Effect of inhaled sulphur dioxide and carbon particles on heart rate variability and markers of inflammation and coagulation in human subjects

Objective: To measure the inflammatory and autonomic responses of healthy humans and patients with coronary artery disease to controlled concentrations of two specific components of vehicle derived air pollution, carbon particles and sulphur dioxide (SO2). Methods: Placebo controlled, double blind, random order human challenge study examining the effects of carbon particles (50 μg/m3) and SO2 (200 parts per billion (ppb)) on heart rate variability (HRV) and circulating markers of inflammation and coagulation in healthy volunteers and patients with stable angina. Results: In healthy volunteers, markers of cardiac vagal control did not fall in response to particle exposure but, compared with the response to air, increased transiently immediately after exposure (root mean square of successive RR interval differences (RMSSD) 15 (5) ms with carbon particles and 4 (3) ms) with air, p < 0.05). SO2 exposure resulted in no immediate change but a significant reduction in HRV markers of cardiac vagal control at four hours (RMSSD −2 (3.6) ms with air, −7 (2.7) ms with SO2, p < 0.05). No such changes were seen in patients with stable angina. Neither pollutant caused any change in markers of inflammation or coagulation at zero, four, or 24 hours. Conclusion: In healthy volunteers, short term exposure to pure carbon particles does not cause adverse effects on HRV or a systemic inflammatory response. The adverse effects of vehicle derived particulates are likely to be caused by more reactive species found on the particle surface. SO2 exposure does, however, reduce cardiac vagal control, a response that would be expected to increase susceptibility to ventricular arrhythmia.

[1]  P. Schwartz,et al.  Autonomic mechanisms and sudden death. New insights from analysis of baroreceptor reflexes in conscious dogs with and without a myocardial infarction. , 1988, Circulation.

[2]  D. Dockery,et al.  An association between air pollution and mortality in six U.S. cities. , 1993, The New England journal of medicine.

[3]  D. Dockery,et al.  Particulate air pollution as a predictor of mortality in a prospective study of U.S. adults. , 1995, American journal of respiratory and critical care medicine.

[4]  A. Malliani,et al.  Heart rate variability. Standards of measurement, physiological interpretation, and clinical use , 1996 .

[5]  G. Breithardt,et al.  Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. , 1996 .

[6]  A. Peters,et al.  Increased plasma viscosity during an air pollution episode: a link to mortality? , 1997, The Lancet.

[7]  S Perz,et al.  Increases in heart rate during an air pollution episode. , 1999, American journal of epidemiology.

[8]  R. Elton,et al.  Particulate air pollution and the blood , 1999, Thorax.

[9]  H. Ross,et al.  Use of opposing reflex stimuli and heart rate variability to examine the effects of lipophilic and hydrophilic beta-blockers on human cardiac vagal control. , 1999, Clinical science.

[10]  J. Schwartz,et al.  Heart rate variability associated with particulate air pollution. , 1999, American heart journal.

[11]  S T Holgate,et al.  Acute inflammatory responses in the airways and peripheral blood after short-term exposure to diesel exhaust in healthy human volunteers. , 1999, American journal of respiratory and critical care medicine.

[12]  J Schwartz,et al.  Air pollution and incidence of cardiac arrhythmia. , 2000, Epidemiology.

[13]  J Schwartz,et al.  Ambient pollution and heart rate variability. , 2000, Circulation.

[14]  R. Devlin,et al.  Concentrated ambient air particles induce mild pulmonary inflammation in healthy human volunteers. , 2000, American journal of respiratory and critical care medicine.

[15]  F. Dominici,et al.  Fine particulate air pollution and mortality in 20 U.S. cities, 1987-1994. , 2000, The New England journal of medicine.

[16]  H. Ross,et al.  Nitric oxide and cardiac autonomic control in humans. , 2000, Hypertension.

[17]  Peter J. Schwartz,et al.  Baroreflex Sensitivity and Heart Rate Variability in the Identification of Patients at Risk for Life-Threatening Arrhythmias Implications for Clinical Trials , 2001 .

[18]  A J Camm,et al.  Baroreflex Sensitivity and Heart Rate Variability in the Identification of Patients at Risk for Life-Threatening Arrhythmias: Implications for Clinical Trials , 2001, Circulation.

[19]  A. Peters,et al.  Particulate air pollution is associated with an acute phase response in men; results from the MONICA-Augsburg Study. , 2001, European heart journal.

[20]  M. Hilton,et al.  The effect of sulphur dioxide exposure on indices of heart rate variability in normal and asthmatic adults. , 2001, The European respiratory journal.

[21]  D. Dockery,et al.  Epidemiologic evidence of cardiovascular effects of particulate air pollution. , 2001, Environmental health perspectives.

[22]  D. Dockery,et al.  Increased Particulate Air Pollution and the Triggering of Myocardial Infarction , 2001, Circulation.

[23]  W. Burch,et al.  Passage of inhaled particles into the blood circulation in humans. , 2002, Circulation.

[24]  D. Dockery,et al.  Effect of air-pollution control on death rates in Dublin, Ireland: an intervention study , 2002, The Lancet.

[25]  Thomas J. Smith,et al.  The Association Between Personal Measurements of Environmental Exposure to Particulates and Heart Rate Variability , 2002, Epidemiology.

[26]  Brent Coull,et al.  Rapid increases in the steady-state concentration of reactive oxygen species in the lungs and heart after particulate air pollution inhalation. , 2002, Environmental health perspectives.

[27]  Stefan Ma,et al.  Cardiorespiratory and all-cause mortality after restrictions on sulphur content of fuel in Hong Kong: an intervention study , 2002, The Lancet.

[28]  Joel Schwartz,et al.  The association of daily sulfur dioxide air pollution levels with hospital admissions for cardiovascular diseases in Europe (The Aphea-II study). , 2003, European heart journal.

[29]  K. Pinkerton,et al.  Pulmonary responses of acute exposure to ultrafine iron particles in healthy adult rats , 2003, Environmental toxicology.

[30]  Roy M. Harrison,et al.  A pragmatic mass closure model for airborne particulate matter at urban background and roadside sites , 2003 .

[31]  Vicki Stone,et al.  Oxidative stress and calcium signaling in the adverse effects of environmental particles (PM10). , 2003, Free radical biology & medicine.

[32]  W. Cascio,et al.  Elderly humans exposed to concentrated air pollution particles have decreased heart rate variability , 2003, European Respiratory Journal.

[33]  Roy M. Harrison,et al.  Primary particle formation from vehicle emissions during exhaust dilution in the roadside atmosphere , 2003 .

[34]  R. Harrison,et al.  The generation and characterisation of elemental carbon aerosols for human challenge studies , 2003 .

[35]  D. Gardner Toxicology of the Lung , 2005 .