title: Polycyclic aromatic hydrocarbons, brachial artery distensibility and blood pressure among children residing near an oil refinery.
abstract: BACKGROUND
  Polycyclic aromatic hydrocarbons (PAH) are produced by the burning and processing of fuel oils, and have been associated with oxidant stress, insulin resistance and hypertension in adults. Few studies have examined whether adolescents are susceptible to cardiovascular effects of PAHs.
  
  
  OBJECTIVE
  To study associations of PAH exposure with blood pressure (BP) and brachial artery distensibility (BAD), an early marker of arterial wall stiffness, in young boys attending three schools in Jeddah, Saudi Arabia in varying proximity to an oil refinery.
  
  
  METHODS
  Air samples collected from the three schools were analyzed for PAHs. PAH metabolites (total hydroxyphenanthrenes and 1-hydroxypyrene) were measured in urine samples from 184 adolescent males, in whom anthropometrics, heart rate, pulse pressure, brachial artery distensibility and blood pressure were measured. Descriptive, bivariate and multivariable analyses were performed to assess relationships of school location and urinary PAH metabolites with cardiovascular measures.
  
  
  RESULTS
  Total suspended matter was significantly higher (444 ± 143 μg/m(3)) at the school near the refinery compared to a school located near a ring road (395 ± 65 μg/m(3)) and a school located away from vehicle traffic (232 ± 137 μg/m(3)), as were PAHs. Systolic (0.47 S D units, p = 0.006) and diastolic (0.53 SD units, p < 0.001) BP Z-scores were highest at the school near the refinery, with a 4.36-fold increase in prehypertension (p = 0.001), controlling for confounders. No differences in pulse pressure, BAD and heart rate were noted in relationship to school location. Urinary total hydroxyphenanthrenes and 1-hydroxypyrene were not associated with cardiovascular outcomes.
  
  
  CONCLUSIONS
  Proximity to an oil refinery in Saudi Arabia is associated with prehypertension and increases in PAH and particulate matter exposures. Further study including insulin resistance measurements, better control for confounding, and longitudinal measurement is indicated.
authors.affiliation: Departments of Pediatrics, New York University School of Medicine, New York, NY, USA; Environmental Medicine, New York University School of Medicine, New York, NY, USA; Population Health, New York University School of Medicine, New York, NY, USA; New York University Wagner School of Public Service, New York, NY, USA; NYU Steinhardt School of Culture, Education and Human Development, Department of Nutrition, Food & Public Health, New York, NY, USA; Global Institute of Public Health, New York University, New York, NY, USA. Electronic address: Leonardo.trasande@nyumc.org.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Trasande
authors.affiliation: Division of Preventive Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Urbina
authors.affiliation: Department of Environmental Sciences, Faculty of Meteorology, Environment and Arid Land Agriculture, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Mamdouh
authors.initials: M
authors.lastname: Khoder
authors.affiliation: Department of Environmental Sciences, Faculty of Meteorology, Environment and Arid Land Agriculture, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Mansour
authors.initials: M
authors.lastname: Alghamdi
authors.affiliation: Department of Environmental Sciences, Faculty of Meteorology, Environment and Arid Land Agriculture, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Shabaj
authors.affiliation: Division of Environmental Health and Risk Management, School of Geography, Earth and Environmental Sciences. University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: Alam
authors.affiliation: Department of Environmental Sciences, Faculty of Meteorology, Environment and Arid Land Agriculture, King Abdulaziz University, Jeddah, Saudi Arabia; Division of Environmental Health and Risk Management, School of Geography, Earth and Environmental Sciences. University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; Center of Excellence in Environmental Studies, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Roy M
authors.initials: RM
authors.lastname: Harrison
authors.affiliation: Department of Environmental Sciences, Faculty of Meteorology, Environment and Arid Land Agriculture, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Magdy
authors.initials: M
authors.lastname: Shamy
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000187:drug effects*; D001916:Brachial Artery / Q000187:drug effects* / Q000503:physiopathology; D002617:Chemical Industry; D002648:Child; D004781:Environmental Exposure; D006801:Humans; D010578:Petroleum; D011084:Polycyclic Aromatic Hydrocarbons / Q000633:toxicity*
chemical_list: D010578:Petroleum; D011084:Polycyclic Aromatic Hydrocarbons
keywords: Adolescents; Brachial artery distensibility; Particulate matter; Polycyclic aromatic hydrocarbons; Prehypertension