title: Effects of air pollution on blood pressure and heart rate variability: a panel study of vehicular traffic controllers in the city of São Paulo, Brazil.
abstract: OBJECTIVE
  Evaluating the effects of air pollution on Sao Paulo city's vehicular traffic controllers by means of risk indicators for cardiovascular diseases.
  
  
  RESULTS
  Twenty-four hour blood pressure recordings and an electrocardiogram were obtained in 48 healthy, non-smoking vehicular traffic controllers, aged 31-55 years, during three periods: winter 2000, summer 2001, and winter 2001. Effects of air pollutants on the outcomes were estimated using linear regression based on generalized estimated equations, controlling for age, body mass index, humidity, and temperature. An interquartile range (IQR) increase in CO (1.1 p.p.m.) was associated with increases of 2.6 mmHg (95% CI 1.0, 4.2), 1.8 mmHg (95% CI 0.8, 2.8), and 2.4 mmHg (95% CI 1.1, 3.6) in systolic, diastolic, and mean 24 h ambulatory blood pressures. SO(2) also had relevant effects on blood pressure. On heart rate variability, an IQR increase of SO2 (9.6 microg/m3) was negatively associated with the standard deviation (SD) of normal RR intervals (SDNN) -7.93 ms (95% CI -15.3, -0.6).
  
  
  CONCLUSIONS
  This study supplies biological plausibility for observational studies on air pollution-related cardiovascular morbidity and mortality.
authors.affiliation: Divisão de Pneumologia, Instituto do Coração (InCor), Av. Dr Enéas de Carvalho Aguiar, 44, CEP 05403-000, São Paulo, SP, Brazil. pneubiratan@incor.usp.br
authors.forename: Ubiratan
authors.initials: U
authors.lastname: de Paula Santos
authors.forename: Alfésio Luís Ferreira
authors.initials: AL
authors.lastname: Braga
authors.forename: Dante Marcelo Artigas
authors.initials: DM
authors.lastname: Giorgi
authors.forename: Luiz Alberto Amador
authors.initials: LA
authors.lastname: Pereira
authors.forename: César Jose
authors.initials: CJ
authors.lastname: Grupi
authors.forename: Chin An
authors.initials: CA
authors.lastname: Lin
authors.forename: Marcos Antonio
authors.initials: MA
authors.lastname: Bussacos
authors.forename: Dirce Maria Trevisan
authors.initials: DM
authors.lastname: Zanetta
authors.forename: Paulo Hilário
authors.initials: PH
authors.lastname: do Nascimento Saldiva
authors.forename: Mario Terra
authors.initials: MT
authors.lastname: Filho
mesh_terms: D000328:Adult; D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D001336:Automobiles; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D006813:Humidity; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis / Q000633:toxicity; D012307:Risk Factors; D013458:Sulfur Dioxide / Q000032:analysis / Q000633:toxicity; D013696:Temperature
chemical_list: D000393:Air Pollutants; D013458:Sulfur Dioxide; D009569:Nitric Oxide