Coarse Particulate Matter (PM2.5–10) Affects Heart Rate Variability, Blood Lipids, and Circulating Eosinophils in Adults with Asthma

Introduction We investigated whether markers of airway and systemic inflammation, as well as heart rate variability (HRV) in asthmatics, change in response to fluctuations in ambient particulate matter (PM) in the coarse [PM with aerodynamic diameter 2.5–10 μm (PM2.5–10)] and fine (PM2.5) size range. Methods Twelve adult asthmatics, living within a 30-mile radius of an atmospheric monitoring site in Chapel Hill, North Carolina, were followed over a 12-week period. Daily PM2.5–10 and PM2.5 concentrations were measured separately for each 24-hr period. Each subject had nine clinic visits, at which spirometric measures and peripheral blood samples for analysis of lipids, inflammatory cells, and coagulation-associated proteins were obtained. We also assessed HRV [SDNN24HR (standard deviation of all normal-to-normal intervals in a 24-hr recording), ASDNN5 (mean of the standard deviation in all 5-min segments of a 24-hr recording)] with four consecutive 24-hr ambulatory electrocardiogram measurements. Linear mixed models with a spatial covariance matrix structure and a 1-day lag were used to assess potential associations between PM levels and cardiopulmonary end points. Results For a 1-μg/m3 increase in coarse PM, SDNN24HR, and ASDNN5 decreased 3.36% (p = 0.02), and 0.77%, (p = 0.05) respectively. With a 1-μg/m3 increase in coarse PM, circulating eosinophils increased 0.16% (p = 0.01), triglycerides increased 4.8% (p = 0.02), and very low-density lipoprotein increased 1.15% (p = 0.01). No significant associations were found with fine PM, and none with lung function. Conclusion These data suggest that small temporal increases in ambient coarse PM are sufficient to affect important cardiopulmonary and lipid parameters in adults with asthma. Coarse PM may have underappreciated health effects in susceptible populations.

[1]  H. Frumkin,et al.  Ambient Air Pollution and Respiratory Emergency Department Visits , 2005, Epidemiology.

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

[3]  Zhi‐Jie Zheng,et al.  Association of higher levels of ambient criteria pollutants with impaired cardiac autonomic control: a population-based study. , 2004, American journal of epidemiology.

[4]  N. Alexis,et al.  Biological material on inhaled coarse fraction particulate matter activates airway phagocytes in vivo in healthy volunteers. , 2006, The Journal of allergy and clinical immunology.

[5]  Daniel Krewski,et al.  The influence of ambient coarse particulate matter on asthma hospitalization in children: case-crossover and time-series analyses. , 2002, Environmental health perspectives.

[6]  A. Peters,et al.  Exposure to traffic and the onset of myocardial infarction. , 2004, The New England journal of medicine.

[7]  D. Mannino,et al.  Air Pollution and Heart Rate Variability Among the Elderly in Mexico City , 2003, Epidemiology.

[8]  R. Burnett,et al.  Effects of particulate and gaseous air pollution on cardiorespiratory hospitalizations. , 1999, Archives of environmental health.

[9]  E. Svendsen,et al.  Coarse particulate matter concentrations from residential outdoor sites associated with the North Carolina Asthma and Children's Environment Studies (NC-ACES) , 2007 .

[10]  N. Alexis,et al.  CD14-dependent airway neutrophil response to inhaled LPS: role of atopy. , 2001, The Journal of allergy and clinical immunology.

[11]  H. Hein,et al.  Increased heart rate and reduced heart-rate variability are associated with subclinical inflammation in middle-aged and elderly subjects with no apparent heart disease. , 2004, European heart journal.

[12]  Ronald W. Williams,et al.  Daily variation of particulate air pollution and poor cardiac autonomic control in the elderly. , 1999, Environmental health perspectives.

[13]  T G Buchman,et al.  Experimental human endotoxemia increases cardiac regularity: results from a prospective, randomized, crossover trial. , 1996, Critical care medicine.

[14]  R. Hamman,et al.  Airborne endotoxin predicts symptoms in non-mouse-sensitized technicians and research scientists exposed to laboratory mice. , 2003, American journal of respiratory and critical care medicine.

[15]  V. Fuster,et al.  Long-term air pollution exposure and acceleration of atherosclerosis and vascular inflammation in an animal model. , 2005, JAMA.

[16]  J. Sarnat,et al.  Assessing the Relationship between Personal Particulate and Gaseous Exposures of Senior Citizens Living in Baltimore, MD , 2000, Journal of the Air & Waste Management Association.

[17]  R. Pauwels,et al.  Severity of asthma is related to endotoxin in house dust. , 1996, American journal of respiratory and critical care medicine.

[18]  B. Brunekreef,et al.  Epidemiological evidence of effects of coarse airborne particles on health , 2005, European Respiratory Journal.

[19]  L Sheppard,et al.  Effects of ambient air pollution on nonelderly asthma hospital admissions in Seattle, Washington, 1987-1994. , 1999, Epidemiology.

[20]  N. Alexis,et al.  Inhalation of low-dose endotoxin favors local T(H)2 response and primes airway phagocytes in vivo. , 2004, The Journal of allergy and clinical immunology.

[21]  Jing-Shiang Hwang,et al.  Effects of Subchronic Exposures to Concentrated Ambient Particles (CAPs) in Mice: III. Acute and Chronic Effects of CAPs on Heart Rate, Heart-Rate Fluctuation, and Body Temperature , 2005, Inhalation toxicology.

[22]  A. Peters,et al.  Relationship between electrocardiographic and biochemical variables in coronary artery disease. , 2007, International journal of cardiology.

[23]  P. Vokonas,et al.  Effects of Air Pollution on Heart Rate Variability: The VA Normative Aging Study , 2004, Environmental health perspectives.

[24]  J. Schwartz,et al.  Short term effects of particulate matter on cause specific mortality: effects of lags and modification by city characteristics , 2005, Occupational and Environmental Medicine.

[25]  R. Sergysels,et al.  Inflammatory response to acute inhalation of endotoxin in asthmatic patients. , 1992, The American review of respiratory disease.

[26]  F. Gilliland,et al.  Ambient Air Pollution and Atherosclerosis in Los Angeles , 2004, Environmental health perspectives.

[27]  E. Tomao,et al.  The effects of air pollution on the lipid balance of traffic police personnel. , 2002, Annals of Saudi medicine.

[28]  M. Fenton,et al.  Involvement of microbial components and toll-like receptors 2 and 4 in cytokine responses to air pollution particles. , 2002, American journal of respiratory cell and molecular biology.

[29]  B. Gordon,et al.  A single intravenous dose of endotoxin rapidly alters serum lipoproteins and lipid transfer proteins in normal volunteers Published, JLR Papers in Press, May 16, 2003. DOI 10.1194/jlr.M200440-JLR200 , 2003, Journal of Lipid Research.

[30]  Lung-Chi Chen,et al.  Effects of Subchronic Exposures to Concentrated Ambient Particles (CAPs) in Mice: V. CAPs Exacerbate Aortic Plaque Development in Hyperlipidemic Mice , 2005, Inhalation toxicology.

[31]  J. Hogg,et al.  AMBIENT AIR PARTICULATES STIMULATE ALVEOLAR MACROPHAGES OF SMOKERS TO PROMOTE DIFFERENTIATION OF MYELOID PRECURSOR CELLS , 2002, Experimental lung research.

[32]  D. Zeldin,et al.  Endotoxin exposure is a risk factor for asthma: the national survey of endotoxin in United States housing. , 2005, American journal of respiratory and critical care medicine.

[33]  J. Schwartz,et al.  Characterization of particulate and gas exposures of sensitive subpopulations living in Baltimore and Boston. , 2005, Research report.

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

[35]  R. Burnett,et al.  Influence of Relatively Low Level of Particulate Air Pollution on Hospitalization for COPD in Elderly People , 2004, Inhalation toxicology.

[36]  J. Peters,et al.  Ambient endotoxin concentrations in PM10 from Southern California. , 2004, Environmental health perspectives.

[37]  K. Feingold,et al.  Effects of endotoxin on lipid metabolism. , 1995, Biochemical Society transactions.

[38]  D Krewski,et al.  The role of particulate size and chemistry in the association between summertime ambient air pollution and hospitalization for cardiorespiratory diseases. , 1997, Environmental health perspectives.

[39]  S. Becker,et al.  Human alveolar macrophage responses to air pollution particulates are associated with insoluble components of coarse material, including particulate endotoxin. , 2001, Toxicology and applied pharmacology.

[40]  B. Taylor,et al.  Endotoxin Effects on Markers of Autonomic Nervous System Function in the Piglet: Implications for SIDS , 2004, Neonatology.

[41]  J. Schwartz,et al.  The Relationship between Ambient Air Pollution and Heart Rate Variability Differs for Individuals with Heart and Pulmonary Disease , 2005, Environmental health perspectives.

[42]  Bert Brunekreef,et al.  Particulate Air Pollution and Risk of ST-Segment Depression During Repeated Submaximal Exercise Tests Among Subjects With Coronary Heart Disease: The Exposure and Risk Assessment for Fine and Ultrafine Particles in Ambient Air (ULTRA) Study , 2002, Circulation.

[43]  Antonella Zanobetti,et al.  Diabetes Enhances Vulnerability to Particulate Air Pollution–Associated Impairment in Vascular Reactivity and Endothelial Function , 2004, Circulation.

[44]  R. Sergysels,et al.  Dose-response relationship to inhaled endotoxin in normal subjects. , 1997, American journal of respiratory and critical care medicine.

[45]  M. H. Kempski,et al.  Autonomic modulation of heart rate variability during endotoxin shock in rabbits. , 1995, Critical care medicine.

[46]  Brigit VanGraafeiland,et al.  National Asthma Education and Prevention Program. , 2002, The Nurse practitioner.

[47]  Delbert J Eatough,et al.  Ambient particulate air pollution, heart rate variability, and blood markers of inflammation in a panel of elderly subjects. , 2004, Environmental health perspectives.

[48]  W. Cascio,et al.  Altered Heart-Rate Variability in Asthmatic and Healthy Volunteers Exposed to Concentrated Ambient Coarse Particles , 2004, Inhalation toxicology.

[49]  Jonathan Thornburg,et al.  THE RESEARCH TRIANGLE PARK PARTICULATE MATTER PANEL STUDY: PM MASS CONCENTRATION RELATIONSHIPS , 2003 .

[50]  Jonathan Thornburg,et al.  The Research Triangle Park particulate matter panel study: modeling ambient source contribution to personal and residential PM mass concentrations , 2003 .

[51]  Alexandra Schneider,et al.  Air pollution and markers of inflammation and coagulation in patients with coronary heart disease. , 2006, American journal of respiratory and critical care medicine.

[52]  Ronald W. Williams,et al.  Particulate matter exposure in cars is associated with cardiovascular effects in healthy young men. , 2004, American journal of respiratory and critical care medicine.

[53]  Chang-Chuan Chan,et al.  Effects of Particle Size Fractions on Reducing Heart Rate Variability in Cardiac and Hypertensive Patients , 2005, Environmental health perspectives.

[54]  A. Peters,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 , 2006, Journal of Exposure Science and Environmental Epidemiology.

[55]  James R Murphy,et al.  Importance of the personal endotoxin cloud in school-age children with asthma. , 2005, The Journal of allergy and clinical immunology.

[56]  S. V. van Deventer,et al.  Lipid composition and lipopolysaccharide binding capacity of lipoproteins in plasma and lymph of patients with systemic inflammatory response syndrome and multiple organ failure. , 2003, Critical care medicine.

[57]  J. Kaufman,et al.  Association between short term exposure to fine particulate matter and heart rate variability in older subjects with and without heart disease , 2005, Thorax.

[58]  D. Patel,et al.  Acute LPS inhalation in healthy volunteers induces dendritic cell maturation in vivo. , 2005, The Journal of allergy and clinical immunology.

[59]  Candis Claiborn,et al.  An Analysis of the Association Between Respiratory Symptoms in Subjects with Asthma and Daily Air Pollution in Spokane, Washington , 2004, Inhalation toxicology.