Cardiovascular effects of air pollution.
Open accessAbstract
Air pollution is composed of particulate matter (PM) and gaseous pollutants, such as nitrogen dioxide and ozone. PM is classified according to size into coarse particles (PM 10), fine particles (PM 2.5) and ultrafine particles. We aim to provide an original review of the scientific evidence from epidemiological and experimental studies examining the cardiovascular effects of outdoor air pollution. Pooled epidemiological studies reported that a 10μg/m 3 increase in long-term exposure to PM 2.5 was associated with an 11% increase in cardiovascular mortality. Increased cardiovascular mortality was also related to long-term and short-term exposure to nitrogen dioxide. Exposure to air pollution and road traffic was associated with an increased risk of arteriosclerosis, as shown by premature aortic and coronary calcification. Short-term increases in air pollution were associated with an increased risk of myocardial infarction, stroke and acute heart failure. The risk was increased even when pollutant concentrations were below European standards. Reinforcing the evidence from epidemiological studies, numerous experimental studies demonstrated that air pollution promotes a systemic vascular oxidative stress reaction. Radical oxygen species induce endothelial dysfunction, monocyte activation and some proatherogenic changes in lipoproteins, which initiate plaque formation. Furthermore, air pollution favours thrombus formation, because of an increase in coagulation factors and platelet activation. Experimental studies also indicate that some pollutants have more harmful cardiovascular effects, such as combustion-derived PM 2.5 and ultrafine particles. Air pollution is a major contributor to cardiovascular diseases. Promotion of safer air quality appears to be a new challenge in cardiovascular disease prevention.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Brook, R. D., Rajagopalan, S., Pope, C. A., Brook, J. R., Bhatnagar, A., Diez-Roux, A. V., Holguin, F., Hong, Y., Luepker, R. V., Mittleman, M. A., et al. (2010) · Circulation · doi:10.1161/cir.0b013e3181dbece1 · Cited by 6,548 · see citing works
The contribution of outdoor air pollution sources to premature mortality on a global scale
Lelieveld, J., Evans, J. S., Fnais, M., Giannadaki, D., & Pozzer, A. (2015) · Nature · doi:10.1038/nature15371 · Cited by 5,977 · see citing works
Kittelson, D. B. (1998) · Journal of Aerosol Science · doi:10.1016/s0021-8502(97)10037-4 · Cited by 2,289 · see citing works
Long-term exposure to air pollution and incidence of cardiovascular events in women
Miller, K. A., Siscovick, D. S., Sheppard, L., Shepherd, K., Sullivan, J. H., Anderson, G. L., & Kaufman, J. D. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa054409 · Cited by 1,854 · see citing works
Long-term air pollution exposure and cardio- respiratory mortality: a review
Hoek, G., Krishnan, R. M., Beelen, R. M. J., Peters, A., Ostro, B. D., Brunekreef, B., & Kaufman, J. D. (2013) · Environmental Health · doi:10.1186/1476-069x-12-43 · Cited by 1,841 · see citing works
Feigin, V. L., Roth, G. A., Naghavi, M., Parmar, P., Krishnamurthi, R., Chugh, S., Mensah, G. A., Norrving, B., Shiue, I., Ng, M., et al. (2016) · The Lancet Neurology · doi:10.1016/s1474-4422(16)30073-4 · Cited by 1,691 · see citing works
Long-term ozone exposure and mortality
Jerrett, M., Burnett, R. T., Pope, C. A., Ito, K., Thurston, G., Krewski, D., Shi, Y., Calle, E., & Thun, M. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0803894 · Cited by 1,602 · see citing works
Hoek, G., Brunekreef, B., Bausch-Goldbohm, S., Fischer, P. H., & van den Brandt, P. A. (2002) · The Lancet · doi:10.1016/s0140-6736(02)11280-3 · Cited by 1,547 · see citing works
Increased Particulate Air Pollution and the Triggering of Myocardial Infarction
Peters, A., Dockery, D. W., Muller, J. E., & Mittleman, M. A. (2001) · Circulation · doi:10.1161/01.cir.103.23.2810 · Cited by 1,470 · see citing works
Laden, F., Neas, L., Dockery, D. W., & Schwartz, J. (2000) · Environmental Health Perspectives · doi:10.1289/ehp.00108941 · Cited by 1,296 · see citing works
Global association of air pollution and heart failure: a systematic review and meta-analysis
Shah, A. S. V., Langrish, J. P., Nair, H., McAllister, D., Hunter, A. L., Donaldson, K., Newby, D. E., & Mills, N. L. (2013) · The Lancet · doi:10.1016/s0140-6736(13)60898-3 · Cited by 1,232 · see citing works
Atkinson, R. W., Kang, S., Anderson, H. R., Mills, I., & Walton, H. (2014) · Thorax · doi:10.1136/thoraxjnl-2013-204492 · Cited by 1,017 · see citing works
(2014) · doi:10.1007/s11356-014-3696-8 · Cited by 946 · see citing works
Sun, Q. (2005) · JAMA · doi:10.1001/jama.294.23.3003 · Cited by 850 · see citing works
Pope, C. A., Bhatnagar, A., McCracken, J. P., Abplanalp, W. T., Conklin, D. J., & O’Toole, T. E. (2016) · Circulation Research · doi:10.1161/circresaha.116.309279 · Cited by 697 · see citing works
Cesaroni, G., Forastiere, F., Stafoggia, M., Andersen, Z. J., Badaloní, C., Beelen, R. M. J., Caracciolo, B., Fairé, U. D., Erbel, R., Eriksen, K. T., et al. (2014) · BMJ · doi:10.1136/bmj.f7412 · Cited by 679 · see citing works
Diesel Exhaust Inhalation Causes Vascular Dysfunction and Impaired Endogenous Fibrinolysis
Mills, N. L., Törnqvist, H., Robinson, S. D., Gonzalez, M. A., Darnley, K., MacNee, W., Boon, N. A., Donaldson, K., Blomberg, A., Sandström, T., et al. (2005) · Circulation · doi:10.1161/circulationaha.105.588962 · Cited by 648 · see citing works
Mills, N. L., Törnqvist, H., Gonzalez, M. C., Vink, E., Robinson, S. D., Söderberg, S., Boon, N. A., Donaldson, K., Sandström, T., Blomberg, A., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa066314 · Cited by 644 · see citing works
Ischemic Heart Disease Events Triggered by Short-Term Exposure to Fine Particulate Air Pollution
Pope, C. A., Muhlestein, J. B., May, H. T., Renlund, D. G., Anderson, J. L., & Horne, B. D. (2006) · Circulation · doi:10.1161/circulationaha.106.636977 · Cited by 617 · see citing works
Kaufman, J. D., Adar, S. D., Barr, R. G., Budoff, M. J., Burke, G. L., Curl, C. L., Daviglus, M. L., Roux, A. V. D., Gassett, A. J., Jacobs, D. R., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00378-0 · Cited by 537 · see citing works
Public health importance of triggers of myocardial infarction: a comparative risk assessment
Nawrot, T. S., Pérez, L., Künzli, N., Munters, E., & Nemery, B. (2011) · The Lancet · doi:10.1016/s0140-6736(10)62296-9 · Cited by 516 · see citing works
Residential Exposure to Traffic Is Associated With Coronary Atherosclerosis
Hoffmann, B. H., Moebus, S., Möhlenkamp, S., Stang, A., Lehmann, N., Dragano, N., Schmermund, A., Memmesheimer, M., Mann, K., Erbel, R., et al. (2007) · Circulation · doi:10.1161/circulationaha.107.693622 · Cited by 498 · see citing works
Nitrogen dioxide and mortality: review and meta-analysis of long-term studies
Faustini, A., Rapp, R., & Forastiere, F. (2014) · European Respiratory Journal · doi:10.1183/09031936.00114713 · Cited by 440 · see citing works
Stafoggia, M., Cesaroni, G., Peters, A., Andersen, Z. J., Badaloní, C., Beelen, R. M. J., Caracciolo, B., Cyrys, J., Fairé, U. D., de Hoogh, K., et al. (2014) · Environmental Health Perspectives · doi:10.1289/ehp.1307301 · Cited by 360 · see citing works
Associations of Short-Term and Long-Term Exposure to Ambient Air Pollutants With Hypertension
Cai, Y., Zhang, B., Ke, W., Feng, B., Lin, H., Xiao, J., Zeng, W., Li, X., Tao, J., Yang, Z., et al. (2016) · Hypertension · doi:10.1161/hypertensionaha.116.07218 · Cited by 348 · see citing works
Diesel exhaust inhalation increases thrombus formation in man
Lucking, A. J., Lundbäck, M., Mills, N. L., Faratian, D., Barath, S. L., Pourazar, J., Cassee, F. R., Donaldson, K., Boon, N. A., Badimón, J. J., et al. (2008) · European Heart Journal · doi:10.1093/eurheartj/ehn464 · Cited by 321 · see citing works
From Particles to Patients: Oxidative Stress and the Cardiovascular Effects of Air Pollution
Miller, M. R., Shaw, C. A., & Langrish, J. P. (2012) · Future Cardiology · doi:10.2217/fca.12.43 · Cited by 304 · see citing works
Langrish, J. P., Li, X., Wang, S., Lee, M. M. Y., Barnes, G. D., Miller, M. R., Cassee, F. R., Boon, N. A., Donaldson, K., Li, J., et al. (2012) · Environmental Health Perspectives · doi:10.1289/ehp.1103898 · Cited by 301 · see citing works
Air Pollution and Markers of Coagulation, Inflammation, and Endothelial Function
Bind, M., Baccarelli, A., Zanobetti, A., Tarantini, L., Suh, H. H., Vokonas, P., & Schwartz, J. D. (2012) · Epidemiology · doi:10.1097/ede.0b013e31824523f0 · Cited by 296 · see citing works
Self-citationMilojevic, A., Wilkinson, P., Armstrong, B., et al. (2014) · Heart · doi:10.1136/heartjnl-2013-304963 · Cited by 285 · see citing works
Particulate air pollution, systemic oxidative stress, inflammation, and atherosclerosis
Araujo, J. A. (2010) · Air Quality Atmosphere & Health · doi:10.1007/s11869-010-0101-8 · Cited by 269 · see citing works
Ozone Air Pollution Is Associated With Acute Myocardial Infarction
Ruidavets, J., Cournot, M., Cassadou, S., Giroux, M., Meybeck, M. P., & Ferrières, J. (2005) · Circulation · doi:10.1161/01.cir.0000154546.32135.6e · Cited by 246 · see citing works
Reducing burden of disease from residential indoor air exposures in Europe (HEALTHVENT project)
Asikainen, A. H., Carrer, P., Kephalopoulos, S., Fernandes, E. D. O., Wargocki, P. L., & Hänninen, O. (2016) · Environmental Health · doi:10.1186/s12940-016-0101-8 · Cited by 229 · see citing works
Combustion-derived nanoparticulate induces the adverse vascular effects of diesel exhaust inhalation
Mills, N. L., Miller, M. R., Lucking, A. J., Beveridge, J., Flint, L., Boere, A. J. F., Fokkens, P. H. B., Boon, N. A., Sandström, T., Blomberg, A., et al. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr195 · Cited by 221 · see citing works
Kettunen, J., Lanki, T., Tiittanen, P., Aalto, P. P., Koskentalo, T., Kulmala, M., Salomaa, V. V., & Pekkanen, J. (2007) · Stroke · doi:10.1161/01.str.0000257999.49706.3b · Cited by 211 · see citing works
Mills, I., Atkinson, R. W., Kang, S., Walton, H., & Anderson, H. R. (2015) · BMJ Open · doi:10.1136/bmjopen-2014-006946 · Cited by 188 · see citing works
Atkinson, R. W., Butland, B. K., Dimitroulopoulou, S., Heal, M. R., Stedman, J. R., Carslaw, N., Jarvis, D., Heaviside, C., Vardoulakis, S., Walton, H., et al. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-009493 · Cited by 185 · see citing works
O’Toole, T. E., Hellmann, J. L., Wheat, L., Haberzettl, P., Lee, J., Conklin, D. J., Bhatnagar, A., & Pope, C. A. (2010) · Circulation Research · doi:10.1161/circresaha.110.222679 · Cited by 154 · see citing works
Fuks, K. B., Weinmayr, G., Foraster, M., Dratva, J., Hampel, R., Houthuijs, D., Oftedal, B., Oudin, A., Panasevich, S., Penell, J. C., et al. (2014) · Environmental Health Perspectives · doi:10.1289/ehp.1307725 · Cited by 136 · see citing works
Nutritional Solutions to Reduce Risks of Negative Health Impacts of Air Pollution
Péter, S., Holguín, F., Wood, L. G., Clougherty, J. E., Raederstorff, D., Antal, M., Weber, P., & Eggersdorfer, M. L. (2015) · Nutrients · doi:10.3390/nu7125539 · Cited by 126 · see citing works
Wang, T., Wang, L., Moreno‐Vinasco, L., Lang, G. D., Siegler, J. H., Mathew, B., Usatyuk, P. V., Samet, J. M., Geyh, A. S., Breysse, P. N., et al. (2012) · Particle and Fibre Toxicology · doi:10.1186/1743-8977-9-35 · Cited by 117 · see citing works
Wauters, A., Dreyfuss, C., Pochet, S., Hendrick, P., Berkenboom, G. M., van de Borne, P., & Argacha, J. (2013) · Hypertension · doi:10.1161/hypertensionaha.111.00991 · Cited by 115 · see citing works
Self-citationAmbient ultrafine particles alter lipid metabolism and HDL anti-oxidant capacity in LDLR-null mice
Li, R., Navab, M., Pakbin, P., et al. (2013) · Journal of Lipid Research · doi:10.1194/jlr.m035014 · Cited by 115 · see citing works
Ambient Air Pollution and Stroke
Ljungman, P. L. S., & Mittleman, M. A. (2014) · Stroke · doi:10.1161/strokeaha.114.003130 · Cited by 114 · see citing works
Short-term effects of air pollution on out-of-hospital cardiac arrest in Stockholm
Raza, A., Bellander, T., Bedada, G. B., Dahlquist, M., Hollenberg, J., Jonsson, M. N., Lind, T., Rosenqvist, M., Svensson, L. A., & Ljungman, P. L. S. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht489 · Cited by 111 · see citing works
Argacha, J., Collart, P., Wauters, A., et al. (2016) · International Journal of Cardiology · doi:10.1016/j.ijcard.2016.07.191 · Cited by 97 · see citing works
Self-citationRapid effects of air pollution on ventricular arrhythmias
Ljungman, P. L. S., Berglind, N., Holmgren, C. M., Gadler, F., Edvardsson, N. G., Pershagen, G., Rosenqvist, M., Sjögren, B., & Bellander, T. (2008) · European Heart Journal · doi:10.1093/eurheartj/ehn463 · Cited by 86 · see citing works
Traffic Air Pollution and Oxidized LDL
Jacobs, L., Emmerechts, J., Hoylaerts, M., Mathieu, C., Hoet, P., Nemery, B., & Nawrot, T. S. (2011) · PLoS ONE · doi:10.1371/journal.pone.0016200 · Cited by 83 · see citing works
Henrotin, J., Zeller, M., Lorgis, L., Cottin, Y., Giroud, M., & Béjot, Y. (2010) · Heart · doi:10.1136/hrt.2010.200337 · Cited by 78 · see citing works
Self-citationAir Pollution and Ischemic Stroke Among Young Adults
Yitshak‐Sade, M., Novack, V., Ifergane, G., Horev, A., & Kloog, I. (2015) · Stroke · doi:10.1161/strokeaha.115.010992 · Cited by 69 · see citing works
Bagryantseva, Y., Novotná, B., Rössner, P., Chvátalová, I., Milcová, A., Švecová, V., Lnenickova, Z., Solanský, I., & Šrám, R. J. (2010) · Toxicology Letters · doi:10.1016/j.toxlet.2010.08.007 · Cited by 68 · see citing works
Hawley, B., L’Orange, C., Olsen, D. B., Marchese, A. J., & Volckens, J. (2014) · Toxicological Sciences · doi:10.1093/toxsci/kfu147 · Cited by 68 · see citing works
Mordukhovich, I., Coull, B. A., Kloog, I., Koutrakis, P., Vokonas, P., & Schwartz, J. D. (2015) · Environmental Health · doi:10.1186/s12940-015-0074-z · Cited by 62 · see citing works
Cardiovascular Emergency Hospital Visits and Hourly Changes in Air Pollution
Yorifuji, T., Suzuki, E., & Kashima, S. (2014) · Stroke · doi:10.1161/strokeaha.114.005227 · Cited by 60 · see citing works
Foam cell formation by particulate matter (PM) exposure: a review
Cao, Y., Long, J., Ji, Y., Chen, G., Shen, Y., Gong, Y. L., & Li, J. (2016) · Inhalation Toxicology · doi:10.1080/08958378.2016.1236157 · Cited by 54 · see citing works
Effects of urban fine particulate matter and ozone on HDL functionality
Ramanathan, G., Yin, F., Speck, M., Tseng, C., Brook, J. R., Silverman, F., Urch, B., Brook, R. D., & Araujo, J. A. (2015) · Particle and Fibre Toxicology · doi:10.1186/s12989-016-0139-3 · Cited by 53 · see citing works
Fine-particulate Air Pollution from Diesel Emission Control and Mortality Rates in Tokyo
Yorifuji, T., Kashima, S., & Doi, H. (2016) · Epidemiology · doi:10.1097/ede.0000000000000546 · Cited by 52 · see citing works
Roadway Proximity and Risk of Sudden Cardiac Death in Women
Hart, J. E., Chiuve, S. E., Laden, F., & Albert, C. M. (2014) · Circulation · doi:10.1161/circulationaha.114.011489 · Cited by 48 · see citing works
Outdoor Fine Particles and Nonfatal Strokes
Shin, H. H., Fann, N. L., Burnett, R. T., Cohen, A., & Hubbell, B. (2014) · Epidemiology · doi:10.1097/ede.0000000000000162 · Cited by 42 · see citing works
Wauters, A., Vicenzi, M., Becker, B. D., et al. (2015) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00149.2015 · Cited by 38 · see citing works
Association between Particulate Air Pollution and QT Interval Duration in an Elderly Cohort
Mordukhovich, I., Kloog, I., Coull, B. A., et al. (2015) · Epidemiology · doi:10.1097/ede.0000000000000424 · Cited by 35 · see citing works
Shen, M., Bin, P., Li, H., et al. (2015) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2015.10.165 · Cited by 20 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Environmental and Health Impacts of Air Pollution: A Review
Manisalidis, I., Stavropoulou, E., Stavropoulos, A., & Bezirtzoglou, E. (2020) · Frontiers in Public Health · doi:10.3389/fpubh.2020.00014 · Cited by 5,269 · see citing works
Bourdrel, T., Annesi-Maesano, I., Alahmad, B., Maesano, C. N., & Bind, M.-A. (2021) · European Respiratory Review · doi:10.1183/16000617.0242-2020 · Cited by 224 · see citing works
Self-citationImpact of ambient PM2.5 on adverse birth outcome and potential molecular mechanism
Li, Z., Tang, Y., Song, X., Lazar, L., Li, Z., & Zhao, J. (2019) · Ecotoxicology and Environmental Safety · doi:10.1016/j.ecoenv.2018.10.109 · Cited by 193 · see citing works
Association of Wildfire Air Pollution and Health Care Use for Atopic Dermatitis and Itch
Fadadu, R. P., Grimes, B., Jewell, N. P., Vargo, J., Young, A. T., Abuabara, K., Balmes, J. R., & Wei, M. L. (2021) · JAMA Dermatology · doi:10.1001/jamadermatol.2021.0179 · Cited by 120 · see citing works
Tauber, J., Chinwuba, I., Kleyn, D., Rothschild, M., Kahn, J., & Thiel, C. L. (2019) · JAMA Ophthalmology · doi:10.1001/jamaophthalmol.2019.2901 · Cited by 83 · see citing works
Particulate pollution and its toxicity to fish: An overview
Gokul, T., Kumar, K. R., Prema, P., Arun, A., Balaji, P., & Faggio, C. (2023) · Comparative Biochemistry and Physiology Part C: Toxicology & Pharmacology · doi:10.1016/j.cbpc.2023.109646 · Cited by 56 · see citing works
- Authors
- Bourdrel, T., Bind, M.-A., Béjot, Y., Morel, O., & Argacha, J.-F.
- Affiliations
- Harvard University (US)
- Université de Bourgogne (FR)
- Hôpital Civil, Strasbourg (FR)
- Vrije Universiteit Brussel (BE)
- Corresponding author
- Bourdrel, Thomas
- Venue
- Archives of Cardiovascular Diseases
- Publisher
- Elsevier BV
- Published
- 2017-11
- Volume
- 110
- Issue
- 11
- Pages
- 634-642
- ISSN
- 1875-2128 (ISSN-L)
- 1875-2136
- PMC
- PMC5963518
- OpenAlex
- W2739223225
- Cited by
- 783
- References
- 62
- Citations by year
- 2026: 29 · 2025: 48 · 2024: 55 · 2023: 69 · 2022: 82 · 2021: 370 · 2020: 70 · 2019: 37 · 2018: 17 · 2017: 2 · 2016: 1 · 2012: 1
- FWCI
- 3.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Archives of cardiovascular diseases (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- HAL (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Funders
- National Institutes of Health (DP5OD021412)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Physical Sciences › Environmental Science › Global and Planetary Change › COVID-19 impact on air quality
- Keywords
- air pollution, cardiovascular effects, particulate matter, PM2.5, PM10, ultrafine particles, nitrogen dioxide, ozone, cardiovascular mortality, arteriosclerosis, aortic calcification, coronary artery calcification, myocardial infarction, stroke, acute heart failure, oxidative stress, endothelial dysfunction, thrombosis, platelet activation, air quality
- MeSH terms
- Air Pollutants, Animals, Blood Coagulation, Cardiovascular Diseases, Cardiovascular System, Environmental Exposure, Humans, Prognosis, Risk Factors, Time Factors, Reactive Oxygen Species, Oxidative Stress, Risk Assessment, Particulate Matter, Plaque, Atherosclerotic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
