Exposure to air pollution near a steel plant is associated with reduced heart rate variability: a randomised crossover study

Association of ambient ozone exposure with early cardiovascular damage among general urban adults: A repeated-measures cohort study in China

Longitudinal evidence of long-term ozone exposure on heart rate variability (HRV, an early indicator of cardiovascular damage) is lacking and the potential mechanism remains largely unclear. Our objectives were to evaluate the cross-sectional and longitudinal associations of ozone exposure with HRV alteration, and the potential roles of protein carbonyl (PC, biomarker of oxidative protein damage) and transforming growth factor (TGF)-β1 in this association. This repeated-measures prospective study included 4138 participants with 6617 observations from the Wuhan-Zhuhai cohort. Ozone concentrations were estimated using a high temporospatial resolution model for each participant. HRV indices, PC, and TGF-β1 were also repeatedly measured. Cross-sectional and longitudinal relationships of ozone exposure with HRV alteration were evaluated by linear mixed model. Cross-sectionally, the strongest lag effect of each 10 ppb increment in short-term ozone exposure showed a 12.40 %, 8.47 %, 4.31 %, 8.03 %, 3.69 %, and 2.41 % decrement on very low frequency (VLF, lag 3 weeks), LF (lag 2 weeks), high frequency (HF, lag 0-7 days), total power (TP, lag 2 weeks), standard deviation of all normal-to-normal intervals (SDNN, lag 3 weeks), and square root of the mean squared difference between adjacent normal-to-normal intervals (lag 2 weeks), respectively. Longitudinally, each 10 ppb increment of annual average ozone was related with an annual change rate of -0.024 ms2/year in VLF, -0.009 ms2/year in LF, -0.013 ms2/year in HF, -0.014 ms2/year in TP, and -0.004 ms/year in SDNN. Mediation analyses indicated that PC mediated 20.77 % and 12.18 % of ozone-associated VLF and TP decline, respectively; TGF-β1 mediated 16.87 % and 27.78 % of ozone-associated VLF and SDNN reduction, respectively. Our study demonstrated that ozone exposure was cross-sectionally and longitudinally related with HRV decline in general Chinese urban adults, and oxidative protein damage and increased TGF-β1 partly mediated ozone exposure-related HRV reduction.

Short- and medium-term cumulative effects of traffic-related air pollution on resting heart rate in the elderly: A wearable device study

BACKGROUND

Epidemiological evidence regarding the association between air pollution and resting heart rate (RHR), a predictor of cardiovascular disease and mortality, is limited and inconsistent.

OBJECTIVES

We used wearable devices and time-series analysis to assess the exposure-response relationship over an extended lag period.

METHODS

Ninety-seven elderly individuals (>65 years) from the Taipei Basin participated from May to November 2020 and wore Garmin® smartwatches continuously until the end of 2021 for heart rate monitoring. RHR was defined as the daily average of the lowest 30-min heart rate. Air pollution exposure data, covering lag periods from 0 to 60 days, were obtained from nearby monitoring stations. We used distributed lag non-linear models and linear mixed-effect models to assess cumulative effects of air pollution. Principal component analysis was utilized to explore underlying patterns in air pollution exposure, and subgroup analyses with interaction terms were conducted to explore the modification effects of individual factors.

RESULTS

After adjusting for co-pollutants in the models, an interquartile range increase of 0.18 ppm in carbon monoxide (CO) was consistently associated with increased RHR across lag periods of 0-1 day (0.31, 95 % confidence interval [CI]: 0.24-0.38), 0-7 days (0.68, 95 % CI: 0.57-0.79), and 0-50 days (1.02, 95 % CI: 0.82-1.21). Principal component analysis identified two factors, one primarily influenced by CO and nitrogen dioxide (NO2), indicative of traffic sources. Increases in the varimax-rotated traffic-related score were correlated with higher RHR over 0-1 day (0.36, 95 % CI: 0.25-0.47), 0-7 days (0.62, 95 % CI: 0.46-0.77), and 0-50 days (1.27, 95 % CI: 0.87-1.67) lag periods. Over a 0-7 day lag, RHR responses to traffic pollution were intensified by higher temperatures (β = 0.80 vs. 0.29; interaction p-value [P_int] = 0.011). Males (β = 0.66 vs. 0.60; P_int < 0.0001), hypertensive individuals (β = 0.85 vs. 0.45; P_int = 0.028), diabetics (β = 0.96 vs. 0.52; P_int = 0.042), and those with lower physical activity (β = 0.70 vs. 0.54; P_int < 0.0001) also exhibited stronger responses. Over a 0-50 day lag, males (β = 0.99 vs. 0.96; P_int < 0.0001), diabetics (β = 1.66 vs. 0.69; P_int < 0.0001), individuals with lower physical activity (β = 1.49 vs. 0.47; P_int = 0.0006), and those with fewer steps on lag day 1 (β = 1.17 vs. 0.71; P_int = 0.029) showed amplified responses.

CONCLUSIONS

Prolonged exposure to traffic-related air pollution results in cumulative cardiovascular risks, persisting for up to 50 days. These effects are more pronounced on warmer days and in individuals with chronic conditions or inactive lifestyles.

A comparative study on the effectiveness of pollutants control measures adopted in the steel industry to reduce workplace and environmental exposure: a case study

Our understanding of the environmental and occupational health implications of pollutants emitted in steel production is still lacking, despite the considerable amount of research devoted to this topic. Given the significance of steel recycling and the need to reduce greenhouse gas emissions, many steel factories are adopting electric arc furnace (EAF) technology. The use of a technological system designed for the capture of pollutants emitted through EAF steel production is highly ecological because of its utilization of iron scrap and low investment cost. Despite this, the main issue with the EAF is the environmental impact it poses, specifically the release of pollutants into the air, such as dust and organic substances, chlorinated dioxins and furans, dioxin-like polychlorinated biphenyls and brominated dioxins and furans. As a result, workers in this field have a considerable rate of morbidity. The main challenge for EAFs is to optimize the capture of powders produced during the techno-logical process, both from the EAF and the workplace. A state-of-the art solution for managing pollutants in modern steel manufacturing is highlighted in this paper, featuring a method used in Romania that employs the Best Available Techniques (BAT) reference document for iron and steel production to directly collect pollutants from the EAF. The system included a cylindrical fitting, a heat exchanger to cool the gases and a hood to collect contaminants. In comparison to other ventilation options, this equipment boasts lower investment and lower operational costs because of its effective and minimal air flow. Through the use of cutting-edge technology and progressive strategies, we can move closer toward our objective of a workplace free from injuries in the steel industry.

Randomized Cross-Over Study of In-Vehicle Cabin Air Filtration, Air Pollution Exposure, and Acute Changes to Heart Rate Variability, Saliva Cortisol, and Cognitive Function

To determine how traffic-related air pollution (TRAP) exposures affect commuter health, and whether cabin air filtration (CAF) can mitigate exposures, we conducted a cross-over study of 48 adults exposed to TRAP during two commutes with and without CAF. Measurements included particulate air pollutants (PM_2.5, black carbon [BC], ultrafine particles [UFPs]), volatile organic compounds, and nitrogen dioxide. We measured participants' heart rate variability (HRV), saliva cortisol, and cognitive function. On average, CAF reduced concentrations of UFPs by 26,232 (95%CI: 11,734, 40,730) n/cm³, PM_2.5 by 6 (95%CI: 5, 8) μg/m³, and BC by 1348 (95%CI: 1042, 1654) ng/m³, or 28, 30, and 32%, respectively. Each IQR increase in PM_2.5 was associated with a 28% (95%CI: 2, 60) increase in high-frequency power HRV at the end of the commute and a 22% (95%CI: 7, 39) increase 45 min afterward. IQR increases in UFPs were associated with increased saliva cortisol in women during the commute (18% [95%CI: 0, 40]). IQR increases in UFPs were associated with strong switching costs (19% [95%CI: 2, 39]), indicating a reduced capacity for multitasking, and PM_2.5 was associated with increased reaction latency, indicating slower responses (5% [95%CI: 1, 10]). CAF can reduce particulate exposures by almost a third.

Short-term effects of ultrafine particles on heart rate variability: A systematic review and meta-analysis

An increasing number of epidemiological studies have examined the association between ultrafine particles (UFP) and imbalanced autonomic control of the heart, a potential mechanism linking particulate matter air pollution to cardiovascular disease. This study systematically reviews and meta-analyzes studies on short-term effects of UFP on autonomic function, as assessed by heart rate variability (HRV). We searched PubMed and Web of Science for articles published until June 30, 2022. We extracted quantitative measures of UFP effects on HRV with a maximum lag of 15 days from single-pollutant models. We assessed the risk of bias in the included studies regarding confounding, selection bias, exposure assessment, outcome measurement, missing data, and selective reporting. Random-effects models were applied to synthesize effect estimates on HRV of various time courses. Twelve studies with altogether 1,337 subjects were included in the meta-analysis. For an increase of 10,000 particles/cm³ in UFP assessed by central outdoor measurements, our meta-analysis showed immediate decreases in the standard deviation of the normal-to-normal intervals (SDNN) by 4.0% [95% confidence interval (CI): 7.1%, -0.9%] and root mean square of successive R-R interval differences (RMSSD) by 4.7% (95% CI: 9.1%, 0.0%) within 6 h after exposure. The immediate decreases in SDNN and RMSSD associated with UFP assessed by personal measurements were smaller and borderline significant. Elevated UFP were also associated with decreases in SDNN, low-frequency power, and the ratio of low-frequency to high-frequency power when pooling estimates of lags across hours to days. We did not find associations between HRV and concurrent-day UFP exposure (daily average of at least 18 h) or exposure at lags ≥ one day. Our study indicates that short-term exposure to ambient UFP is associated with decreased HRV, predominantly as an immediate response within hours. This finding highlights that UFP may contribute to the onset of cardiovascular events through autonomic dysregulation.

Association between Short-Term Exposure to Ozone and Heart Rate Variability: A Systematic Review and Meta-Analysis

At present, ambient air pollution poses a significant threat to patients with cardiovascular disease (CVD). The heart rate variability (HRV) is a marker of the cardiac autonomic nervous system, and it is related to air pollution and cardiovascular disease. There is, however, considerable disagreement in the literature regarding the association between ozone (O₃) and HRV. To further investigate the effects of short-term exposure to O₃ on HRV, we conducted the first meta-analysis of relevant studies. The percentage change of HRV indicator(s) is the effect estimate extracted for the quantitative analysis in this study. In our meta-analysis, per 10 ppb increase in O₃ was significantly associated with decreases in the time-domain measurements, for standard deviation of the normal-to-normal (NN) interval (SDNN) -1.11% (95%CI: -1.35%, -0.87%) and for root mean square of successive differences (RMSSD) -3.26% (95%CI: -5.42%, -1.09%); in the frequency-domain measurements, for high frequency (HF) -3.01% (95%CI: -4.66%, -1.35%) and for low frequency (LF) -2.14% (95%CI: -3.83%, -0.45%). This study showed short-term exposure to O₃ was associated with reduced HRV indicators in adults, which suggested that the cardiac autonomic nervous system might be affected after O₃ exposure, contributing to the association between O₃ exposure and CVD risk.

Acute cardiovascular effects of inhaled ambient particulate matter: Chemical composition-related oxidative stress, endothelin-1, blood pressure, and ST-segment changes in Wistar rats

Short-term increases in particulate matter (PM) are associated with heightened morbidity and mortality from cardiovascular causes. Inhalation of PM is known to increase endothelin (ET)-1 levels. Yet, less is known about particle composition-related changes at the molecular level including the endothelinergic system and relationship with cardiovascular function changes. In this work, adult Wistar male rats were exposed for 4 h by nose-only inhalation to clean air, Ottawa urban particles (EHC-93, 48 mg/m³) and water-leached (EHC-93L, 49 mg/m³) particles, to examine the effect of particle compositional changes on oxidative stress, circulating ETs, blood pressure, and heart electrophysiology. Particle deposition in the respiratory compartment was estimated at 85 μg (25 ng/cm²). Lung cell proliferation was low in both treatment groups, indicating absence of acute injury. Inhalation of EHC-93 caused statistically significant elevations (p < 0.05) of oxidative stress markers, ET-1, ET-3, blood pressure, and a decrease of ST-segment duration in the ECG at 1.5 days post-exposure. Leached particles (EHC-93L) caused rapid but transient elevation (p < 0.05) of oxidative stress, ET-1, ET-2, and ET-3 at earlier time points, with no changes in blood pressure or ST-segment. These results demonstrate that inhalation of urban particles at an internal dose inadequate to cause acute lung injury can induce oxidative stress, enhance vasoactive endothelins, leading to vasopressor response, affecting cardiac electrophysiology in Wistar rats, consistent with the cardiovascular impacts of ambient particles in human populations. Change in particle potency after removal of soluble species, notably cadmium, zinc and polar organics suggests that the toxicodynamics of cardiovascular effects can be modified by physicochemical properties of particles.

Air Pollution Role as Risk Factor of Cardioinhibitory Carotid Hypersensitivity

Little is known about the impact of air pollution on neuroautonomic system. The authors have investigated possible influence of air pollution and outdoor temperature on the carotid sinus hypersensitivity (CSH), as main cause of neurally mediated syncope in forty-years-old subjects and older. Pollutants’ concentrations and outdoor temperature of days in which 179 subjects with recurrent syncope underwent carotid sinus massage (CSM) were analyzed. Before this manoeuvre, cardiovascular control by short period heart and blood pressure spectral duration of segment between the end of P and R ECG-waves (PeR) were registred; RR variability on the same short period ECG recordings and their spectral coherence were also analyzed. CSH was found in 57 patients (28 with cardioinhibitory response and 29 subjects showed vasodepressor reaction), while 122 subjects had a normal response. CSM performed during high ozone concentrations was associated with slightly higher risk of cardioinhibitory response (odd ratio 1.012, 95% CI 1.001–1.023, p < 0.05), but neither this or other polluting agent nor outdoor temperature seemed to influence autonomic control in basal resting condition. Thus, ozone seemed to influence response to the CSM in CSH patients and it is probably able to facilitate a cardioinhibitory response, perhaps through an increase of nerve acetylcholine release. P→PR coherence could be useful in predicting a sinus cardioinhibitory hypersensitivity in those cases when CSM is contraindicated.

Impact of a pollution breach at a coke oven factory on asthma control in nearby vulnerable adults

BACKGROUND

Previous studies have related sulfur dioxide (SO₂) exposure to asthma exacerbations. We utilized the University of Pittsburgh Asthma Institute registry to study associations of asthma exacerbations between 2 geographically distinct populations of adults with asthma.

OBJECTIVE

Our objective was to examine whether asthma symptoms worsened following a significant fire event that destroyed pollution control equipment at the largest coke works in the United States.

METHODS

Two groups of patients with asthma, namely, those residing within 10 miles of the coke works fire (the proximal group [n = 39]) and those residing beyond that range (the control group [n = 44]), were geocoded by residential address. Concentrations of ambient air SO₂ were generated by using local University of Pittsburgh Asthma Institute registry air monitoring data. Factory emissions were also evaluated. Data from a patient historical acute exposure survey and in-person follow-up data were evaluated. Inferential statistics were used to compare the groups.

RESULTS

In the immediate postfire period (6-8 weeks), the level of emissions of SO₂ from the factory emissions increased to 25 times more than the typical level. Following the pollution control breach, the proximal cohort self-reported an increase in medication use (risk ratio = 1.76; 95% CI = 1.1-2.8; P < .01) and more exacerbations. In a small subset of the follow-up cohort of those who completed the acute exposure survey only, asthma control metrics improved.

CONCLUSIONS

Real-world exposure to a marked increase in ambient levels of SO₂ from a pollution control breach was associated with worsened asthma control in patients proximal to the event, with the worsened control improving following repair of the controls. Improved spatial resolution of air pollutant measurements would enable better examination of exposures and subsequent health impacts.

Associations between PM2.5 metal components and QT interval length in the Normative Aging Study

BACKGROUND

Several studies have found associations between increases in QT interval length, a marker of cardiac electrical instability, and short-term fine particulate matter (PM2.5) exposures. To our knowledge, this is the first study to examine the association between specific PM2.5 metal components and QT interval length.

METHODS

We measured heart-rate corrected QT interval (QTc) duration among 630 participants in the Normative Aging Study (NAS) based in Eastern Massachusetts between 2000 and 2011. We utilized time-varying linear mixed-effects regressions with a random intercept for each participant to analyze associations between QTc interval and moving averages (0-7 day moving averages) of 24-h mean concentrations of PM2.5 metal components (vanadium, nickel, copper, zinc and lead) measured at the Harvard Supersite monitoring station. Models were adjusted for daily PM2.5 mass estimated at a 1 km × 1 km grid cell from a previously validated prediction model and other covariates. Bayesian kernel machine regression (BKMR) was utilized to assess the overall joint effect of the PM2.5 metal components.

RESULTS

We found consistent results with higher lead (Pb) associated with significant higher QTc intervals for both the multi-pollutant and the two pollutant (PM2.5 mass and a PM2.5 component) models across the moving averages. The greatest effect of lead on QTc interval was detected for the 4-day moving average lead exposure. In the multi-pollutant model, each 2.72 ng/m3 increase in daily lead levels for a 4-day moving average was associated with a 7.91 ms (95% CI: 3.63, 12.18) increase in QTc interval. In the two-pollutant models with PM2.5 mass and lead, each 2.72 ng/m3 increase in daily lead levels for a 4-day moving average was associated with an 8.50 ms (95% CI: 4.59, 12.41) increase in QTc interval. We found that 4-day moving average of copper has a negative association with QTc interval when compared to the other PM2.5 metal components. In the multi-pollutant model, each 1.81 ng/m3 increase in daily copper levels for a 4-day moving average was associated with an -3.89 ms (95% CI: -6.98, -0.79) increase in QTc interval. Copper's essential function inside the human body could mediate its cardiotoxicity on cardiac conductivity and explain why we found that copper in comparison to the other metals was less harmful for QTc interval.

CONCLUSIONS

Exposure to metals contained in PM2.5 are associated with acute changes in ventricular repolarization as indicated by QT interval characteristics.

Response of the Cardiac Autonomic Control to Exposure to Nanoparticles and Noise: A Cross-Sectional Study of Airport Ground Staff

Airport activity causes the emission of particulate matter and noise, two environmental contaminants and potential health hazards, particularly for the personnel operating nearby taxiways. We explored the association between exposure to fine/ultrafine particles (UFPs) and noise with heart rate variability (HRV), an early indicator of cardiovascular autonomic response, among a sample of airport ground staff. Between May and June 2018, thirty-four male operators (mean age = 43 years and SD = 6.7) underwent personal monitoring of exposure to nanoparticles and noise, and HRV during their work activity. We conducted univariate and multivariate analysis to test the effect of UFP and noise exposure HRV. Total Lung Deposition Surface Area (LDSA) was significantly associated with a decrease in HRV Total Power and Triangular index (β = -0.038 p = 0.016 and β = -7.8 × 10-5, p = 0.042, respectively). Noise peak level showed an opposite effect, which was significant for Total Power (β = 153.03, p = 0.027), and for Triangular index (β = 0.362, p = 0.035). Further investigation is warranted to clarify the effect of the concurrent exposure to UFPs and noise on early changes of cardiac autonomic regulation.

Cardiovascular effects of air pollution: current evidence from animal and human studies

Air pollution is a global health concern. Particulate matter (PM)_2.5, a component of ambient air pollution, has been identified by the World Health Organization as one of the pollutants that poses the greatest threat to public health. Cardiovascular health effects have been extensively documented, and these effects are still being researched to provide an overview of recent literature regarding air pollution-associated cardiovascular morbidity and mortality in humans. Additionally, potential mechanisms through which air pollutants affect the cardiovascular system are discussed based on human and additional animal studies. We used the strategy of a narrative review to summarize the scientific literature of studies that were published in the past 7 yr. Searches were carried out on PubMed and Web of Science using predefined search queries. We obtained an initial set of 800 publications that were filtered to 78 publications that were relevant to include in this review. Analysis of the literature showed significant associations between air pollution, especially PM_2.5, and the risk of elevated blood pressure (BP), acute coronary syndrome, myocardial infarction (MI), cardiac arrhythmia, and heart failure (HF). Prominent mechanisms that underlie the adverse effects of air pollution include oxidative stress, systemic inflammation, endothelial dysfunction, autonomic imbalance, and thrombogenicity. The current review underscores the relevance of air pollution as a global health concern that affects cardiovascular health. More rigorous standards are needed to reduce the cardiovascular disease burden imposed by air pollution. Continued research on the health impact of air pollution is needed to provide further insight.

Regular running in an air-polluted environment: physiological and anthropometric protocol for a prospective cohort study (Healthy Aging in Industrial Environment Study - Program 4)

INTRODUCTION

Ambient air pollution is a global environmental problem, which causes adverse health effects and premature deaths worldwide. Although regular exercise and physical activity have evident health benefits, the influence of long-term air pollution exposure during regular outdoor running has not been definitively clarified.

METHODS AND ANALYSIS

This study protocol describes the physiological and anthropometric perspectives of the 'Healthy Aging in Industrial Environment' Study - Programme 4 (4HAIE). The 4HAIE research project is intended to be a single-centre, prospective, longitudinal and multidisciplinary cohort study. The presented study protocol describes the cross-sectional measurements and analyses. Overall, 1500 adult participants (age 18-65 years), runners and inactive individuals, living in a high or low air-polluted area of the Czech Republic will be recruited. We will measure and analyse biomarkers of oxidative stress and inflammation in the blood, exercise capacity (graded exercise test and spiroergometry), blood pressure, lung function (spirometry), cardiac autonomic regulation and anthropometry (body composition).

ETHICS AND DISSEMINATION

The 4HAIE study protocol has already been approved by the Ethics Committee of the University of Ostrava (3/2018). A detailed participant information sheet will be provided to each individual prior to obtaining their written informed consent. The study poses little to no risk to participants. The findings of this study will be disseminated at regional and international conferences, in peer-reviewed journals and via social and broadcast media.

Acute effect of ambient fine particulate matter on heart rate variability: an updated systematic review and meta-analysis of panel studies

Background

Decreased heart rate variability (HRV) is a predictor of autonomic system dysfunction, and is considered as a potential mechanism of increased risk of cardiovascular disease (CVD) induced by exposure to particulate matter less than 2.5 μm in diameter (PM_2.5). Previous studies have suggested that exposure to PM_2.5 may lead to decreased HRV levels, but the results remain inconsistent.

Methods

An updated systematic review and meta-analysis of panel studies till November 1, 2019 was conducted to evaluate the acute effect of exposure to ambient PM_2.5 on HRV. We searched electronic databases (PubMed, Web of Science, and Embase) to identify panel studies reporting the associations between exposure to PM_2.5 and the four indicators of HRV (standard deviation of all normal-to-normal intervals (SDNN), root mean square of successive differences in adjacent normal-to-normal intervals (rMSSD), high frequency power (HF), and low frequency power (LF)). Random-effects model was used to calculate the pooled effect estimates.

Results

A total of 33 panel studies were included in our meta-analysis, with 16 studies conducted in North America, 12 studies in Asia, and 5 studies in Europe. The pooled results showed a 10 μg/m³ increase in PM_2.5 exposure which was significantly associated with a − 0.92% change in SDNN (95% confidence intervals (95%CI) − 1.26%, − 0.59%), − 1.47% change in rMSSD (95%CI − 2.17%, − 0.77%), − 2.17% change in HF (95%CI − 3.24%, − 1.10%), and − 1.52% change in LF (95%CI − 2.50%, − 0.54%), respectively. Overall, subgroup analysis suggested that short-term exposure to PM_2.5 was associated with lower HRV levels in Asians, healthy population, and those aged ≥ 40 years.

Conclusion

Short-term exposure to PM_2.5 was associated with decreased HRV levels. Future studies are warranted to clarity the exact mechanism of exposure to PM_2.5 on the cardiovascular system through disturbance of autonomic nervous function.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12199-020-00912-2.

Biological effects of inhaled hydraulic fracturing sand dust. VI. Cardiovascular effects

Hydraulic fracturing is used to access oil and natural gas reserves. This process involves the high-pressure injection of fluid to fracture shale. Fracking fluid contains approximately 95% water, chemicals and 4.5% fracking sand. Workers may be exposed to fracking sand dust (FSD) during the manipulation of the sand, and negative health consequences could occur if FSD is inhaled. In the absence of any information about its potential toxicity, a comprehensive rat animal model study (see Fedan et al., 2020) was designed to investigate the bioactivities of several FSDs in comparison to MIN-U-SIL® 5, a respirable α-quartz reference dust used in previous animal models of silicosis, in several organ systems. The goal of this study was to assess the effects of inhalation of one FSD, i.e., FSD 8, on factors and tissues that affect cardiovascular function. Male rats were exposed to 10 or 30 mg/m³ FSD (6 h/d for 4 d) by whole body inhalation, with measurements made 1, 7 or 27 d post-exposure. One day following exposure to 10 mg/m³ FSD the sensitivity to phenylephrine-induced vasoconstriction in tail arteries in vitro was increased. FSD exposure at both doses resulted in decreases in heart rate (HR), HR variability, and blood pressure in vivo. FSD induced changes in hydrogen peroxide concentrations and transcript levels for pro-inflammatory factors in heart tissues. In kidney, expression of proteins indicative of injury and remodeling was reduced after FSD exposure. When analyzed using regression analysis, changes in proteins involved in repair and remodeling were correlated. Thus, it appears that inhalation of FSD does have some prolonged effects on cardiovascular, and, possibly, renal function. The findings also provide information regarding potential mechanisms that may lead to these changes, and biomarkers that could be examined to monitor physiological changes that could be indicative of impending cardiovascular dysfunction.

[Contribution of Emissions from the Iron and Steel Industry to Air Quality in China]

Based on the data from a continuous emission monitoring systems network in 2015, this study analyzed the compliance rates of exhaust gas in the processes of China's iron and steel industry, and established a high-resolution steel plant emission inventory for China (HSEC, 2015), based on the bottom-up method. The contribution of emissions from the iron and steel industry to regional air quality was quantitatively simulated using a CAMx model. The results showed that in 2015, the total emissions of SO₂, NO_x, PM₁₀, PM_2.5, PCDD/Fs, VOCs, CO, BC, OC, EC, and F were 374800 t, 720500 t, 334800 t, 150300 t, 1.91 kg, 842900 t, 34788500 t, 6400 t, 8300 t, 800 t, and 7700 t, respectively. From a regional perspective, the iron and steel industry in Shanghai and Tianjin has the highest emission intensity per unit area and contributes a high proportion to regional air pollution. From a process perspective, in 2015, the exhaust concentration of flue gas in the main process gradually decreased, with a high compliance rate, and the emission factor significantly decreased to lower than that in the existing research results. From a species perspective, in 2015, NO_x emission from the steel industry contributed the most to regional air quality, and there is therefore a great emission reduction potential for NO_x.

Do acute changes in ambient air pollution increase the risk of potentially fatal cardiac arrhythmias in patients with implantable cardioverter defibrillators?

BACKGROUND

Daily changes in ambient air pollution have been associated with cardiac morbidity and mortality. Precipitating a cardiac arrhythmia in susceptible individuals may be one mechanism. We investigated the influence of daily changes in air pollution in the Province of Ontario, Canada on the frequency of discharges from implantable cardio defibrillators (ICDs) which occur in response to potentially life threatening arrhythmias.

METHODS

Using a case- crossover design, we compared ambient air pollution concentrations on the day of an ICD discharge to other days in the same month and year in 1952 patients. We adjusted for weather, lagged the exposure data from 0 to 3 days, and stratified the results by several patient-related characteristics.

RESULTS

Median (interquartile range) for ozone (O₃), fine particulate matter (PM_2.5), sulphur dioxide (SO₂) and nitrogen dioxide (NO₂) were 26.0 ppb (19.4, 33.0), 6.6 μg/m³ (4.3, 10.6), 1.00 ppb (0.4,2.1), 10.0 ppb (6.0,15.3) respectively. Unlagged odds ratios (95%) for an ICD discharge associated with an interquartile range increase in pollutant were 0.97 (0.86, 1.09) for O₃, 0.99 (0.92, 1.06) for PM_2.5, 0.97 (0.91, 1.03) for SO₂, and 1.00 (0.89, 1.12) for NO₂.

CONCLUSION

We found no evidence that the concentrations of ambient air pollution observed in our study were a risk factor for potentially fatal cardiac arrhythmias in patients with ICDs.

Effect of industrial point-source air pollutants on fractional exhaled nitric oxide in healthy volunteers

BACKGROUND

Few studies have examined the effects of industrial, fixed-site sources of air pollution on lung inflammation in nearby residents. We investigated the effects of short-term exposure to ambient air near a steel plant on the fractional exhaled concentration of nitric oxide (FeNO), a measure of airway inflammation, in healthy volunteers.

METHODS

A cross-over study design was used. Fifty-nine non-smoking participants (mean age 24 years) were randomly assigned to each of two 5-day exposure scenarios: breathing ambient air adjacent to a steel plant or 5 km away at a college campus site. FeNO and on-site air pollutants were measured daily. Mixed effects linear regression models were used for data analysis, adjusting for sex, temperature, humidity and day of week.

RESULTS

Compared with the college site, PM _2.5, ultrafine PM, SO₂, NO₂ and CO levels were significantly greater near the steel plant. FeNO was 15.3% (95% CI, 6.6%, 24.8%) higher near the plant compared to the college site.

CONCLUSIONS

Exposure to ambient air near a steel plant was associated with increased airway inflammation as measured by exhaled nitric oxide.

A New Integrative Theory of Brain-Body-Ecosystem Medicine: From the Hippocratic Holistic View of Medicine to Our Modern Society

Humans are increasingly aware that their fate will depend on the wisdom they apply in interacting with the ecosystem. Its health is defined as the condition in which the ecosystem can deliver and continuously renew its fundamental services. A healthy ecosystem allows optimal interactions between humans and the other biotic/abiotic components, and only in a healthy ecosystem can humans survive and efficiently reproduce. Thus, both the human and ecosystem health should be considered together in view of their interdependence. The present article suggests that this relationship could be considered starting from the Hippocrates (460 BC-370 BC) work "On Airs, Waters, and Places" to derive useful medical and philosophical implications for medicine which is indeed a topic that involves scientific as well as philosophical concepts that implicate a background broader than the human body. The brain-body-ecosystem medicine is proposed as a new more complete approach to safeguarding human health. Epidemiological data demonstrate that exploitation of the environment resulting in ecosystem damage affects human health and in several instances these diseases can be detected by modifications in the heart-brain interactions that can be diagnosed through the analysis of changes in heart rate variability.

Occupational Fine/Ultrafine Particles and Noise Exposure in Aircraft Personnel Operating in Airport Taxiway

The occupational exposure to airborne fine and ultrafine particles (UFPs) and noise in aircraft personnel employed in airport taxiway was investigated. Stationary samplings and multiple personal sampling sites and job tasks were considered. Size distribution, particle number concentrations, lung dose surface area were measured by personal particle counters and by means of an electric low pressure impactor (ELPI+TM). Morphological and chemical characterization of UFPs were performed by transmission and scanning electron microscopy, the latter together with energy dispersive X-Ray spectroscopy based spatially resolved compositional mapping. A-weighted noise exposure level A-weighted noise exposure level normalized to an 8 h working day and Peak Sound C-weighted Pressure Level was calculated for single worker and for homogeneous exposure groups. Our study provides evidence on the impact of aviation-related emissions on occupational exposure to ultrafine particles and noise exposure of workers operating in an airport taxiway. Main exposure peaks are related to pre-flight operations of engine aircrafts. Although exposure to ultrafine particles and noise appears to not be critical if compared with other occupational scenarios, the coincidence in time of high peaks of exposure to ultrafine particles and noise suggest that further investigations are warranted in order to assess possible subclinical and clinical adverse health effects in exposed workers, especially for cardiovascular apparatus.

Health effects of particulate matter air pollution in underground railway systems - a critical review of the evidence

BACKGROUND

Exposure to ambient airborne particulate matter is a major risk factor for mortality and morbidity, associated with asthma, lung cancer, heart disease, myocardial infarction, and stroke, and more recently type 2 diabetes, dementia and loss of cognitive function. Less is understood about differential effects of particulate matter from different sources. Underground railways are used by millions of people on a daily basis in many cities. Poor air exchange with the outside environment means that underground railways often have an unusually high concentration of airborne particulate matter, while a high degree of railway-associated mechanical activity produces particulate matter which is physicochemically highly distinct from ambient particulate matter. The implications of this for the health of exposed commuters and employees is unclear.

MAIN BODY

A literature search found 27 publications directly assessing the potential health effects of underground particulate matter, including in vivo exposure studies, in vitro toxicology studies, and studies of particulate matter which might be similar to that found in underground railways. The methodology, findings, and conclusions of these studies were reviewed in depth, along with further publications directly relevant to the initial search results. In vitro studies suggest that underground particulate matter may be more toxic than exposure to ambient/urban particulate matter, especially in terms of endpoints related to reactive oxygen species generation and oxidative stress. This appears to be predominantly a result of the metal-rich nature of underground particulate matter, which is suggestive of increased health risks. However, while there are measureable effects on a variety of endpoints following exposure in vivo, there is a lack of evidence for these effects being clinically significant as may be implied by the in vitro evidence.

CONCLUSION

There is little direct evidence that underground railway particulate matter exposure is more harmful than ambient particulate matter exposure. This may be due to disparities between in vivo exposures and in vitro models, and differences in exposure doses, as well as statistical under powering of in vivo studies of chronic exposure. Future research should focus on outcomes of chronic in vivo exposure, as well as further work to understand mechanisms and potential biomarkers of exposure.

Acute Effects of Air Pollution and Noise from Road Traffic in a Panel of Young Healthy Adults

Panel studies are an efficient means to assess short-term effects of air pollution and other time-varying environmental exposures. Repeated examinations of volunteers allow for an in-depth analysis of physiological responses supporting the biological interpretation of environmental impacts. Twenty-four healthy students walked for 1 h at a minimum of four separate occasions under each of the following four settings: along a busy road, along a busy road wearing ear plugs, in a park, and in a park but exposed to traffic noise (65 dB) through headphones. Particle mass (PM_2.5, PM₁), particle number, and noise levels were measured throughout each walk. Lung function and exhaled nitrogen oxide (NO) were measured before, immediately after, 1 h after, and approximately 24 h after each walk. Blood pressure and heart rate variability were measured every 15 min during each walk. Recorded air pollution levels were found to correlate with reduced lung function. The effects were clearly significant for end-expiratory flows and remained visible up to 24 h after exposure. While immediate increases in airway resistance could be interpreted as protective (muscular) responses to particulate air pollution, the persisting effects indicate an induced inflammatory reaction. Noise levels reduced systolic blood pressure and heart rate variability. Maybe due to the small sample size, no effects were visible per specific setting (road vs. park).

Assessing the associations of daily respiratory symptoms and lung function in schoolchildren using an Air Quality Index for ozone: Results from the RESPOZE panel study in Athens, Greece

BACKGROUND

Air Quality indicators or indices (AQIs) are mainly used for communicating the air pollution levels and risk to the general population. However, very few epidemiological studies have used AQIs for characterizing exposure.

OBJECTIVE

In the framework of the RESPOZE panel study we evaluated the association of daily ozone AQI levels with the daily occurrence of respiratory symptoms and Peak Expiratory Flow (PEF) and compared the effects with those estimated using measurements from fixed outdoor monitoring sites, in the city of Athens, Greece.

MATERIALS AND METHODS

A panel of 97 children, aged 10-11years, was followed intensively for 35days (5weeks) during the academic year 2013-14. PEF and symptoms were recorded daily by each child. Two ozone AQIs classifying the air quality into 7 categories of increasing severity, were calculated; one characterizing the whole Athens area and one the local area around the child's residence and school. Measurements from fixed sites were also used. Mixed effects models for repeated measurements were applied, adjusting for several confounders.

RESULTS

Increasing ozone levels were associated with increased incidence of symptoms, but the strongest and most statistically significant associations were found with the local air quality characterization with the AQI. Specifically, an increase in AQI-local by one category was associated with 34% (95% CI: 9%, 64%) increased odds of stuffy nose. When the AQI categories were "Bad" and "Severe", an increase in the incidence of cough was observed (OR 3.05 (95% CI: 1.29, 7.22) and 6.42 (95% CI: 1.47, 28.03) respectively). We did not observe a statistically significant association between AQI and PEF.

CONCLUSION

Our results show that the use of an AQI based on local conditions may be advantageous over the use of only measurements when investigating the effects of air pollution on health outcomes for improving communication of risk to the public.

Cardiovascular and inflammatory mechanisms in healthy humans exposed to air pollution in the vicinity of a steel mill

Background

There is a paucity of mechanistic information that is central to the understanding of the adverse health effects of source emission exposures. To identify source emission-related effects, blood and saliva samples from healthy volunteers who spent five days near a steel plant (Bayview site, with and without a mask that filtered many criteria pollutants) and at a well-removed College site were tested for oxidative stress, inflammation and endothelial dysfunction markers.

Methods

Biomarker analyses were done using multiplexed protein-array, HPLC-Fluorescence, EIA and ELISA methods. Mixed effects models were used to test for associations between exposure, biological markers and physiological outcomes. Heat map with hierarchical clustering and Ingenuity Pathway Analysis (IPA) were used for mechanistic analyses.

Results

Mean CO, SO₂ and ultrafine particles (UFP) levels on the day of biological sampling were higher at the Bayview site compared to College site. Bayview site exposures “without” mask were associated with increased (p < 0.05) pro-inflammatory cytokines (e.g IL-4, IL-6) and endothelins (ETs) compared to College site. Plasma IL-1β, IL-2 were increased (p < 0.05) after Bayview site “without” compared to “with” mask exposures. Interquartile range (IQR) increases in CO, UFP and SO₂ were associated with increased (p < 0.05) plasma pro-inflammatory cytokines (e.g. IL-6, IL-8) and ET-1_(1–21) levels. Plasma/saliva BET-1 levels were positively associated (p < 0.05) with increased systolic BP. C-reactive protein (CRP) was positively associated (p < 0.05) with increased heart rate. Protein network analyses exhibited activation of distinct inflammatory mechanisms after “with” and “without” mask exposures at the Bayview site relative to College site exposures.

Conclusions

These findings suggest that air pollutants in the proximity of steel mill site can influence inflammatory and vascular mechanisms. Use of mask and multiple biomarker data can be valuable in gaining insight into source emission-related health impacts.

Electronic supplementary material

The online version of this article (10.1186/s12989-018-0270-4) contains supplementary material, which is available to authorized users.

The impact of occupational exposure to traffic-related air pollution among professional motorcyclists from Porto Alegre, Brazil, and its association with genetic and oxidative damage

Vehicles play an important role in modern life; however, they also generate hazards. Occupational exposed subjects are in long-term contact with harmful products, which sets these professionals in a susceptible group to air pollutant damage. The aims of this study were to quantify individual exposure to pollutant gases and chemical elements and to evaluate oxidative and genetic damage in professional motorcyclists and office workers. We recruited professional motorcyclists and office workers from Porto Alegre, Brazil, between January and December 2016. Individual exposure to air pollutants was assessed by passive monitoring. Fingernail trace elements were determined by using inductively coupled plasma mass spectrometry. Oxidative stress biomarkers were quantified spectrophotometrically, and genotoxicity was evaluated by micronuclei assay. Individual exposure to NO₂ and O₃, trace element content (Sb, Pt, As, Cd, V, Mn, and Co), oxidative stress factors, and genetic damage were statistically higher in professional motorcyclists (p < 0.05). Moreover, NO₂ and O₃ levels showed very strong positive correlation with plasmatic lipid peroxidation (p < 0.001 and r = 0.8849 and 0.8995) and strong positive correlation with micronuclei frequency (p < 0.001 and r = 0.7683 and 0.7280). Results suggest that professional motorcyclists are at high risk due to long-term air pollution exposure, which implies in the onset of several harmful effects and worsening of pre-existent diseases.