Cardiovascular effects of sub-daily levels of ambient fine particles: a systematic reviewReportar como inadecuado

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Environmental Health

, 9:26

First Online: 15 June 2010Received: 07 February 2010Accepted: 15 June 2010DOI: 10.1186-1476-069X-9-26

Cite this article as: Burgan, O., Smargiassi, A., Perron, S. et al. Environ Health 2010 9: 26. doi:10.1186-1476-069X-9-26


BackgroundWhile the effects of daily fine particulate exposure PM have been well reviewed, the epidemiological and physiological evidence of cardiovascular effects associated to sub-daily exposures has not. We performed a theoretical model-driven systematic non-meta-analytical literature review to document the association between PM sub-daily exposures ≤6 hours and arrhythmia, ischemia and myocardial infarction MI as well as the likely mechanisms by which sub-daily PM exposures might induce these acute cardiovascular effects. This review was motivated by the assessment of the risk of exposure to elevated sub-daily levels of PM during fireworks displays.

MethodsMedline and Elsevier-s EMBase were consulted for the years 1996-2008. Search keywords covered potential cardiovascular effects, the pollutant of interest and the short duration of the exposure. Only epidemiological and experimental studies of adult humans age > 18 yrs published in English were reviewed. Information on design, population and PM exposure characteristics, and presence of an association with selected cardiovascular effects or physiological assessments was extracted from retrieved articles.

ResultsOf 231 articles identified, 49 were reviewed. Of these, 17 addressed the relationship between sub-daily exposures to PM and cardiovascular effects: five assessed ST-segment depression indicating ischemia, eight assessed arrhythmia or fibrillation and five considered MI. Epidemiologic studies suggest that exposure to sub-daily levels of PM is associated with MI and ischemic events in the elderly. Epidemiological studies of sub-daily exposures suggest a plausible biological mechanism involving the autonomic nervous system while experimental studies suggest that vasomotor dysfunction may also relate to the occurrence of MI and ischemic events.

ConclusionsFuture studies should clarify associations between cardiovascular effects of sub-daily PM exposure with PM size fraction and concurrent gaseous pollutant exposures. Experimental studies appear more promising for elucidating the physiological mechanisms, time courses and causes than epidemiological studies which employ central pollution monitors for measuring effects and for assessing their time course. Although further studies are needed to strengthen the evidence, given that exposure to sub-daily high levels of PM for a few hours is frequent and given the suggestive evidence that sub-daily PM exposures are associated with the occurrence of cardiovascular effects, we recommend that persons with cardiovascular diseases avoid such situations.

AbbreviationsBADBrachial artery diameter

BPBlood pressure

CAPConcentrated Ambient Particles

FBFForearm blood flow measured by plethysmography

FMDFlow mediated diameter

HRVHeart rate variability

MIMyocardial infarction

PMFine particles

SDNNStandard deviation of all the normal-to-normal intervals

t-PA AgTissue plasminogen activator antigen

Electronic supplementary materialThe online version of this article doi:10.1186-1476-069X-9-26 contains supplementary material, which is available to authorized users.

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Autor: Omar Burgan - Audrey Smargiassi - Stéphane Perron - Tom Kosatsky


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