Healthy Heart Toolkit: Resources for Health Professionals
What is the link between Air Pollution and Cardiovascular Effects?
Extensive scientific evidence shows that breathing in fine particulate matter (PM2.5) over the course of many years can lead to an increased risk of developing cardiovascular disease and dying from the disease. Short-term exposures to PM2.5 can trigger heart attack, ischemic stroke, abnormal heart rhythms and worsen heart failure in individuals with cardiovascular disease or older adults with medical conditions that put them at risk. The current National Ambient Air Quality Standards for PM2.5 that protect public health from the detrimental effects of the air pollutant are based on this evidence.
While the United States has experienced improved air quality and reductions in PM2.5, there are still many people who are exposed to high levels of the pollutant because of where they live and/or their vulnerability due to their health conditions. Individuals who live or work near roadways, railyards, ports or industrial areas may be exposed to high levels of PM2.5. Forest fires can also generate high levels of PM2.5, which can be transported great distances.
What is particulate matter (PM) and fine particulate matter (PM2.5)?
Particulate matter (PM) is a complex mixture of extremely small particles and liquid droplets that can be found in smoke and haze. Small airborne particles, also known as fine particulate matter (PM2.5), can be emitted from a number of different natural and man-made sources including forest fires or formed when gases emitted from power plants, industries and automobiles react in the air. Fine particles are a public health concern because after they are breathed in they generally pass through the throat and nose and enter the lungs from which point they can cause serious health effects on the rest of the body among people who are vulnerable.
How does PM2.5 cause death?
Among those who are vulnerable to the adverse effects of air particle pollution—either by frailty in old age or clinically significant heart and blood vessel disease—there are a number of possible ways that breathing in fine particles could lead to death by further harming the heart and blood vessels. These include changes in the way the heart and blood vessels function and blood clots, which can lead to heart attacks, stroke, life-threatening heart rhythm disturbances, and/or heart failure.
How does PM2.5 increase the risk for heart attacks?
Breathing in fine particles can alter blood vessels, which could include clogging arteries (atherosclerosis) after long-term exposures or forming blood clots after short-term exposures. These changes can result in a decrease in the supply of oxygen and nutrients to the heart and subsequently a heart attack.
How does PM2.5 cause a stroke?
There are a number of ways that breathing in fine particles can cause a stroke. Once inhaled the particles can trigger inflammation, changes in blood vessel function and the formation of blood clots, which can interrupt the flow of blood to the brain resulting in stroke.
How does PM2.5 cause cardiac arrest?
Among people with advanced heart disease who have internal cardiac defibrillators it has been shown that breathing in fine particles can disrupt the electrical function of the heart leading to potentially fatal abnormal heart rhythms (arrhythmias).
- Criteria air pollutants
- Status and Trends of Key Air Pollutants
- State of Global Air report
- Health Effects Institute Publications
- Short-term effects of fine particulate matter and ozone on the cardiac conduction system in patients undergoing cardiac catheterization, Exitpublished in Particle and Fibre Toxicology, Oct. 2018
- Ambient Air Quality and Cardiovascular Health: Translation of Environmental Research for Public Health and Clinical Care, Exitpublished in the North Carolina Medical Journal, Sept.-Oct. 2018.
- Cardiovascular and Cerebrovascular Emergency Department Visits Associated With Wildfire Smoke Exposure in California in 2015, Exit published in the Journal of American Heart Association in April 2018
- Community vulnerability to health impacts of wildland fire smoke exposure, EXIT published in Environmental Science & Technology in May 2017.
- Proposed Pathophysiologic Framework to Explain Some Excess Cardiovascular Death Associated with Ambient Air Particle Pollution: Insights for Public Health Translation, Exit published in the special issue of the journal Biochimica et Biophysica Acta on air pollution.
- Association between air pollution and coronary artery calcification within six metropolitan areas in the USA (the Multi-Ethnic Study of Atherosclerosis and Air Pollution): a longitudinal cohort study, Exit published in The Lancet.
- Air Pollution, Climate, and Heart Disease, Exit published in Circulation.
- What health care providers should know about particle pollution and cardiovascular risk
- Heart Disease, Stroke and Air Pollution
- Air Pollution and Heart Disease
- 10-Year Study Links Faster Progression of Atherosclerosis to Air Pollution