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Elevated particulate matter raises sudden cardiac death risk in women at lower temperatures

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Jaime E. Hart

BOSTON — Women exposed to elevated levels of particulate matter in colder temperatures, even in the short term, are at increased risk for sudden cardiac death, according to findings presented at the Heart Rhythm Society Annual Scientific Sessions.

The researchers performed a time-stratified case-crossover analysis of 112,601 women from the Nurses’ Health Study to determine the association between exposures to particulate matter less than 2.5 µm in diameter (PM_2.5), mean temperatures and sudden cardiac death.

Jaime E. Hart, ScD, assistant professor at Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, and colleagues identified 221 cases of sudden cardiac death in the cohort between 1999 and 2011. For each case of sudden cardiac death, exposure to particulate matter on the day of death was compared with that on control days matched on the day of the week and selected from the same month as the case day.

Increasing levels of exposure to PM_2.5 on the same day were associated with increasing sudden cardiac death risk for each interquartile range in exposure (7.72 g/m³; OR = 1.22; 95% CI, 0.97-1.53), but the relationship was affected by ambient temperature (P for interaction = .01), according to the researchers.

In the two lowest quartiles of temperature, exposure to higher levels of PM_2.5 was associated with sudden cardiac death (OR for quartile 1 = 1.95; 95% CI, 1.83-2.09; OR for quartile 2 = 2.56; 95% CI, 2.35-2.8), but that was not the case in the two highest quartiles of temperature (P for quartile 3 = .6; P for quartile 4 = .1), Hart and colleagues found.

All PM_2.5 exposures were below the current daily Environmental Protection Agency standard of 35 g/m³.

“Before this study, the relationship between short-term exposure to air pollution and sudden cardiac death was not known, especially within the lower risk, general population. Our study demonstrates that even a small amount of air pollution on colder days could put people at risk,” Hart said in a press release. “To reduce exposures, people who don’t live with smokers should try to keep their windows closed and minimize outdoor activities on cold days and to be aware of pollution levels in the air. We hope our results will raise awareness of air pollution as a risk factor and potentially lead to a review of EPA standards, to ultimately help reduce the number of sudden cardiac death cases.” – by Erik Swain

Reference:

Hart JE, et al. Abstract B-P001-186. Presented at: Heart Rhythm Society Annual Scientific Sessions; May 9-12, 2018; Boston.

Disclosure: Hart reports no relevant financial disclosures.