Air Pollution Can Trigger Cardiovascular Disease at a Young Age

By Dr. Mercola

Air pollution has been implicated in the exacerbation of heart disease, lung disease and stroke for a number of years. The particles from vehicle and industrial pollution increase the inflammatory response in your body, intensifying disease processes.

Toxic exposure from air pollution is responsible for 1 in every 4 deaths in the world, according to the World Health Organization (WHO).¹ Although industrial pollution is responsible for a fair share of particulate matter, vehicle emissions also play a significant role.

Spending hours behind the wheel of your car, commuting back and forth to work, may increase your potential exposure to particulate pollution. It appears the ventilation system of cars more efficiently clean the incoming air of coarse or large particulate matter, allowing small particulate matter to slip by.²

Recent research has now linked this small particulate matter pollution with an inflammatory process that triggers heart disease and stroke, not just exacerbating the condition.

Particle Size Matters

Particulate matter (PM), also called particulate pollution, is a mixture of solid and liquid particles that range in size from 10 micrometers and smaller to those less than 2.5 micrometers in size.³

Particulates that measure between 2.5 and 10 micrometers are called PM10, and include dust, pollen and mold. PM2.5 particles include combustion emissions, metals and volatile organic compounds (VOC). Substances classified as PM2.5 are the main cause for reduced visibility in the U.S.⁴

Any particle PM10 and smaller can be inhaled into your lungs. Particles 2.5 micrometers and smaller can also pass into your blood stream through your lung tissue. To put size into perspective, PM10 is seven times smaller than the diameter of a strand of hair and PM2.5 is 30 times smaller.⁵

Vehicle Exhaust Produces Pollution Particles Linked to Heart Disease

This short video gives a brief explanation of the different types of air pollution to which you may be exposed. Vehicle and industrial exhaust may plant the seeds for the future development of heart disease and stroke, as PM2.5 are absorbed into your bloodstream.

A scientific statement by the American Heart Association (AHA) in 2004, and later updated in 2010, warned of the health risks of air pollution.⁶ However, it was unclear as to how the exposure to pollution was damaging the arterial system.

In order to evaluate the effect PM2.5 was having on the cardiovascular system, researchers collected samples from nearly 75 participants between December 2014 and April 2015.⁷

When the PM2.5 levels were at their highest, the blood samples also had more fragments of dead cells from the lining of veins, arteries and lung tissue. Those samples also demonstrated a reduction in factors related to growth of blood vessels.

Immune system factors that increased inflammation increased in the samples when PM2.5 levels were highest.⁸

Each of the participants in this study were initially evaluated and were healthy subjects, leading the authors of the study to believe exposure to fine particulate pollution didn’t just exacerbate existing problems, but may also be a factor in the origination of cardiovascular disease. Lead author C. Arden Pope III, Ph.D., of Brigham Young University, said:⁹

"Cardiovascular disease continues to be a major cause of death and disease … Blood vessel damage is an underlying characteristic of much cardiovascular disease including coronary artery disease and cerebrovascular disease and can lead to serious, even life threatening acute disease events including heart attacks and strokes.”

Particle Pollution Triggers Endothelial Cell Death

The researchers concluded even sporadic exposure to PM2.5 was associated with an increase in endothelial cell death and elevations of specific immune cells that could contribute to the development of atherosclerosis and acute coronary events.¹⁰

This new evidence begins to fill in the blanks about how air pollution affects your arterial system and subsequently may trigger both lung disease and cardiovascular disease.¹¹ Pope commented:¹²

"This provides very important mechanistic evidence regarding how air pollution affects cardiovascular disease. These are healthy nonsmokers, and yet you see this subclinical injury even in these very young people.

The initial vascular injury is likely to be minor, but prolonged exposure can contribute to the risk of life-threatening events like stroke and heart attack."

Pollution levels in the U.S. have significantly reduced over the past several decades, thanks in part to the U.S. Clean Air Act initially passed in 1970 and then amended in 1990.¹³

The push for clean air was triggered by a weather inversion over Donora, Pennsylvania, in 1948 when the town was engulfed in toxic fumes, leaving 20 people dead and thousands sickened by the “killer smog.”¹⁴

This event helped to highlight problems with emissions and pollution, leading to years of political and environment battles. While better, Mark Jacobson, Ph.D., Stanford University professor and author, points out that air pollution continues to kill Americans prematurely and injure hundreds of thousands more.¹⁵

In other areas of the world, particulate pollution has not been addressed as it has been in the U.S. While air quality is better in the U.S., emissions are not at zero and researchers warn that people may want to take extra precautions on high pollution days.

Industrial and Vehicle Pollution Is a Global Problem

WHO set air quality standards indicating a level at which PM2.5 might be considered safe to breathe. In 2016 those standards indicated 10 ug/m3 as an annual mean and 25 ug/m3 as a 24-hour mean would be the highest levels considered safe.¹⁶

Unfortunately, many areas of the world, including within the U.S., fall short of these standards. In a comparison between air quality in the Bay area of California and that in Shanghai, China, it appeared the two cities had similar measurements over a 30-day period, hovering around 35 ug/m3.¹⁷

Six cities in California are ranked in the top 10 cities in the U.S. with the worst air quality by the American Lung Association.¹⁸ Bonnie Holmes-Gen, senior director of air quality and climate change with the American Lung Association in California, acknowledges there has been change in the effort toward better air quality.

Since 1970 the economic output of the U.S. has more than tripled and the number of miles traveled in vehicles increased by 172 percent, but the aggregate emissions have fallen nationwide by 69 percent.¹⁹

While the California Bay area experiences days when PM2.5 measurements reach 50 ug/m3, other areas of the world would consider these numbers a vast improvement.

According to WHO, 80 percent of the cities in the world experience air quality readings well above the highest level considered safe.²⁰ The most polluted cities have between 11 and 20 times the highest level of 25 ub/m3, based on data WHO collected.

On average days Kanpur, India, measured 115 ug/m3 of PM2.5; Xingtai, China, 128 ug/m3; and Zabol, Iran, 217 ug/m3. While the comparison between China and California pollution rates, measured in June and July, reflected notoriously high pollution days in California, they are commonly among the best months for pollution in China.

Dirty Air Kills More People Than Polluted Water in Africa

Quickly developing countries in Africa are struggling with poor air quality that rivals the population’s adverse health effects from challenges related to poverty.

In the first effort to assess health damage from air pollution in Africa, researchers found the number of people who died prematurely from poor air quality exceeded the number who died from unsafe water, poor sanitation and malnutrition.²¹ A researcher involved in the study funded by the Paris-based Organization for Economic Co-operation and Development (OECD), stated:

“Annual deaths from ambient [outdoor] particulate matter pollution across the African continent increased by 36 percent from 1990 to 2013. Over the same period, deaths from household air pollution also continued to increase, but only by 18 percent.”

The OECD is a 50-year-old organization, funded by 35 of the world’s richest countries, with the expressed mission to “promote policies that will improve the economic and social well-being of people around the world.”²²

Rana Roy, Ph.D., author of the study from OECD, pointed out that Africa is not currently in a position like China, in which they can focus on air quality without distractions from an unsafe water supply, malnutrition and unsafe sanitation. However, without bold policy changes, the human and economic cost of air pollution may trigger a phenomenal rise in death and disease attributed to air pollution. She said:²³

“It is striking that air pollution costs in Africa are rising in spite of slow industrialisation [sic], and even de-industrialisation [sic] in many countries. Should this latter trend successfully be reversed, the air pollution challenge would worsen faster, unless radically new approaches and technologies were put to use.”

Air Pollution Affects Your Pocketbook in Ways You May Not Realize

Further research has identified yet another impact that air quality has on the world economy. Although the cost of premature death and disease is in the trillions of dollars across the world, air pollution also significantly impacts decision making on an unconscious level.²⁴

In a recent collaborative study between researchers from the University of Ottawa and Columbia University, scientists compared the S&P 500 Index, one benchmark of the New York Stock Exchange, across a 15-year period.²⁵ During that time, researchers discovered that one standard deviation of air quality measurement consistently resulted in decreasing returns, by up to 11.9 percent.²⁶

The findings appeared to cast a different light on a popular theory which suggests that stock market prices are affected by specific internal information. However, the study submits air quality, an outside and unpredictable force, has an effect on stock prices.

The researchers posited,²⁷ “We hypothesize that pollution decreases the risk attitudes of investors via short-term changes in brain and/or physical health.” Higher levels of PM2.5 pollution can make office workers feel worse during the day as the particulates can easily enter office buildings.

These same results have been found in other office situations when air quality has been poor.²⁸ In a study of office workers at Ctrip, China’s largest travel agency, they found pollution affected productivity, even when air pollution measurements were relatively low.

The researchers theorized that if the negative impact on productivity was the result of a reduction in cognitive function, then pollution may have a higher impact on skilled jobs than previously believed.²⁹

Tips to Reduce Indoor Air Pollution

While the number of potential indoor pollutants is large, there are several things you can do to reduce the air pollution in your home and reduce your health risks.