Abstract
Previous studies have shown an association between elevated concentrations of particulate air pollution and cardiovascular morbidity and mortality. Therefore, the association between daily variation of ultrafine and fine particulate air pollution and cardiac autonomic control measured as heart rate variability (HRV) was studied in a large multicenter study in Amsterdam, the Netherlands, Erfurt, Germany, and Helsinki, Finland. Elderly subjects (n=37 in Amsterdam, n=47 in both Erfurt and Helsinki) with stable coronary artery disease were followed for 6 months with biweekly clinical visits. During the visits, ambulatory electrocardiogram was recorded during a standardized protocol including a 5-min period of paced breathing. Time and frequency domain analyses of HRV were performed. A statistical model was built for each center separately. The mean 24-h particle number concentration (NC) (1000/cm3) of ultrafine particles (diameter 0.01–0.1 μm) was 17.3 in Amsterdam, 21.1 in Erfurt, and 17.0 in Helsinki. The corresponding values for PM2.5 were 20.0, 23.1, and 12.7 μg/m3. During paced breathing, ultrafine particles, NO2, and CO were at lags of 0–2 days consistently and significantly associated with decreased low-to-high frequency ratio (LF/HF), a measure of sympathovagal balance. In a pooled analysis across the centers, LF/HF decreased by 13.5% (95% confidence interval: −20.1%, −7.0%) for each 10,000/cm3 increase in the NC of ultrafine particles (2-day lag). PM2.5 was associated with reduced HF and increased LF/HF in Helsinki, whereas the opposite was true in Erfurt, and in Amsterdam, there were no clear associations between PM2.5 and HRV. The results suggest that the cardiovascular effects of ambient ultrafine and PM2.5 can differ from each other and that their effect may be modified by the characteristics of the exposed subjects and the sources of PM2.5.
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Acknowledgements
The study was carried out within the framework of the “Exposure and risk assessment for fine and ultrafine particles in ambient air”(ULTRA) project. The project was funded by the EU ENVIRONMENT and CLIMATE Research Programme Contract ENV4-CT97-0568. The project was coordinated by the Unit of Environmental Epidemiology, National Public Health Institute, PO Box 95, Kuopio 70701, Finland with funding also from Academy of Finland, the Centre of Excellence Programme 2002–2007 of the Academy of Finland (Contract 53307), and the National Technology Fund (TEKES, Contract 40715/01). Dr. Gold was supported by EPA 826780-01-0 and NIH PO1 ES09825. The contribution of following persons and institutions to the field work of the project is gratefully acknowledged: Helsinki: Aadu Mirme, Ph.D., Gintautas Buzorius, Ph.D., Ismo Koponen, M.Sc., Marko Vallius, M.Sc., Sami Penttinen, Kati Oravisjärvi, Annalea Lohila, M.Sc., Anita Tyrväinen, Helsinki Metropolitan Area Council, Helsinki (Päivi Aarnio, Lic Tech., and Tarja Koskentalo, Lic Tech.), and the Finnish Heart Association. Erfurt: Gabi Wölke, M.A., Martina Stadeler, M.D., Regina Müller, Cornelia Engel, Thomas Tuch, Ph.D., and Sabine Koett, Klaus Koschine, Mike Pitz, MA. Amsterdam: Andrey Khlystov, Ph.D., Gerard Kos, Carolien Mommers, M.Sc., Marloes Jongeneel, M.Sc., Boukje de Wit, Isabella van Schothorst, Veronique van den Beuken, M.Sc., Marieke Oldenwening, Nicole Janssen, Ph.D., Jean Pierre van Mulken, and Environmental Medicine, Municipal Health Service Amsterdam (Saskia van der Zee, Ph.D., Willem Roemer, Ph.D., and Joop van Wijnen, M.D.).
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Timonen, K., Vanninen, E., de Hartog, J. et al. Effects of ultrafine and fine particulate and gaseous air pollution on cardiac autonomic control in subjects with coronary artery disease: The ULTRA study. J Expo Sci Environ Epidemiol 16, 332–341 (2006). https://doi.org/10.1038/sj.jea.7500460
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DOI: https://doi.org/10.1038/sj.jea.7500460
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