Cardiopulmonary health effects

Evidence from long-term exposure studies indicates that cardiopulmonary health effects are associated with PM2.5 and that PM2.5 was more closely associated with health outcomes than PMiq. Total mortality, in general, is observed to be associated with long-term exposure to PM by 2-4% per 5 pg m increase in PM2.5. 

Although a number of studies have demonstrated that various metals may play a primary role in mediating PM-related cardiopulmonary health effects and autoimmunity, less is known regarding the potential impacts of environmental exposures to PGE. In particular, very httle data is available regarding the sub-clinical effects of chronic low dose exposures. This is especially relevant regarding attempts to assess the effects of exposures to low concentrations of PGE that are being continuously emitted into the environment. 

Donaldson, Ken, Nicholas Mills, WUliam MacNee, Simon Robinson, and David Newby, Role of Inflammation in Cardiopulmonary Health Effects of PMj s, Toxicology and Applied Pharmacology 207, 8483 88 (2005). 

Tomqvist H, Mills NL, Gonzalez M et al (2007) Persistent endothelial dysfuncdon in humans after diesel exhaust inhalation. Am J Respir Grit Car Med 176 395 00 Ulrich MMW, Alink GM, Kumarathasan P et al (2002) Health effects and time course of particulate matter on the cardiopulmonary system in rats with lung inflammation. J Toxicol Environ Health 65 1571-1595... 

Pope CA III (1991) Respiratory hospital admissions associated with PMjo pollution in Utah, Salt Lake, and Cache Valleys. Arch Environ Health 46 90-97 Pope CA III (2000) Epidemiology of fine particulate air pollution and human health biologic mechanisms and who s at risk Environ Health Perspect 108 713-723 Pope CA III, Dockery DW (2006) Health effects of fine particulate air pollution lines that connect. J Air Waste Manag Assoc 56 709-742 Pope CA III, Burnett RT, Thun MJ, Calle EE, Krewski D, Ito K, Thurston GD (2002) Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA 287 1132-1141... 

Exposures to ambient particulate matter (PM), especially fine PM with an aerodynamic radius of 2.5 pm (PM2.5), have been consistently related to increases in mortality and morbidity (Dockery et al. 1993 Burnett et al. 1999). The effects of ambient PM exposures on certain vulnerable populations such as the elderly, those with compromised cardiopulmonary health and children are of particular concern. A number of studies have demonstrated, for instance, that exposure to air pollution is associated with reductions in lung function and growth, asthma, allergic rhinitis and respiratory infections in children (Janssen et al. 2003 Brauer et al. 2007). Among other things, their susceptibility can be attributed to the immaturity of their respiratory defence mechanisms and higher permeability of their airways to air pollutants compared to adults. 

Increases in the concentration of fine particles in the air are associated with increases in mortality. The excess deaths are predominantly from respiratory causes, but deaths from cardiovascular causes are affected as well. This association has been observed in many cities worldwide and perhaps most remarkably, remains strong at low particle concentrations previously thought to be without adverse health effects. The mechanisms by which particulate pollution induces health effects at such low mass concentrations remain unclear. Determining the biological mechanisms involved has been identified as a high-priority research need in the United States (1) and other countries. As suggested by the word cardiopulmonary this chapter will explore hypotheses and evidence linking particle exposure with both respiratory and cardiac dysfunction and disease. 

Tepper, J.S., Wiester, M.J., Costa, D.L., Watkinson, W.P., Weber, M.F. (1987). Cardiopulmonary effects in awake rats four and six months after exposure to methyl isocyanate. Environ. Health Perspect. IT. 95-103. 

The finding that hemoperfusion through the polymeric BetaSorb column effectively removes several middle-molecular-weight toxic proteins and that such toxins and cytokines are heavily involved in the systemic inflammatory response syndrome (SIRS) have stimulated extensive preclinical studies to demonstrate the wider utility of the hemoperfusion procedure. Winchester et al. [365] list 24 cytokines and other protein and glycoprotein molecules in the molecular weight range of 4—llOkDa that are implicated in SIRS. In addition to ESRD, SIRS is caused by various other health problems, such as acute renal failure (350,000 cases per year in the USA), cardiopulmonary bypass surgery (1.5 million/year), and sepsis. 

Graff DW, Cascio WE, Rappold A et al (2009) Exposure to concentrated coarse air pollution particles causes mild cardiopulmonary effects in healthy young adults. Environ Health Perspect 117 1089-1094... 

Gehring U, Heinrich J, Kramer U et al (2006) Long-term exposure to ambient air pollution and cardiopulmonary mortality in women. Epidemiology 17 545-551 Ohio AJ, Devlin RB (2001) Inflammatory lung injury after bronchial instillation of air pollution particles. Am J Respir Crit Care Med 164 704-708 Gielen MH, vanderZee SC, Vanwijnen JH et al (1997) Acute effects of summer air pollution on respiratory health of asthmatic children. Am J Respir Crit Care Med 155 2105-2108 Godleski JJ (2006) Responses of the heart to ambient particle inhalation. Clin Occup Environ Med 5 849-864... 

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