Years of exposure to air pollution and road traffic noise may raise
heart failure risk

Date:
October 6, 2021
Source:
American Heart Association
Summary:
A study including more than 22,000 female nurses in Denmark
evaluated exposure over 15-20 years to air pollution and road
traffic noise to evaluate the impact on heart failure. Exposure to
small particulate matter and road traffic noise over three years
was associated with an increased risk for heart failure. The risks
were greater among women who were former smokers or women who had
high blood pressure.



FULL STORY ========================================================================== Exposure to air pollution and road traffic noise over the course of
many years may be associated with an increased risk of developing heart failure, and the correlation appears to be even greater in people who
are former smokers or have high blood pressure, according to new research published today in theJournal of the American Heart Association, an open
access journal of the American Heart Association.


==========================================================================
"We found that long-term exposure to specific air pollutants and road
traffic noise increased the risk of incident heart failure, especially for former smokers or people with hypertension, so preventive and educational measures are necessary," said Youn-Hee Lim, Ph.D., lead author of the
study and assistant professor in the section of environmental health
within the department of public health at the University of Copenhagen
in Copenhagen, Denmark. "To minimize the impact of these exposures,
broad public tactics such as emissions control measures should be
implemented. Strategies like smoking cessation and blood pressure
control must be encouraged to help reduce individual risk." This analysis examined the impact of long-term environmental exposure, specifically from
air pollution and road traffic noise, on the development of heart failure
in a group of female nurses in Denmark over a 15-to-20-year period.

Researchers collected data from a prospective study of over 22,000 members
of the all-female Danish Nurse Cohort study. The women were 44 years of
age and older at study enrollment and living in Denmark. Participants
were recruited in 1993 or 1999, and when they enrolled, each woman
completed a comprehensive questionnaire on body mass index, lifestyle
factors (smoking, alcohol consumption, physical activity and dietary
habits), pre-existing health conditions, reproductive health and working conditions. Information on heart failure diagnoses was gathered throughout
the 20-year follow by linking study participants to the Danish National
Patient Register, which includes records on all health care provided
at hospitals in Denmark. Patient data was collected through December
31, 2014.

The study group lived in rural, urban and suburban areas throughout
Denmark. To best measure individual exposure to air pollution and road
traffic noise, researchers maintained records of each individual's
residential addresses, including any moves to new residences from 1970
and 2014. To determine levels of air pollution, the yearly average concentrations of two components, fine particulate matter (PM2.5)
and nitrogen dioxide (NO2), were measured using a Danish air pollution
modeling system. Road traffic noise levels within a three- kilometer
radius from the participants' residential addresses were estimated using
a validated model system called Nord2000 and measured in decibels (dB),
the standard unit for the intensity of sound.

The analysis of various pollutants and their effects on incident heart
failure found:
* For every 5.1 myg/m3 increase in fine particulate matter exposure
over
three years, the risk of incident heart failure increased by 17%;
* For every 8.6 myg/m3 increase in NO2 exposure over three years,
the risk
of incident heart failure increased by 10%;
* For every 9.3 dB increase in road traffic noise exposure over three
years, the risk of incident heart failure increased by 12%; and,
* Increased exposure to fine particulate matter and status as a former
smoker were associated with a 72% increased risk of incident
heart failure.

"We were surprised by how two environmental factors -- air pollution
and road traffic noise -- interacted," Lim said. "Air pollution was a
stronger contributor to heart failure incidence compared to road traffic
noise; however, the women exposed to both high levels of air pollution and
road traffic noise showed the highest increase in heart failure risk. In addition, about 12% of the total study participants had hypertension at enrollment of the study.

However, 30% of the nurses with heart failure incidence had a previous
history of hypertension, and they were the most susceptible population to
air pollution exposure." The study has several limitations. Researchers
did not have information on additional variables that may have affected
the results of the analysis, such as measures for each individual's
exposure to indoor air pollution or occupational noise; the amount of
time spent outdoors; glass thickness of the windows of their home,
which may influence noise pollution levels; if they had a hearing
impairment; or individual socioeconomic status. Additionally, almost
one-fourth of the original participants in the Danish Nurse Cohort were excluded from the final analysis because information was missing at the beginning of the study or at the study's completion, so selection bias
may be a contributing factor. The researchers also note that since they investigated Danish female nurses' exposure levels and health outcomes,
a generalization of the results to men or other populations warrants
caution.

Previous research has shown an association between air pollution and cardiovascular disease, and the American Heart Association detailed
a collection of research on the risks of pollution in a scientific
statement in 2004, with additional updated findings added in 2010. In
2020 the American Heart Association American Heart Association published
a scientific statement and policy guidance to address the implications
of air pollution amid the COVID-19 pandemic and beyond. The policy
statement discusses policy guidance at the local, state and federal
levels to improve the health of our communities.

Short-term exposure to high levels of some air pollutants has also been
linked to heart failure.

Co-authors are Jeanette Therming Jo/rgensen, M.Sc., Ph.D.; Rina So, Ph.D.

student; Tom Cole-Hunter, Ph.D.; Amar Mehta, Sc.D.; Heresh Amini, Ph.D.;
Elvira Bra"uner, Ph.D.; Rudi Westendorp, M.D., Ph.D.; Shuo Liu, M.P.H.;
Laust Mortensen, Ph.D.; Barbara Hoffmann; Steffen Loft, D.M.Sc.; Matthias Ketzel, Ph.D.; Ole Hertel, D.Sc.; Jo/rgen Brandt, Ph.D.; Steen Solvang
Jensen, Ph.D.; Claus Backalarz; Mette K. Simonsen, M.Sc.; Nebojsa Tasic;
Matija Maric; and Zorana J. Andersen, Ph.D. Authors' disclosures are in
the manuscript.

The study was funded by the Danish Council for Independent Research, the
Region Zealand Fund and the Novo Nordisk Foundation Challenge Programme.

========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Youn‐Hee Lim, Jeanette T. Jo/rgensen, Rina So, Tom
Cole‐Hunter, Amar J. Mehta, Heresh Amini, Elvira V. Bra"uner,
Rudi G. J. Westendorp, Shuo Liu, Laust H. Mortensen, Barbara
Hoffmann, Steffen Loft, Matthias Ketzel, Ole Hertel, Jo/rgen Brandt,
Steen Solvang Jensen, Claus Backalarz, Mette K. Simonsen, Nebojsa
Tasic, Matija Maric, Zorana J. Andersen. Long‐Term Exposure
to Air Pollution, Road Traffic Noise, and Heart Failure Incidence:
The Danish Nurse Cohort. Journal of the American Heart Association,
2021; DOI: 10.1161/JAHA.121.021436 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/10/211006080556.htm

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