Health Research on Air Pollution and Cardiovascular Disease
EPA has conducted extensive research to learn about the association between the air pollutants, fine particulate matter (PM2.5) and cardiovascular disease. The discoveries have contributed to a growing knowledge base on the impacts of air pollution on the heart and vascular system. The work has been used by the Agency to develop scientific assessments for the regular review of the National Ambient Air Quality Standards, required under the Clean Air Act.
Researchers continue to study air pollutants to further understand the impacts on the heart and blood vessels and the potential impacts on underlying conditions, including hypertension, diabetes, and obesity.
Key scientific questions remain to be investigated. They include:
- What factors may modify the effect of PM2.5 on the cardiovascular system, including pre-existing disease, co-exposure to other pollutants, and sociodemographic factors such as social stressors and access to green space?
- While health effects have been observed at higher concentrations, are there similar or distinct effects at lower concentrations either alone or in combination with other air pollutants?
- What biological mechanisms are involved in cardiovascular effects from the molecular level to the whole organism?
Research activities include:
- Big Data Research: One of the many cutting-edge research methods at the EPA involves the use of electronic health records with large data sets to conduct environmental studies. The data are enabling researchers to probe health effects in understudied, sensitive populations such as those with severe cardiovascular disease. Already these records have been used to show the increased health risks faced by individuals with heart failure as a result of PM2.5 exposure. Research is focused on subclinical effects of PM2.5 exposure in healthy and sensitive populations, how exposure affects the development of disease, how PM2.5 composition alters toxicity, and how clinical features such pre-existing disease and even specific disease subtypes alter responses to air pollution exposure.
- CATHGEN Research: Using the CATHGEN database developed by Duke University School of Medicine, EPA researchers are exploring how molecular and clinical risk factors are affected by air pollution and affect individual responses to air pollution. This research includes examinations of the effects of environmental exposures on cardiovascular risk factors, accelerated aging, and mortality risk. Duke University’s CATHGEN web page
- Co-morbidities Research: Air pollution exposure has often been shown to be more toxic for individuals with more than one underlying health condition, referred to as co-morbidities. Researchers are studying how underlying chronic diseases such as cardiovascular disease, or other existing disease risk factors such as medication usage, epigenetic risk factors and genetic risk/family history, may modify individual responses to air pollution. Researchers are also studying this within the context of specific air pollution sources and components to gain a more detailed understanding of how chemical composition of air pollutants may give rise to specific health risks.
- Susceptible/Vulnerable Populations: Some groups of people may be at increased risk to the negative effects of air pollution, including those with heart disease. Through close examination of populations that may be at risk of air pollutant-related health effects as well as healthy people, scientists are identifying risk factors and genes that may contribute to a person experiencing an air pollution-related health effect.
- Environmental Justice: Air pollution exposures vary substantially across the population and are often determined by proximity to sources of air pollution. Some communities are disproportionately impacted by air pollution exposures, and are also subjected to psychosocial stress and sociodemographic factors that can detrimentally impact their overall health status. The interaction of sociodemographic factors and air pollution exposure is complex and still requires further scientific characterization; however, research indicates that it can contribute to adverse health effects.
- Wildfires: Smoke from wildfires is posing an increased health threat to the public. A main component of smoke is PM2.5. The largest health threat is PM2.5, a main component of smoke. Exposure to these particles can affect both the lungs and heart. Numerous scientific studies have linked particle pollution exposure to a variety of problems, including nonfatal heart attacks, irregular heartbeat, and premature death in people with heart or lung disease. It is important to more fully understand the human health effects associated with short- and long-term exposures to smoke from wildfires as well as prescribed fires, referred together as wildland fires. Research is being conducted to advance understanding of the health effects from different types of fires as well as combustion phases.
- Intervention strategies to reduce health impacts: Researchers are evaluating tools and methods to help communities, states, and policy makers control and reduce air pollution's health risks, including those to the heart. Among the studies being conducted include research with community partners to develop smoke-ready communications strategies for wildfires and research on potential personal intervention strategies such as diet to reduce the health risks from air pollution exposure.
- EPA-Funded Research: EPA provides grants to research organizations to study the health effects of air pollutants, including impacts on the cardiovascular system. They include:
- Long-term Exposure to Air Pollution and Development of Cardiovascular Disease. EPA awarded a grant to the University of Washington to expand and inform the understanding of mechanisms of how air pollution contributes to cardiovascular disease. The Science to Achieve Results (STAR) grant supports reducing uncertainty regarding the effects of particulate matter and other criteria pollutants on health. Long-term Exposure to Air Pollution and Development of Cardiovascular Disease
- Air, Climate and Energy (ACE) Centers. EPA awarded grants to create research centers at three universities to investigate the effects of global climate change, technology, and societal choices on local and regional air quality and health. These university research centers will provide sound science to policymakers at the state and local levels for developing strategies that reduce health and environmental impacts of air pollution. Air, Climate and Energy Centers
- Health Effects Institute (HEI). With partial funding by EPA, HEI is conducting research and assembling reports on exposure to mixtures of pollutants and very small particles, called ultrafine particles. Using models, researchers are working to analyze the health effects of these mixtures, including cardiovascular problems. Health Effects Institute Research