Link between pollution and heart disease explored

While not the biggest risk factor air pollution plays a significant role in worsening, or even sparking, heart disease.

A new report published by the Department of Health's Committee on the Medical Effects of Air Pollution (COMEAP) look at the possible links between cardiovascular deaths and breathing in the relatively low levels of pollutants found in a typical British street.

This is, perhaps surprisingly, the first time such a study has taken place in the UK.

While links between particulate pollution and respiratory and lung disease are well established, less work has been done to explore their connection with heart problems.

Coming from a Government department, the report gives an 'official stamp' on what many have suspected for some time.

"Recognition that air pollution might impact on cardiovascular disease, the commonest cause of death in the UK, came as a surprise to most when first identified," said Professor John Ayres, chairman of COMEAP.

"Since that time, a huge amount of research has been undertaken to ensure that these initial findings were supported and to define potential mechanisms for these effects.

"Because of these findings, this committee decided to undertake an extensive review of the evidence for these effects, to assess possible mechanisms and identify areas for future research.

"Clearly, an understanding of the size of the effect of air pollution on cardiovascular disease is very important in terms of the contribution to public health and this report will contribute to a formal quantification of the effects of air pollution currently being undertaken by the committee."

The report concludes that outdoor air pollutants are likely to increase the number of hospital admissions and deaths from heart attacks and other cardiovascular disease but that their contribution is not as significant as others such as smoking, family history and hypertension.

The committee recommends that this be taken into account by town planners and policy makers.

"The evidence that exposure to air pollutants has important effects on the cardiovascular system is of public health concern and calls for greater research," said Prof Ayres.

"Results from studies should feed into policy-making decision processes across different sectors of Government."

As the heart is one step removed from the lungs and pulmonary system, the negative impact of particulates is less straightforward to understand.

Although the committee failed to identify exactly how air pollution affects the cardiovascular system, they suggest the most likely explanation is that the particles subtly affect the control of the heart's rhythm or that inhalation causes chemical reactions in the body that increase the risk of a blood clot.

Prof Ayres stressed the importance of the research and said it opened up more avenues for investigation.

"Cardiovascular disease is very common and, as exposure to air pollution, both in the long and short term, contributes to initiation and exacerbation of disease, it is likely that even modest reductions in exposure will result in significant health gain," he said.

"We hope this report helps in assessing the importance of this area and welcome any comments that you may have."

by Sam Bond



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