Ambient Air Pollution and Cardiovascular Emergency Department Visits in Potentially Sensitive Groups

Abstract

Limited evidence suggests that persons with conditions such as diabetes, hypertension, congestive heart failure, and respiratory conditions may be at increased risk of adverse cardiovascular morbidity and mortality associated with ambient air pollution. The authors collected data on over 4 million emergency department visits from 31 hospitals in Atlanta, Georgia, between January 1993 and August 2000. Visits for cardiovascular disease were examined in relation to levels of ambient pollutants by use of a case-crossover framework. Heterogeneity of risk was examined for several comorbid conditions. The results included evidence of stronger associations of dysrhythmia and congestive heart failure visits with comorbid hypertension in relation to increased air pollution levels compared with visits without comorbid hypertension; similar evidence of effect modification by diabetes and chronic obstructive pulmonary disease (COPD) was observed for dysrhythmia and peripheral and cerebrovascular disease visits, respectively. Evidence of effect modification by comorbid hypertension and diabetes was observed in relation to particulate matter less than 10 microm in aerodynamic diameter, nitrogen dioxide, and carbon monoxide, while evidence of effect modification by comorbid COPD was also observed in response to ozone levels. These findings provide further evidence of increased susceptibility to adverse cardiovascular events associated with ambient air pollution among persons with hypertension, diabetes, and COPD.

10.4172/2155-9880.1000255

“…Mechanisms proposed to explain associations between air pollution and cardiovascular disease, specifically, inflammation, oxidative stress, and endothelial dysfunction, are plausible mechanisms linking air pollution with the development or exacerbation of diabetic conditions. Several studies have been indicate that type 2 diabetes subjects present a greater inflammatory response to PM 2.5 exposure [29][30][31][32], but what is not known is whether diabetes is in itself an adverse outcome of air pollution [33].…”

Air Pollution and Cardiovascular Diseases

“…In this setting, sulfur dioxide levels were also noted to affect blood pressure, validating the importance of gaseous co-pollutants 44 . Intriguingly, a large volume of data also suggests that the deleterious effects of particulate air pollution can be aggravated by the presence of cofactors such as diabetes, obesity, hypertension, chronic pulmonary disease, and previous cardiovascular disease, as well as an additive effect of advancing age 45,46 .…”

Heated submicron particle fluxes using an optical particle counter in urban environment

“…Several studies have attempted to link particle toxicity with aerosol physical and/or chemical characteristics such as particle size, number concentration and chemical composition. One chemical constituent being studied closely in this regard is BC (e.g., Mar et al, 2000;Peel et al, 2007), particularly given that high concentrations of BC have been measured in urban areas (Suglia et al, 2008;Krecl et al, 2011). Chemical analysis of measurements taken in urban areas suggests that BC contributes 5-10 % to PM 2.5 (Putaud et al, 2004).…”