Acute Blood Pressure and Cardiovascular Effects of Near-Roadway Exposures with and without N95-Respirators.

BACKGROUND The risk for cardiovascular events increases within hours of near-roadway exposures. We aimed to determine the traffic-related air pollutants (TRAP) and biological mechanisms involved and if reducing particulate matter<2.5 µm (PM2.5) inhalation is protective. METHODS Fifty healthy-adults underwent multiple 2-hour near-roadway exposures (Tuesdays-Fridays) in Ann Arbor during 2 separate weeks (randomized to wear an N95-respirator during one week). Monday both weeks, participants rested 2-hours in an exam room (once wearing an N95-respirator). Brachial blood pressure, aortic hemodynamics and heart rate variability were repeatedly-measured during exposures. Endothelial function (reactive hyperemia index [RHI]) was measured post-exposures (Thursdays). Black carbon (BC), total particle count (PC), PM2.5, noise and temperature were measured throughout exposures. RESULTS PM2.5 (9.3±7.7 µg/m3), BC (1.3±0.6 µg/m3), PC (8375±4930 particles/cm3) and noise (69.2±4.2 dB) were higher (p-values<0.01) and aortic hemodynamic parameters trended worse while near-roadway (p-values<0.15 versus exam room). Other outcomes were unchanged. Aortic hemodynamics trended towards improvements with N95-respirator usage while near-roadway (p-values<0.15 versus no-use), whereas other outcomes remained unaffected. Higher near-roadway PC and BC exposures were associated with increases in aortic augmentation pressures (p-values<0.05) and trends toward lower RHI (p-values<0.2). N95-respirator usage did not mitigate these adverse responses (non-significant pollutant-respirator interactions). Near-roadway outdoor-temperature and noise were also associated with cardiovascular changes. CONCLUSIONS Exposure to real-world combustion-derived particulates in TRAP, even at relatively-low concentrations, acutely worsened aortic hemodynamics. Our mixed findings regarding the health benefits of wearing N95-respirators support that further studies are needed to validate if they adequately-protect against TRAP given their growing worldwide usage.

[1]  B. Hoffmann,et al.  Health effects of ultrafine particles: a systematic literature review update of epidemiological evidence , 2019, International Journal of Public Health.

[2]  Wojciech Zareba,et al.  Ambient and controlled exposures to particulate air pollution and acute changes in heart rate variability and repolarization , 2019, Scientific Reports.

[3]  J. Schwartz,et al.  Long- and short-term air pollution exposure and measures of arterial stiffness in the Framingham Heart Study. , 2018, Environment international.

[4]  B. Brunekreef,et al.  Long-Term Exposure to Ultrafine Particles and Incidence of Cardiovascular and Cerebrovascular Disease in a Prospective Study of a Dutch Cohort , 2018, Environmental health perspectives.

[5]  M. Brauer,et al.  Particulate matter exposure and health impacts of urban cyclists: a randomized crossover study , 2018, Environmental Health.

[6]  Ikenna C. Eze,et al.  A systematic analysis of mutual effects of transportation noise and air pollution exposure on myocardial infarction mortality: a nationwide cohort study in Switzerland , 2018, European heart journal.

[7]  Sadeer G. Al-Kindi,et al.  Air Pollution and Cardiovascular Disease: JACC State-of-the-Art Review. , 2018, Journal of the American College of Cardiology.

[8]  Chris C. Lim,et al.  Global estimates of mortality associated with long-term exposure to outdoor fine particulate matter , 2018, Proceedings of the National Academy of Sciences.

[9]  S. Rajagopalan,et al.  Effects of gaseous and solid constituents of air pollution on endothelial function , 2018, European heart journal.

[10]  Hanqing Fan,et al.  The effects of facemasks on airway inflammation and endothelial dysfunction in healthy young adults: a double-blind, randomized, controlled crossover study , 2018, Particle and Fibre Toxicology.

[11]  R. Brook,et al.  Echoes from Gaea, Poseidon, Hephaestus, and Prometheus: environmental risk factors for high blood pressure , 2018, Journal of Human Hypertension.

[12]  D. Riggs,et al.  Defining the Human Envirome: An Omics Approach for Assessing the Environmental Risk of Cardiovascular Disease. , 2018, Circulation research.

[13]  R. Brook,et al.  Short-Term Blood Pressure Responses to Ambient Fine Particulate Matter Exposures at the Extremes of Global Air Pollution Concentrations , 2018, American journal of hypertension.

[14]  Chun Lin,et al.  Effectiveness of face masks used to protect Beijing residents against particulate air pollution , 2018, Occupational and Environmental Medicine.

[15]  S. Tebbutt,et al.  The effect of low and high-intensity cycling in diesel exhaust on flow-mediated dilation, circulating NOx, endothelin-1 and blood pressure , 2018, PloS one.

[16]  M. Ezzati,et al.  Household air pollution and measures of blood pressure, arterial stiffness and central haemodynamics , 2018, Heart.

[17]  M. Sørensen,et al.  Environmental Noise and the Cardiovascular System. , 2018, Journal of the American College of Cardiology.

[18]  M. Delgado-Rodríguez,et al.  Systematic review and meta-analysis. , 2017, Medicina intensiva.

[19]  R. Brook,et al.  Extreme levels of ambient air pollution adversely impact cardiac and central aortic hemodynamics: the AIRCMD-China study. , 2017, Journal of the American Society of Hypertension : JASH.

[20]  A. Bhatnagar Environmental Determinants of Cardiovascular Disease. , 2017, Circulation research.

[21]  Matthew L. Thomas,et al.  Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015 , 2017, The Lancet.

[22]  S. Signorelli,et al.  A systematic review of arterial stiffness, wave reflection and air pollution. , 2017, Molecular medicine reports.

[23]  Susan Hodgson,et al.  Road traffic noise, blood pressure and heart rate: Pooled analyses of harmonized data from 88,336 participants. , 2016, Environmental research.

[24]  H. Kan,et al.  Cardiovascular Benefits of Wearing Particulate-Filtering Respirators: A Randomized Crossover Trial , 2016, Environmental health perspectives.

[25]  R. Brook,et al.  Environmental stressors and cardio-metabolic disease: part II–mechanistic insights , 2016, European heart journal.

[26]  R. Brook,et al.  Environmental stressors and cardio-metabolic disease: part I–epidemiologic evidence supporting a role for noise and air pollution and effects of mitigation strategies , 2016, European heart journal.

[27]  J. Schauer,et al.  Associations between microvascular function and short-term exposure to traffic-related air pollution and particulate matter oxidative potential , 2016, Environmental Health.

[28]  Tao Liu,et al.  Associations of Short-Term and Long-Term Exposure to Ambient Air Pollutants With Hypertension: A Systematic Review and Meta-Analysis , 2016, Hypertension.

[29]  James Brian Byrd,et al.  Acute increase in blood pressure during inhalation of coarse particulate matter air pollution from an urban location. , 2016, Journal of the American Society of Hypertension : JASH.

[30]  Craig A Fitzner,et al.  Particulate matter air pollution and ambient temperature: opposing effects on blood pressure in high-risk cardiac patients , 2015, Journal of hypertension.

[31]  J. Lelieveld,et al.  The contribution of outdoor air pollution sources to premature mortality on a global scale , 2015, Nature.

[32]  R. Brook,et al.  Understanding Air Pollution and Cardiovascular Diseases: Is It Preventable? , 2015, Current Cardiovascular Risk Reports.

[33]  S. Loft,et al.  Controlled exposure to particulate matter from urban street air is associated with decreased vasodilation and heart rate variability in overweight and older adults , 2015, Particle and Fibre Toxicology.

[34]  Marianne Hatzopoulou,et al.  Exposure to traffic-related air pollution during physical activity and acute changes in blood pressure, autonomic and micro-vascular function in women: a cross-over study , 2014, Particle and Fibre Toxicology.

[35]  M. Adams,et al.  Residential Proximity to Major Roadways and Prevalent Hypertension Among Postmenopausal Women: Results From the Women's Health Initiative San Diego Cohort , 2014, Journal of the American Heart Association.

[36]  J. Sarnat,et al.  Exposure to traffic pollution, acute inflammation and autonomic response in a panel of car commuters. , 2014, Environmental research.

[37]  Q. Fang,et al.  Personal Black Carbon Exposure Influences Ambulatory Blood Pressure: Air Pollution and Cardiometabolic Disease (AIRCMD-China) Study , 2014, Hypertension.

[38]  Gregory Rowangould,et al.  A census of the US near-roadway population: Public health and environmental justice considerations , 2013 .

[39]  Fuyuen Y Yip,et al.  Residential proximity to major highways - United States, 2010. , 2013, MMWR supplements.

[40]  Christine Meisinger,et al.  Triggering of acute myocardial infarction by different means of transportation , 2013, European journal of preventive cardiology.

[41]  Jing Li,et al.  Reducing Personal Exposure to Particulate Air Pollution Improves Cardiovascular Health in Patients with Coronary Heart Disease , 2012, Environmental health perspectives.

[42]  Christoffer Boman,et al.  Particle Traps Prevent Adverse Vascular and Prothrombotic Effects of Diesel Engine Exhaust Inhalation in Men , 2011, Circulation.

[43]  A. Peters,et al.  Estimated personal soot exposure is associated with acute myocardial infarction onset in a case-crossover study. , 2011, Progress in cardiovascular diseases.

[44]  T. Nawrot,et al.  Public health importance of triggers of myocardial infarction: a comparative risk assessment , 2011, The Lancet.

[45]  Christodoulos Stefanadis,et al.  Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis. , 2010, European heart journal.

[46]  R. Brook,et al.  Particulate Matter Air Pollution and Cardiovascular Disease: An Update to the Scientific Statement From the American Heart Association , 2010, Circulation.

[47]  P. Borne,et al.  Environmental determinants of blood pressure, arterial stiffness, and central hemodynamics , 2010, Journal of hypertension.

[48]  C. Vlachopoulos,et al.  Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. , 2010, Journal of the American College of Cardiology.

[49]  D. Rich,et al.  Acute Changes in Heart Rate Variability in Subjects With Diabetes Following a Highway Traffic Exposure , 2010, Journal of occupational and environmental medicine.

[50]  Thomas Sandström,et al.  Exposure to nitrogen dioxide is not associated with vascular dysfunction in man , 2010, Inhalation toxicology.

[51]  Ali S. Kamal,et al.  Insights Into the Mechanisms and Mediators of the Effects of Air Pollution Exposure on Blood Pressure and Vascular Function in Healthy Humans , 2009, Hypertension.

[52]  T. Sandström,et al.  Experimental exposure to diesel exhaust increases arterial stiffness in man , 2009, Particle and Fibre Toxicology.

[53]  R. Kulka,et al.  Particulate air pollution and vascular reactivity: the bus stop study , 2007, International archives of occupational and environmental health.

[54]  L S Robertson Traffic Safety , 2005, Injury Prevention.

[55]  M. Shima Health effects of traffic-related air pollution. , 2005 .

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

[57]  C. Ward‐Caviness,et al.  Associations Between Residential Proximity to Traffic and Vascular Disease in a Cardiac Catheterization Cohort , 2018, Arteriosclerosis, thrombosis, and vascular biology.

[58]  R. Brook,et al.  Air Pollution and Cardiometabolic Disease: An Update and Call for Clinical Trials. , 2017, American journal of hypertension.

[59]  S. Ernst,et al.  Respiratory and cardiovascular responses to walking down a traffic-polluted road compared with walking in a traffic-free area in participants aged 60 years and older with chronic lung or heart disease and age-matched healthy controls: a randomised, crossover study , 2017 .

[60]  J. Veranth,et al.  Particle and Fibre Toxicology BioMed Central , 2006 .