The effects of particulate matter air pollution on respiratory health and on the cardiovascular system
Particulate matter (PM) is a major component of urban air pollution and has a significant effect on human health. Natural PM sources are volcanic eruptions, dust storms, forest and grassland fires, living vegetation and sea spray. Traffic, domestic heating, power plants and various industrial processes generate significant amounts of anthropogenic PM. PM consists of a complex mixture of solid and liquid particles of organic and inorganic substances suspended in the air. The chemical composition of particles is very complex and depends on emission sources, meteorological conditions and their aerodynamic diameter. Several epidemiological studies have demonstrated that exposure to PM of varying size fractions is associated with an increased risk of respiratory and cardiovascular diseases. Adverse health effects have been documented from studies of both acute and chronic exposure. The most severe effects in terms of overall health burden include a significant reduction in life expectancy by a several months for the average population, which is linked to long-term exposure to moderate concentrations of PM. Nevertheless, numerous deaths and serious cardiovascular and respiratory problems have also been attributed to short-term exposure to peak levels of PM. Although many studies attribute greater toxicity to smaller size fractions, which are able to penetrate deeper into the lung, the molecular mechanisms and the size fractions of the PM that are responsible for the observed diseases are not completely understood.
If the inline PDF is not rendering correctly, you can download the PDF file here.
Monn C, Shaeppi G. Concentrations of total suspended particulates, fine particles and their anionic compounds in ambient air and indoor air. Environ Technol 1993; 14: 869-875.
Matsumoto K, Tanaka H. Formation and dissociation of atmospheric particulate nitrate and chloride: an approach based on phase equilibrium. Atmos Environ 1996; 30: 639-648.
Matsumoto K, Naggo I, Tanaka H, Miyaji H, Iida K, Ikebe Y. Seasonal characteristics of organic and inorganic species and their size distributions in atmospheric aerosols over the northwest Pacific Ocean. Atmos Environ 1998; 32: 1931-1946.
Liu S, Trainer M, Fehsenfeld FC, Parrish DD, Williams EJ, Fahey DW. et al. Ozone production in the rural troposphere and the implication for regional and global ozone distributions. J Geophys Res 1987; 92: 4191-4207.
World Health Organization. Global health risks: mortality and burden of diseases attributable to selected major risks. Geneve: WHO, 2009: 23-53.
Goldberg MS, Burnett RT, Bailar JC, Tamblyn R, Ernst P, Flegel K. et al. Identification of persons with cardiorespiratory conditions who are at risk of dying from the acute effects of ambient air particles. Environ Health Perspect 2001; 109: 487-94.
Samoli E, Peng R, Ramsay T, Pipikou M, Touloumi G, Dominici F. et al. Acute effects of ambient particulate matter on mortality in Europe and North America: results from the APHENA study. Environ Health Perspect 2008; 116: 1480-1486.
Zanobetti A, Schwartz J, Gold D. Are there sensitive subgroups for the effects of airborne particles? Environ Health Perspect 2000; 108: 841-5.
Zanobetti A, Schwartz J. Cardiovascular damage by airborne particles: are diabetics more susceptible? Epidemiology 2002; 13: 588-92.
Dong GH, Chen T, Liu MM, Wang D, Ma YN, Ren WH. et al. Gender differences and effect of air pollution on asthma in children with and without allergic predisposition: northeast Chinese children health study. PLoS One 2011; 6: e22470.
Burr ML, Butland BK, King S, Vaughan-Williams E. Changes in asthma prevalence: two surveys 15 years apart. Arch Dis Child 1989; 64: 1452-1456.
Burney PGJ. Evidence for an increase in atopic disease and possible causes. Clin Exp Allergy 1993; 23: 484-492.
D' amato G, Cecchi L, D' amato M, Liccardi G. Urban air pollution and climate change as environmental risk factors of respiratory allergy: an update. J Investig Allergol Clin Immunol 2010; 20: 95-102.
Hogg JC. Pathophysiology of airflow limitation in chronic obstructive pulmonary disease. Lancet 2004; 364: 709-721.
Mannino DM, Watt G, Hole D, Gillis C, Hart C, McConnachie A. et al. The natural history of chronic obstructive pulmonary disease. Eur Respir J 2006; 27: 627-643.
Ling SH, van Eeden SF. Particulate matter air pollution exposure: role in the development and exacerbation of chronic obstructive pulmonary disease. Int J COPD 2009; 4: 233-243.
Schwartz J. Particulate air pollution and daily mortality: a synthesis. Public Health Rev 1992; 19: 39-60.
Dockery DW, Stone PH. Cardiovascular risks from fine particulate air pollution. N Engl J Med 2007; 356: 511-513.
Brook RD, Franklin B, Cascio W, Hong Y, Howard G, Lipsett M, Luepker R, Mittleman M, Samet J, Smith SC Jr., Tager I. Air pollution and cardiovascular disease: a statement for healthcare professionals from the Expert Panel on Population and Prevention Science of the American Heart Association. Circulation 2004; 109: 2655-2671.
Pope CA, III, Muhlestein JB, May HT, Renlund DG, Anderson JL, Horne BD. Ischemic Heart Disease events triggered by short-term exposure to fine particulate air pollution. Circulation 2006; 114: 2443-2448.
Brook RD. Cardiovascular effects of air pollution. Clin Sci (Lond) 2008; 115: 175-187.
Dockery DW, Pope CA, Xu X, Spengler JD, Ware JH, Fay ME. et al. An association between air pollution and mortality in six US cities. N Engl J Med 1993; 329: 1753-1759.
Peters A, Dockery DW, Muller JE, Mittleman MA. Increased particulate air pollution and the triggering of myocardial infarction. Circulation 2001; 103: 2810-2815.
Pope CA, III, Burnett RT, Thun MJ, Calle EE, Krewski D, Ito K, Thurston GD. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA 2002; 287: 1132-1141.
Schwartz J, Dockery DW, Neas LM. Is daily mortality associated specifically with fine particles? J Air Waste Manag Assoc 1996; 46: 927-939.
World Health Organization. Air quality and health. Geneve: WHO, 2008: 313.
Air quality framework directive. Official Journal L 1999; 163: 41-60.
Directive 2008/50/EC of the European Parliament and of the Council of 21 May 2008 on ambient air quality and cleaner air for Europe.
WHO Air quality guidelines for particulate matter, ozone, nitrogen dioxide and sulfur dioxide-global update 2005: summary of risk assessment, Geneve: WHO, 2005.
Kerminen VM, Teinilä K, Hillamo R. Chemistry of sea-salt particles in the summer Antarctic atmosphere. Atmos Environ 2000; 34: 2817-2825.
Song CH, Carmichael GR. The aging process of naturally emitted aerosol (sea-salt and mineral aerosol) during long range transport. Atmos Environ 1999; 33: 2203-2218.
Corbett JJ, Fischbeck P. Emissions from ships. Science 1997; 278: 823-824.
Eyring V, Köhler HW, van Aardenne J, Lauer A. Emissions from international shipping: the last 50 years. J Geophys Res 2005; 110: D17305.
Bowman F, Odum J, Pandis SN, Seinfeld JH. A new adsorption/absorption model for the formation of secondary atmospheric aerosol. Atmos Environ 1997; 31: 3921-3931.
Pandis SN and Seinfeld JH. Mathematical modeling of acid deposition due to radiation fog. J Geophys Res 1989; 94: 12911-12923.
Stelson AW, Friedlander SK, Seinfeld JH. Note on the equilibrium relationship between ammonia and nitric-acid and particulate ammonium-nitrate. Atmos Environ 1979; 13: 369-371.
Stockwell WR, Calvert JG. The mechanism of the hydroxyl-sulfur dioxide reaction. Atmos Environ 1983; 17: 2231-2235.
Trebs I, Metzger S, Meixner FX, Helas G, Hoffer A, Rudich Y. et al. The NH4+-NO3--Cl--SO42--H2O aerosol system and its gas phase precursors at a pasture site in the Amazon Basin: how relevant are mineral cations and soluble organic acids? J Geophys Res 2005: 110: 345-355.
Wexler AS, Lurmann FW, Seinfeld JH. Modeling urban and regional aerosols: model development. Atmos Environ 1994; 28: 531-546.
Turpin BJ, Huntzinker JJ. Identification of secondary organic aerosol episodes and quantification of primary and secondary organic aerosol concentrations during SCAQS. Atmos Environ 1995; 29: 3527-3544.
Report on WHO Working Group: health aspects of air pollution with particulate, matter ozone and nitrogen dioxide. Geneve: WHO, 2003.
Seinfeld JH, Pandis SN. Atmospheric Chemistry and Physics: From Air Pollution to Climate Change 2006.
Lightly JS, Veranth JS, Sarofim AF. Combustion aerosols: Factors governing their size and composition and implications to human health. J Air Waste Manag Assoc 2000; 50: 1565-1618.
Brook JF, Dann TF, Burnett RT. The relationship among TSP, PM10, PM2.5, and inorganic constituents of atmospheric particulate matter at multiple Canadian locations. J Air and Waste Manag Assoc 1997; 47: 2-19.
Putaud JP, Raes F, Van Dingenen R, Brüggemann E, Facchini MC, Decesari S. et al. A European aerosol phenomenology—2: chemical characteristics of particulate matter at kerbside, urban, rural and background sites in Europe. Atmos Environ 2004; 38: 2579-2595.
Turnbull AB, Harrison RM. Major component contributions to PM10 composition in the UK atmosphere. Atmos Environ 2000; 34: 3129-3137.
Horvath H, Kasaharat M, Pesava P. The size distribution and composition of the atmospheric aerosol at a rural and nearby urban location. J Aerosol Science 1996; 27: 417-435.
Chen ML, Mao IF, Lin IK. The PM2.5 and PM10 particles in urban areas of Taiwan. Science of the Total Environment 1999; 226: 227-235.
Alves LC, Reis MA, Freitas MC. Air particulate matter characterization of a rural area in Portugal. Nuclear Instruments and Methods in Physics Research B 1998; 136: 941-947.
Kuang-Ling Y. Spatial and seasonal variation of PM10 mass concentrations in Taiwan. Atmos Environ 2002; 36: 3403-3411.
van der Wal JT, Janssen LHJM. How contribute emission of PM10 and meteorology to concentrations of fine particles in the Netherlands. J Aerosol Sci 1996; 27: 681-682.
Chang KH, Jeng FT, Tsai YL, Lin PL. Modeling of long-range transport on Taiwan's acid deposition under different weather conditions. Atmos Environ 2000; 34: 3281-3295.
Qin Y, Chan CK, Chan LY, 1997. Characteristics of chemical compositions of atmospheric aerosols in Hong Kong: spatial and seasonal distributions. The Sci Total Environ 1997; 206: 25-37.
Orlic I, Wen X, Ng TH, Tang SM. Two years of aerosol pollution monitoring in Singapore: a review. Nucl Instr Meth Res B 1999; 150: 457-464.
Var F, Narita Y, Tanaka S. The concentration, trend and seasonal variation of metals in the atmosphere in 16 Japanese cities shown by the results of National Air Surveillance Network (NASN) from 1974 to 1996. Atmos Environ 2000; 34; 2755-2770.
Abbey DE, Nishino N, McDonnell WF, Burchette RJ, Knutsen SF, Lawrence Beeson W. et al. Long-term inhalable particles and other air pollutants related to mortality in nonsmokers. Am J Respir Crit Care Med 1999; 159: 373-82.
Brunekreef B, Forsberg B. Epidemiological evidence of effects of coarse airborne particles on health. Eur Respir J 2005; 26: 309-18.
Schwartz J. Short term fluctuations in air pollution and hospital admissions of the elderly for respiratory disease. Thorax 1995; 50: 531-538.
Ryan PH, LeMasters G, Biagini J, Bernstein D, Grinshpun SA, Shukla R. et al. Is it traffic type, volume or distance? wheezing in infants living near truck and bus traffic. J Allergy Clin Immunol 2005; 116: 279-284.
Epton MJ, Dawson RD, Brooks WM, Kingham S, Aberkane T, Cavanagh JA. et al. The effect of ambient air pollution on respiratory health of school children; a panel study. Environ Health 2008; 14: 7-16.
Nordling E, Berglind N, Melen E, Emenius G, Hallberg J, Nyberg F. et al. Traffic-related air pollution and childhood respiratory symptoms, function and allergies. Epidemiology 2008; 19: 401-408.
Van Roosbroeck S, Li R, Hoek G, Lebret E, Brunekreef B, Spiegelman D. Traffic-relatedoutdoor air pollution and respiratory symptoms in children: the impact of adjustment for exposure measurement error. Epidemiology 2008; 19: 409-416.
Salvi S. Health effects of ambient air pollution in children. Paediatr Respir rev 2007; 8: 275-280.
Morgenstern V, Zutavern A, Cyrys J, Brockow I, Gehring U, Koletzko S. et al. Respiratory health and individual estimated exposure to traffic-related air pollutants in a cohorot of young children. Occup Environ Med 2007; 64: 8-16.
Gauderman WJ, Avol E, Gilliland F, Vora H, Thomas D, Berhane K. et al. The effect of air pollution on lung development from 10 to 18 years of age. N Engl J Med 2004; 351: 1057-1076.
Gauderman WJ, Vora H, McConnell R, Berhane K, Gilliland F, Thomas D. et al. Effect of exposure to traffic on lung development from 10 to 18 years of age: a cohorot study. Lancet 2007; 369: 571-577.
Sugiri D, Ranft U, Schikowski T, Kramer U. The influence of large-scale airborne particle decline and traffic-related exposure on children's lung function. Environ Health Perspect 2006; 114: 282-288.
McCreanor J, Cullinan P, Nieuwenhuijsen MJ, Stewart-Evans J, Malliarou E, Jarup L. et al. Respiratory effects of exposure to diesel traffic in persons with asthma. N Engl J Med 2007; 357: 2348-2358.
Atkinson RW, Anderson HR, Sunyer J, Ayres J, Baccini M, Vonk JM. et al. Acute effects of particulate air pollution on respiratory admissions: results from APHEA 2 project. Air Pollution and Health: a European approach. Am J Respir Crit Care Med 2001; 164: 1860-1866.
Polichetti G, Cocco S, Spinali A, Trimarco V, Nunziata A. Effects of particulate matter (PM(10), PM(2.5) and PM(1)) on the cardiovascular system. Toxicology 2009; 261: 1-8.
Wellenius GA, Schwartz J, Mittleman MA. Air pollution and hospital admissions for ischemic and hemorrhagic stroke among medicare beneficiaries. Stroke 2005; 36: 2549-2553.
von Klot S, Peters A, Aalto P, Bellander T, Berglind N, D'Ippoliti D. et al. Ambient air pollution is associated with increased risk of hospital cardiac readmissions of myocardial infarction survivors in five European cities. Circulation 2005; 112: 3073-3079.
Chang CC, Tsai SS, Ho SC, Yang CY. Air pollution and hospital admissions for cardiovascular disease in Taipei, Taiwan. Environ Res 2005; 98: 114-119.
Zeka A, Zanobetti A, Schwartz J. Short term effects of particulate matter on cause specific mortality: effects of lags and modification by city characteristics. Occup Environ Med 2005; 62: 718-725.
Lanki T, Pekkanen J, Aalto P, Elosua R, Berglind N, D'Ippoliti D. et al. Associations of traffic related air pollutants with hospitalisation for first acute myocardial infarction: the HEAPSS study. Occup Environ Med 2006; 63: 844-851.
Ballester F, Rodriguez P, Iniguez C, Saez M, Daponte A, Galán I. et al. Air pollution and cardiovascular admissions association in Spain: results within the EMECAS project. J Epidemiol Commun Health 2006; 60: 328-336.
Miller KA, Siscovick DS, Sheppard L, Shepherd K, Sullivan JH, Anderson GL, Kaufman JD. Long-term exposure to air pollution and incidence of cardiovascular events in women. N Engl J Med 2007; 356: 447-458.
Teo KK, Ounpuu S, Hawken S, Pandey MR, Valentin V, Hunt D. et al. Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: a case-control study. Lancet 2006; 368: 647-658.
Künzli N, Jerrett M, Mack WJ, Beckerman B, LaBree L, Gilliland F. et al. Ambient air pollution and atherosclerosis in Los Angeles. Environ Health Perspect 2005; 113: 201-206.
Hoffmann B, Moebus S, Möhlenkamp S, Stang A, Lehmann N, Dragano N. et al. Residential exposure to traffic is associated with coronary atherosclerosis. Circulation 2007; 116: 489-496.
Gong HJr., Linn WS, Terrell SL, Clark KW, Geller MD, Anderson KR. et al. Altered heart-rate variability in asthmatic and healthy volunteers exposed to concentrated ambient coarse particles. Inhal Toxicol 2004; 16: 335-343.
Harrabi I, Rondeau V, Dartigues JF, Tessier JF, Filleul L. Effects of particulate air pollution on systolic blood pressure: a population-based approach. Environ Res 2006; 101: 89-93.
Kettunen J, Lanki T, Tiittanen P, Aalto PP, Koskentalo T, Kulmala M. et al. Associations of fine and ultrafine particulate air pollution with stroke mortality in an area of low air pollution levels. Stroke 2007; 38: 918-922.
Gilmour PS, Morrison ER, Vickers MA, Ford I, Ludlam CA, Greaves M. et al. The procoagulant potential of environmental particles (PM10). Occup Environ Med 2005; 62: 164-171.
Baccarelli A, Martinelli I, Zanobetti A, Grillo P, Hou LF, Bertazzi PA. et al. Exposure to particulate air pollution and risk of deep vein thrombosis. Arch Intern Med 2008; 168: 920-927.
Mutlu GM, Green D, Bellmeyer A, Baker CM, Burgess Z, Rajamannan N. et al. Ambient particulate matter accelerates coagulation via an IL-6-dependent pathway. J Clin Invest 2007; 117: 2952-2961.
Schicker B, Kuhn M, Fehr R, Asmis LM, Karagiannidis C, Reinhart WH. Particulate matter inhalation during hay storing activity induces systemic inflammation and platelet aggregation. Eur J Appl Physiol 2009; 105: 771-778.
Cozzi E, Wingard CJ, Cascio WE, Devlin RB, Miles JJ, Bofferding AR. et al. Effect of ambient particulate matter exposure on hemostasis. Trans Res 2007; 149: 324-332.
Chuang KJ, Chan CC, Su TC, Lee CT, Tang CS. The effect of urban air pollution on inflammation, oxidative stress, coagulation, and autonomic dysfunction in young adults. Am J Respir Crit Care Med 2007; 176: 370-376.
Schwartz J. Particulate air pollution and daily mortality: a synthesis. Public Health Rev 1992; 19: 39-60.
Katsouyanni K, Samet JM, Anderson HR, Atkinson R, Le Tertre A, Medina S. et al. HEI Health Review Committee. Air pollution and health: a European and North American approach (APHENA). Res Rep Health Eff Inst 2009; 142: 5-90.
Medina, Plasencia A, Ballester F, Mücke HG, Schwartz J, Apheis Group. Apheis: public health impact of PM10 in 19 European cities. J Epidemiol Commun Health 2004; 58: 831-836.
Medina S, Le Tertre A, Saklad M, on behalf of the Apheis Collaborative Network. The Apheis project: air pollution and health - a European information system. Air Qual Atmos Health 2009; 2:185-198.
Pope CA, III, Burnett RT, Thurston GD, Thun MJ, Calle EE, Krewski D. et al. Cardiovascular mortality and long-term exposure to particulate air pollution: epidemiological evidence of general pathophysiological pathways of disease. Circulation 2004; 109: 71-77.
Cohen AJ, Ross Anderson H, Ostro B, Pandey KD, Krzyzanowski M, Kunzli N. et al. The global burden of disease due to outdoor air pollution. J Toxicol Environ Health 2005; 68: 1301-1307.
Stuart BO. Deposition and clearance of inhaled particles. Environ Health Perspect 1976; 16: 41-53.
Kendall M, Tetley TD, Wigzell E, Hutton B, Nieuwenhuijsen M, Luckham P. Lung lining liquid modifies PM(2.5) in favor of particle aggregation: a protective mechanism. Am J Physiol Lung Cell Mol Physiol 2002; 282: 109-114.
Schurch S, Gehr P, Im Hof V, Geiser M, Green F. Surfactant displaces particles toward the epithelium in airways and alveoli. Respir Physiol 1990; 80: 17-32.
Oberdorster G, Ferin J, Gelein R, Soderholm SC, Finkelstein J. Role of the alveolar macrophage in lung injury: studies with ultrafine particles. Environ Health Perspect 1992; 97: 193-199.
Li XY, Gilmour PS, Donaldson K, MacNee W. Free radical activity and pro-inflammatory effects of particulate air pollution (PM10) in vivo and in vitro. Thorax 1996; 51: 1216-1222.
van Eeden SF, Yeung A, Quinlam K, Hogg JC. Systemic response to ambient particulate matter: relevance to chronic obstructive pulmonary disease. Proc Am Thorac Soc 2005; 2: 61-67.
Fujii T, Hayashi S, Hogg JC, Mukae H, Suwa T, Goto Y. et al. Interaction of alveolar macrophages and airway epithelial cells following exposure to particulate matter produces mediators that stimulate the bone marrow. Am J Respir Cell Mol Biol 2002; 27: 34-41.
Fujii T, Hayashi S, Hogg JC, Vincent R, Van Eeden SF. Particulate matter induces cytokine expression in human bronchial epithelial cells. Am J Respir Cell Mol Biol 2001; 25: 265-271.
Gilmour PS, Rahman I, Hayashi S, Hogg JC, Donaldson K, MacNee W. Adenoviral E1A primes alveolar epithelial cells to PM(10)-induced transcription of interleukin-8. Am J Physiol Lung Cell Mol Physiol 2001; 281: 598-606.
Oberdorster G, Oberdorster E, Oberdorster J. Nanotoxicology: an emerging discipline evolving from studies of ultrafine particles. Environ Health Perspect 2005; 113: 823-839.
Araujo JA, Barajas B, Kleinman M, Wang X, Bennett BJ, Gong KW. et al. Ambient particulate pollutants in the ultrafine range promote early atherosclerosis and systemic oxidative stress. Circ Res 2008; 102: 589-596.
Araujo JA, Nel AE. Particulate matter and atherosclerosis: role of particle size, composition and oxidative stress. Par Fibre Toxicol 2009; 6: 24.
Nemmar A, Vanbilloen H, Hoylaerts MF, Hoet PH, Verbruggen A, Nemery B. Passage of intratracheally instilled ultrafine particles from the lung into the systemic circulation in hamster. Am J Respir Crit Care Med 2001; 164: 1665-1668.
Nemmar A, Hoet PHM, Vanquickenborne B, Dinsdale D, Thomeer M, Hoylaerts MF. et al. Passage of inhaled particles into the blood circulation in humans. Circulation 2002; 105: 411-414.
Oberdörster G, Sharp Z, Atudorei V, Elder A, Gelein R, Kreyling W, Cox C. Translocation of inhaled ultrafine particles to the brain. Inhal Toxicol 2004; 16: 437-445.
Peters A, Veronesi B, Calderòn-Garciduenas L, Gehr P, Chen LC, Geiser M. et al. Translocation and potential neurological effects of fine and ultrafine particles a critical update. Part Fibre Toxicol 2006; 3: 13.
Wiebert P, Sanchez-Crespo A, Seitz J, Falk R, Philipson K, Kreyling WG. et al. Negligible clearance of ultrafine particles retained in healthy and affected human lungs. Eur Respir J 2006; 28: 286-290.
Wiebert P, Sanchez-Crespo A, Falk R, Philipson K, Lundin A, Larsson S. et al. No significant translocation of inhaled 35-nm carbon particles to the circulation in humans. Inhal Toxicol 2006; 18: 741-747.
Möller W, Felten K, Sommerer K, Scheuch G, Meyer G, Meyer P. et al. Deposition, retention, and translocation of ultrafine particles from the central airways and lung periphery. Am J Respir Crit Care Med 2008; 177: 426-432.
Seaton A, MacNee W, Donaldson K, Godden D. Particulate air pollution and acute health effects. Lancet 1995; 345: 176-178.
Li C, Liu H, Sun Y, Wang H, Guo F, Rao S. et al. PAMAM nanoparticles promote acute lung injury by inducing autophagic cell death through the Akt-TSC2-mTOR signaling pathway. J Mol Cell Biol 2009; 1: 37-45.