Indoor Particles Affect Vascular Function in the Aged

Rationale:

Exposure to particulate matter is associated with risk of cardiovascular events, possibly through endothelial dysfunction, and indoor air may be most important.

Objectives:We investigated effects of controlled exposure to indoor air particles on microvascular function (MVF) as the primary endpoint and biomarkers of inflammation and oxidative stress as

secondary endpoints in a healthy elderly population.

Methods:

Atotal of 21 nonsmoking couples participated in a randomized, double-blind, crossover study with two consecutive 48-hourexposures to either particle-filtered or nonfiltered air (2,533–4,058 and 7,718–12,988 particles/cm3, respectively) in their homes.

Measurements and Main Results:

MVF was assessed noninvasively by measuring digital peripheral artery tone after arm ischemia. Secondary endpoints included hemoglobin, red blood cells, platelet count, coagulation factors, P-selectin, plasma amyloid A, C-reactive protein, fibrinogen, IL-6, tumor necrosis factor-a, protein oxidation measured as 2-aminoadipic semialdehyde in plasma, urinary

8-iso-prostaglandin F2a, and blood pressure. Indoor air filtration significantly improved MVF by 8.1% (95% confidence interval, 0.4– 16.3%), and the particulate matter (diameter,2.5 mm) mass of the indoor particles was more important than the total number concentration (10–700 nm) for these effects. MVF was significantly associated with personal exposure to iron, potassium, copper, zinc, arsenic, and lead in the fine fraction. After Bonferroni correction,

none of the secondary biomarkers changed significantly.

Conclusions:

Reduction of particle exposure by filtration of recirculated indoor air for only 48 hours improved MVF in healthy elderly citizens, suggesting that this may be a feasible way of reducing the

risk of cardiovascular disease .

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Acute Effects of Ambient Particulate Matter on Mortality in Europe and North America: Results From the APHENA Study

Acute Effects of Ambient Particulate Matter on Mortality in Europe and

North America: Results from the APHENA Study

Background: The APHENA (Air Pollution and Health: A Combined European and North American Approach) study is a collaborative analysis of multicity time-series data on the effect of air pollution on population health, bringing together data from the European APHEA (Air Pollution and Health: A European Approach) and U.S. NMMAPS (National Morbidity, Mortality and Air Pollution Study) projects, along with Canadian data.

Objectives: The main objective of APHENA was to assess the coherence of the findings of the multicity studies carried out in Europe and North America, when analyzed with a common protocol, and to explore sources of possible heterogeneity. We present APHENA results on the effects of particulate matter (PM) ≤ 10 µm in aerodynamic diameter (PM₁₀) on the daily number of deaths for all ages and for those < 75 and ≥ 75 years of age. We explored the impact of potential environmental and socioeconomic factors that may modify this association.

Methods: In the first stage of a two-stage analysis, we used Poisson regression models, with natural and penalized splines, to adjust for seasonality, with various degrees of freedom. In the second stage, we used meta-regression approaches to combine time-series results across cites and to assess effect modification by selected ecologic covariates.

Results: Air pollution risk estimates were relatively robust to different modeling approaches. Risk estimates from Europe and United States were similar, but those from Canada were substantially higher. The combined effect of PM₁₀ on all-cause mortality across all ages for cities with daily air pollution data ranged from 0.2% to 0.6% for a 10-µg/m³ increase in ambient PM₁₀ concentration. Effect modification by other pollutants and climatic variables differed in Europe and the United States. In both of these regions, a higher proportion of older people and higher unemployment were associated with increased air pollution risk.

Conclusions: Estimates of the increased mortality associated with PM air pollution based on the APHENA study were generally comparable with results of previous reports. Overall, risk estimates were similar in Europe and in the United States but higher in Canada. However, PM₁₀ effect modification patterns were somewhat different in Europe and the United State

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Acute Effects of Ambient Particulate Matter on Mortality in Europe and

North America: Results from the APHENA Study