are the most important sources of atmospheric pollutants. However a significant portion of the earth’s population is exposed to still another source of air pollution, the burning of biomass that primarily affects developing countries. This review article calls the attention of lung specialists, public authorities and the community in general to the health risks entailed in the burning of biomass, be it indoors or outdoors to which the population is exposed. This review describes the main conditions that lead to the burning of biomass and how the literature has recorded its effects on human health discussing the psychopathological mechanisms. Finally two recent studies are presented that emphasize an important type of biomass burning that of the sugar cane straw. This is a common practice in several regions of Brazil changing the respiratory morbidity standards of the population exposed…

Among such elements, the most toxic pollutant and the one that has been studied the most is the particulate matter resulting from biomass burning, either from indoor or outdoor combustion. It is mostly (94%) made of fine and ultrafine particles (Figure 1), in other words, particles that are able to reach deep into the respiratory system, passing through the epithelial barrier, reaching the interstitial lung and triggering an inflammatory process (11-13) (Figure 2). Shi et al (14) infer that the adverse effects of the particulate matter to one’s health may be a result of the production of intracellular oxidizing agents; henceforth, being the first response and acting as the inflammation’s stimulating factor, as it is shown on Figure 3.

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Fine Particulate Air Pollution and Hospital Admission for Cardiovascular and Respiratory Diseases

Journal of the American Medical Association

Results There was a short-term increase in hospital admission rates associated with
PM2.5 for all of the health outcomes except injuries. The largest association was for
heart failure, which had a 1.28% (95% confidence interval, 0.78%-1.78%) increase
in risk per 10-μg/m3 increase in same-day PM2.5. Cardiovascular risks tended to be
higher in counties located in the Eastern region of the United States, which included
the Northeast, the Southeast, the Midwest, and the South.

Conclusion Short-term exposure to PM2.5 increases the risk for hospital admission
for cardiovascular and respiratory diseases.

[note: PM = particulate matter (like soot) and the number following it is the size of the particles in microns]

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Long-term exposure to air pollution and incidence of cardiovascular events in women.

BACKGROUND: