Journal Article

Effects of Fine and Ultrafine Particles on Cardiorespiratory Symptoms in Elderly Subjects with Coronary Heart Disease

J. J. de Hartog, G. Hoek, A. Peters, K. L. Timonen, A. Ibald-Mulli, B. Brunekreef, J. Heinrich, P. Tiittanen, J. H. van Wijnen, W. Kreyling, M. Kulmala and J. Pekkanen

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 157, issue 7, pages 613-623
Published in print April 2003 | ISSN: 0002-9262
Published online April 2003 | e-ISSN: 1476-6256 | DOI:
Effects of Fine and Ultrafine Particles on Cardiorespiratory Symptoms in Elderly Subjects with Coronary Heart Disease

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The ULTRA Study, a study investigating the association between fine and ultrafine particulate air pollution and cardiorespiratory health, was conducted during the winter of 1998–1999 in Amsterdam, the Netherlands; Erfurt, Germany; and Helsinki, Finland. At each study center, a panel of elderly subjects with coronary heart disease recorded cardiac and respiratory symptoms in a diary. Exposure to ambient air pollution was characterized by measuring daily mass concentrations of particles smaller than 10 µm (PM10) and 2.5 µm (PM2.5), number concentrations of ultrafine particles (NC0.01–0.1), and gases. Odds ratios for the relation of symptoms to air pollution, adjusted for time trend, respiratory infections, and meteorologic variables, were mostly homogeneous across the centers. No association was found between air pollution and chest pain. A 10-µg/m3 increase in PM2.5 was positively associated with the incidence of shortness of breath (odds ratio (OR) = 1.12, 95% confidence interval (CI): 1.02, 1.24) and with avoidance of activities (OR = 1.09, 95% CI: 0.97, 1.22). NC0.01–0.1 was only associated with the prevalence of avoidance of activities (OR = 1.10, 95% CI: 1.01, 1.19). In conclusion, PM2.5 was associated with some cardiac symptoms in three panels of elderly subjects. PM2.5 was more strongly related to cardiorespiratory symptoms than ultrafine particles were.

Keywords: aged; air pollution; cardiovascular diseases; coronary disease; environmental exposure; particle size; pathological conditions, signs and symptoms; respiration disorders; Abbreviations: CI, confidence interval; CPC, condensation particle counter; NC, number concentration; NC0.01–0.1, number concentrations of particles with a size range of 0.01–0.1 µm; PM10, mass concentration of particles less than 10 µm in diameter; PM2.5, mass concentration of particles less than 2.5 µm in diameter; ULTRA, Exposure and Risk Assessment for Fine and Ultrafine Particles in Ambient Air.

Journal Article.  7179 words.  Illustrated.

Subjects: Public Health and Epidemiology

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