Ambient particulate air pollution and cardiac arrhythmia in a panel of older adults in Steubenville, Ohio

Stefanie Ebelt Sarnat ^1*, Helen H Suh ², Brent A Coull ², Joel Schwartz ², Peter H Stone ³ and Diane R Gold ⁴

¹ Emory University, United States
² Harvard School of Public Health, United States
³ Brigham and Women's Hospital, United States
⁴ Harvard School of Public Health and Brigham and Women's Hospital, United States

^* To whom correspondence should be addressed. E-mail: sebelt{at}sph.emory.edu.

Accepted 26 May 2006

Abstract

Objectives: Ambient particulate air pollution has been associated with increased risk of cardiovascular morbidity and mortality. Pathways by which particles may act involve autonomic nervous system dysfunction or inflammation, which can affect cardiac rate and rhythm. The importance of these pathways may vary by particle component or source. In an eastern U.S. location with significant regional pollution, we examine the association of air pollution and odds of cardiac arrhythmia in older adults.

Methods: We evaluated 32 non-smoking older adults on a weekly basis for 24-weeks during the summer and fall of 2000 with a standardized 30-minute protocol that included continuous electrocardiogram measurements. A central ambient monitoring station provided daily concentrations of fine particles (PM2.5, sulfate, elemental carbon) and gases. Sulfate was used as a marker of regional pollution. We used logistic mixed effects regression to examine the odds of having any supraventricular ectopy (SVE) or ventricular ectopy (VE) in association with increases in air pollution for moving average pollutant concentrations up to ten days prior to the health assessment.

Results: Participant-specific mean counts of arrhythmia over the protocol varied between 0.1 - 363 for SVE and 0 - 350 for VE. We observed odds ratios for having SVE over the length of the protocol of 1.42 (95% CI: 0.99, 2.04), 1.70 (95% CI: 1.12, 2.57) and 1.78 (95% CI: 0.95, 3.35) for 10.0 ìg/m3, 4.2 ìg/m3 and 14.9 ppb increases in 5-day moving average PM2.5, sulfate and ozone concentrations, respectively. The other pollutants, including elemental carbon, showed no effect on arrhythmia. Participants reporting cardiovascular conditions (e.g., previous myocardial infarction or hypertension) were the most susceptible to pollution-induced SVE. We found no association of pollution with VE.

Conclusion: Increased levels of ambient sulfate and ozone may increase the risk of supraventricular arrhythmia in the elderly.

Keywords: Air pollution, Arrhythmia, Cardiovascular disease, Epidemiology

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