Existing Air Pollution Standards Linked to Higher Heart Risks

According to recent Kaiser Permanente research, prolonged exposure to air pollution raises the chance of having a heart attack or passing away from heart risks, with the biggest consequences occurring in underserved areas.

One of the largest studies to date on the effects of prolonged exposure to fine particle air pollution, which is released from sources like cars, smokestacks, and fires, was published on February 24 in JAMA Network Open. PM2.5, or fine particle air pollution, refers to particles with a diameter of 2.5 micrometers or less. The study supports existing initiatives to tighten the nation’s air pollution limits.

“We found that people exposed to fine particulate air pollution have an increased risk of experiencing a heart attack or dying from coronary heart disease—even when those exposure levels are at or below our current U.S. air quality standards,” said lead author Stacey E. Alexeeff, Ph.D., a research scientist and biostatistician at the Kaiser Permanente Division of Research.

“Our work has the potential to play an important role in ongoing national conversations led by the Environmental Protection Agency on whether—and how much—to tighten air quality standards to protect the public from pollution’s effects.”

3.7 million persons who had lived in California for at least a year and were Kaiser Permanente members in Northern California between 2007 and 2016 were included in the study. In order to determine annual average exposure to fine particle pollution and link it to annual PM2.5 exposure data, the researchers geocoded each adult’s address to a specific region. Next, they determined which individuals had been given a heart attack diagnosis or had passed away due to heart or circulatory disease.

The current yearly regulatory threshold set by the Environmental Protection Agency for PM2.5 fine particle air pollution is 12 micrograms per cubic meter on average over the course of a year. There is evidence that long-term exposure to PM2.5 air pollution increases the chance of developing cardiovascular disease. That’s why the EPA initially instituted air quality standards.

In comparison to concentrations below 8 micrograms per cubic meter, the study found that exposure to PM2.5 at a concentration between 12.0 and 13.9 micrograms per cubic meter was associated with a 10% increased risk of having a heart attack and a 16% increased risk of dying from heart disease or cardiovascular disease.

As cholesterol deposits form in the heart’s arteries, which restrict the heart from receiving the blood and oxygen it requires, the heart risks begin to develop. Cardiovascular disease is a comprehensive term that encompasses all conditions that might harm the heart and blood arteries, including peripheral artery disease, heart failure, and stroke.

The EPA proposed tightening the annual PM2.5 limit in January 2023 by lowering the permissible level to 9.0 to 10.0 micrograms per cubic meter. According to the Clean Air Act’s requirements, the current standard did not effectively protect the public’s health, hence the EPA advised this revision.

The study also examined heart attack diagnoses, heart disease-related fatalities, and cardiovascular disease mortality in individuals who had exposures below the current standard of 12 micrograms per cubic meter. According to the study, adults exposed to air pollution at moderate concentrations of 10.0 to 11.9 micrograms per cubic meter had a 6% higher risk of having a heart attack and a 7% higher risk of dying from heart disease than adults exposed to air pollution at low concentrations of less than 8.0 micrograms per cubic meter. This shows that if the new guideline were 10.0 micrograms per cubic meter or below, people would experience health advantages.

Further research revealed that, in comparison to readings below 8.0 micrograms per cubic meter, the elevated risk of heart attacks was maintained even at concentrations of 8.0 to 9.9 micrograms per cubic meter. Research shows that lowering the revised threshold to 8.0 micrograms per cubic meter might result in a decrease in heart attacks in the United States.

“This is one of the largest studies to date to look at the impact of air pollution on heart disease,” said senior author Stephen Sidney, MD, MPH, a research scientist at the Division of Research.

“Importantly, Kaiser Permanente’s electronic health records made it possible for us to account for other factors that might increase a person’s risk of having a heart attack or developing cardiovascular disease, such as smoking status, body mass index, or having other illnesses, such as diabetes. This allows us to be confident in our conclusion that fine particle air pollution has adverse associations with cardiovascular health.”

The study also showed that neighborhood socioeconomic status was tied to pollution exposure and the risk of cardiovascular disease. “We found strong evidence that neighborhood matters when it comes to exposures to this type of air pollution,” said co-author Stephen Van Den Eeden, Ph.D., a research scientist at the Division of Research.

“The strongest association between exposure to air pollution and risk of cardiovascular events in our study was seen in people who live in low socioeconomic areas, where there is often more industry, busier streets, and more highways.”

The researchers say their findings add important new information to ongoing policy discussions. “Our study clearly adds to the evidence that the current regulatory standards are not sufficient to protect the public,” said Dr. Alexeeff.

“Our findings support the EPA’s analysis that lowering the standard to at least 10.0 micrograms per cubic meter is needed to protect the public. Our findings also suggest that lowering the standard to 8.0 micrograms per cubic meter may be needed to reduce the risk of heart attacks.

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