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Heart doctors lay out health effects of air pollution and urge climate action

REUTERS/Charles Platiau
Rush hour traffic fills an avenue leading up to the Arc de Triomphe, which is seen through a small-particle haze at Neuilly-sur-Seine, Western Paris, earlier this year.

Individuals with heart disease should avoid being outside during rush-hour traffic, and policymakers should “urgently” pass laws to lower the levels of air pollution by reducing the use of fossil fuels, declared a major European heart-disease organization, the European Society of Cardiology, in a position paper published Tuesday in the European Heart Journal.

More than 3 million deaths worldwide each year can be attributed to ambient (outdoor) air pollution, the heart-disease experts point out. Indeed, air pollution ranks ninth globally among modifiable risk factors for disease — above such other commonly recognized factors as low physical activity, a diet high in sodium or cholesterol, and illicit drug use.

Air pollution is also responsible for a significant portion of the time people around the world spend in states of reduced health, the experts add.

“There is now ample evidence that air pollution is associated with cardiovascular morbidity and mortality,” says Dr. Robert F. Story, a co-author of the paper and a cardiologist at the University of Sheffield in the United Kingdom, in a released statement. “It not only makes existing heart conditions worse, but also contributes to development of the disease. Avoiding air pollution where possible may help to reduce cardiovascular risk, and cardiologists should incorporate this information into lifestyle advice for their patients. We also need to increase pressure on policy makers to reduce levels of air pollution.”

What this means, of course, is that telling individuals to change heart-unhealthy habits is not enough. Communities also need to make major structural changes — if, that is, we truly want to lower the personal and economic burden of heart disease.

That burden is enormous. Here in the United States, heart disease is the leading cause of death in both men and women. It’s responsible for one in four deaths, or about 600,000 lives each year.

The total cost of cardiovascular diseases in the U.S. was estimated at $444 billion in 2010, according to the Centers for Disease Control and Prevention. About $1 of every $6 spent on health care in the United States goes to the treatment of these diseases.

Various pathways

Air pollution is linked to cardiovascular disease and cardiovascular-related deaths through several pathways, the European cardiologists point out in their paper. Long-term exposure to air pollutants is associated, for example, with a thickening of artery walls (atherosclerosis) and the development of high blood pressure (hypertension), leading causes of heart attack and stroke.

Short-term exposure to air pollutants is associated with an increased risk of blood clots (thrombosis). Recent studies have reported, for example, a link between exposure to traffic and the triggering (within hours) of heart attacks.

Individuals should take steps to reduce their exposure to such pollutants by avoiding being outside in high-pollution areas, the cardiologists stress. But, they add, the role of indoor air pollution should not be downplayed.

“Although people in Western societies spend about 90% of their time indoors, predominantly in their own homes, outdoor air pollution [especially particulate matter] infiltrates buildings and most of the exposure typically occurs indoors,” they warn.

Recommendations

The cardiologists make several recommendations to individuals to reduce their exposure to air pollution:

  • Travel by walking, cycling, and public transportation in preference to car or motorbike.
  • Avoid inefficient burning of biomass for domestic heating.
  • Avoid walking and cycling in streets with high traffic intensity, particularly during rush hour traffic.
  • Exercise in parks and gardens, but avoid major traffic roads.
  • Limit time spent outdoors during highly polluted periods, especially infants, elderly, and those with cardiorespiratory disorders.
  • Consider ventilation systems with filtration for homes in high pollution areas.

But, as the cardiologists stress throughout their paper, changes undertaken by individuals can go only so far in mediating the danger from pollutants. Governments must also take action.

“The burning of fossil fuels are not only a major source of air pollution but also the major source of greenhouse gases,” the cardiologists point out. “Therefore, moving away from the use of fossil fuels for energy production will result in major benefits to human health, both from reduced exposure to air pollution and from mitigation of climate change.”

You can read the European Society of Cardiology’s position paper on air pollution and cardiovascular disease in full on the European Heart Journal’s website.

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