ENVIRONMENTAL EXPOSURE

Traffic related pollution and heart rate variability in a panel of elderly subjects

J Schwartz¹, A Litonjua², H Suh¹, M Verrier², A Zanobetti¹, M Syring², B Nearing³, R Verrier³, P Stone², G MacCallum², F E Speizer², D R Gold²

¹ Department of Environmental Health, Harvard School of Public Health, Boston, USA
² Channing Laboratory, Brigham and Women’s Hospital, Department of Medicine, Harvard Medical School, Boston, MA, USA
³ Division of Cardiology, Brigham and Women’s Hospital, Department of Medicine, Harvard Medical School, Boston, MA, USA

Correspondence to:
Correspondence to:
Professor J Schwartz
Department of Environmental Health, Environmental Epidemiology Program, Harvard School of Public Health, 401 Park Drive,P O Box 15677, Landmark Center, Suite 415, Boston, MA 02215, USA; jschwrtz{at}hsph.harvard.edu

Background: Particulate air pollution has been associated with increased cardiovascular deaths and hospital admissions. To help understand the mechanisms, the types of particles most involved, and the types of persons most susceptible, the association between exposure to summertime air pollution and heart rate variability (HRV) was examined in a panel study of 28 elderly subjects.

Methods: Subjects were seen once a week for up to 12 weeks and HRV (SDNN, r-MSSD, PNN₅₀, low frequency/high frequency ratio (LFHFR)) was measured for approximately 30 minutes at each session using a defined protocol. Temperature, day of the week, and hour of the day were controlled, and dummy variables for each subject were controlled for subject specific risk factors.

Results: PM_2.5 was associated with r-MSSD (–10.1% change for an interquartile range (IQR) increase in exposure (95% CI –2.8 to –16.9)) and PNN₅₀, but stronger associations were seen with black carbon, an indicator of traffic particles, which was also associated with SDNN (–4.6% per IQR (95% CI –2.0 to –7.2)) and LFHFR. Secondary particles were more weakly associated with r-MSSD, as was ozone. No associations were seen with SO₂ or NO₂. CO had similar patterns of association to black carbon, which disappeared after controlling for black carbon. Black carbon had a substantially higher effect on SDNN in subjects who had had a previous myocardial infarction (–12.7%, 95% CI –5.7 to –19.25).

Conclusions: Particles, especially from traffic, are associated with disturbances of autonomic control of the heart.

Abbreviations: CO, carbon monoxide; HRV, heart rate variability; MI, myocardial infarction; NO₂, nitrogen dioxide; PM, particulate matter; SO₂, sulphur dioxide

Keywords: air pollution; heart rate variability; traffic; elderly

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