title: Air pollution and arrhythmic risk: the smog is yet to clear.
abstract: Epidemiologic evidence has demonstrated that air pollution may impair cardiovascular health, leading to potentially life-threatening arrhythmias. Efforts have been made, with the use of epidemiologic data and controlled exposures in diverse animal and human populations, to verify the relationship between air pollution and arrhythmias. The purpose of this review is to examine and contrast the epidemiologic and toxicologic evidence to date that relates airborne pollutants with cardiac arrhythmia. We have explored the potential biological mechanisms driving this association. Using the PubMed database, we conducted a literature search that included the terms "air pollution" and "arrhythmia" and eventually divergent synonyms such as "particulate matter," "bradycardia," and "atrial fibrillation." We reviewed epidemiologic studies and controlled human and animal exposures independently to determine whether observational conclusions were corroborated by toxicologic results. Numerous pollutants have demonstrated some arrhythmic capacity among healthy and health-compromised populations. However, some exposure studies have shown no significant correlation of air pollutants with arrhythmia, which suggests some uncertainty about the arrhythmogenic potential of air pollution and the mechanisms involved in arrhythmogenesis. While data from an increasing number of controlled exposures with human volunteers suggest a potential mechanistic link between air pollution and altered cardiac electrophysiology, definite conclusions regarding air pollution and arrhythmia are elusive as the direct arrhythmic effects of air pollutants are not entirely consistent across all studies.
authors.affiliation: Department of Environmental Services, University of Waterloo, Ontario, Canada.
authors.forename: Alex
authors.initials: A
authors.lastname: Watkins
authors.forename: Marlon
authors.initials: M
authors.lastname: Danilewitz
authors.forename: Marjan
authors.initials: M
authors.lastname: Kusha
authors.forename: Stéphane
authors.initials: S
authors.lastname: Massé
authors.forename: Bruce
authors.initials: B
authors.lastname: Urch
authors.forename: Kenneth
authors.initials: K
authors.lastname: Quadros
authors.forename: Danna
authors.initials: D
authors.lastname: Spears
authors.forename: Talha
authors.initials: T
authors.lastname: Farid
authors.forename: Kumaraswamy
authors.initials: K
authors.lastname: Nanthakumar
mesh_terms: D000397:Air Pollution / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D009864:Ontario / Q000453:epidemiology; D012307:Risk Factors; D012905:Smog / Q000009:adverse effects*
chemical_list: D012905:Smog