Air pollution and cardiac and respiratory function in three groups of patients

The association between exposure to urban air pollution and cardiac or respiratory impairments in susceptible subjects was evaluated in a panel study including 11 patients with chronic obstructive pulmonary disease (COPD), 7 with ischemic heart disease (IHD), and 11 asthmatics resident in Rome (Italy). Patients underwent repeated 24 h Holter EKG monitoring, 12 h pulse oximetry at night and spirometry examinations during 1999 summer and winter. Multiple linear regression models for repeated individual measures (fixed-effect) were used to analyse the relationship between average daily concentrations of pollutants (PM10-2.5, PM2.5 NO2 and O3) and outcome variables, controlling for meteorological conditions, survey period, and week-ends. In the BPCO panel, increasing ambient PM2.5 levels were associated with increased heart rate and decreased respiratory function. In the asthmatic panel, inverse associations between pulmonary function and both NO2 and PM10-2.5 concentrations were observed, as well as direct association between ambient NO2 concentrations and NO in exhaled breath. In the IHD panel an increase of hearth rate variability associated with increasing concentration of PM2.5 was observed.     

遗传性心律失常

遗传性心律失常是环境因素和遗传因素共同作用的结果。对于患有遗传性心律失常家系的成员来说 ,遗传因素可以作用在传导系统的不同层面。目前 ,虽然已确立了很多心律失常的遗传模式 ,但致病基因的确立为数不多。本文将对几种常见的遗传性心律失常进行论述。1　长ＱＴ综合征 (ｌｏｎｇＱＴｓｙｎｄｒｏｍｅ ,ＬＱＴＳ)6 0年代早期 ,Ｒｏｍａｎｏ和Ｗａｒｄ描述了一种常染色体显性遗传的疾病 ,以ＱＴ间期延长、Ｔ波形态异常和致死性心律失常为特征 ,称为Ｒｏｍａｎｏ -Ｗａｒｄ综合征。在更早几年 ,Ｊｅｒｖｅｌｌ和Ｌａｎｇｅ -Ｎｉｅｌｓｅ…     

Acute effects of fine particulate air pollution on cardiac arrhythmia: the APACR study

Background: The mechanisms underlying the relationship between particulate matter (PM) air pollution and cardiac disease are not fully understood.Objectives: We examined the effects and time course of exposure to fine PM [aerodynamic diameter ≤ 2.5 μm (PM_2.5)] on cardiac arrhythmia in 105 middle-age community-dwelling healthy nonsmokers in central Pennsylvania.Methods: The 24-hr beat-to-beat electrocardiography data were obtained using a high-resolution Holter system. After visually identifying and removing artifacts, we summarized the total number of premature ventricular contractions (PVCs) and premature atrial contractions (PACs) for each 30-min segment. A personal PM_2.5 nephelometer was used to measure individual-level real-time PM_2.5 exposures for 24 hr. We averaged these data to obtain 30-min average time–specific PM_2.5 exposures. Distributed lag models under the framework of negative binomial regression and generalized estimating equations were used to estimate the rate ratio between 10-μg/m³ increases in average PM_2.5 over 30-min intervals and ectopy counts.Results: The mean ± SD age of participants was 56 ± 8 years, with 40% male and 73% non-Hispanic white. The 30-min mean ± SD for PM_2.5 exposure was 13 ± 22 μg/m³, and PAC and PVC counts were 0.92 ± 4.94 and 1.22 ± 7.18. Increases of 10 μg/m³ in average PM_2.5 concentrations during the same 30 min or the previous 30 min were associated with 8% and 3% increases in average PVC counts, respectively. PM_2.5 was not significantly associated with PAC count.Conclusion: PM_2.5 exposure within approximately 60 min was associated with increased PVC counts in healthy individuals.     

Air pollution and hospital admissions for ischemic heart disease in persons with congestive heart failure or arrhythmia

We examined whether ischemic heart disease (IHD) hospital admissions were associated with air pollutants in those with and without secondary diagnoses of arrhythmia (ARR) or congestive heart failure (CHF). We assessed the occurrence of increased vulnerability among persons with these conditions to daily variations in ozone, carbon monoxide, nitrogen dioxide, or particulate matter less than or equal to 10 micro m in aerodynamic diameter (PM10). The study population consisted of members of a large health maintenance organization residing in the South Coast Air Basin of California from 1988 to 1995. After adjustment for day of week, study year, and smoothing splines for day of study, temperature, and relative humidity, CO and NO2 were both associated with admissions with the greatest effects for CO. A 1-ppm increase in 8-hr average CO was associated with a 3.60% [95% confidence interval (CI), 1.62-5.63%] increase in same-day IHD admissions in persons with a secondary diagnosis of CHF, a 2.99% (95% CI, 1.80-4.19%) increase in persons with a secondary diagnosis of ARR, and a 1.62% (95% CI, 0.65-2.59%) increase in IHD admissions in persons without either secondary diagnosis. Air pollution was most strongly associated with myocardial infarction hospital admissions. The vulnerability of the secondary CHF subgroup may be due to a greater prevalence of myocardial infarction primary diagnoses and not the modifying effect of CHF. This study suggests that people with IHD and accompanying CHF and/or ARR constitute a sensitive subgroup in relation to the effects of criteria ambient air pollutants associated with motor vehicle combustion.     

Ambient particulate air pollution and cardiac arrhythmia in a panel of older adults in Steubenville, Ohio

Objectives

Ambient particulate air pollution has been associated with increased risk of cardiovascular morbidity and mortality. Pathways by which particles may act involve autonomic nervous system dysfunction or inflammation, which can affect cardiac rate and rhythm. The importance of these pathways may vary by particle component or source. In an eastern US location with significant regional pollution, the authors examined the association of air pollution and odds of cardiac arrhythmia in older adults.

Methods

Thirty two non‐smoking older adults were evaluated on a weekly basis for 24 weeks during the summer and autumn of 2000 with a standardised 30 minute protocol that included continuous electrocardiogram measurements. A central ambient monitoring station provided daily concentrations of fine particles (PM_2.5, sulfate, elemental carbon) and gases. Sulfate was used as a marker of regional pollution. The authors used logistic mixed effects regression to examine the odds of having any supraventricular ectopy (SVE) or ventricular ectopy (VE) in association with increases in air pollution for moving average pollutant concentrations up to 10 days before the health assessment.

Results

Participant specific mean counts of arrhythmia over the protocol varied between 0.1–363 for SVE and 0–350 for VE. The authors observed odds ratios for having SVE over the length of the protocol of 1.42 (95% CI 0.99 to 2.04), 1.70 (95% CI 1.12 to 2.57), and 1.78 (95% CI 0.95 to 3.35) for 10.0 μg/m³, 4.2 μg/m³, and 14.9 ppb increases in five day moving average PM_2.5, sulfate, and ozone concentrations respectively. The other pollutants, including elemental carbon, showed no effect on arrhythmia. Participants reporting cardiovascular conditions (for example, previous myocardial infarction or hypertension) were the most susceptible to pollution induced SVE. The authors found no association of pollution with VE.

Conclusion

Increased levels of ambient sulfate and ozone may increase the risk of supraventricular arrhythmia in the elderly.     

Air pollution and health

The authors have investigated the issue of air pollution and its impact on people's health. The study touches such topics as the origins and types of pollutants, airspread contaminants, pollutants' biological effect and consequences on human health. Although pollution levels have recently shown to be lower, they still reflect a major concern for public health. Automobile traffic is the main responsible for air pollution and thin dusts are virtually the most dangerous particles in the atmosphere. Prevention will only be possible if governing bodies adopt effective strategies and public health agents develop adequate prevention plans.     

空气污染对女性生育能力及妊娠影响

空气污染对人类健康带来诸多不利影响,包括对女性生育能力的影响。然而,空气污染损害生育的具体机制并不清楚。本综述对以往有关空气污染对女性生殖的影响进行系统回顾,以全面认识空气污染对人类生育能力的影响。不同人群流行病学及实验室研究中,研究场所和所关注的主要污染物有所不同,流调场所包括石化厂、道路等,污染成分主要包括可吸入颗粒物（PM₁₀）、细颗粒物（PM_2.5）、NO₂、SO₂、O₃等煤炭燃烧和交通尾气相关成分。这些研究主要从空气污染物影响卵子发育、受精卵形成与着床、临床受孕、体外受精及胚胎移植、流产、早产等多个不同阶段进行评估总结。各研究尽管存在设计类型不一致、混杂因素多等所带来的偏倚,但在一定程度上为深入研究空气污染对女性生殖影响的机制提供了线索。     

Air pollution studies

The aim of this paper is to give an overview of the research in the area of air pollution, carried out exclusively at the Institute for Medical Research and Occupational Health and performed by the scientists of the Institute. For the past fifty years, air quality has been studied at work, in the ambient air of urban and industrial areas, and in various indoor environments without occupational exposure. Methods for sampling and measuring air pollutants have been introduced or developed and verified. The behaviour and the fate of air pollutants in the environment have also been investigated. Since the primary goal of the studies was to assess the extent of human exposure to air pollutants, the data were used to calculate the risk for various population groups. A dynamic model of exposure for various population groups relied on calculations of collected data, taking into account time spent in various microenvironments. This text describes the cooperation of the Institute with other institutions and agencies on the national and international level and outlines the current and prospective activities.