Air Pollution and Cardiovascular Disease

The 9 December 2014 issue of the European Heart Journal published an article entitled "Expert position paper on air pollution and cardiovascular disease". The paper is a consensus document on behalf of the European Society of Cardiology and is intended to raise awareness of the link between air pollution and cardiovascular disease.

The paper highlights particulate matter, ozone, nitrogen dioxide, volatile organic compounds, carbon monoxide and sulphur dioxide as the pollutants of greatest concern from a health perspective. The infiltration of outdoor pollutants into buildings results in most exposure occurring indoors.

Findings from a number of studies are described, including:

• The US Women's Health Initiative (WHI) study involving 65,000 post-menopausal women showed a 21% increased incidence of combined fatal and non-fatal coronary heart disease per 10 micrograms/m3 increase in PM2.5.
• Chronic exposure to air pollution is believed to influence the development of atherosclerosis.
• The additional inflammation resulting from exposure to air pollution may aggravate existing lung disease such as asthma.
• Air pollution affects multiple epigenetic mechanisms and because of their stability, environmentally induced changes accumulate over time and persist even in the absence of the factors that induced them.
• Air pollutants may impair insulin sensitivity and promote the development of diabetes.

The authors emphasize that awareness of outdoor pollution and its adverse health effects should not downplay the role of indoor air pollution.