January 27, 2020
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Pollution And The Heart

Pollution And The Heart
Dr Asit Khanna
MD,DM,FACC,FESC, FSCAI, Principal Consultant & Clinical Coordinator Department Of Interventional Cardiology Yahsoda Hospital Kaushambi,Ghaziabad
Pollution And The Heart

Noise Pollution

Nobel Prize Winner Robert Koch had predicted in 1910 that ‘One day man will have to fight noise as fiercely as cholera and pest’. Acutely, noise interferes with communication, disturbs sleep, and causes annoyance. These disturbance are usually highest for aircraft noise, and higher for road compared with rail traffic noise. A negative impact on cardiovascular and autonomic homeostasis has been shown, even for noise levels that are quite commonly observed in urbanized regions. Earlier studies carried out around Amsterdam's Schiphol airport gave some hints of a higher risk of cardiovascular disorders in subjects that lived close to it. More recent studies, provided evidence of a higher cardiovascular risk for subjects who reside near airports. In a study carried out around Heathrow airport, London, an increased risk of stroke and coronary heart disease was reported in relation to day- and night-time exposure to aircraft noise. The health burden of environmental noise has recently been quantified in a report of the World Health organization (WHO) in terms of disability-adjusted life years (i.e. the number of years lost because of disability or death). The WHO estimates that in western Europeans annually 61,000 years are lost due to noise-induced cardiovascular disease. Additionally, while not being a disease per se, noise-induced annoyance decreases quality of life and thus also causes disability, quantified in 587 000 disability-adjusted life years lost in the western European population.   Increasingly, epidemiologic studies indicate that nocturnal noise exposure may be more relevant for cardiovascular health than day-time noise exposure. Road traffic noise was associated with myocardial infarction in case–control and cohort studies.  A large cohort study in Switzerland reported an increased mortality due to myocardial infarction with increasing exposure levels and duration of aircraft noise. The Night Noise Guidelines for Europe were published by WHO in 2009 and constitute an expert consensus correlating four noise exposure ranges to negative health outcomes. The WHO considers average nocturnal noise levels of  55 dB as an interim goal when the recommended guideline value of 40 dB is not feasible in the short term for the prevention of noise-induced health effects.

Water Contamination

When water becomes contaminated, there is a distinct possibility that people who drink or use the contaminated water could become sick. One of the more serious implications of this is various forms of heart disease, which can come from repeated exposure to certain contaminants in water. Heart disease is debilitating as well as frequently fatal for many people, especially those who are already at risk from weakened immune systems. These contaminants can be easily filtered out though, and some contaminants that cause heart disease include the following:

Atrazine  is a chemical herbicide that ends up leaking into ground water through surface runoff in agricultural areas. Continual contamination with it alongwith a poor immune system can lead to heart disease. One type of heart disease that it can cause is congestive heart failure. Chronic Atrazine exposure can also cause low blood pressure (hypotension).
Antimony is used in a wide array of household items such as paints and enamels. It is from the poor disposal of these paints and enamels that antimony can find its way into ground water and surface water through surface runoff. Antimony can cause health problems when ingested for long periods of time. Its exposure can cause an increase in blood cholesterol, leading to blockages in the coronary arteries.

Barium  is a metallic element that is not found in nature. Yet, manipulated into many different chemicals and substances, barium is frequently used in common objects. It is used in the medical field as well as in many household items such as spark plugs and fluorescent lamps. Barium is also used in rat poison in a form known as barium carbonate. This is definitely harmful to people, especially when it gets into water sources. Barium can be the source of cardiac irregularity (arrythmias) and more commonly an increase in blood pressure.

Lead poisoning from contaminated water can also cause types of heart disease. The most noticeable of these is hypertension, or high blood pressure. High blood pressure caused by lead poisoning can be hard to fight because lead builds in the body and stays there instead of leaving the system.

Selenium overdoses  can cause circulatory problems, which can eventually have a negative effect on the heart as well as the rest of the body.

Air Pollution

Main sources of air pollution are: particulate matter (PM), ozone pollution (O3), carbon monoxide (CO), lead (Pb), Nitrogen dioxide NO2, Volatile organic compounds (VOC) and sulphur dioxide (SO2).  Particulate matter (PM) of sizes 2.5 and 10 μm pose the greatest danger to humans. Evidence suggests that global rise in air pollution levels during the past century is correlated with the increased incidence of cardiovascular diseases. On a global scale, 7 million individuals died as a result of the effects of air pollution in 2012. Air pollution leads to tremendous amounts of financial burden (in 2010, $16 trillion in the US and Europe) on the health-care system. Pollutants affect the heart, blood vessels, and blood at a molecular level through proinflammatory or oxidative stress response, autonomic nervous system imbalance, and the direct permeation of harmful compounds into the tissue. The dysfunction of cells and biological processes of the cardiovascular system leads to an increased prevalence of cardiovascular diseases such as atherosclerosis, hypertension, myocardial infarction, thrombosis, and restricted valve motion. Studies in China have shown an increase of 0.25% in ischemic heart disease (IHD) mortality and a 0.27% increase in IHD morbidity due to a 10 μg/m3 increase in PM. In a study in the US, for every 5−μg/m3 increase in PM2.5  coronary calcification  increased by 4.1 Agatston units/yr. Studies on traffic-related air pollution found that nonhypertensive participants residing within 100 m of major roadways experienced an increase in systolic (0.35 mmHg) and diastolic (0.22 mmHg) blood pressure. The AHA estimates that, on average, we could all be losing one to three years of life expectancy due to pollution-related heart issues. Air pollution from particulate matter2.5 alone increases the risk of premature death from stroke by 19%7 and from CHD by 13%. According to the Air quality in Europe Report (2016) this translates into 444 000 people dying prematurely from CHD and stroke due to air pollution (in the 41 European countries covered by the report)!. A 5 μg/m3 increase in estimated annual mean PM2.5 is associated with a 13% increased risk of coronary events and a 19% increased risk of cerebrovascular events.

Disclaimer:  “ This initiative is undertaken in public interest. The information is only suggestive/for patient education and shall not be considered as a substitute for a doctor’s advice or recommendations. Please consult your doctor for more information.”

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