Air pollution and emergency department visits for chest pain and weakness in Edmonton, Canada

In cold temperatures, vehicles idle more, have high cold-start emissions including greenhouse gases, and have less effective exhaust filtration systems, which can cause up to ten-fold more harmful vehicular emissions. Only a few vehicle technologies have been tested for emissions below −7 °C (20 °F). Four-hundred-million people living in cities with sub-zero temperatures may be impacted. We conducted a scoping review to identify the existing knowledge about air-pollution-related health outcomes in a cold climate, and pinpoint any research gaps. Of 1019 papers identified, 76 were selected for review. The papers described short-term health impacts associated with air pollutants. However, most papers removed the possible direct effect of temperature on pollution and health by adjusting for temperature. Only eight papers formally explored the modifying effect of temperatures. Five studies identified how extreme cold and warm temperatures aggravated mortality/morbidity associated with ozone, particles, and carbon-monoxide. The other three found no health associations with tested pollutants and temperature. Additionally, in most papers, emissions could not be attributed solely to traffic. In conclusion, evidence on the relationship between cold temperatures, traffic-related pollution, and related health outcomes is lacking. Therefore, targeted research is required to guide vehicle regulations, assess extreme weather-related risks in the context of climate change, and inform public health interventions.

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“…(b) Nine papers identified associations of pollution and health in both cold and warm seasons/temperatures [68][69][70][71][72][73][74][75][76];…”

Section: Temperature/season Impact On Air Pollution and Health Outcomesmentioning

confidence: 99%

“…(a) Twelve papers identified that the association between pollution and health outcomes was more robust in the cold seasons/temperatures [56][57][58][59][60][61][62][63][64][65][66][67]; (b) Nine papers identified associations of pollution and health in both cold and warm seasons/temperatures [68][69][70][71][72][73][74][75][76];…”

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confidence: 99%

Cold Climate Impact on Air-Pollution-Related Health Outcomes: A Scoping Review

Wine

Osornio-Vargas

Campbell

et al. 2022

IJERPH

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“…In studies with short-term exposure to air pollution, the shortest lag (often lag 0) is most frequently used and focused. Thus, if more than one lag estimate was presented [15,[17][18][19][27][28][29] , the shortest lag in the study was selected to calculate the pooled OR [24,30] . The study that only provided cumulative lag (lag 0-5) was also used to determine overall risk estimates [31] .…”

Section: Data Synthesis and Statistical Analysismentioning

confidence: 99%

Association of ambient air pollution and cardiovascular symptoms: a systematic review and meta-analysis

Zhou

Liu

et al. 2023

Cardiology Plus

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Background and purpose: Cardiovascular disease is the leading cause of disease burden globally. Previous studies have suggested that air pollution is a risk factor for cardiovascular symptoms, however, the results are controversial. Thus, we conducted this study to systematically review available evidence quantifying the relationship between exposure to ambient gaseous and particulate air pollutants and cardiovascular symptoms. Methods: Three databases were searched up to September 10, 2022, for articles investigating the association of air pollutants including sulfur dioxide, nitrogen dioxide, ozone, carbon monoxide, and particulate matter with aerodynamic diameters of ≤10 μm and ≤2.5 μm (PM10 and PM2.5) with cardiovascular symptoms of chest pain, shortness of breath, respiratory distress, and palpitation. Random-effects model was used to calculate the pooled odds ratio (OR) and 95% confidence interval (95% CI) for chest pain in association with PM2.5. Egger test was used to assess publication bias in the included studies. Results: Of the 16 studies that were included in the systematic review, 10 were used to calculate the pooled OR for chest pain. Most of them were from developed countries, where air pollution levels were relatively low. Short-term exposure to air pollutants may increase the risk of chest pain, with the pooled OR 1.016 (95% CI 1.003–1.030) per 10 μg/m³ increment of PM2.5. Conclusions: Air pollution is a potential risk factor for cardiovascular symptoms, especially chest pain. However, most current studies are conducted in low-pollution regions. More studies from high-pollution regions are needed to confirm the role of ambient air pollution in cardiovascular symptoms and reveal the underlying health effects.

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“…Experiments in mice show that PM2.5 can induce insulin resistance and increased visceral adiposity, both risk factors for type 2 diabetes and hence atherosclerosis [30]. Short‐term acute exposure to particulate matter also increased cardiac complications [31–33].…”

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confidence: 99%

“…Carbon monoxide (CO) is perhaps one of the most toxic chemicals for the heart, even at very low levels, as it binds with haemoglobin in the lungs to form carboxyhaemoglobin, impairing oxygen transport, inducing hypoxia and neurological problems and increasing cardiovascular mortality [44]. Similarly, nitrogen dioxide (NO 2 ), ozone (O 3 ) and/or sulphur dioxide (SO 2 ) have been associated with a variety of cardiovascular conditions [31, 32, 45, 46] and increased related mortality [47–50]. Even traffic noise can affect cardiovascular health in a dose–response relationship [51], although several studies have found that it is the annoyance from traffic noise, rather than the noise itself, which is associated with hypertension [52] and ischaemic heart disease [53].…”

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confidence: 99%