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Damoun N, Amekran Y, Taiek N, Hangouche AJE. Heart rate variability measurement and influencing factors: Towards the standardization of methodology. Glob Cardiol Sci Pract 2024; 2024:e202435. [PMID: 39351472 PMCID: PMC11439429 DOI: 10.21542/gcsp.2024.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/23/2024] [Indexed: 10/04/2024] Open
Abstract
Heart rate variability (HRV) is widely recognized as an effective and valuable tool for evaluating cardiac autonomic modulation. However, various factors can influence HRV before and during assessment, complicating the interpretation and comparability of results. This review outlines the different factors affecting HRV and underscores the importance of considering them to ensure consistent and reliable HRV outcomes. Key influencing factors are categorized into physiological (e.g., age, gender, genetics), lifestyle (e.g., physical activity, alcohol use, smoking, drugs, diet), environmental (e.g., time of day, temperature, noise), and methodological (e.g., body position, recording duration, and respiration) domains. Knowing these factors can help researchers and physicians gain a better understanding of HRV and improve the interpretation of their findings. Consequently, this can lead to the development of standardized methods for consistently assessing and interpreting HRV measures in clinical practice.
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Affiliation(s)
- Narjisse Damoun
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Youssra Amekran
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Nora Taiek
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Abdelkader Jalil El Hangouche
- Department of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco
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Pan S, Karey E, Nieves-Cintron M, Chen YJ, Hwang SH, Hammock BD, Pinkerton KE, Chen CY. Effects of chronic secondhand smoke exposure on cardiovascular regulation and the role of soluble epoxide hydrolase in mice. Front Physiol 2023; 14:1185744. [PMID: 37362438 PMCID: PMC10285070 DOI: 10.3389/fphys.2023.1185744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023] Open
Abstract
Background: Secondhand smoke (SHS) is a significant risk factor for cardiovascular morbidity and mortality with an estimated 80% of SHS-related deaths attributed to cardiovascular causes. Public health measures and smoking bans have been successful both in reducing SHS exposure and improving cardiovascular outcomes in non-smokers. Soluble epoxide hydrolase (sEH) inhibitors have been shown to attenuate tobacco exposure-induced lung inflammatory responses, making them a promising target for mitigating SHS exposure-induced cardiovascular outcomes. Objectives: The objectives of this study were to determine 1) effects of environmentally relevant SHS exposure on cardiac autonomic function and blood pressure (BP) regulation and 2) whether prophylactic administration of an sEH inhibitor (TPPU) can reduce the adverse cardiovascular effects of SHS exposure. Methods: Male C57BL/6J mice (11 weeks old) implanted with BP/electrocardiogram (ECG) telemetry devices were exposed to filtered air or 3 mg/m3 of SHS (6 hr/d, 5 d/wk) for 12 weeks, followed by 4 weeks of recovery in filtered air. Some mice received TPPU in drinking water (15 mg/L) throughout SHS exposure. BP, heart rate (HR), HR variability (HRV), baroreflex sensitivity (BRS), and BP variability were determined monthly. Results: SHS exposure significantly decreased 1) short-term HRV by ∼20% (p < 0.05) within 4 weeks; 2) overall HRV with maximum effect at 12 weeks (-15%, p < 0.05); 3) pulse pressure (-8%, p < 0.05) as early as week 4; and 4) BRS with maximum effect at 12 weeks (-11%, p < 0.05). Four weeks of recovery following 12 weeks of SHS ameliorated all SHS-induced cardiovascular detriments. Importantly, mice exposed to TPPU in drinking water during SHS-related exposure were protected from SHS cardiovascular consequences. Discussion: The data suggest that 1) environmental relevant SHS exposure significantly alters cardiac autonomic function and BP regulation; 2) cardiovascular consequences from SHS can be reversed by discontinuing SHS exposure; and 3) inhibiting sEH can prevent SHS-induced cardiovascular consequences.
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Affiliation(s)
- Shiyue Pan
- Department of Pharmacology, University of California Davis, Davis, CA, United States
| | - Emma Karey
- Department of Pharmacology, University of California Davis, Davis, CA, United States
| | | | - Yi-Je Chen
- Department of Pharmacology, University of California Davis, Davis, CA, United States
| | - Sung Hee Hwang
- Department of Entomology and Nematology, UC Davis Comprehensive Cancer Center, University of California Davis, Davis, CA, United States
| | - Bruce D. Hammock
- Department of Entomology and Nematology, UC Davis Comprehensive Cancer Center, University of California Davis, Davis, CA, United States
| | - Kent E. Pinkerton
- Center for Health and the Environment, University of California Davis, Davis, CA, United States
| | - Chao-Yin Chen
- Department of Pharmacology, University of California Davis, Davis, CA, United States
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Dimitriadis K, Narkiewicz K, Leontsinis I, Konstantinidis D, Mihas C, Andrikou I, Thomopoulos C, Tousoulis D, Tsioufis K. Acute Effects of Electronic and Tobacco Cigarette Smoking on Sympathetic Nerve Activity and Blood Pressure in Humans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3237. [PMID: 35328926 PMCID: PMC8952787 DOI: 10.3390/ijerph19063237] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/01/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023]
Abstract
Acute tobacco cigarette (TC) smoking increases blood pressure and sympathetic nerve activity, whereas there are scarce data on the impact of electronic cigarette (EC) smoking. We assessed the acute effects of TC, EC and sham smoking on blood pressure, heart rate and sympathetic nervous system. Methods: We studied 12 normotensive male habitual smokers (mean age 33 years) free of cardiovascular disease. The study design was randomized and sham controlled with three experimental sessions (sham smoking, TC smoking and EC smoking). After baseline measurements at rest, the subjects were then asked to smoke (puffing habits left uncontrolled) two TC cigarettes containing 1.1 mg nicotine, EC smoking or simulated smoking with a drinking straw with a filter (sham smoking), in line with previous methodology. Results: EC smoking at 5 and 30 min compared to baseline was accompanied by the augmentation of mean arterial pressure (MAP) and heart rate (p < 0.001 for all). The muscle sympathetic nerve activity (MSNA) decrease was significant during both TC and EC sessions (p < 0.001 for both comparisons) and was similar between them (−25.1% ± 9.8% vs. −34.4% ± 8.3%, respectively, p = 0.018). Both MSNA decreases were significantly higher (p < 0.001 for both comparisons) than that elicited by sham smoking (−4.4% ± 4.8%). Skin sympathetic nerve activity increase was significant in both TC and EC groups (p < 0.001 for both comparisons) and similar between them (73.4% ± 17.9% and 71.9% ± 7%, respectively, p = 0.829). Conclusions: The unfavorable responses of sympathetic and arterial pressure to EC smoking are similar to those elicited by TC in healthy habitual smokers.
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Affiliation(s)
- Kyriakos Dimitriadis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece; (K.D.); (I.L.); (D.K.); (C.M.); (I.A.); (C.T.); (D.T.)
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdansk, 80-210 Gdansk, Poland;
| | - Ioannis Leontsinis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece; (K.D.); (I.L.); (D.K.); (C.M.); (I.A.); (C.T.); (D.T.)
| | - Dimitris Konstantinidis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece; (K.D.); (I.L.); (D.K.); (C.M.); (I.A.); (C.T.); (D.T.)
| | - Costas Mihas
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece; (K.D.); (I.L.); (D.K.); (C.M.); (I.A.); (C.T.); (D.T.)
| | - Ioannis Andrikou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece; (K.D.); (I.L.); (D.K.); (C.M.); (I.A.); (C.T.); (D.T.)
| | - Costas Thomopoulos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece; (K.D.); (I.L.); (D.K.); (C.M.); (I.A.); (C.T.); (D.T.)
| | - Dimitrios Tousoulis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece; (K.D.); (I.L.); (D.K.); (C.M.); (I.A.); (C.T.); (D.T.)
| | - Konstantinos Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece; (K.D.); (I.L.); (D.K.); (C.M.); (I.A.); (C.T.); (D.T.)
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Secondhand smoke exposure is associated with abnormal P-wave axis. Public Health 2022; 205:79-82. [PMID: 35247863 PMCID: PMC8995340 DOI: 10.1016/j.puhe.2022.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Secondhand smoke exposure (SHSE) is associated with increased risk of cerebrovascular accident (CVA). Abnormal P-wave axis (aPWA) is a marker for atriopathy that is also associated with CVA risk. We hypothesized that SHSE is associated with aPWA. METHODS This analysis included 5986 non-smokers (age 61.7 ± 13.8 years, 45.8% men, 77.4% Whites) from the Third National Health and Nutrition Examination Survey. SHSE was defined as serum cotinine ≥1 ng/ml aPWA was defined as any P-wave axis outside of 0-75°. Multivariable logistic regression was used to examine the association between SHSE and aPWA, overall and among subgroups stratified by demographics and comorbidities. RESULTS About 18.5% (n = 1109) of the participants had SHSE. aPWA was more prevalent among those with SHSE than those without (23.9% versus 19.8%, respectively, P-value = 0.003). In a model adjusted for sociodemographic and potential confounders, presence (versus absence) of SHSE was associated with increased odds of aPWA (odds ratio [95% confidence interval]: 1.28 [1.09, 1.50]; P-value = 0.003). This association was stronger among Whites vs non-Whites (interaction P-value = 0.04) and non-obese versus obese (interaction P-value = 0.04). Higher levels of serum cotinine were associated with increased odds of aPWA. Compared with serum cotinine level <1 ng/ml, serum cotinine ≥3 ng/ml and ≥6 ng/ml were associated with 35% (P-value = 0.002) and 38% (P-value = 0.002) increased odds of aPWA, respectively. CONCLUSIONS SHSE is associated with abnormal atrial conduction, measured as aPWA, with possible effect modification by ethnicity and obesity. These findings underscore the harmful effects of SHSE on cardiovascular health which merits a personalized risk assessment when counseling patients on SHSE.
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Lung SCC, Thi Hien T, Cambaliza MOL, Hlaing OMT, Oanh NTK, Latif MT, Lestari P, Salam A, Lee SY, Wang WCV, Tsou MCM, Cong-Thanh T, Cruz MT, Tantrakarnapa K, Othman M, Roy S, Dang TN, Agustian D. Research Priorities of Applying Low-Cost PM 2.5 Sensors in Southeast Asian Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1522. [PMID: 35162543 PMCID: PMC8835170 DOI: 10.3390/ijerph19031522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 12/19/2022]
Abstract
The low-cost and easy-to-use nature of rapidly developed PM2.5 sensors provide an opportunity to bring breakthroughs in PM2.5 research to resource-limited countries in Southeast Asia (SEA). This review provides an evaluation of the currently available literature and identifies research priorities in applying low-cost sensors (LCS) in PM2.5 environmental and health research in SEA. The research priority is an outcome of a series of participatory workshops under the umbrella of the International Global Atmospheric Chemistry Project-Monsoon Asia and Oceania Networking Group (IGAC-MANGO). A literature review and research prioritization are conducted with a transdisciplinary perspective of providing useful scientific evidence in assisting authorities in formulating targeted strategies to reduce severe PM2.5 pollution and health risks in this region. The PM2.5 research gaps that could be filled by LCS application are identified in five categories: source evaluation, especially for the distinctive sources in the SEA countries; hot spot investigation; peak exposure assessment; exposure-health evaluation on acute health impacts; and short-term standards. The affordability of LCS, methodology transferability, international collaboration, and stakeholder engagement are keys to success in such transdisciplinary PM2.5 research. Unique contributions to the international science community and challenges with LCS application in PM2.5 research in SEA are also discussed.
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Affiliation(s)
- Shih-Chun Candice Lung
- Research Center for Environmental Changes, Academia Sinica, Taipei 115, Taiwan; (S.-Y.L.); (W.-C.V.W.); (M.-C.M.T.)
- Department of Atmospheric Sciences, National Taiwan University, Taipei 106, Taiwan
| | - To Thi Hien
- Faculty of Environment, University of Science, Ho Chi Minh City 700000, Vietnam; (T.T.H.); (T.C.-T.)
- Vietnam National University, Ho Chi Minh City 700000, Vietnam
| | - Maria Obiminda L. Cambaliza
- Department of Physics, Ateneo de Manila University, Quezon City 1108, Philippines;
- Air Quality Dynamics Laboratory, Manila Observatory, Quezon City 1108, Philippines;
| | | | - Nguyen Thi Kim Oanh
- Environmental Engineering and Management, SERD, Asian Institute of Technology, Pathumthani 12120, Thailand;
| | - Mohd Talib Latif
- Department of Earth Sciences and Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia;
| | - Puji Lestari
- Faculty of Civil and Environmental Engineering, Bandung Institute of Technology, Bandung 40132, Indonesia;
| | - Abdus Salam
- Department of Chemistry, Faculty of Science, University of Dhaka, Dhaka 1000, Bangladesh; (A.S.); (S.R.)
| | - Shih-Yu Lee
- Research Center for Environmental Changes, Academia Sinica, Taipei 115, Taiwan; (S.-Y.L.); (W.-C.V.W.); (M.-C.M.T.)
| | - Wen-Cheng Vincent Wang
- Research Center for Environmental Changes, Academia Sinica, Taipei 115, Taiwan; (S.-Y.L.); (W.-C.V.W.); (M.-C.M.T.)
| | - Ming-Chien Mark Tsou
- Research Center for Environmental Changes, Academia Sinica, Taipei 115, Taiwan; (S.-Y.L.); (W.-C.V.W.); (M.-C.M.T.)
| | - Tran Cong-Thanh
- Faculty of Environment, University of Science, Ho Chi Minh City 700000, Vietnam; (T.T.H.); (T.C.-T.)
- College of Public Health, National Taiwan University, Taipei 100, Taiwan
| | | | - Kraichat Tantrakarnapa
- Department of Social and Environmental Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Murnira Othman
- Institute for Environment and Development (Lestari), Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia;
| | - Shatabdi Roy
- Department of Chemistry, Faculty of Science, University of Dhaka, Dhaka 1000, Bangladesh; (A.S.); (S.R.)
| | - Tran Ngoc Dang
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh 700000, Vietnam;
| | - Dwi Agustian
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung 40171, Indonesia;
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Heart rate variability in patients with refractory epilepsy: The influence of generalized convulsive seizures. Epilepsy Res 2021; 178:106796. [PMID: 34763267 DOI: 10.1016/j.eplepsyres.2021.106796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/05/2021] [Accepted: 10/15/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Patients with epilepsy, mainly drug-resistant, have reduced heart rate variability (HRV), linked to an increased risk of sudden death in various other diseases. In this context, it could play a role in SUDEP. Generalized convulsive seizures (GCS) are one of the most consensual risk factors for SUDEP. Our objective was to assess the influence of GCS in HRV parameters in patients with drug-resistant epilepsy. METHODS We prospectively evaluated 121 patients with refractory epilepsy admitted to our Epilepsy Monitoring Unit. All patients underwent a 48-hour Holter recording. Only patients with GCS were included (n = 23), and we selected the first as the index seizure. We evaluated HRV (AVNN, SDNN, RMSSD, pNN50, LF, HF, and LF/HF) in 5-min epochs (diurnal and nocturnal baselines; preictal - 5 min before the seizure; ictal; postictal - 5 min after the seizure; and late postictal - >5 h after the seizure). These data were also compared with normative values from a healthy population (controlling for age and gender). RESULTS We included 23 patients, with a median age of 36 (min-max, 16-55) years and 65% were female. Thirty percent had cardiovascular risk factors, but no previously known cardiac disease. HRV parameters AVNN, RMSSD, pNN50, and HF were significantly lower in the diurnal than in the nocturnal baseline, whereas the opposite occurred with LF/HF and HR. Diurnal baseline parameters were inferior to the normative population values (which includes only diurnal values). We found significant differences in HRV parameters between the analyzed periods, especially during the postictal period. All parameters but LF/HF suffered a reduction in that period. LF/HF increased in that period but did not reach statistical significance. Visually, there was a tendency for a global reduction in our patients' HRV parameters, namely AVNN, RMSSD, and pNN50, in each period, comparing with those from a normative healthy population. No significant differences were found in HRV between diurnal and nocturnal seizures, between temporal lobe and extra-temporal-lobe seizures, between seizures with and without postictal generalized EEG suppression, or between seizures of patients with and without cardiovascular risk factors. SIGNIFICANCE/CONCLUSION Our work reinforces the evidence of autonomic cardiac dysfunction in patients with refractory epilepsy, at baseline and mainly in the postictal phase of a GCS. Those changes may have a role in some SUDEP cases. By identifying patients with worse autonomic cardiac function, HRV could fill the gap of a lacking SUDEP risk biomarker.
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Sun J, Pan S, Karey E, Chen YJ, Pinkerton KE, Wilson CG, Chen CY. Secondhand Smoke Decreased Excitability and Altered Action Potential Characteristics of Cardiac Vagal Neurons in Mice. Front Physiol 2021; 12:727000. [PMID: 34630146 PMCID: PMC8498211 DOI: 10.3389/fphys.2021.727000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Secondhand smoke (SHS), a major indoor pollutant, is a significant risk factor for cardiovascular morbidity and mortality including arrhythmias and sudden cardiac death. Exposure to SHS can produce autonomic imbalance, as evidenced by reduced heart rate variability (HRV)—a clinical metric of cardiac vagal regulation. Currently, the mechanisms through which SHS changes the vagal preganglionic neuronal inputs to the heart to produce this remains unknown. Objectives: To characterize the effect of SHS on both the excitability and action potential (AP) characteristics of anatomically identified cardiac vagal neurons (CVNs) in the nucleus ambiguus and examine whether SHS alters small conductance calcium-activated potassium (SK) channel activity of these CVNs. Methods: Adult male mice were exposed to four weeks of filtered air or SHS (3 mg/m3) 6 h/day, 5 day/week. Using patch-clamp recordings on identified CVNs in brainstem slices, we determined neuronal excitability and AP characteristics with depolarizing step- and ramp-current injections. Results: Four weeks of SHS exposure reduced spiking responses to depolarizing current injections and increased AP voltage threshold in CVNs. Perfusion with apamin (20 nM) magnified these SHS-induced effects, suggesting reduced SK channel activity may serve to minimize the SHS-induced decreases in CVNs excitability. Medium afterhyperpolarization (a measurement of SK channel activity) was smaller in the SHS group, further supporting a lower SK channel activity. AP amplitude, rise rate, fast afterhyperpolarization amplitude (a measurement of voltage-gated channel activity), and decay rate were higher in the SHS group at membrane voltages more positive to 0 mV, suggesting altered inactivation properties of voltage-dependent channels underlying APs. Discussion: SHS exposure reduced neuronal excitability of CVNs with compensatory attenuation of SK channel activity and altered AP characteristics. Neuroplasticity of CVNs could blunt regulatory cardiac vagal signaling and contribute to the cardiovascular consequences associated with SHS exposure, including reduced HRV.
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Affiliation(s)
- Junqing Sun
- Department of Pharmacology, University of California, Davis, Davis, CA, United States
| | - Shiyue Pan
- Department of Pharmacology, University of California, Davis, Davis, CA, United States
| | - Emma Karey
- Department of Pharmacology, University of California, Davis, Davis, CA, United States
| | - Yi-Je Chen
- Department of Pharmacology, University of California, Davis, Davis, CA, United States
| | - Kent E Pinkerton
- Department of Pediatrics and Center for Health and the Environment, University of California, Davis, Davis, CA, United States
| | - Christopher G Wilson
- Department of Basic Sciences, Loma Linda University, Loma Linda, CA, United States
| | - Chao-Yin Chen
- Department of Pharmacology, University of California, Davis, Davis, CA, United States
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Yu J, Fang Q, Liu M, Zhang X. Polycyclic aromatic hydrocarbons associated long non-coding RNAs and heart rate variability in coke oven workers. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:47035-47045. [PMID: 33886053 DOI: 10.1007/s11356-021-13967-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 03/15/2021] [Indexed: 06/12/2023]
Abstract
Epidemiological studies have showed that polycyclic aromatic hydrocarbons (PAHs) were associated with heart rate variability (HRV), but the role of long non-coding RNAs (lncRNAs) in the association is unknown. We aimed to identify PAHs-related lncRNAs and assess their associations with HRV among coke oven workers. Differential lncRNAs expression between 12 exposed workers and 12 controls was tested by Human 8X60k LncRNA Arrays in discovery stage, then selected NR_024564 was validated in 353 workers using droplet digital RT-PCR. Microarray results showed that 1234 lncRNAs were downregulated with 805 lncRNAs upregulated in exposed group (≥ 2-fold change). In validation stage, no significant association was observed between NR_024564 and PAH exposure or HRV in total subjects, while urinary 2-hydroxyfluorene (2-OHFlu) was inversely related to root mean square successive difference (RMSSD). However, in current smokers, NR_024564 was inversely related to urinary 2-OHFlu, 2-hydroxyphenanthrene, 1-hydroxypyrene (1-OHP), and total PAHs metabolites (ΣOH-PAHs), of which 1-OHP accounted for the strongest estimation for interaction with smoking status (Pinteraction = 0.011). Also, the positive associations of NR_024564 with RMSSD and high frequency power showed an interaction with smoking status (Pinteraction = 0.034 and 0.023, respectively). Also, urinary 2-OHFlu and ΣOH-PAHs were inversely associated with RMSSD in current smokers. In addition, elevated NR_024564 was dose-responsive related to increased RMSSD in above high-PAHs groups among smokers (all Ptrend < 0.05). Our results revealed that NR_024564 and its interactions with smoking status might act as novel mechanisms regulating the adverse effects of PAHs on HRV.
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Affiliation(s)
- Jie Yu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Qin Fang
- Department of Medical Affairs, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, 519000, Guangdong, China
| | - Miao Liu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China.
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He X, Zhao J, He J, Dong Y, Liu C. Association of household secondhand smoke exposure and mortality risk in patients with heart failure. BMC Cardiovasc Disord 2019; 19:280. [PMID: 31791236 PMCID: PMC6889209 DOI: 10.1186/s12872-019-1269-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 11/19/2019] [Indexed: 12/28/2022] Open
Abstract
Background Secondhand smoke (SHS) exposure is a well-established cardiovascular risk factor, yet association between SHS and prognosis of heart failure remains uncertain. Method Data were obtained from the US National Health and Nutrition Examination Surveys III from 1988 to 1994. Currently nonsmoking adults with a self-reported history of heart failure were included. Household SHS exposure was assessed by questionnaire. Participants were followed up through December 31, 2011. Cox proportional-hazards models were used to assess the association of household SHS exposure and mortality risk. Potential confounding factors were adjusted. Results Of 572 currently nonsmoking patients with heart failure, 88 were exposed to household SHS while 484 were not. There were totally 475 deaths during follow-up. In univariate analysis, household SHS was not associated with mortality risk (hazard ratio [HR]: 0.98, 95% confidence interval [CI]: 0.76–1.26, p = 0.864). However, after adjustment for demographic variables, socioeconomic variables and medication, heart failure patients in exposed group had a 43% increase of mortality risk compared with those in unexposed group (HR: 1.43, 95% CI: 1.10–1.86, p = 0.007). Analysis with further adjustment for general health status and comorbidities yielded similar result (HR: 1.47, 95% CI: 1.13–1.92, p = 0.005). Conclusion Household SHS exposure was associated with increased mortality risk in heart failure patients.
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Affiliation(s)
- Xin He
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
| | - Jingjing Zhao
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
| | - Jiangui He
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China
| | - Yugang Dong
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. .,NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China.
| | - Chen Liu
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. .,NHC Key Laboratory of Assisted Circulation, Sun Yat-sen University, Guangzhou, China.
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Karey E, Pan S, Morris AN, Bruun DA, Lein PJ, Chen CY. The Use of Percent Change in RR Interval for Data Exclusion in Analyzing 24-h Time Domain Heart Rate Variability in Rodents. Front Physiol 2019; 10:693. [PMID: 31244671 PMCID: PMC6562196 DOI: 10.3389/fphys.2019.00693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/16/2019] [Indexed: 11/13/2022] Open
Abstract
While epidemiological data support the link between reduced heart rate variability (HRV) and a multitude of pathologies, the mechanisms underlying changes in HRV and disease progression are poorly understood. Even though we have numerous rodent models of disease for mechanistic studies, not being able to reliably measure HRV in conscious, freely moving rodents has hindered our ability to extrapolate the role of HRV in the progression from normal physiology to pathology. The sheer number of heart beats per day (>800,000 in mice) makes data exclusion both time consuming and daunting. We sought to evaluate an RR interval exclusion method based on percent (%) change of adjacent RR intervals. Two approaches were evaluated: % change from “either” and “both” adjacent RR intervals. The data exclusion method based on standard deviation (SD) was also evaluated for comparison. Receiver operating characteristic (ROC) curves were generated to determine the performance of each method. Results showed that exclusion based on % change from “either” adjacent RR intervals was the most accurate method in identifying normal and abnormal RR intervals, with an overall accuracy of 0.92–0.99. As the exclusion value increased (% change or SD), the sensitivity (correctly including normal RR intervals) increased exponentially while the specificity (correctly rejecting abnormal RR intervals) decreased linearly. Compared to the SD method, the “either” approach had a steeper rise in sensitivity and a more gradual decrease in specificity. The intersection of sensitivity and specificity where the exclusion criterion had the same accuracy in identifying normal and abnormal RR intervals was 10–20% change for the “either” approach and ∼ 1 SD for the SD-based exclusion method. Graphically (tachogram and Lorenz plot), 20% change from either adjacent RR interval resembled the data after manual exclusion. Finally, overall (SDNN) and short-term (rMSSD) indices of HRV generated using 20% change from “either” adjacent RR intervals as the exclusion criterion were closer to the manual exclusion method with lower subject-to-subject variability than those generated using the 2 SD exclusion criterion. Thus, 20% change from “either” adjacent RR intervals is a good criterion for data exclusion for reliable 24-h time domain HRV analysis in rodents.
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Affiliation(s)
- Emma Karey
- Department of Pharmacology, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Shiyue Pan
- Department of Pharmacology, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Amber N Morris
- Department of Pharmacology, School of Medicine, University of California, Davis, Davis, CA, United States
| | - Donald A Bruun
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Pamela J Lein
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Chao-Yin Chen
- Department of Pharmacology, School of Medicine, University of California, Davis, Davis, CA, United States
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11
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Conklin DJ, Schick S, Blaha MJ, Carll A, DeFilippis A, Ganz P, Hall ME, Hamburg N, O'Toole T, Reynolds L, Srivastava S, Bhatnagar A. Cardiovascular injury induced by tobacco products: assessment of risk factors and biomarkers of harm. A Tobacco Centers of Regulatory Science compilation. Am J Physiol Heart Circ Physiol 2019; 316:H801-H827. [PMID: 30707616 PMCID: PMC6483019 DOI: 10.1152/ajpheart.00591.2018] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 01/09/2019] [Accepted: 01/27/2019] [Indexed: 02/07/2023]
Abstract
Although substantial evidence shows that smoking is positively and robustly associated with cardiovascular disease (CVD), the CVD risk associated with the use of new and emerging tobacco products, such as electronic cigarettes, hookah, and heat-not-burn products, remains unclear. This uncertainty stems from lack of knowledge on how the use of these products affects cardiovascular health. Cardiovascular injury associated with the use of new tobacco products could be evaluated by measuring changes in biomarkers of cardiovascular harm that are sensitive to the use of combustible cigarettes. Such cardiovascular injury could be indexed at several levels. Preclinical changes contributing to the pathogenesis of disease could be monitored by measuring changes in systemic inflammation and oxidative stress, organ-specific dysfunctions could be gauged by measuring endothelial function (flow-mediated dilation), platelet aggregation, and arterial stiffness, and organ-specific injury could be evaluated by measuring endothelial microparticles and platelet-leukocyte aggregates. Classical risk factors, such as blood pressure, circulating lipoproteins, and insulin resistance, provide robust estimates of risk, and subclinical disease progression could be followed by measuring coronary artery Ca2+ and carotid intima-media thickness. Given that several of these biomarkers are well-established predictors of major cardiovascular events, the association of these biomarkers with the use of new and emerging tobacco products could be indicative of both individual and population-level CVD risk associated with the use of these products. Differential effects of tobacco products (conventional vs. new and emerging products) on different indexes of cardiovascular injury could also provide insights into mechanisms by which they induce cardiovascular harm.
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Affiliation(s)
- Daniel J Conklin
- Diabetes and Obesity Center, University of Louisville , Louisville, Kentucky
| | - Suzaynn Schick
- Department of Medicine, University of California-San Francisco , San Francisco, California
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Heart Disease, Department of Medicine, Johns Hopkins University , Baltimore, Maryland
| | - Alex Carll
- Diabetes and Obesity Center, University of Louisville , Louisville, Kentucky
| | - Andrew DeFilippis
- Diabetes and Obesity Center, University of Louisville , Louisville, Kentucky
| | - Peter Ganz
- Department of Medicine, University of California-San Francisco , San Francisco, California
| | - Michael E Hall
- Department of Physiology and Biophysics, University of Mississippi Medical Center , Jackson, Mississippi
| | - Naomi Hamburg
- Department of Medicine/Cardiovascular Medicine, School of Medicine, Boston University , Boston, Massachusetts
| | - Tim O'Toole
- Diabetes and Obesity Center, University of Louisville , Louisville, Kentucky
| | - Lindsay Reynolds
- Department of Epidemiology and Prevention, Wake Forest School of Medicine , Winston-Salem, North Carolina
| | - Sanjay Srivastava
- Diabetes and Obesity Center, University of Louisville , Louisville, Kentucky
| | - Aruni Bhatnagar
- Diabetes and Obesity Center, University of Louisville , Louisville, Kentucky
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12
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DiGiacomo SI, Jazayeri MA, Barua RS, Ambrose JA. Environmental Tobacco Smoke and Cardiovascular Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:E96. [PMID: 30602668 PMCID: PMC6339042 DOI: 10.3390/ijerph16010096] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 12/24/2018] [Accepted: 12/24/2018] [Indexed: 01/19/2023]
Abstract
Environmental tobacco smoke (ETS) and its sequelae are among the largest economic and healthcare burdens in the United States and worldwide. The relationship between active smoking and atherosclerosis is well-described in the literature. However, the specific mechanisms by which ETS influences atherosclerosis are incompletely understood. In this paper, we highlight the definition and chemical constituents of ETS, review the existing literature outlining the effects of ETS on atherogenesis and thrombosis in both animal and human models, and briefly outline the public health implications of ETS based on these data.
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Affiliation(s)
- Sydne I DiGiacomo
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA.
| | - Mohammad-Ali Jazayeri
- Department of Cardiovascular Medicine of Cardiovascular Diseases, University of Kansas Medical Center, Kansas City, KS 66160, USA.
| | - Rajat S Barua
- Department of Cardiovascular Medicine of Cardiovascular Diseases, University of Kansas Medical Center, Kansas City, KS 66160, USA.
- Division of Cardiovascular Medicine, Kansas City VA Medical Center, Kansas City, MO 64128, USA.
| | - John A Ambrose
- Division of Cardiovascular Medicine, University of California San Francisco, Fresno, CA 93701, USA.
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13
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Wang Z, Wang L, Tapa S, Pinkerton KE, Chen CY, Ripplinger CM. Exposure to Secondhand Smoke and Arrhythmogenic Cardiac Alternans in a Mouse Model. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:127001. [PMID: 30675795 PMCID: PMC6371715 DOI: 10.1289/ehp3664] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 11/02/2018] [Accepted: 11/07/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Epidemiological evidence suggests that a majority of deaths attributed to secondhand smoke (SHS) exposure are cardiovascular related. However, to our knowledge, the impact of SHS on cardiac electrophysiology, [Formula: see text] handling, and arrhythmia risk has not been studied. OBJECTIVES The purpose of this study was to investigate the impact of an environmentally relevant concentration of SHS on cardiac electrophysiology and indicators of arrhythmia. METHODS Male C57BL/6 mice were exposed to SHS [total suspended particles (THS): [Formula: see text], nicotine: [Formula: see text], carbon monoxide: [Formula: see text], or filtered air (FA) for 4, 8, or 12 wk ([Formula: see text]]. Hearts were excised and Langendorff perfused for dual optical mapping with voltage- and [Formula: see text]-sensitive dyes. RESULTS At slow pacing rates, SHS exposure did not alter baseline electrophysiological parameters. With increasing pacing frequency, action potential duration (APD), and intracellular [Formula: see text] alternans magnitude progressively increased in all groups. At 4 and 8 wk, there were no statistical differences in APD or [Formula: see text] alternans magnitude between SHS and FA groups. At 12 wk, both APD and [Formula: see text] alternans magnitude were significantly increased in the SHS compared to FA group ([Formula: see text]). SHS exposure did not impact the time constant of [Formula: see text] transient decay ([Formula: see text]) at any exposure time point. At 12 wk exposure, the recovery of [Formula: see text] transient amplitude with premature stimuli was slightly (but nonsignificantly) delayed in SHS compared to FA hearts, suggesting that [Formula: see text] release via ryanodine receptors may be impaired. CONCLUSIONS In male mice, chronic exposure to SHS at levels relevant to social situations in humans increased their susceptibility to cardiac alternans, a known precursor to ventricular arrhythmia. https://doi.org/10.1289/EHP3664.
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Affiliation(s)
- Zhen Wang
- Department of Pharmacology, University of California, Davis, Davis, California, USA
| | - Lianguo Wang
- Department of Pharmacology, University of California, Davis, Davis, California, USA
| | - Srinivas Tapa
- Department of Pharmacology, University of California, Davis, Davis, California, USA
| | - Kent E Pinkerton
- Center for Health and the Environment, University of California, Davis, Davis, California, USA
| | - Chao-Yin Chen
- Department of Pharmacology, University of California, Davis, Davis, California, USA
| | - Crystal M Ripplinger
- Department of Pharmacology, University of California, Davis, Davis, California, USA
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14
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Mazzonna F, Salari P. Can a smoking ban save your heart? HEALTH ECONOMICS 2018; 27:1435-1449. [PMID: 29863291 DOI: 10.1002/hec.3778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 03/06/2018] [Accepted: 04/24/2018] [Indexed: 06/08/2023]
Abstract
This paper evaluates the causal effect of environmental tobacco exposure on health by exploiting the time and geographical variation in public-place smoking bans implemented in Switzerland between 2007 and 2011. We use administrative data on hospitalizations for acute myocardial infarction, which allow to measure the short-run effects of the policy on an objective metric of health. We show that the incidence of acute myocardial infarction decreases by approximately 8% immediately after implementation of the law with large heterogeneity across regions. Our results indicate that the policy was effective in reducing the negative externality of smoking with potential spillovers on health inequality.
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Affiliation(s)
- Fabrizio Mazzonna
- Universitá della Svizzera Italiana (USI), Lugano, Switzerland
- MEA, Munich, Germany
| | - Paola Salari
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
- University of Basel, Basel, Switzerland
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15
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Sureda X, Bilal U, Fernández E, Valiente R, Escobar FJ, Navas-Acien A, Franco M. Second-hand smoke exposure in outdoor hospitality venues: Smoking visibility and assessment of airborne markers. ENVIRONMENTAL RESEARCH 2018; 165:220-227. [PMID: 29727822 DOI: 10.1016/j.envres.2018.04.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 05/15/2023]
Abstract
INTRODUCTION After the implementation of smoke-free policies in indoor hospitality venues (including bars, cafeterias, restaurants, and pubs), smokers may have been displaced to their outdoor areas. We aimed to study smoking visibility and second-hand smoke exposure in outdoor hospitality venues. METHODS We collected information on signs of tobacco consumption on entrances and terraces of hospitality venues in 2016 in the city of Madrid, Spain. We further measured airborne nicotine concentrations and particulate matter of less than 2.5 µm in diameter (PM2.5) in terraces with monitors by active sampling during 30 min. We calculated the medians and the interquartile ranges (IQR) of nicotine and PM2.5 concentrations, and fitted multivariate models to characterize their determinants. RESULTS We found 202 hospitality venues between May and September (summer), and 83 between October and December 2016 (fall) that were opened at the time of observation. We found signs of tobacco consumption on 78.2% of the outdoor main entrances and on 95.1% of outdoor terraces. We measured nicotine and PM2.5 concentrations in 92 outdoor terraces (out of the 123 terraces observed). Overall median nicotine concentration was 0.42 (IQR: 0.14-1.59) μg/m3, and overall PM2.5 concentration was 10.40 (IQR: 6.76-15.47) μg/m3 (statistically significantly higher than the background levels). Multivariable analyses showed that nicotine and PM2.5 concentrations increased when the terraces were completely closed, and when tobacco smell was noticed. Nicotine concentrations increased with the presence of cigarette butts, and when there were more than eight lit cigarettes at a time. CONCLUSIONS Outdoor hospitality venues are areas where non-smokers, both employees and patrons, continue to be exposed to second-hand smoke. These spaces should be further studied and considered in future tobacco control interventions.
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Affiliation(s)
- Xisca Sureda
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain.
| | - Usama Bilal
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA, USA
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine, Campus de Bellvitge, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Roberto Valiente
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Francisco J Escobar
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, USA
| | - Manuel Franco
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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16
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Li L, Ho SSH, Chow JC, Watson JG, Lee FSC, Cui L, Gao Y, Dai W, Ho KF, Huang Y, Cao J. Characterization and health risk assessment of PM 2.5-bound organics inside and outside of Chinese smoking lounges. CHEMOSPHERE 2017; 186:438-445. [PMID: 28806671 DOI: 10.1016/j.chemosphere.2017.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/28/2017] [Accepted: 08/03/2017] [Indexed: 06/07/2023]
Abstract
PM2.5 samples were collected at six indoor public places that contained dedicated smoking lounges. Samples were taken in the smoking lounges, at two indoor locations outside of the lounges, and in outdoor air near the venues. Organic carbon (OC), elemental carbon (EC), and non-polar organic compounds including polycyclic aromatic hydrocarbons (PAHs), n-alkanes (n-C16 to n-C40), iso/anteiso-alkanes (C29 to C33), hopanes and phthalate esters (PAEs) were quantified. Average PM2.5 levels of 170.2 ± 85.9 μg/m3 in the lounges exceeded limits of 25 μg/m3 set by World Health Organization (WHO); these levels were 5.4 and 3.9 times higher than those indoors and outdoors, respectively. High ratios of OC to PM2.5, OC to EC, and PAHs diagnostic ratios in the lounges indicated contributions from environmental tobacco smoke (ETS). The maximum carbon number (Cmax) and carbon preference indices (CPI) for n-alkanes showed ETS transport from the enclosed lounges to nearby indoor non-smoking areas. Iso/anteiso-alkanes in the lounges were 876.5 ng/m3, ∼80 times higher than outdoor levels. 17α(H)-21β(H),30-norhopane and 17α(H)-21β(H),(22R)-homohopane were much higher in the lounges than outdoor air, but they cannot be directly attributed to ETS. Estimated carcinogenic risks of PAHs in the lounges exceeded the acceptable level of 10- 6.
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Affiliation(s)
- Lijuan Li
- Key Lab of Aerosol Chemistry & Physics, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an, China; State Key Lab of Loess and Quaternary Geology (SKLLQG), Institute of Earth Environment, Chinese Academy of Sciences, Xi'an, China; University of Chinese Academy of Sciences, Beijing, China
| | - Steven Sai Hang Ho
- Key Lab of Aerosol Chemistry & Physics, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an, China; State Key Lab of Loess and Quaternary Geology (SKLLQG), Institute of Earth Environment, Chinese Academy of Sciences, Xi'an, China; Division of Atmospheric Sciences, Desert Research Institute, Reno, NV, USA.
| | - Judith C Chow
- Division of Atmospheric Sciences, Desert Research Institute, Reno, NV, USA
| | - John G Watson
- Division of Atmospheric Sciences, Desert Research Institute, Reno, NV, USA
| | - Frank S C Lee
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Long Cui
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Yuan Gao
- Department of Civil Engineering, The Chu Hai College of Higher Education, Castle Peak Bay, Hong Kong, China
| | - Wenting Dai
- Key Lab of Aerosol Chemistry & Physics, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an, China; State Key Lab of Loess and Quaternary Geology (SKLLQG), Institute of Earth Environment, Chinese Academy of Sciences, Xi'an, China
| | - Kin Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yu Huang
- Key Lab of Aerosol Chemistry & Physics, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an, China; State Key Lab of Loess and Quaternary Geology (SKLLQG), Institute of Earth Environment, Chinese Academy of Sciences, Xi'an, China
| | - Junji Cao
- Key Lab of Aerosol Chemistry & Physics, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an, China; State Key Lab of Loess and Quaternary Geology (SKLLQG), Institute of Earth Environment, Chinese Academy of Sciences, Xi'an, China.
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17
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Torok M, Winickoff J, McMillen R, Klein J, Wilson K. Prevalence and location of tobacco smoke exposure outside the home in adults and children in the United States. Public Health 2017; 151:149-159. [DOI: 10.1016/j.puhe.2017.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/06/2017] [Accepted: 07/09/2017] [Indexed: 12/01/2022]
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18
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Ogunwale M, Li M, Ramakrishnam Raju MV, Chen Y, Nantz MH, Conklin DJ, Fu XA. Aldehyde Detection in Electronic Cigarette Aerosols. ACS OMEGA 2017; 2:1207-1214. [PMID: 28393137 PMCID: PMC5377270 DOI: 10.1021/acsomega.6b00489] [Citation(s) in RCA: 180] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 03/14/2017] [Indexed: 05/23/2023]
Abstract
Acetaldehyde, acrolein, and formaldehyde are the principal toxic aldehydes present in cigarette smoke and contribute to the risk of cardiovascular disease and noncancerous pulmonary disease. The rapid growth of the use of electronic cigarettes (e-cigarettes) has raised concerns over emissions of these harmful aldehydes. This work determines emissions of these aldehydes in both free and bound (aldehyde-hemiacetal) forms and other carbonyls from the use of e-cigarettes. A novel silicon microreactor with a coating phase of 4-(2-aminooxyethyl)-morpholin-4-ium chloride (AMAH) was used to trap carbonyl compounds in the aerosols of e-cigarettes via oximation reactions. AMAH-aldehyde adducts were measured using gas chromatography-mass spectrometry. 1H nuclear magnetic resonance spectroscopy was used to analyze hemiacetals in the aerosols. These aldehydes were detected in the aerosols of all e-cigarettes. Newer-generation e-cigarette devices generated more aldehydes than the first-generation e-cigarettes because of higher battery power output. Formaldehyde-hemiacetal was detected in the aerosols generated from some e-liquids using the newer e-cigarette devices at a battery power output of 11.7 W and above. The emission of these aldehydes from all e-cigarettes, especially higher levels of aldehydes from the newer-generation e-cigarette devices, indicates the risk of using e-cigarettes.
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Affiliation(s)
- Mumiye
A. Ogunwale
- Department
of Chemistry, Department of Chemical Engineering,
and American Heart Association—Tobacco
Regulation and Addiction Center, University
of Louisville, Louisville, Kentucky 40292, United States
| | - Mingxiao Li
- Department
of Chemistry, Department of Chemical Engineering,
and American Heart Association—Tobacco
Regulation and Addiction Center, University
of Louisville, Louisville, Kentucky 40292, United States
| | - Mandapati V. Ramakrishnam Raju
- Department
of Chemistry, Department of Chemical Engineering,
and American Heart Association—Tobacco
Regulation and Addiction Center, University
of Louisville, Louisville, Kentucky 40292, United States
| | - Yizheng Chen
- Department
of Chemistry, Department of Chemical Engineering,
and American Heart Association—Tobacco
Regulation and Addiction Center, University
of Louisville, Louisville, Kentucky 40292, United States
| | - Michael H. Nantz
- Department
of Chemistry, Department of Chemical Engineering,
and American Heart Association—Tobacco
Regulation and Addiction Center, University
of Louisville, Louisville, Kentucky 40292, United States
| | - Daniel J. Conklin
- Department
of Chemistry, Department of Chemical Engineering,
and American Heart Association—Tobacco
Regulation and Addiction Center, University
of Louisville, Louisville, Kentucky 40292, United States
| | - Xiao-An Fu
- Department
of Chemistry, Department of Chemical Engineering,
and American Heart Association—Tobacco
Regulation and Addiction Center, University
of Louisville, Louisville, Kentucky 40292, United States
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19
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The Association of Cigarette Smoking With High-Frequency Heart Rate Variability: An Ecological Momentary Assessment Study. Psychosom Med 2017; 79:1045-1050. [PMID: 28731984 PMCID: PMC5675783 DOI: 10.1097/psy.0000000000000507] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Evidence from both laboratory and observational studies suggests that acute and chronic smoking leads to reduced high-frequency heart rate variability (HF-HRV), a measure of cardiac vagal regulation. We used ecological momentary assessment (EMA) to study the effect of smoking on concurrent HF-HRV in a trial measuring the effects of hostility reduction and compared 24-hour HF-HRV in smokers and nonsmokers. METHOD Ambulatory electrocardiogram data were collected before randomization from 149 healthy individuals with high hostility levels (20-45 years, body mass index ≤ 32 kg/m) and paired with concurrent EMA ratings of smoking and physical position during waking hours. A multilevel mixed model was estimated associating ln(HF-HRV) from smoking status (between-person factor) and person-centered momentary smoking (within-person factor, treated as a random effect), adjusting for momentary physical position, medication use, and consumption of alcohol and caffeine. RESULTS Thirty-five smokers and 114 nonsmokers provided both EMA and HF-HRV data. Within smokers, ln HF-HRV was reduced by 0.31 millisecond (p = .04) when participants reported having recently smoked cigarettes, compared with when they had not. The 24-hour HF-HRV was significantly lower in smokers (M [SD] = 5.24 [0.14] milliseconds) than nonsmokers (5.63 ± 0.07 milliseconds, p = .01). CONCLUSIONS In healthy smokers with high hostility levels used as their own controls during daily living, smoking acutely reduced HF-HRV. HF-HRV was also reduced in smokers as compared with nonsmokers. Although limited by a small sample of individuals with high hostility levels, these findings nonetheless provide additional evidence that cardiac vagal regulation is lowered by cigarette smoking, which may be one of the numerous pathophysiological effects of smoking.
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20
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Hu MX, Lamers F, de Geus EJC, Penninx BWJH. Influences of lifestyle factors on cardiac autonomic nervous system activity over time. Prev Med 2017; 94:12-19. [PMID: 27836526 DOI: 10.1016/j.ypmed.2016.11.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/08/2016] [Accepted: 11/06/2016] [Indexed: 11/29/2022]
Abstract
Physical activity, alcohol use and smoking might affect cardiovascular disease through modifying autonomic nervous system (ANS) activity. We investigated: 1) whether there are consistent relationships between lifestyle factors and cardiac ANS activity over time, and 2) whether 2-year changes in lifestyle factors relate to 2-year changes in cardiac activity. Baseline (n=2618) and 2-year follow-up (n=2010) data of the Netherlands Study of Depression and Anxiety was combined. Baseline data was collected in the Netherlands from 2004-2007. Lifestyle factors were habitual physical activity, frequency of sport activities, alcohol use, and smoking. Indicators of cardiac activity were heart rate (HR), respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP) (100min of registration). The results showed that high physical activity (-1.8beats/min compared to low activity), high frequency of sport activities ('couple of times/week': -2.5beats/min compared to 'almost never') and mild/moderate alcohol use (-1.2beats/min compared to non-drinking) were related to low HR. Heavy smoking was related to high HR (>30cigarettes/day: +5.1beats/min compared to non-smoking). High frequency of sport activities was associated with high RSA ('couple of times/week':+1.7ms compared to 'almost never') and moderate smoking with longer PEP (11-20cigarettes/day: +2.8ms compared to non-smoking). Associations were consistent across waves. Furthermore, 2-year change in frequency of sport activities and number of smoked cigarettes/day was accompanied by 2-year change in HR (β=-0.076 and β=0.101, respectively) and RSA (β=0.046 and β=-0.040, respectively). Our findings support consistent effects of lifestyle on HR and parasympathetic activity in the expected direction. Cardiac autonomic dysregulation may be partly mediating the relationship between lifestyle and subsequent cardiovascular health.
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Affiliation(s)
- Mandy Xian Hu
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
| | - Femke Lamers
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
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Zhou Z, Bohac D, Boyle RG. Continuous weeklong measurements of indoor particle levels in a Minnesota Tribal Casino Resort. BMC Public Health 2016; 16:870. [PMID: 27557528 PMCID: PMC4997741 DOI: 10.1186/s12889-016-3553-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 08/18/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Secondhand smoke (SHS) exposure for workers and patrons in hospitality venues is a persistent and significant public health concern. We designed this study to provide a comprehensive assessment of SHS exposure inside an Indian Tribal Casino in Minnesota. METHODS Real-time fine particulate matter (PM2.5) concentrations were measured at multiple locations for up to 7 days. The field monitoring provided information on the day of week and time of day variation of SHS exposure, as well as comparisons between smoking and non-smoking areas. RESULTS Indoor PM2.5 level was nearly 13 times the concurrent outdoor PM2.5 level. Gaming floor hourly PM2.5 level was highest on Saturday night, averaged at 62.9 μg/m(3). Highest PM2.5 concentration was observed in smoking-permitted employee break room, reaching 600 μg/m(3). PM2.5 readings in non-smoking sections exhibited same temporal pattern as the readings in smoking sections. CONCLUSIONS The results show that indoor concentration of PM2.5 is substantially higher than the outdoor level, posing health risks to casino workers and patrons. SHS can migrate into adjacent non-smoking areas very quickly. The casino's ventilation system did not fully eliminate SHS. A completely smoke-free casino would be the only way to fully protect non-smoking patrons and employees from the dangers of tobacco smoke.
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Affiliation(s)
- Zheng Zhou
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 11th Floor, New York, NY 10032 USA
| | - David Bohac
- Center for Energy and Environment, 212 Third Avenue North, Suite 560, Minneapolis, MN 55401 USA
| | - Raymond G. Boyle
- Clearway Minnesota SM, 8011 34th Avenue South, Suite 400, Minneapolis, MN 55425 USA
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22
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Environmental Tobacco Smoke and Atrial Fibrillation: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study. J Occup Environ Med 2016; 57:1154-8. [PMID: 26539762 DOI: 10.1097/jom.0000000000000565] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This study examines the association between environmental tobacco smoke (ETS) exposure and atrial fibrillation (AF). METHODS We examined the cross-sectional association between ETS exposure and AF in 12,021 participants (mean age: 65 ± 9.9 years; 60% women; 40% blacks) from the REasons for Geographic And Racial Differences in Stroke study who self-identified as never smokers between 2003 and 2007. RESULTS A total of 2503 (21%) participants reported ETS exposure. In a multivariate logistic regression model adjusted for sociodemographics and potential confounders, ETS exposure was significantly associated with AF (odds ratio = 1.27, 95% confidence interval = 1.08, 1.50). CONCLUSIONS Our findings suggest that the harmful effects of ETS exposure extend to sustained arrhythmias such as AF.
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23
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E-Cigarettes and Cardiovascular Disease Risk: Evaluation of Evidence, Policy Implications, and Recommendations. CURRENT CARDIOVASCULAR RISK REPORTS 2016. [DOI: 10.1007/s12170-016-0505-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Garza JL, Mittleman MA, Zhang J, Christiani DC, Cavallari JM. Time Course of Heart Rate Variability Response to PM2.5 Exposure from Secondhand Smoke. PLoS One 2016; 11:e0154783. [PMID: 27223894 PMCID: PMC4880193 DOI: 10.1371/journal.pone.0154783] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 04/19/2016] [Indexed: 11/19/2022] Open
Abstract
Purpose: Exposure to secondhand smoke (SHS) has been associated with decreased heart rate variability (HRV). However, the time course of this association is unclear. Therefore, the objective of this study was to investigate the association between 15–240 minute SHS-related fine particulate matter (PM2.5) moving averages and indices of HRV. Methods: With a panel study design, we used personal monitors to continuously measure PM2.5 and HRV of 35 participants who were exposed to SHS for approximately 6 hours. Results: We observed negative, significant associations between 5-minute HRV indices and 15 minute PM2.5 moving averages and 240 minute PM2.5 moving averages: there was a significant (p<0.01) 7.5% decrease in the 5-minute square root of the mean squared differences of successive normal heart beats associated with (RMSSD), and a significant (p<0.01) 14.7% decrease in the 5-minute high frequency (HF) power associated with the 15 minute PM2.5 moving averages; there was also a significant (p<0.01) 46.9% decrease in the 5-minute RMSSD, and a significant (p<0.01) 77.7% decrease in the 5-minute high frequency (HF) power associated with the 240 minute PM2.5 moving averages. Conclusions: Our findings that exposure to SHS related PM2.5 was associated with HRV support the hypothesis that SHS can affect the cardiovascular system. The negative associations reported between short and longer term PM2.5 and HRV indicate adverse effects of SHS on the cardiovascular system.
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Affiliation(s)
- Jennifer L. Garza
- Division of Occupational and Environmental Medicine, UConn Health, Farmington, Connecticut, United States of America
| | - Murray A. Mittleman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Beth Israel Deaconess Medical Center Cardiovascular Epidemiology Research Unit, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jinming Zhang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - David C. Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jennifer M Cavallari
- Division of Occupational and Environmental Medicine, UConn Health, Farmington, Connecticut, United States of America
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- * E-mail:
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25
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Klepeis NE, Dhaliwal N, Hayward G, Acevedo-Bolton V, Ott WR, Read N, Layton S, Jiang R, Cheng KC, Hildemann LM, Repace JL, Taylor S, Ong SL, Buchting FO, Lee JP, Moore RS. Measuring Indoor Air Quality and Engaging California Indian Stakeholders at the Win-River Resort and Casino: Collaborative Smoke-Free Policy Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13010143. [PMID: 26805860 PMCID: PMC4730534 DOI: 10.3390/ijerph13010143] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 01/11/2016] [Accepted: 01/13/2016] [Indexed: 11/24/2022]
Abstract
Most casinos owned by sovereign American Indian nations allow smoking, even in U.S. states such as California where state laws restrict workplace smoking. Collaborations between casinos and public health workers are needed to promote smoke-free policies that protect workers and patrons from secondhand tobacco smoke (SHS) exposure and risks. Over seven years, a coalition of public health professionals provided technical assistance to the Redding Rancheria tribe in Redding, California in establishing a smoke-free policy at the Win-River Resort and Casino. The coalition provided information to the casino general manager that included site-specific measurement of employee and visitor PM2.5 personal exposure, area concentrations of airborne nicotine and PM2.5, visitor urinary cotinine, and patron and staff opinions (surveys, focus groups, and a Town Hall meeting). The manager communicated results to tribal membership, including evidence of high SHS exposures and support for a smoke-free policy. Subsequently, in concert with hotel expansion, the Redding Rancheria Tribal Council voted to accept a 100% restriction of smoking inside the casino, whereupon PM2.5 exposure in main smoking areas dropped by 98%. A 70% partial-smoke-free policy was instituted ~1 year later in the face of revenue loss. The success of the collaboration in promoting a smoke-free policy, and the key element of air quality feedback, which appeared to be a central driver, may provide a model for similar efforts.
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Affiliation(s)
- Neil E Klepeis
- Education, Training, and Research, Inc., Scotts Valley, CA 95066, USA.
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA.
- Neil Klepeis and Associates, Environmental Health Research and Consulting, Aromas, CA 95004, USA.
| | - Narinder Dhaliwal
- Education, Training, and Research, Inc., Scotts Valley, CA 95066, USA.
| | - Gary Hayward
- Win-River Resort & Casino, Redding Rancheria, Redding, CA 96001, USA.
| | - Viviana Acevedo-Bolton
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA.
| | - Wayne R Ott
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA.
| | - Nathan Read
- Shasta County Public Health Tobacco Education Program, Shasta County Public Health, Redding, CA 96001, USA.
| | - Steve Layton
- Shasta County Public Health Tobacco Education Program, Shasta County Public Health, Redding, CA 96001, USA.
| | - Ruoting Jiang
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA.
| | - Kai-Chung Cheng
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA.
| | - Lynn M Hildemann
- Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA.
| | - James L Repace
- Repace Associates, Inc., Secondhand Smoke Consultants, Bowie, MD 20720, USA.
| | - Stephanie Taylor
- Shasta County Public Health Tobacco Education Program, Shasta County Public Health, Redding, CA 96001, USA.
| | - Seow-Ling Ong
- Education, Training, and Research, Inc., Scotts Valley, CA 95066, USA.
| | | | - Juliet P Lee
- Prevention Research Center, Pacific Institute for Research and Evaluation (PIRE), Oakland, CA 94612, USA.
| | - Roland S Moore
- Prevention Research Center, Pacific Institute for Research and Evaluation (PIRE), Oakland, CA 94612, USA.
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Dixit S, Pletcher MJ, Vittinghoff E, Imburgia K, Maguire C, Whitman IR, Glantz SA, Olgin JE, Marcus GM. Secondhand smoke and atrial fibrillation: Data from the Health eHeart Study. Heart Rhythm 2016; 13:3-9. [PMID: 26340844 PMCID: PMC4698178 DOI: 10.1016/j.hrthm.2015.08.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Cigarette smoking is a risk factor for atrial fibrillation (AF), but whether secondhand smoke (SHS) impacts the risk of AF remains unknown. OBJECTIVE To determine if SHS exposure is associated with an increased risk of AF. METHODS We performed a cross-sectional analysis of data from participants enrolled in the Health eHeart Study, an internet-based, longitudinal cardiovascular cohort study, who completed baseline SHS exposure and medical conditions questionnaires. SHS was assessed through a validated 22-question survey, and prevalent AF was assessed by self-report, with validation of a subset (n = 42) by review of electronic medical records. RESULTS Of 4976 participants, 593 (11.9%) reported having AF. In unadjusted analyses, patients with AF were more likely to have been exposed to SHS in utero, as a child, as an adult, at home, and at work. After multivariable adjustment for potential confounders, having had a smoking parent during gestational development (OR 1.37, 95% CI 1.08-1.73, P = .009) and residing with a smoker during childhood (OR 1.40, 95% CI 1.10-1.79, P = .007) were each significantly associated with AF. Both positive associations were more pronounced among patients without risk factors for AF (P values for interaction <.05). CONCLUSIONS SHS exposure during gestational development and during childhood was associated with having AF later in life. This association was even stronger in the absence of established risk factors for AF. Our findings indicate that SHS in early life may be an important, potentially modifiable risk factor for the development of AF.
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Affiliation(s)
- Shalini Dixit
- Division of Cardiology(,) Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Mark J Pletcher
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Kourtney Imburgia
- Division of Cardiology(,) Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Carol Maguire
- Division of Cardiology(,) Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Isaac R Whitman
- Division of Cardiology(,) Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Stanton A Glantz
- Division of Cardiology(,) Department of Medicine, University of California, San Francisco, San Francisco, California; Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, California
| | - Jeffrey E Olgin
- Division of Cardiology(,) Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Gregory M Marcus
- Division of Cardiology(,) Department of Medicine, University of California, San Francisco, San Francisco, California.
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Mordukhovich I, Coull B, Kloog I, Koutrakis P, Vokonas P, Schwartz J. Exposure to sub-chronic and long-term particulate air pollution and heart rate variability in an elderly cohort: the Normative Aging Study. Environ Health 2015; 14:87. [PMID: 26546332 PMCID: PMC4636903 DOI: 10.1186/s12940-015-0074-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 10/29/2015] [Indexed: 05/20/2023]
Abstract
BACKGROUND Short-term particulate air pollution exposure is associated with reduced heart rate variability (HRV), a risk factor for cardiovascular morbidity and mortality, in many studies. Associations with sub-chronic or long-term exposures, however, have been sparsely investigated. We evaluated the effect of fine particulate matter (PM2.5) and black carbon (BC) exposures on HRV in an elderly cohort: the Normative Aging Study. METHODS We measured power in high frequency (HF) and low frequency (LF), standard deviation of normal-to-normal intervals (SDNN), and the LF:HF ratio among participants from the Greater Boston area. Residential BC exposures for 540 men (1161 study visits, 2000-2011) were estimated using a spatio-temporal land use regression model, and residential PM2.5 exposures for 475 men (992 visits, 2003-2011) were modeled using a hybrid satellite based and land-use model. We evaluated associations between moving averages of sub-chronic (3-84 day) and long-term (1 year) pollutant exposure estimates and HRV parameters using linear mixed models. RESULTS One-standard deviation increases in sub-chronic, but not long-term, BC were associated with reduced HF, LF, and SDNN and an increased LF:HF ratio (e.g., 28 day BC: -2.3% HF [95% CI:-4.6, -0.02]). Sub-chronic and long-term PM2.5 showed evidence of relations to an increased LF and LF:HF ratio (e.g., 1 year PM: 21.0% LF:HF [8.6, 34.8]), but not to HF or SDNN, though the effect estimates were very imprecise and mostly spanned the null. CONCLUSIONS We observed some evidence of a relation between longer-term BC and PM2.5 exposures and changes in HRV in an elderly cohort. While previous studies focused on short-term air pollution exposures, our results suggest that longer-term exposures may influence cardiac autonomic function.
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Affiliation(s)
- Irina Mordukhovich
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard School of Public Health, Landmark Center, 401 Park Dr, Boston, MA, 02215, USA.
| | - Brent Coull
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA.
| | - Itai Kloog
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard School of Public Health, Landmark Center, 401 Park Dr, Boston, MA, 02215, USA.
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel.
| | - Petros Koutrakis
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard School of Public Health, Landmark Center, 401 Park Dr, Boston, MA, 02215, USA.
| | - Pantel Vokonas
- VA Normative Aging Study, Veterans Affairs Boston Healthcare System and the Department of Medicine Boston University School of Medicine, Boston, MA, USA.
| | - Joel Schwartz
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard School of Public Health, and Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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28
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Goudis CA, Konstantinidis AK, Ntalas IV, Korantzopoulos P. Electrocardiographic abnormalities and cardiac arrhythmias in chronic obstructive pulmonary disease. Int J Cardiol 2015. [DOI: 10.1016/j.ijcard.2015.06.096] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Mizukoshi A, Kumagai K, Yamamoto N, Noguchi M, Yoshiuchi K, Kumano H, Sakabe K, Yanagisawa Y. In-situ Real-Time Monitoring of Volatile Organic Compound Exposure and Heart Rate Variability for Patients with Multiple Chemical Sensitivity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:12446-65. [PMID: 26445055 PMCID: PMC4626978 DOI: 10.3390/ijerph121012446] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 09/24/2015] [Accepted: 09/28/2015] [Indexed: 11/23/2022]
Abstract
In-situ real-time monitoring of volatile organic compound (VOC) exposure and heart rate variability (HRV) were conducted for eight multiple chemical sensitivity (MCS) patients using a VOC monitor, a Holter monitor, and a time-activity questionnaire for 24 h to identify the relationship between VOC exposure, biological effects, and subjective symptoms in actual life. The results revealed no significantly different parameters for averaged values such as VOC concentration, HF (high frequency), and LF (low frequency) to HF ratio compared with previous data from healthy subjects (Int. J. Environ. Res. Public Health2010, 7, 4127–4138). Significant negative correlations for four subjects were observed between HF and amounts of VOC change. These results suggest that some patients show inhibition of parasympathetic activities along with VOC exposure as observed in healthy subjects. Comparing the parameters during subjective symptoms and normal condition, VOC concentration and/or VOC change were high except for one subject. HF values were low for five subjects during subjective symptoms. Examining the time-series data for VOC exposure and HF of each subject showed that the subjective symptoms, VOC exposure, and HF seemed well related in some symptoms. Based on these characteristics, prevention measures of symptoms for each subject may be proposed.
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Affiliation(s)
- Atsushi Mizukoshi
- Department of Environmental Medicine and Behavioral Science, Kinki University Faculty of Medicine, 377-2, Ohno-higashi, Osakasayama, Osaka 589-8511, Japan.
- Institute of Applied Brain Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama 359-1192, Japan.
| | - Kazukiyo Kumagai
- Environmental Health Laboratory, California Department of Public Health, 850 Marina Bay Pkwy, Richmond, CA 94804, USA.
| | - Naomichi Yamamoto
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea.
| | - Miyuki Noguchi
- Department of Materials and Life Science, Faculty of Science and Technology, Seikei University, 3-3-1 Kichijoji-kitamachi, Musashino, Tokyo 180-8633, Japan.
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Hiroaki Kumano
- Institute of Applied Brain Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama 359-1192, Japan.
- Faculty of Human Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama 359-1192, Japan.
| | - Kou Sakabe
- Department of Anatomy and Cellular Biology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
| | - Yukio Yanagisawa
- The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8654, Japan.
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Ruffini N, D'Alessandro G, Mariani N, Pollastrelli A, Cardinali L, Cerritelli F. Variations of high frequency parameter of heart rate variability following osteopathic manipulative treatment in healthy subjects compared to control group and sham therapy: randomized controlled trial. Front Neurosci 2015; 9:272. [PMID: 26300719 PMCID: PMC4523739 DOI: 10.3389/fnins.2015.00272] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 07/17/2015] [Indexed: 12/03/2022] Open
Abstract
Context: Heart Rate Variability (HRV) indicates how heart rate changes in response to inner and external stimuli. HRV is linked to health status and it is an indirect marker of the autonomic nervous system (ANS) function. Objective: To investigate the influence of osteopathic manipulative treatment (OMT) on cardiac autonomic modulation in healthy subjects, compared with sham therapy and control group. Methods: Sixty-six healthy subjects, both male and female, were included in the present 3-armed randomized placebo controlled within subject cross-over single blinded study. Participants were asymptomatic adults (26.7 ± 8.4 y, 51% male, BMI 18.5 ± 4.8), both smokers and non-smokers and not on medications. At enrollment subjects were randomized in three groups: A, B, C. Standardized structural evaluation followed by a patient need-based osteopathic treatment was performed in the first session of group A and in the second session of group B. Standardized evaluation followed by a protocoled sham treatment was provided in the second session of group A and in the first session of group B. No intervention was performed in the two sessions of group C, acting as a time-control. The trial was registered on clinicaltrials.gov identifier: NCT01908920. Main Outcomes Measures: HRV was calculated from electrocardiography before, during and after the intervention, for a total amount time of 25 min and considering frequency domain as well as linear and non-linear methods as outcome measures. Results: OMT engendered a statistically significant increase of parasympathetic activity, as shown by High Frequency power (p < 0.001), expressed in normalized and absolute unit, and possibly decrease of sympathetic activity, as revealed by Low Frequency power (p < 0.01); results also showed a reduction of Low Frequency/High Frequency ratio (p < 0.001) and Detrended fluctuation scaling exponent (p < 0.05). Conclusions: Findings suggested that OMT can influence ANS activity increasing parasympathetic function and decreasing sympathetic activity, compared to sham therapy and control group.
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Affiliation(s)
- Nuria Ruffini
- Research Department, Accademia Italiana Osteopatia Tradizionale Pescara, Italy ; Clinical-based Human Research Department, Centre for Osteopathic Medicine Collaboration Pescara, Italy
| | - Giandomenico D'Alessandro
- Research Department, Accademia Italiana Osteopatia Tradizionale Pescara, Italy ; Clinical-based Human Research Department, Centre for Osteopathic Medicine Collaboration Pescara, Italy
| | - Nicolò Mariani
- Research Department, Accademia Italiana Osteopatia Tradizionale Pescara, Italy
| | | | - Lucia Cardinali
- Research Department, Accademia Italiana Osteopatia Tradizionale Pescara, Italy ; Clinical-based Human Research Department, Centre for Osteopathic Medicine Collaboration Pescara, Italy
| | - Francesco Cerritelli
- Clinical-based Human Research Department, Centre for Osteopathic Medicine Collaboration Pescara, Italy
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Conrad M, Gorka SM, Kassel J. Smoking's effects on respiratory sinus arrhythmia in adolescent smokers. Int J Psychophysiol 2015; 97:8-13. [PMID: 25957697 PMCID: PMC4458705 DOI: 10.1016/j.ijpsycho.2015.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 05/01/2015] [Accepted: 05/03/2015] [Indexed: 11/24/2022]
Abstract
Respiratory sinus arrhythmia (RSA) has emerged as an indicator of how well the body maintains homeostasis and flexibly responds to environmental demands. Previous research has shown that smoking has both acute and chronic effects on RSA in adults. More recent work has focused on adolescent smokers because the natural decrease in RSA over the lifespan might be hastened by smoking at an early age. The goal of the current study, then, was to examine the acute effects of smoking on RSA and mean heart rate (HR) in a group of adolescent smokers. Participants completed two experimental sessions separated by 6-10 weeks, during which resting electrocardiogram (EKG) data were collected before and after smoking or not smoking a single cigarette ad libitum. Results indicate that smoking significantly decreased resting RSA and increased mean HR. In addition, those who smoked their first cigarette earlier in life (i.e., before age 8 or 10) evidenced a greater decrease in RSA during their smoking session relative to those who tried smoking after age 10. Importantly, these findings are largely consistent with the adult literature and suggest that smoking has acute effects on both RSA and HR in adolescence.
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Affiliation(s)
- Megan Conrad
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States; Cincinnati VA Medical Center, Cincinnati, OH, United States.
| | - Stephanie M Gorka
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States
| | - Jon Kassel
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States
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Gondim RM, Farah BQ, Santos CDFBF, Ritti-Dias RM. Are smoking and passive smoking related with heart rate variability in male adolescents? EINSTEIN-SAO PAULO 2015; 13:27-33. [PMID: 25993065 PMCID: PMC4946813 DOI: 10.1590/s1679-45082015ao3226] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 09/28/2014] [Indexed: 11/26/2022] Open
Abstract
Objective To analyze the relation between smoking and passive smoking with heart rate variability parameters in male adolescents. Methods The sample consisted of 1,152 males, aged 14 and 19 years. Data related to smoking and passive smoking were collected using a questionnaire. RR intervals were obtained by a heart rate monitor, on supine position, for 10 minutes. After collecting the RR intervals, time (standard deviation of all RR intervals, root mean square of the squared differences between adjacent normal RR intervals and the percentage of adjacent intervals over 50ms) and frequency domains (low and high frequency and sympathovagal balance) parameters of heart rate variability were obtained. Results No significant differences between smoker and nonsmoker adolescents were observed in heart rate variability parameters (p>0.05). Similarly, heart rate variability parameters did not show significant difference between exposed and not exposed to passive smoking (p>0.05). Conclusion Cigarette smoking and passive smoking are not related to heart rate variability in adolescence.
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Sureda X, Fernández E, Martínez-Sánchez JM, Fu M, López MJ, Martínez C, Saltó E. Secondhand smoke in outdoor settings: smokers' consumption, non-smokers' perceptions, and attitudes towards smoke-free legislation in Spain. BMJ Open 2015; 5:e007554. [PMID: 25854974 PMCID: PMC4390691 DOI: 10.1136/bmjopen-2014-007554] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To describe where smokers smoke outdoors, where non-smokers are exposed outdoors to secondhand smoke (SHS), and attitudes towards smoke-free outdoor areas after the implementation of national smoke-free legislation. DESIGN This cross-sectional study was conducted between June 2011 and March 2012 (n=1307 participants). SETTING Barcelona, Spain. PARTICIPANTS Representative, random sample of the adult (≥16 years) population. PRIMARY AND SECONDARY OUTCOMES Proportion of smoking and prevalence of exposure to SHS in the various settings according to type of enclosure. Percentages of support for outdoor smoke-free policies according to smoking status. RESULTS Smokers reported smoking outdoors most in bars and restaurants (54.8%), followed by outdoor places at work (46.8%). According to non-smokers, outdoor SHS exposure was highest at home (42.5%) and in bars and restaurants (33.5%). Among non-smoking adult students, 90% claimed exposure to SHS on university campuses. There was great support for banning smoking in the majority of outdoor areas, which was stronger among non-smokers than smokers. Over 70% of participants supported smoke-free playgrounds, school and high school courtyards, and the grounds of healthcare centres. CONCLUSIONS Extending smoking bans to selected outdoor settings should be considered in further tobacco control interventions to protect non-smokers from SHS exposure and to establish a positive model for youth. The majority of public support for some outdoor smoke-free areas suggests that it is feasible to extend smoking bans to additional outdoor settings.
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Affiliation(s)
- Xisca Sureda
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
- Catalan Network of Smoke-free Hospitals, Insitut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jose M Martínez-Sánchez
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Biostatistic Unit, Department of Basic Science, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Satn Cugat del Valles, Spain
| | - Marcela Fu
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
| | - María J López
- Evaluation and Interventions Methods Service, Agència de Salut Pública de Barcelona, Barcelona, Spain
- Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Agència de Salut Pública de Barcelona, Barcelona, Spain
- Institut d'Investigació Biomèdica-IBB Sant Pau, Sant Antoni Maria Claret, Barcelona, Spain
| | - Cristina Martínez
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Catalan Network of Smoke-free Hospitals, Insitut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Nursing, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Valles, Spain
| | - Esteve Saltó
- Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Direcció General de Planificació i Recerca en Salut, Generalitat de Catalunya, Travessera de les Corts, Barcelona, Spain
- Department of Public Health, School of Medicine, Universitat de Barcelona, Barcelona, Spain
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Middlekauff HR, Park J, Moheimani RS. Adverse effects of cigarette and noncigarette smoke exposure on the autonomic nervous system: mechanisms and implications for cardiovascular risk. J Am Coll Cardiol 2015; 64:1740-50. [PMID: 25323263 DOI: 10.1016/j.jacc.2014.06.1201] [Citation(s) in RCA: 157] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 06/24/2014] [Accepted: 06/30/2014] [Indexed: 11/27/2022]
Abstract
This review summarizes the detrimental effects of cigarette and noncigarette emission exposure on autonomic function, with particular emphasis on the mechanisms of acute and chronic modulation of the sympathetic nervous system. We propose that the nicotine and fine particulate matter in tobacco smoke lead to increased sympathetic nerve activity, which becomes persistent via a positive feedback loop between sympathetic nerve activity and reactive oxidative species. Furthermore, we propose that baroreflex suppression of sympathetic activation is attenuated in habitual smokers; that is, the baroreflex plays a permissive role, allowing sympathoexcitation to occur without restraint in the setting of increased pressor response. This model is also applicable to other nontobacco cigarette emission exposures (e.g., marijuana, waterpipes [hookahs], electronic cigarettes, and even air pollution). Fortunately, emerging data suggest that baroreflex sensitivity and autonomic function may be restored after smoking cessation, providing further evidence in support of the health benefits of smoking cessation.
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Affiliation(s)
- Holly R Middlekauff
- Division of Cardiology, Department of Medicine, University of California-Los Angeles, Los Angeles, California.
| | - Jeanie Park
- Renal Division, Department of Medicine, Emory University School of Medicine, and the Veterans Affairs Medical Center, Atlanta, Georgia
| | - Roya S Moheimani
- David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California
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Evans JM, Jenkins RA, Ilgner RH, Knapp CF, Zhang Q, Patwardhan AR. Acute cardiovascular autonomic responses to inhaled particulates. Eur J Appl Physiol 2014; 115:257-68. [DOI: 10.1007/s00421-014-2998-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 09/10/2014] [Indexed: 11/24/2022]
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Mehta AJ, Kloog I, Zanobetti A, Coull BA, Sparrow D, Vokonas P, Schwartz J. Associations between changes in city and address specific temperature and QT interval--the VA Normative Aging Study. PLoS One 2014; 9:e106258. [PMID: 25238150 PMCID: PMC4169528 DOI: 10.1371/journal.pone.0106258] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 08/04/2014] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The underlying mechanisms of the association between ambient temperature and cardiovascular morbidity and mortality are not well understood, particularly for daily temperature variability. We evaluated if daily mean temperature and standard deviation of temperature was associated with heart rate-corrected QT interval (QTc) duration, a marker of ventricular repolarization in a prospective cohort of older men. METHODS This longitudinal analysis included 487 older men participating in the VA Normative Aging Study with up to three visits between 2000-2008 (n = 743). We analyzed associations between QTc and moving averages (1-7, 14, 21, and 28 days) of the 24-hour mean and standard deviation of temperature as measured from a local weather monitor, and the 24-hour mean temperature estimated from a spatiotemporal prediction model, in time-varying linear mixed-effect regression. Effect modification by season, diabetes, coronary heart disease, obesity, and age was also evaluated. RESULTS Higher mean temperature as measured from the local monitor, and estimated from the prediction model, was associated with longer QTc at moving averages of 21 and 28 days. Increased 24-hr standard deviation of temperature was associated with longer QTc at moving averages from 4 and up to 28 days; a 1.9°C interquartile range increase in 4-day moving average standard deviation of temperature was associated with a 2.8 msec (95%CI: 0.4, 5.2) longer QTc. Associations between 24-hr standard deviation of temperature and QTc were stronger in colder months, and in participants with diabetes and coronary heart disease. CONCLUSION/SIGNIFICANCE In this sample of older men, elevated mean temperature was associated with longer QTc, and increased variability of temperature was associated with longer QTc, particularly during colder months and among individuals with diabetes and coronary heart disease. These findings may offer insight of an important underlying mechanism of temperature-related cardiovascular morbidity and mortality in an older population.
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Affiliation(s)
- Amar J. Mehta
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Itai Kloog
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, United States of America
- The Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Antonella Zanobetti
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Brent A. Coull
- Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - David Sparrow
- The VA Normative Aging Study, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States of America
- The Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Pantel Vokonas
- The VA Normative Aging Study, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States of America
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Joel Schwartz
- Exposure, Epidemiology and Risk Program, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, United States of America
- The Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
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Laumbach R, Kipen H. Mechanistic data support protecting non-smokers from the lethal effects of second-hand smoke. Int J Public Health 2014; 59:575-6. [PMID: 24781823 DOI: 10.1007/s00038-014-0550-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 03/24/2014] [Indexed: 11/28/2022] Open
Affiliation(s)
- Robert Laumbach
- Environmental and Occupational Health Sciences Institute, Rutgers-Robert Wood Johnson Medical School, 170 Frelinghuysen Road, Piscataway, NJ, 08854, USA
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Acevedo-Bolton V, Ott WR, Cheng KC, Jiang RT, Klepeis NE, Hildemann LM. Controlled experiments measuring personal exposure to PM2.5 in close proximity to cigarette smoking. INDOOR AIR 2014; 24:199-212. [PMID: 23808850 DOI: 10.1111/ina.12057] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 06/20/2013] [Indexed: 06/02/2023]
Abstract
Few measurements of exposure to secondhand smoke (SHS) in close proximity to a smoker are available. Recent health studies have demonstrated an association between acute (<2 h) exposures to high concentrations of SHS and increased risk of cardiovascular and respiratory disease. We performed 15 experiments inside naturally ventilated homes and 16 in outdoor locations, each with 2-4 non-smokers sitting near a cigarette smoker. The smoker's and non-smokers' real-time exposures to PM2.5 from SHS were measured by using TSI SidePak monitors to sample their breathing zones. In 87% of the residential indoor experiments, the smoker received the highest average exposure to SHS, with PM2.5 concentrations ranging from 50-630 μg/m(3) . During the active smoking period, individual non-smokers sitting within approximately 1 m of a smoker had average SHS exposures ranging from negligible up to >160 μg/m(3) of PM2.5 . The average incremental exposure of the non-smokers was higher indoors (42 μg/m(3) , n = 35) than outdoors (29 μg/m(3) , n = 47), but the overall indoor and outdoor frequency distributions were similar. The 10-s PM2.5 averages during the smoking periods showed great variability, with multiple high concentrations of short duration (microplumes) both indoors and outdoors.
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Affiliation(s)
- V Acevedo-Bolton
- Civil and Environmental Engineering Department, Stanford University, Stanford, CA, USA
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39
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Schick SF, Farraro KF, Perrino C, Sleiman M, van de Vossenberg G, Trinh MP, Hammond SK, Jenkins BM, Balmes J. Thirdhand cigarette smoke in an experimental chamber: evidence of surface deposition of nicotine, nitrosamines and polycyclic aromatic hydrocarbons and de novo formation of NNK. Tob Control 2014; 23:152-9. [PMID: 23716171 DOI: 10.1136/tobaccocontrol-2012-050915] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND A growing body of evidence shows that secondhand cigarette smoke undergoes numerous chemical changes after it is released into the air: it can adsorb to indoor surfaces, desorb back into the air and undergo chemical changes as it ages. OBJECTIVES To test the effects of aging on the concentration of polycyclic aromatic hydrocarbons (PAHs), nicotine and tobacco-specific nitrosamines in cigarette smoke. METHODS We generated sidestream and mainstream cigarette smoke with a smoking machine, diluted it with conditioned filtered air, and passed it through a 6 m(3) flow reactor with air exchange rates that matched normal residential air exchange rates. We tested the effects of 60 min aging on the concentration of 16 PAHs, nicotine, cotinine and tobacco-specific nitrosamines. We also measured sorption and deposition of nicotine, cotinine and tobacco-specific nitrosamines on materials placed within the flow reactor. RESULTS We observed mass losses of 62% for PAHs, 72%, for nicotine, 79% for N-nitrosonornicotine and 80% for 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). Extraction of cotton cloth exposed to smoke yielded nicotine and NNK. The ratio of NNK:nicotine on the exposed cloth was 10-fold higher than that in aerosol samples. CONCLUSIONS Our data suggest that the majority of the PAHs, nicotine, cotinine and tobacco-specific nitrosamines that are released during smoking in homes and public places deposit on room surfaces. These data give an estimate of the potential for accumulation of carcinogens in thirdhand cigarette smoke. Exposure to PAHs and tobacco-specific nitrosamines, through dermal absorption and inhalation of contaminated dust, may contribute to smoking-attributable morbidity and mortality.
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Affiliation(s)
- Suzaynn F Schick
- Department of Medicine, University of California, , San Francisco, California, USA
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40
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Rajkumar S, Schmidt-Trucksäss A, Wellenius GA, Bauer GF, Huynh CK, Moeller A, Röösli M. The effect of workplace smoking bans on heart rate variability and pulse wave velocity of non-smoking hospitality workers. Int J Public Health 2014; 59:577-85. [PMID: 24504155 DOI: 10.1007/s00038-014-0545-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 01/09/2014] [Accepted: 01/22/2014] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To investigate the effect of a change in second-hand smoke (SHS) exposure on heart rate variability (HRV) and pulse wave velocity (PWV), this study utilized a quasi-experimental setting when a smoking ban was introduced. METHODS HRV, a quantitative marker of autonomic activity of the nervous system, and PWV, a marker of arterial stiffness, were measured in 55 non-smoking hospitality workers before and 3-12 months after a smoking ban and compared to a control group that did not experience an exposure change. SHS exposure was determined with a nicotine-specific badge and expressed as inhaled cigarette equivalents per day (CE/d). RESULTS PWV and HRV parameters significantly changed in a dose-dependent manner in the intervention group as compared to the control group. A one CE/d decrease was associated with a 2.3% (95% CI 0.2-4.4; p = 0.031) higher root mean square of successive differences (RMSSD), a 5.7% (95% CI 0.9-10.2; p = 0.02) higher high-frequency component and a 0.72% (95% CI 0.40-1.05; p < 0.001) lower PWV. CONCLUSIONS PWV and HRV significantly improved after introducing smoke-free workplaces indicating a decreased cardiovascular risk.
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Affiliation(s)
- Sarah Rajkumar
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, Switzerland
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Gać P, Sobieszczańska M. Effects of cigarette smoke on Holter ECG recordings in patients with arterial hypertension. Part 1: Time domain parameters of heart rate variability. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2014; 37:404-413. [PMID: 24444697 DOI: 10.1016/j.etap.2013.12.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 12/16/2013] [Accepted: 12/19/2013] [Indexed: 06/03/2023]
Abstract
UNLABELLED This report was intended to evaluate the effect of cigarette smoke on heart rate variability (HRV) in patients with arterial hypertension (AH). 223 individuals were qalified to the studies. The following groups of patients not suffering from other disease which may affect HRV were delineated: 1 - patients with AH (n=145); 2 - patients without AH (n=48). In group 1 the following patient groups were studied: A - active smokers (n=42), B - non-smokers exposed to cigarette smoke (n=30), C - non-smokers not exposed to tobacco smoke (n=34), D - former smokers (n=26). A time domain HRV analysis was carried out. Group 1 versus group 2 manifested significantly lower mean values of most parameters in the HRV time domain analysis. Subgroups A, B and D versus subgroup C also exhibited significantly lower mean values of most parameters in the HRV time domain analysis. Active cigarette smoking and passive exposure to tobacco smoke represented independent risk factors for a decreased HRV. CONCLUSIONS Active and passive exposure to cigarette smoke decreases HRV in hypertensive patients.
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Affiliation(s)
- Paweł Gać
- Department of Pathophysiology, Wroclaw Medical University, Marcinkowskiego 1, PL 50-368 Wrocław, Poland.
| | - Małgorzata Sobieszczańska
- Department of Pathophysiology, Wroclaw Medical University, Marcinkowskiego 1, PL 50-368 Wrocław, Poland
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Lee CL, Chang WD. The effects of cigarette smoking on aerobic and anaerobic capacity and heart rate variability among female university students. Int J Womens Health 2013; 5:667-79. [PMID: 24204174 PMCID: PMC3804543 DOI: 10.2147/ijwh.s49220] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Aim In this study, the effects of cigarette smoking on maximal aerobic capacity, anaerobic capacity, and heart rate variability among female university students were investigated. Materials and methods Twelve smokers and 21 nonsmokers participated in this study. All participants performed an intermittent sprint test (IST) and a 20 m shuttle run test to measure their anaerobic capacity and maximal aerobic capacity. The IST was comprised of 6 × 10-second sprints with a 60-second active recovery between each sprint. Heart rate variability was recorded while the participants were in a supine position 20 minutes before and 30 minutes after the IST. Results The total work, peak power, and heart rate of the smokers and nonsmokers did not differ significantly. However, the smokers’ average power declined significantly during sprints 4 to 6 (smokers versus nonsmokers, respectively: 95% confidence interval =6.2–7.2 joule/kg versus 6.8–7.6 joule/kg; P<0.05), and their fatigue index increased (smokers versus nonsmokers, respectively: 35.8% ± 2.3% versus 24.5% ± 1.76%; P<0.05) during the IST. The maximal oxygen uptake of nonsmokers was significantly higher than that of the smokers (P<0.05). The standard deviation of the normal to normal intervals and the root mean square successive difference did not differ significantly between nonsmokers and smokers. However, the nonsmokers exhibited a significantly higher normalized high frequency (HF), and significantly lower normalized low frequency (LF), LF/HF ratio, and natural logarithm of the LF/HF when compared with those of the smokers (P<0.05). Conclusion Smoking may increase female smokers’ exercise fatigue and decrease their average performance during an IST, while reducing their maximal aerobic capacity. Furthermore, smoking reduces parasympathetic nerve activity and activates sympathetic cardiac control.
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Affiliation(s)
- Chia-Lun Lee
- Physical Education Section for General Education, National Sun Yat-sen University, Kaohsiung, Taiwan
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Zhang J, Fang SC, Mittleman MA, Christiani DC, Cavallari JM. Secondhand tobacco smoke exposure and heart rate variability and inflammation among non-smoking construction workers: a repeated measures study. Environ Health 2013; 12:83. [PMID: 24083379 PMCID: PMC3906998 DOI: 10.1186/1476-069x-12-83] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 09/25/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Although it has been well recognized that exposure to secondhand tobacco smoke (SHS) is associated with cardiovascular mortality, the mechanisms and time course by which SHS exposure may lead to cardiovascular effects are still being explored. METHODS Non-smoking workers were recruited from a local union and monitored inside a union hall while exposed to SHS over approximately 6 hours. Participants were fitted with a continuous electrocardiographic monitor upon enrollment which was removed at the end of a 24-hr monitoring period. A repeated measures study design was used where resting ECGs and blood samples were taken from individuals before SHS exposure (baseline), immediately following SHS exposure (post) and the morning following SHS exposure (next-morning).Inflammatory markers, including high sensitivity C-reactive protein (CRP) and white blood cell count (WBC) were analyzed. Heart rate variability (HRV) was analyzed from the ECG recordings in time (SDNN, rMSSD) and frequency (LF, HF) domain parameters over 5-minute periods. SHS exposure was quantified using a personal fine particulate matter (PM2.5) monitor.Linear mixed effects regression models were used to examine within-person changes in inflammatory and HRV parameters across the 3 time periods. Exposure-response relationships with PM2.5 were examined using mixed effects models. All models were adjusted for age, BMI and circadian variation. RESULTS A total of 32 male non-smokers were monitored between June 2010 and June 2012. The mean PM2.5 from SHS exposure was 132 μg/m3. Immediately following SHS exposure, a 100 μg/m3 increase in PM2.5 was associated with declines in HRV (7.8% [standard error (SE) =3%] SDNN, 8.0% (SE = 3.9%) rMSSD, 17.2% (SE = 6.3%) LF, 29.0% (SE = 10.1%) HF) and increases in WBC count 0.42 (SE = 0.14) k/μl. Eighteen hours following SHS exposure, a 100 μg/m3 increase in PM2.5 was associated with 24.2% higher CRP levels. CONCLUSIONS Our study suggest that short-term SHS exposure is associated with significantly lower HRV and higher levels of inflammatory markers. Exposure-associated declines in HRV were observed immediately following exposure while higher levels of CRP were not observed until 18 hours following exposure. Cardiovascular autonomic and inflammation responses may contribute to the pathophysiologic pathways that link SHS exposure with adverse cardiovascular outcomes.
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Affiliation(s)
- Jinming Zhang
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Shona C Fang
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- New England Research Institutes, Inc, Watertown, Massachusetts, USA
| | - Murray A Mittleman
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
- Harvard Medical School, Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - David C Christiani
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Jennifer M Cavallari
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- Division of Occupational and Environmental Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA
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Baja ES, Schwartz JD, Coull BA, Wellenius GA, Vokonas PS, Suh HH. Structural equation modeling of parasympathetic and sympathetic response to traffic air pollution in a repeated measures study. Environ Health 2013; 12:81. [PMID: 24059437 PMCID: PMC3907044 DOI: 10.1186/1476-069x-12-81] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 08/13/2013] [Indexed: 05/29/2023]
Abstract
BACKGROUND Traffic-related air pollution has been associated to a range of adverse health impacts, including decreased heart rate variability (HRV). The association between traffic-related pollution and HRV, however, has varied by traffic-related or HRV marker as well as by study, suggesting the need for a more comprehensive and integrative approach to examining air pollution-mediated biological impacts on these outcomes. In a Bayesian framework, we examined the effect of traffic pollution on HRV using structural equation models (SEMs) and looked at effect modification by participant characteristics. METHODS We studied measurements of 5 HRV markers [high frequency (HF), low frequency (LF), 5-min standard deviation of normal-to-normal intervals (SDNN), square root of the mean squared differences of successive normal-to-normal intervals (rMSSD), and LF/HF ratio (LF/HF)] for 700 elderly men from the Normative Aging Study. Using SEMs, we fit a latent variable for traffic pollution that is reflected by levels of carbon monoxide, nitrogen monoxide, nitrogen dioxide, and black carbon (BC) to estimate its effect on latent variable for parasympathetic tone that included HF, SDNN and rMSSD, and the sympathetic tone marker, LF/HF. Exposure periods were assessed using 4-, 24-, 48-, 72-hour moving average pre-visit. We compared our main effect findings using SEMs with those obtained using linear mixed models. RESULTS Traffic pollution was not associated with mean parasympathetic tone and LF/HF for all examined moving averages. In Bayesian linear mixed models, however, BC was related to increased LF/HF, an inter quartile range (IQR) increase in BC was associated with a 6.5% (95% posterior interval (PI): -0.7%, 14.2%) increase in mean LF/HF 24-hours later. The strongest association observed was for the 4-hour moving average (10.1%; 95% PI: 3.0%, 17.6%). The effect of traffic on parasympathetic tone was stronger among diabetic as compared to non-diabetic participants. Specifically, an IQR increase in traffic pollution in the 48-hr prior to the clinic visit was associated with a 44.3% (95% PI: -67.7%, -4.2%) lower mean parasympathetic tone among diabetics, and a 7.7% (95% PI: -18.0%, 41.4%) higher mean parasympathetic tone among non-diabetics. CONCLUSIONS BC was associated with adverse changes LF/HF in the elderly. Traffic pollution may decrease parasympathetic tone among diabetic elderly.
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Affiliation(s)
- Emmanuel S Baja
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
- Institute of Clinical Epidemiology, National Institutes of Health, University of the Philippines, Manila, Philippines
| | - Joel D Schwartz
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Brent A Coull
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
| | - Gregory A Wellenius
- Center for Environmental Health and Technology, Brown University, Providence, RI, USA
| | - Pantel S Vokonas
- VA Normative Aging Study, Veterans Affairs Boston Healthcare System, Boston, MA, USA
- Department of Medicine, Boston University, Boston, MA, USA
| | - Helen H Suh
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
- Environmental Health Program, NORC at the University of Chicago, Boston, MA, USA
- Department of Health Sciences, Northeastern University, Boston, MA, USA
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Klepeis NE, Hughes SC, Edwards RD, Allen T, Johnson M, Chowdhury Z, Smith KR, Boman-Davis M, Bellettiere J, Hovell MF. Promoting smoke-free homes: a novel behavioral intervention using real-time audio-visual feedback on airborne particle levels. PLoS One 2013; 8:e73251. [PMID: 24009742 PMCID: PMC3751871 DOI: 10.1371/journal.pone.0073251] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 07/19/2013] [Indexed: 12/01/2022] Open
Abstract
Interventions are needed to protect the health of children who live with smokers. We pilot-tested a real-time intervention for promoting behavior change in homes that reduces second hand tobacco smoke (SHS) levels. The intervention uses a monitor and feedback system to provide immediate auditory and visual signals triggered at defined thresholds of fine particle concentration. Dynamic graphs of real-time particle levels are also shown on a computer screen. We experimentally evaluated the system, field-tested it in homes with smokers, and conducted focus groups to obtain general opinions. Laboratory tests of the monitor demonstrated SHS sensitivity, stability, precision equivalent to at least 1 µg/m(3), and low noise. A linear relationship (R(2) = 0.98) was observed between the monitor and average SHS mass concentrations up to 150 µg/m(3). Focus groups and interviews with intervention participants showed in-home use to be acceptable and feasible. The intervention was evaluated in 3 homes with combined baseline and intervention periods lasting 9 to 15 full days. Two families modified their behavior by opening windows or doors, smoking outdoors, or smoking less. We observed evidence of lower SHS levels in these homes. The remaining household voiced reluctance to changing their smoking activity and did not exhibit lower SHS levels in main smoking areas or clear behavior change; however, family members expressed receptivity to smoking outdoors. This study established the feasibility of the real-time intervention, laying the groundwork for controlled trials with larger sample sizes. Visual and auditory cues may prompt family members to take immediate action to reduce SHS levels. Dynamic graphs of SHS levels may help families make decisions about specific mitigation approaches.
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Affiliation(s)
- Neil E Klepeis
- Center for Behavioral Epidemiology and Community Health (C-BEACH), Graduate School of Public Health, SDSU Research Foundation, San Diego State University, San Diego, California, USA.
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Rostron B. Mortality risks associated with environmental tobacco smoke exposure in the United States. Nicotine Tob Res 2013; 15:1722-8. [PMID: 23852001 DOI: 10.1093/ntr/ntt051] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Researchers have presented various estimates of mortality attributable to environmental tobacco smoke (ETS) exposure in the United States, but mortality risk estimates for ETS exposure from U.S. health survey data are generally unavailable. METHODS I estimated mortality hazard ratios (HRs) for ETS exposure from Third National Health and Nutrition Examination Survey (NHANES III) data from 1988 to 1994 linked for 4 and 8 years of mortality follow-up. I classified ETS exposure based on observed serum cotinine concentrations (low ETS exposure: <0.1 ng/ml, medium ETS exposure: ≥ 0.1 ng/ml, and <1 ng/ml, and high ETS exposure: ≥ 1 ng/ml and <15 ng/ml) and reported home ETS exposure information. I also estimated ETS exposure among U.S. nonsmokers over time using NHANES III data and continuous NHANES data from 1999 to 2010. RESULTS High ETS exposure was associated with higher ischemic heart disease mortality risk (HR = 2.47, 95% CI = 1.04-5.86) among never-smokers during 4 years of follow-up, adjusting for age, sex, race/ethnicity, educational attainment, alcohol consumption, body mass index, high blood pressure, and serious circulatory conditions. The prevalence of medium ETS exposure among nonsmokers decreased from 53.0% (95% CI = 51.5%-54.5%) in NHANES III to 16.7% (95% CI = 15.3%-18.1%) in NHANES from 2005 to 2010. CONCLUSIONS I found an association between high ETS exposure and heart disease mortality risk among never-smokers during short-term mortality follow-up using U.S. national health survey data. I also found that ETS exposure among U.S. nonsmokers has substantially decreased in recent decades.
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Sureda X, Fernández E, López MJ, Nebot M. Secondhand tobacco smoke exposure in open and semi-open settings: a systematic review. ENVIRONMENTAL HEALTH PERSPECTIVES 2013; 121:766-73. [PMID: 23651671 PMCID: PMC3701994 DOI: 10.1289/ehp.1205806] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 05/01/2013] [Indexed: 05/06/2023]
Abstract
BACKGROUND Some countries have recently extended smoke-free policies to particular outdoor settings; however, there is controversy regarding whether this is scientifically and ethically justifiable. OBJECTIVES The objective of the present study was to review research on secondhand smoke (SHS) exposure in outdoor settings. DATA SOURCES We conducted different searches in PubMed for the period prior to September 2012. We checked the references of the identified papers, and conducted a similar search in Google Scholar. STUDY SELECTION Our search terms included combinations of "secondhand smoke," "environmental tobacco smoke," "passive smoking" OR "tobacco smoke pollution" AND "outdoors" AND "PM" (particulate matter), "PM(2.5)" (PM with diameter ≤ 2.5 µm), "respirable suspended particles," "particulate matter," "nicotine," "CO" (carbon monoxide), "cotinine," "marker," "biomarker" OR "airborne marker." In total, 18 articles and reports met the inclusion criteria. RESULTS Almost all studies used PM(2.5) concentration as an SHS marker. Mean PM(2.5) concentrations reported for outdoor smoking areas when smokers were present ranged from 8.32 to 124 µg/m(3) at hospitality venues, and 4.60 to 17.80 µg/m(3) at other locations. Mean PM(2.5) concentrations in smoke-free indoor settings near outdoor smoking areas ranged from 4 to 120.51 µg/m(3). SHS levels increased when smokers were present, and outdoor and indoor SHS levels were related. Most studies reported a positive association between SHS measures and smoker density, enclosure of outdoor locations, wind conditions, and proximity to smokers. CONCLUSIONS The available evidence indicates high SHS levels at some outdoor smoking areas and at adjacent smoke-free indoor areas. Further research and standardization of methodology is needed to determine whether smoke-free legislation should be extended to outdoor settings.
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Affiliation(s)
- Xisca Sureda
- Tobacco Control Unit, Cancer Control and Prevention Programme, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain
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Lin H, Wang H, Wu W, Lang L, Wang Q, Tian L. The effects of smoke-free legislation on acute myocardial infarction: a systematic review and meta-analysis. BMC Public Health 2013; 13:529. [PMID: 23721370 PMCID: PMC3671962 DOI: 10.1186/1471-2458-13-529] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 05/21/2013] [Indexed: 11/17/2022] Open
Abstract
Background Comprehensive smoke-free legislation has been implemented in many countries. The current study quantitatively examined the reduction in risk of acute myocardial infarction (MI) occurrence following the legislations and the relationship with the corresponding smoking prevalence decrease. Methods PubMed, EMBASE, and Google Scholar databases and bibliographies of relevant studies and reviews were searched for potential original studies published from January 1, 2004, through October 31, 2011. Meta-analysis was performed using a random effect model to estimate the overall effects of the smoking-free legislations. Meta-regression was used to investigate possible causes of heterogeneity in risk estimates. Results A total of 18 eligible studies with 44 estimates of effect size were used in this study. Meta-analysis produced a pooled estimate of the relative risk of 0.87 (95% confidence interval (CI): 0.84 to 0.91). There was significant heterogeneity in the risk estimates (overall I2 = 96.03%, p<0.001). In meta-regression analysis, studies with greater smoking prevalence decrease produced larger relative risk (adjusted coefficient −0.027, 95% CI: -0.049 to −0.006, p=0.014). Conclusion Smoke-free legislations in public and work places were associated with significant reduction in acute MI risk, which might be partly attributable to reduced smoking prevalence.
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Affiliation(s)
- Hualiang Lin
- Guangdong Provincial Institute of Public Health, Guangzhou, China
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Effects of Moxa (Folium Artemisiae argyi) Smoke Exposure on Heart Rate and Heart Rate Variability in Healthy Young Adults: A Randomized, Controlled Human Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:510318. [PMID: 23762143 PMCID: PMC3676951 DOI: 10.1155/2013/510318] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 04/10/2013] [Accepted: 04/29/2013] [Indexed: 12/19/2022]
Abstract
Objective. To determine the effects of the moxa smoke on human heart rate (HR) and heart rate variability (HRV). Methods. Fifty-five healthy young adults were randomly divided into experimental (n = 28) and control (n = 27) groups. Experimental subjects were exposed to moxa smoke (2.5 ± 0.5 mg/m3) twice for 25 minutes in one week. ECG monitoring was performed before, during, and after exposure. Control subjects were exposed to normal indoor air in a similar environment and similarly monitored. Followup was performed the following week. Short-term (5 min) HRV parameters were analyzed with HRV analysis software. SPSS software was used for statistical analysis. Results. During and after the first exposure, comparison of percentage changes or changes in all parameters between groups showed no significant differences. During the second exposure, percentage decrease in HR, percentage increases in lnTP, lnHF, lnLF, and RMSSD, and increase in PNN50 were significantly greater in the experimental group than in control. Conclusion. No significant adverse HRV effects were associated with this clinically routine 25-minute exposure to moxa smoke, and the data suggests that short-term exposure to moxa smoke might have positive regulating effects on human autonomic function. Further studies are warranted to confirm these findings.
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Perez CM, Ledbetter AD, Hazari MS, Haykal-Coates N, Carll AP, Winsett DW, Costa DL, Farraj AK. Hypoxia stress test reveals exaggerated cardiovascular effects in hypertensive rats after exposure to the air pollutant acrolein. Toxicol Sci 2013; 132:467-77. [PMID: 23335627 DOI: 10.1093/toxsci/kft008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Exposure to air pollution increases the risk of cardiovascular morbidity and mortality, especially in susceptible populations. Despite increased risk, adverse responses are often delayed and require additional stress tests to reveal latent effects of exposure. The goal of this study was to use an episode of "transient hypoxia" as an extrinsic stressor to uncover latent susceptibility to environmental pollutants in a rodent model of hypertension. We hypothesized that exposure to acrolein, an unsaturated aldehyde and mucosal irritant found in cigarette smoke, diesel exhaust, and power plant emissions, would increase cardiopulmonary sensitivity to hypoxia, particularly in hypertensive rats. Spontaneously hypertensive and Wistar Kyoto (normotensive) rats, implanted with radiotelemeters, were exposed once for 3h to 3 ppm acrolein gas or filtered air in whole-body plethysmograph chambers and challenged with a 10% oxygen atmosphere (10min) 24h later. Acrolein exposure increased heart rate, blood pressure, breathing frequency, and minute volume in hypertensive rats and also increased the heart rate variability parameter LF, suggesting a potential role for increased sympathetic tone. Normotensive rats only had increased blood pressure during acrolein exposure. The hypoxia stress test after acrolein exposure revealed increased diastolic blood pressure only in hypertensive rats and increased minute volume and expiratory time only in normotensive rats. These results suggest that hypertension confers exaggerated sensitivity to air pollution and that the hypoxia stress test is a novel tool to reveal the potential latent effects of air pollution exposure.
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Affiliation(s)
- Christina M Perez
- Curriculum in Toxicology, University of North Carolina, Chapel Hill, North Carolina 27514, USA
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