Review: Cardiologists should ‘definitively be worried’ about soil, water pollution
Heavy metals, pesticides and microplastics in the soil and water are not only environmental and ecological hazards, but they also warrant concerns from the cardiology and heart health communities.
A review article, published in Cardiovascular Research, detailed the associations between various pollutants affecting soil and water quality and their impact on CV health.
“Maneuvers such as overfertilization, deforestation, plastic material, heavy metal toxins and pesticides increase cardiovascular mortality, myocardial infarction, heart failure and arrhythmias; and cause arterial hypertension. The most significant pathophysiological mechanisms for CVD are, for example, the increase of oxidative stress and inflammation within the vasculature, thus leading to endothelial dysfunction, suppression of antioxidant defense and disruption of the circadian cycle,” Thomas Münzel, MD, chief of the department of cardiology at the University Medical Center, Johannes Gutenberg University Mainz, Germany, told Healio. “That’s why cardiologists should definitively be worried about soil and water pollution and always screen for potential exposures in case of an established CVD.”
In 2017, The Lancet Commission on Pollution and Health determined that diseases caused by pollution were associated with approximately 9 million premature deaths in 2015, representing 16% of total worldwide deaths, or threefold more than death from AIDS, malaria and tuberculosis combined, according to the review article.
“It is interesting to see that pollution is responsible for 9 million deaths per year. COVID-19 killed 6 million to 7 million in around 2 years. Where is the interest of the public for the health side effects of pollution? For sure, it is considerably less and by far not enough,” Münzel told Healio. “Since pollution contributes substantially to CVD, it should be mentioned as a significant CV risk factor, for example, in the [European Society of Cardiology or American Heart Association] guidelines for prevention. More emphasis should be put on effective mitigation maneuvers to avoid health side effects by soil and water pollution.”
Heavy metals, pesticides and bioactive pollutants
Heavy metals such as cadmium, lead and metalloids such as arsenic can trigger CVDs, according to the review article.
“Toxic substances such as heavy (transition) metals and metalloids or pesticides that contaminate soil frequently produce oxidative stress that is considered as a common initiating event for multiple noncommunicable diseases,” the researchers wrote.
Cadmium may cause vascular damage, endothelial dysfunction and atherosclerosis via replacement of iron and copper in sulfur complexes, thereby boosting Fenton reactions; interfering with antioxidant responses; and inhibition of nitric oxide (NO)-mediated vasodilation, Münzel and colleagues wrote. Lead is believed to have similar biological effects.
Other soil pollutants detailed in the review include polychlorinated biphenyls, polybrominated diphenyl ethers, perfluorocarboxylic acids, perfluorooctanesulphonate, benzene and bisphenol A, all of which can originate from industrial processes or pesticide formulations.
These pollutants can increase oxidative stress, inflammation or epigenetic dysregulations, therefore elevating risk for cancer, endothelial dysfunction, atherosclerosis, apoptosis, nonalcoholic steatohepatitis, obesity, neurodegenerative disorders and cardiometabolic complications, according to the review article.
Nano- and microplastic pollutants
“Nano- and microplastic particles transfer from polluted seawater and soil to the air are by-product of industrial activities, and already represent an appreciable part of household air pollution from synthetic carpets and clothing,” the researchers wrote.
Münzel and colleagues wrote that up to 50% of the weight of manufactured plastics is composed of additives like phthalates, bisphenols, flame retardants, per- and polyfluoroalkyl substances, polychlorinated biphenyls and heavy metals.
The researchers cited several analyses on the uptake of nano- and microplastic particles in marine organisms such as plankton, mussels and fish and the subsequent intake of plastic particles by human consumption of these organisms.
These additive in manufactured plastics are used to modify material color, flexibility, fire resistance and water resistance; however, these modifying substances can include carcinogens, endocrine disruptors and neurotoxicants.
Recent data published in Environment International demonstrated that nano- and microplastic particles can reach the vasculature and potentially damage any organ; although, no population-based studies have been conducted in humans, to date.
“Along with climate change, air pollution and species extinction, soil and water pollution represents an existential threat to the sustainability of human societies,” Münzel told Healio. “All of these forms of environmental degradation are ultimately the consequence of short-term economic thinking and greed that have no respect for natural systems and no concern either for other people today or future generations.
“Concerning all environmental stressors, societal action is highly needed. Without fast actions to decrease the environmental stressors at all levels, the sum of all ‘pollution’ and climate change will likely form a reinforcing feedback loop,” Münzel said. “Currently, around 96% of public health funding is spent for treatment and only 4% for prevention. This must be changed immediately.”
References:
- Landrigan PJ, et al. Lancet. 2017;doi:10.1016/S0140-6736(17)32345-0.
- Leslie HA, et al. Environ Int. 2022;doi:10.1016/j.envint.2022.107199.
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