2000 Progress Report: Cardiovascular Vulnerability to Particulate Pollution
EPA Grant Number:
Cardiovascular Vulnerability to Particulate Pollution
Beth Israel Deaconess Medical Center
Brigham and Women's Hospital, Inc.
Harvard T.H. Chan School of Public Health
EPA Project Officer:
October 1, 1998 through
September 30, 2001
Project Period Covered by this Report:
October 1, 1999 through September 30, 2000
Health Effects of Particulate Matter and Associated Air Pollutants (1998)
Air Quality and Air Toxics
In susceptible adults, we proposed to examine whether fine particle (PM2.5) exposure results in similar changes in cardiovascular function as reflected in changes in blood pressure, heart rate, heart rate regularity, and ECG intervals and morphology, particularly in measures of myocardial conductance, repolarization, and irritability. Specifically, we proposed a time series epidemiologic study involving repeated monitoring of adults to evaluate whether measures of cardiovascular function vary as air pollution varies.
To compare cardiovascular effects of air pollution in communities with different mixes of pollution, two studies sites were selected: Boston, Massachusetts (1998?1999), and Steubenville, Ohio (1999?2000). In Boston, of 38 active adults 60 to 90 years of age who were screened in March?May 1998 for study eligibility, 27 were selected to participate in the community-based panel. These participants were evaluated in June?September, during the summer periods. Once per week for 12 weeks the participants answered a questionnaire regarding cardiac and respiratory symptoms and changes in medication use. They received ECG Holter monitoring for a 25-minute period involving 5 minutes of rest supine, 5 minutes of standing upright, 5 minutes of exercise, 5 minutes of recovery, and 5 minutes of slow breathing. Supine, upright, and post exercise blood pressure, continuous heart rate, and oximetry also were monitored. Continuous measures of PM2.5, PM10, ozone, CO, NO2 and SO2 were performed at nearby monitoring sites. Indoor continuous measures of CO and PM2.5 were performed at the study site. Questionnaire data were entered and verified. Electrophysiologic outcomes of interest will include ECG repolarization abnormalities, ventricular premature beats, measures of heart rate variability, and PR and QT intervals. Through work by Dr. Bruce Nearing, in concert with Drs. Verrier, Stone, and Gold, programs have been developed for the reading of the Holter Monitor data to summarize time domain and frequency domain heart rate variability outcomes and ST segment changes. In Steubenville, of 52 adults who were screened in March?May 1999 for study eligibility, 30 were selected to participate in the community-based panel following a protocol identical to that in Boston. With external funding, additional air pollution monitoring was conducted, including indoor air particle and gas monitoring in the home and at the study site for most study participants, and personal air pollution monitoring for 10 of 30 participants. Questionnaire data were entered and are being verified. In an abstract submitted to the American Thoracic Society 2001, we report our first preliminary results for the Boston 1999 summer panel study. PM2.5 levels were low, averaging 11 g/m3 during the study period. After control for time trend, hour of the day, and subject, PM2.5 was negatively associated with all time domain measures of heart rate variability, including the square root of the mean of the squared differences between adjacent normal RR intervals (r-MSSD), the standard deviation of normal RR intervals (SDNN), and PNN50. Results from 1999 were similar to those of 1997, in a pilot study funded in part by the U.S. Environmental Protection Agency (EPA) Cooperative Agreement CR821762, with key results published in Circulation (101:1267-1273). We reported that in multivariate analyses, significantly less heart rate variability was associated with elevated PM2.5. During slow breathing, a reduction in r-MSSD of 6.1 was associated with an interquartile (14.3 g/m3) increase in PM2.5 during the hour of and the 3 hours previous to the Holter session (P-0.006). Independent of the PM2.5 effect, ozone was also associated with reduction in r-MSSD.
In the coming funding year, we intend to focus on the reading of heart rate variability, ST segment changes and arrhythmias in the Boston and Steubenville data, and on data analysis and manuscript preparation. In addition to evaluating effects of outdoor pollution on these outcomes, we also will be able to evaluate the relative contribution of indoor and outdoor air pollution on these outcomes in the Steubenville study.
No journal articles submitted with this report: View all 15 publications for this project
air pollution, cardiovascular.
, RFA, Health, Scientific Discipline, Air, Geographic Area, particulate matter, air toxics, Health Risk Assessment, Epidemiology, State, Risk Assessments, Disease & Cumulative Effects, Biochemistry, tropospheric ozone, Atmospheric Sciences, ambient aerosol, health effects, particle size, particulates, cardiac arrhythmia, air pollutants, cardiopulmonary responses, effects assessment, fine particles, human health effects, PM 2.5, exposure and effects, cardiovascular vulnerability, heart rate variability, ozone, air pollution, Massachusetts (MA), chronic health effects, human exposure, particulate exposure, Acute health effects, environmental stressors, harmful environmental agents, ambient particulates, blood pressure, mortality, hyperadrenergic, cardiac arrhythmias, exposure assessment, heart rate
Progress and Final Reports:
1999 Progress Report