title: Associations between arrhythmia episodes and temporally and spatially resolved black carbon and particulate matter in elderly patients.
abstract: OBJECTIVE
  Ambient air pollution has been associated with sudden deaths, some of which are likely due to ventricular arrhythmias. Defibrillator discharge studies have examined the association of air pollution with arrhythmias in sensitive populations. No studies have assessed this association using residence-specific estimates of air pollution exposure.
  
  
  METHODS
  In the Normative Aging Study, we investigated the association between temporally resolved and spatially resolved black carbon (BC) and PM2.5 and arrhythmia episodes (bigeminy, trigeminy or couplets episodes) measured as ventricular ectopy (VE) by 4 min ECG monitoring in repeated measures of 701 subjects, during the years 2000-2010. We used a binomial distribution (having or not a VE episode) in a mixed effect model with a random intercept for subject, controlling for seasonality, temperature, day of the week, medication use, smoking, having diabetes, body mass index and age. We also examined whether these associations were modified by genotype or phenotype.
  
  
  RESULTS
  We found significant increases in VE with both pollutants and lags; for the estimated concentration averaged over the 3 days prior to the health assessment, we found increases in the odds of having VE with an OR of 1.52 (95% CI 1.19 to 1.94) for an IQR (0.30 μg/m(3)) increase in BC and an OR of 1.39 (95% CI 1.12 to 1.71) for an IQR (5.63 μg/m(3)) increase in PM2.5. We also found higher effects in subjects with the glutathione S-transferase theta-1 and glutathione S-transferase mu-1 variants and in obese (p<0.05).
  
  
  CONCLUSIONS
  Increased levels of short-term traffic-related pollutants may increase the risk of ventricular arrhythmia in elderly subjects.
authors.affiliation: Environmental Epidemiology and Risk Program, Harvard School of Public Health, Boston, Massachusetts, USA.
authors.forename: Antonella
authors.initials: A
authors.lastname: Zanobetti
authors.forename: Brent A
authors.initials: BA
authors.lastname: Coull
authors.forename: Alexandros
authors.initials: A
authors.lastname: Gryparis
authors.forename: Itai
authors.initials: I
authors.lastname: Kloog
authors.forename: David
authors.initials: D
authors.lastname: Sparrow
authors.forename: Pantel S
authors.initials: PS
authors.lastname: Vokonas
authors.forename: Robert O
authors.initials: RO
authors.lastname: Wright
authors.forename: Diane R
authors.initials: DR
authors.lastname: Gold
authors.forename: Joel
authors.initials: J
authors.lastname: Schwartz
mesh_terms: D000368:Aged; D000393:Air Pollutants / Q000009:adverse effects*; D000397:Air Pollution; D001145:Arrhythmias, Cardiac / Q000201:enzymology / Q000209:etiology* / Q000235:genetics; D002244:Carbon / Q000009:adverse effects*; D014644:Genetic Variation; D005982:Glutathione Transferase / Q000235:genetics*; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects; D008297:Male; D008991:Monitoring, Physiologic; D009154:Mutation; D009765:Obesity / Q000150:complications*; D016017:Odds Ratio; D052638:Particulate Matter / Q000009:adverse effects*; D053260:Soot / Q000009:adverse effects; D001335:Vehicle Emissions
chemical_list: D000393:Air Pollutants; D002244:Carbon; D005982:Glutathione Transferase; D052638:Particulate Matter; D053260:Soot; D001335:Vehicle Emissions; C413545:glutathione S-transferase T1