Environmental Exposures and Cardiovascular Disease

Abstract

Summary Environmental exposures in low- and middle-income countries lie at the intersection of increased economic development and the rising public health burden of cardiovascular disease. Increasing evidence suggests an association of exposure to ambient air pollution, household air pollution from biomass fuel, lead, arsenic, and cadmium with multiple cardiovascular disease outcomes including hypertension, coronary heart disease, stroke, and cardiovascular mortality. While populations in low- and middle-income countries are disproportionately exposed to environmental pollution, the bulk of evidence that links these exposures to cardiovascular disease is derived from populations in high-income countries. More research is needed to further characterize the extent of environmental exposures and develop targeted interventions towards reducing cardiovascular disease in at-risk populations in low- and middle-income countries.

Health Effects of Ambient Air Pollution in Developing Countries

“…In addition to respiratory diseases, there is also increasing evidence that sustained exposure to ambient and household air pollution has a particularly deleterious effect on the cardiovascular system, and an association has been found between hypertension, coronary heart disease, and stroke [ 16 ]. A 2013 review reported a pooled effect of 11% (95% CI 6 to 16%) for cardiovascular mortality with a 10 μg/m 3 PM 2.5 increase [ 43 ].…”

“…A 2013 review reported a pooled effect of 11% (95% CI 6 to 16%) for cardiovascular mortality with a 10 μg/m 3 PM 2.5 increase [ 43 ]. Although populations in low- and middle-income countries are highly exposed to environmental pollution, the bulk of evidence that links these exposures to cardiovascular disease is derived mostly from populations in high-income countries [ 16 ]. Pertaining to developing countries, for instance, the results of a recent study conducted by Chen and colleagues [ 44 ] clearly indicate that life-expectancy in Northern China, where air quality is particularly poor, is 5.5 years lower owing to an increased incidence of cardiorespiratory mortality.…”

“…If acute and long-term exposure to ambient air pollution represents a serious threat for health in western industrialized countries, the burden of this problem is even higher in developing countries, where population explosion along with widespread industrialization coupled with urbanization have resulted in dense urban centers with poor air quality [ 15 , 16 ]. In such developing countries, however, huge economic and social disparities coexist; thus, in addition to the poor ambient air quality, people can be also exposed, especially in rural areas, to high concentrations of indoor air pollution due to the use of biomass fuels (coal, wood, and other solid fuels) as an energy resource [ 17 , 18 ].…”

The 9th Conference on Metal Toxicity and Carcinogenesis: The conference overview

“…It has been reported that lead, arsenic, and cadmium exposures are linked to cardiovascular diseases and mortality (Burroughs Peña and Rollins, 2017). This area provides a newer set of disease endpoints for heavy metal exposures.…”

“…Airborne particles and air pollution have long been associated with diseases and cancer (Burroughs et al , 2017). Metals are known to cause cancer via inhalation exposure (Fay et al ., 2005; Chou et al ., 2007; Wise et al ., 2008; Faroon et al ., 2012; Wilbur et al ., 2012; Wang L, et al ., 2016).…”