Heart disease patients in Europe are being advised to avoid being outside during rush hour traffic in a paper published Dec. 9 in European Heart Journal. The position paper on air pollution and cardiovascular disease was written by experts from the European Society of Cardiology and also recommends decreasing the use of fossil fuels.
According to the paper, air pollution accounts for 3.1% of global disability-adjusted life years, an index that measures the time spent in states of reduced health. More than 3 million deaths worldwide are caused by air pollution each year, Professor Robert F. Storey, corresponding author of the paper, said in a news release.
Up to one-third of Europeans who live in urban areas are exposed to air pollution levels above European Union standards, but based on World Health Organization criteria, around 90% of Europeans are exposed to levels that are damaging to health, according to the release.
There is now ample evidence that air pollution is associated with cardiovascular morbidity and mortality, Storey said in the release. It not only makes existing heart conditions worse but also contributes to development of the disease. Avoiding air pollution where possible may help to reduce cardiovascular risk, and cardiologists should incorporate this information into lifestyle advice for their patients.
The paper recommends the following actions to reduce exposure to air pollution:
Travel by walking, cycling and public transportation in preference to car or motorbike.
Avoid inefficient burning of biomass for domestic heating.
Avoid walking and cycling in streets with high traffic intensity, particularly during rush hour.
Exercise in parks and gardens, but avoid major traffic roads.
Limit time spent outdoors during highly polluted periods, especially infants, elderly and those with cardiorespiratory disorders.
Consider ventilation systems with filtration for homes in high pollution areas.
Obese people and those with diabetes may be at higher risk of the cardiovascular effects of pollution, while air pollutants may exacerbate and instigate the development of risk factors such as high blood pressure and impaired insulin sensitivity, according to the release.
The role of indoor air pollution should not be downplayed, according to the authors, since outdoor air pollution infiltrates buildings and most exposure typically occurs indoors. Air pollution should be considered one of the major modifiable risk factors to prevent and manage cardiovascular disease, Storey said in the release. Individuals, especially those with or at risk of cardiovascular disease, can take measures to reduce their exposure, and doctors should include these in lifestyle advice. Policy makers urgently need to reduce levels of air pollution and this should be backed up by legislation.
To read the paper, visit http://eurheartj.oxfordjournals.org/content/early/2014/12/08/eurheartj.ehu458