Long term exposure to air pollution linked to coronary events

January 21, 2014

Long term exposure to particulate matter in outdoor air is strongly linked to heart attacks and angina, and this association persists at levels of exposure below the current European limits, suggests research conducted at the Department of Epidemiology in Rome, Italy and published in BMJ today.

The results support lowering of the EU limits for particulate matter .

Ambient particulate matter air pollution is estimated to cause 3.2 million deaths worldwide per year, but the association between long term exposure to air pollution and incidence of coronary events remains controversial.

In the European Union the current annual limit for particulate matter with a diameter of 2.5 micrometres (μm) or less (known as PM2.5) is 25 µg/m3, which is far above that implemented in the United States (12 µg/m3). And a 2013 BMJ study found average PM2.5 concentrations over a five year period in Beijing was more than 10 times the World Health Organization air quality guideline value of 10 µg/m3.

So an international team of researchers, coordinated by the University of Utrecht, the Netherlands, set out to study the effect of long term exposure to airborne pollutants on acute coronary events (heart attack and unstable angina) in 11 cohorts participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE).

The study involved over 100,000 people with no history of heart disease enrolled from 1997 to 2007 and followed for an average of 11.5 years.

Mathematical models were used to estimate concentrations of air pollution from particulate matter at each participant's residential address. A total of 5,157 participants experienced coronary events during the follow-up period.

After taking account of several other risk factors, including other illness, smoking, and socioeconomic factors, the researchers found that a 5 μg/m3 increase in PM2.5particulate matter was associated with a 13% increased risk of coronary events and a 10μg/m3 increase in PM10 particulate matter was associated with a 12% increased risk of coronary events.

Positive associations were detected below the current annual European limit of 25 μg/m3 for PM2.5 and below 40 μg/m3 for PM10 and positive but non-significant associations were found with other pollutants.

Further analyses did not alter the results significantly.

"Our study suggests an association between long term exposure to particulate matter and incidence of ," say the authors.

They point out that these associations remained for exposure concentrations below the current European limits, and suggest that the burden of disease attributable to outdoor "might be underestimated if only estimates of mortality are considered."

The results of this study, together with other ESCAPE findings, "support lowering of European limits for particulate air pollution to adequately protect public health," they conclude.

This study "has specific relevance to the management of air quality in Europe," say Professors Michael Brauer and John Mancini from the University of British Columbia, in an accompanying editorial.

They also refer to the 2013 BMJ Beijing study and say: "The important impact of air pollution on cardiovascular disease highlighted by these two papers supports efforts to meet existing and even more stringent standards to minimise cardiovascular morbidity and mortality."

Explore further: Air pollution kills well below European Union air quality limits

More information: Long term exposure to ambient air pollution and incidence of acute coronary events: prospective cohort study and meta-analysis in 11 European cohorts from the ESCAPE Project, BMJ, 2014. doi: dx.doi.org/10.1136/bmj.f7412

Related Stories

Air pollution kills well below European Union air quality limits

December 8, 2013
The study, published in The Lancet, estimates that for every increase of 5 microgrammes per cubic metre (5 µg/m3) in annual exposure to fine-particle air pollution (PM2.5), the risk of dying from natural causes rises by ...

Europe-wide study finds long-term exposure to even low levels of air pollution increases risk of lung cancer

July 9, 2013
Prolonged exposure to particulate air pollution increases the risk of lung cancer (particularly adenocarcinoma) even at levels below the European Union limit values, according to one of the largest studies of its kind published ...

Short-term exposure to most major air pollutants raises the risk of hospitalization for and death from heart failure

July 9, 2013
Short-term exposure to most major air pollutants appears to increase the risk of being hospitalised for and dying from heart failure, according to a systematic review and meta-analysis of data from 12 countries published ...

EU study finds exposure to even low levels of air pollution during pregnancy increases risk of lower birthweight babies

October 14, 2013
Exposure to common air pollutants and traffic during pregnancy significantly increases the risk of restricted fetal growth, even at levels well below those stipulated in current European Union air-quality directives, according ...

Air pollution increases heart attacks

October 7, 2013
Air pollution increases heart attacks, according to research presented at the Acute Cardiac Care Congress 2013 by Dr Savina Nodari from Brescia, Italy. The Acute Cardiac Care Congress 2013 is the annual meeting of the Acute ...

Exposure to air pollution is associated with increased deaths after heart attacks

February 19, 2013
Air pollution contributes to an increased number of deaths among patients who have been admitted to hospital with heart attacks, according to a study published online today (Wednesday) in the European Heart Journal.

Recommended for you

New molecule may hold the key to triggering the regeneration and repair of damaged heart cells

August 21, 2017
New research has discovered a potential means to trigger damaged heart cells to self-heal. The discovery could lead to groundbreaking forms of treatment for heart diseases. For the first time, researchers have identified ...

Researchers investigate the potential of spider silk protein for engineering artificial heart

August 18, 2017
Ever more people are suffering from cardiac insufficiency, despite significant advances in preventing and minimising damage to the heart. The main cause of reduced cardiac functionality lies in the irreversible loss of cardiac ...

Lasers used to detect risk of heart attack and stroke

August 18, 2017
Patients at risk of heart attacks and strokes may be spotted earlier thanks to a diagnosis tool that uses near-infrared light to identify high-risk arterial plaques, according to research carried out at WMG, University of ...

Cholesterol crystals are sure sign a heart attack may loom

August 17, 2017
A new Michigan State University study on 240 emergency room patients shows just how much of a role a person's cholesterol plays, when in a crystallized state, during a heart attack.

How Gata4 helps mend a broken heart

August 15, 2017
During a heart attack, blood stops flowing into the heart; starved for oxygen, part of the heart muscle dies. The heart muscle does not regenerate; instead it replaces dead tissue with scars made of cells called fibroblasts ...

Injectable tissue patch could help repair damaged organs

August 14, 2017
A team of U of T Engineering researchers is mending broken hearts with an expanding tissue bandage a little smaller than a postage stamp.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.