Epidemiological studies have demonstrated an increased risk for cardiovascular events in relation to both short- and long-term exposure to ambient particulate matter (PM). Several plausible mechanistic pathways have been described, including an enhanced propensity for arrhythmias, systemic inflammatory responses, and the chronic promotion of atherosclerosis. On the basis of this review, several new findings were reached, including the following: exposure to PM including PM 2.5 ìm in diameter can trigger cardiovascular disease-related mortality; longer-term exposure (e.g., a few years) increases the risk for cardiovascular mortality; reductions in PM levels are associated with decreases in cardiovascular mortality within a period as short as a few years; and many credible pathological mechanisms have been elucidated that lend biological plausibility to these findings. It is the opinion of the writing group that the overall evidence is consistent with a causal relationship between PM exposure and cardiovascular morbidity and mortality. Finally, PM exposure is deemed a modifiable factor that contributes to cardiovascular morbidity and mortality. The purpose of this statement is to develop evidence-based practical guidelines for healthcare professionals and regulatory agencies with a comprehensive review of the literature on air pollution and cardiovascular disease and a specific focus on the clinical implications.
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Acknowledgements The authors are thankful to Dr. R.L. Coffman for anti IL-2, anti IL-4, anti IFN-c antibodies, Dr. A. Sher for anti IL-10, and Dr. G. Trinchieri for anti IL-12 antibodies. Technical help provided by Mr. Mubarak Ali, Mr. B.V.V. Pardhasaradhi, Ms. Zareena Begum, Mr. P. Jayaraman and Mr. K. Kennady is highly acknowledged. The authors are grateful to Mr. Harina-rayanan, Ms. Rana Anjum, and Ms. Roshni Mitra for helpful suggestions. Ms. T. Hemalatha typed the manuscript. SD received a CSIR fellowship. Financial support was provided by the Department of Science and Technology, Government of India.
© Korean Medical Association.
- Air pollution
- Cardiovascular diseases
- Particulate matter
- Yellow dust
ASJC Scopus subject areas