Abstract
Background: Particulate air pollution has been associated with increased cardiovascular deaths and hospital admissions. To help understand the mechanisms, the types of particles most involved, and the types of persons most susceptible, the association between exposure to summertime air pollution and heart rate variability (HRV) was examined in a panel study of 28 elderly subjects.
Methods: Subjects were seen once a week for up to 12 weeks and HRV (SDNN, r-MSSD, PNN50, low frequency/high frequency ratio (LFHFR)) was measured for approximately 30 minutes at each session using a defined protocol. Temperature, day of the week, and hour of the day were controlled, and dummy variables for each subject were controlled for subject specific risk factors.
Results: PM2.5 was associated with r-MSSD (–10.1% change for an interquartile range (IQR) increase in exposure (95% CI –2.8 to –16.9)) and PNN50, but stronger associations were seen with black carbon, an indicator of traffic particles, which was also associated with SDNN (–4.6% per IQR (95% CI –2.0 to –7.2)) and LFHFR. Secondary particles were more weakly associated with r-MSSD, as was ozone. No associations were seen with SO2 or NO2. CO had similar patterns of association to black carbon, which disappeared after controlling for black carbon. Black carbon had a substantially higher effect on SDNN in subjects who had had a previous myocardial infarction (–12.7%, 95% CI –5.7 to –19.25).
Conclusions: Particles, especially from traffic, are associated with disturbances of autonomic control of the heart.
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Selected References
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- Bettoni Marco, Zimmermann Marc. Autonomic tone variations before the onset of paroxysmal atrial fibrillation. Circulation. 2002 Jun 11;105(23):2753–2759. doi: 10.1161/01.cir.0000018443.44005.d8. [DOI] [PubMed] [Google Scholar]
- Braga A. L., Zanobetti A., Schwartz J. The lag structure between particulate air pollution and respiratory and cardiovascular deaths in 10 US cities. J Occup Environ Med. 2001 Nov;43(11):927–933. doi: 10.1097/00043764-200111000-00001. [DOI] [PubMed] [Google Scholar]
- Bremner S. A., Anderson H. R., Atkinson R. W., McMichael A. J., Strachan D. P., Bland J. M., Bower J. S. Short-term associations between outdoor air pollution and mortality in London 1992-4. Occup Environ Med. 1999 Apr;56(4):237–244. doi: 10.1136/oem.56.4.237. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Godleski J. J., Verrier R. L., Koutrakis P., Catalano P., Coull B., Reinisch U., Lovett E. G., Lawrence J., Murthy G. G., Wolfson J. M. Mechanisms of morbidity and mortality from exposure to ambient air particles. Res Rep Health Eff Inst. 2000 Feb;(91):5–103. [PubMed] [Google Scholar]
- Gold D. R., Litonjua A., Schwartz J., Lovett E., Larson A., Nearing B., Allen G., Verrier M., Cherry R., Verrier R. Ambient pollution and heart rate variability. Circulation. 2000 Mar 21;101(11):1267–1273. doi: 10.1161/01.cir.101.11.1267. [DOI] [PubMed] [Google Scholar]
- Janssen N. A., de Hartog J. J., Hoek G., Brunekreef B., Lanki T., Timonen K. L., Pekkanen J. Personal exposure to fine particulate matter in elderly subjects: relation between personal, indoor, and outdoor concentrations. J Air Waste Manag Assoc. 2000 Jul;50(7):1133–1143. doi: 10.1080/10473289.2000.10464159. [DOI] [PubMed] [Google Scholar]
- Janssen Nicole A. H., Schwartz Joel, Zanobetti Antonella, Suh Helen H. Air conditioning and source-specific particles as modifiers of the effect of PM(10) on hospital admissions for heart and lung disease. Environ Health Perspect. 2002 Jan;110(1):43–49. doi: 10.1289/ehp.0211043. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Katsouyanni K., Touloumi G., Samoli E., Gryparis A., Le Tertre A., Monopolis Y., Rossi G., Zmirou D., Ballester F., Boumghar A. Confounding and effect modification in the short-term effects of ambient particles on total mortality: results from 29 European cities within the APHEA2 project. Epidemiology. 2001 Sep;12(5):521–531. doi: 10.1097/00001648-200109000-00011. [DOI] [PubMed] [Google Scholar]
- Laden F., Neas L. M., Dockery D. W., Schwartz J. Association of fine particulate matter from different sources with daily mortality in six U.S. cities. Environ Health Perspect. 2000 Oct;108(10):941–947. doi: 10.1289/ehp.00108941. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Le Gal Grégoire, Testuz Ariane, Righini Marc, Bounameaux Henri, Perrier Arnaud. Reproduction of chest pain by palpation: diagnostic accuracy in suspected pulmonary embolism. BMJ. 2005 Jan 31;330(7489):452–453. doi: 10.1136/bmj.38331.602384.8F. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Liao D., Creason J., Shy C., Williams R., Watts R., Zweidinger R. Daily variation of particulate air pollution and poor cardiac autonomic control in the elderly. Environ Health Perspect. 1999 Jul;107(7):521–525. doi: 10.1289/ehp.99107521. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Magari S. R., Hauser R., Schwartz J., Williams P. L., Smith T. J., Christiani D. C. Association of heart rate variability with occupational and environmental exposure to particulate air pollution. Circulation. 2001 Aug 28;104(9):986–991. doi: 10.1161/hc3401.095038. [DOI] [PubMed] [Google Scholar]
- Magari Shannon R., Schwartz Joel, Williams Paige L., Hauser Russ, Smith Thomas J., Christiani David C. The association between personal measurements of environmental exposure to particulates and heart rate variability. Epidemiology. 2002 May;13(3):305–310. doi: 10.1097/00001648-200205000-00011. [DOI] [PubMed] [Google Scholar]
- Odemuyiwa O., Malik M., Farrell T., Bashir Y., Poloniecki J., Camm J. Comparison of the predictive characteristics of heart rate variability index and left ventricular ejection fraction for all-cause mortality, arrhythmic events and sudden death after acute myocardial infarction. Am J Cardiol. 1991 Aug 15;68(5):434–439. doi: 10.1016/0002-9149(91)90774-f. [DOI] [PubMed] [Google Scholar]
- Oglesby L., Künzli N., Rösli M., Braun-Fahrländer C., Mathys P., Stern W., Jantunen M., Kousa A. Validity of ambient levels of fine particles as surrogate for personal exposure to outdoor air pollution--results of the European EXPOLIS-EAS Study (Swiss Center Basel). J Air Waste Manag Assoc. 2000 Jul;50(7):1251–1261. doi: 10.1080/10473289.2000.10464156. [DOI] [PubMed] [Google Scholar]
- Pope C. A., 3rd, Verrier R. L., Lovett E. G., Larson A. C., Raizenne M. E., Kanner R. E., Schwartz J., Villegas G. M., Gold D. R., Dockery D. W. Heart rate variability associated with particulate air pollution. Am Heart J. 1999 Nov;138(5 Pt 1):890–899. doi: 10.1016/s0002-8703(99)70014-1. [DOI] [PubMed] [Google Scholar]
- Sarnat J. A., Koutrakis P., Suh H. H. Assessing the relationship between personal particulate and gaseous exposures of senior citizens living in Baltimore, MD. J Air Waste Manag Assoc. 2000 Jul;50(7):1184–1198. doi: 10.1080/10473289.2000.10464165. [DOI] [PubMed] [Google Scholar]
- Sarnat J. A., Schwartz J., Catalano P. J., Suh H. H. Gaseous pollutants in particulate matter epidemiology: confounders or surrogates? Environ Health Perspect. 2001 Oct;109(10):1053–1061. doi: 10.1289/ehp.011091053. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schwartz J. Assessing confounding, effect modification, and thresholds in the association between ambient particles and daily deaths. Environ Health Perspect. 2000 Jun;108(6):563–568. doi: 10.1289/ehp.00108563. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schwartz J. What are people dying of on high air pollution days? Environ Res. 1994 Jan;64(1):26–35. doi: 10.1006/enrs.1994.1004. [DOI] [PubMed] [Google Scholar]
- Selman David. Scopolamine? J Am Coll Cardiol. 2002 Feb 20;39(4):744–745. [PubMed] [Google Scholar]
- Tsuji H., Larson M. G., Venditti F. J., Jr, Manders E. S., Evans J. C., Feldman C. L., Levy D. Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation. 1996 Dec 1;94(11):2850–2855. doi: 10.1161/01.cir.94.11.2850. [DOI] [PubMed] [Google Scholar]
- Watkinson W. P., Campen M. J., Costa D. L. Cardiac arrhythmia induction after exposure to residual oil fly ash particles in a rodent model of pulmonary hypertension. Toxicol Sci. 1998 Feb;41(2):209–216. doi: 10.1006/toxs.1997.2406. [DOI] [PubMed] [Google Scholar]
- Zanobetti A., Schwartz J., Gold D. Are there sensitive subgroups for the effects of airborne particles? Environ Health Perspect. 2000 Sep;108(9):841–845. doi: 10.1289/ehp.00108841. [DOI] [PMC free article] [PubMed] [Google Scholar]