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Susceptibility of older adults to health effects induced by ambient air pollutants regulated by the European Union and the United States

  • Kathryn L. Shumake
  • Jason D. SacksEmail author
  • Janice S. Lee
  • Douglas O. Johns
Mini Review

Abstract

Air pollution is a health concern for the general population, but a few subpopulations (e.g. children, individuals with preexisting cardiovascular or respiratory diseases, etc.) are considered more susceptible to the adverse health effects attributed to air pollution. There is sufficient evidence to suggest that older adults (≥65 years old) are more susceptible to air pollution-induced health effects compared to younger adults due to decreased physiological, metabolic and compensatory processes, and a greater incidence of cardiovascular and respiratory disease. This review examines health effects induced by exposures to common ambient air pollutants regulated by the European Union and the United States. Studies were evaluated that examined the potential susceptibility of older adults to air pollutant-induced health effects. This review focuses on epidemiologic studies that directly compared the health effects of older adults to younger adults and/or the general population in order to compare populations within the same study design. Supplementary information is used from controlled human exposure studies, which examined only older adults, and animal toxicological studies, which utilized animal models of senescence, to provide coherence and biological plausibility for the health effects observed in epidemiologic studies. Overall, evidence from available published studies demonstrates that older adults may be more susceptible to air pollution-induced health effects than younger adults and/or the general population. Clinicians and other health professionals should consider advising older adults on pollution-avoiding behaviors in order to decrease the risk of adverse air pollution-related health effects.

Keywords

Air pollution Elderly Aged Cardiovascular diseases Respiratory diseases Particulate matter 

Notes

Acknowledgments

This work was supported in part by an appointment to the Research Participation Program for the US Environmental Protection Agency, Office of Research and Development, administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and the EPA. The views expressed are those of the authors and do not necessarily reflect the views or policies of the US EPA.

Conflict of interest

None.

References

  1. 1.
    Chen B, Kan H (2008) Air pollution and population health: a global challenge. Environ Health Prev Med 13:94–101PubMedCrossRefGoogle Scholar
  2. 2.
    Air Quality and Health. The World Health Organization. http://www.who.int/mediacentre/factsheets/fs313/en/index.html. Accessed April 22, 2011
  3. 3.
    Chen Y, Craig L, Krewski D (2008) Air quality risk assessment and management. J Toxicol Environ Health A 71:24–39PubMedCrossRefGoogle Scholar
  4. 4.
    Kunzli N, Tager I (2005) Air pollution: from lung to heart. Swiss Med Wkly 135:697–702PubMedGoogle Scholar
  5. 5.
    Gellar A, Zenick H (2005) Aging and the environment: a research framework. Environ Health Perspect 113(9):1257–1262CrossRefGoogle Scholar
  6. 6.
    US EPA. Integrated Science Assessments and Air Quality Criteria Documents at the National Center for Environmental Assessment in Research Triangle Park, US. http://epa.gov/ncea/isa/index.htm. Accessed April 22, 2011
  7. 7.
    Sacks JD, Stanek LW, Luben T et al (2011) Particulate matter induced health effects: who’s susceptible? Environ Health Perspect 119:446–454PubMedCrossRefGoogle Scholar
  8. 8.
    The European Commission. Air Quality Framework Document and Daughter Directives. http://ec.europa.eu/environment/air/quality/legislation/existing_leg.htm. Accessed April 22, 2011
  9. 9.
    The European Commission. Position Papers. http://ec.europa.eu/environment/air/quality/legislation/assessment.htm. Accessed April 22, 2011
  10. 10.
    Barnett AG, Williams GM, Schwartz J et al (2006) The effects of air pollution on hospitalizations for cardiovascular disease in elderly people in Australian and New Zealand Cities. Environ Health Perspect 114:1018–1023PubMedCrossRefGoogle Scholar
  11. 11.
    Ostro B, Broadwin R, Green S, Wen-Ying F, Lipsett M (2006) Fine particulate air pollution and mortality in nine California counties: results from CALFINE. Environ Health Perspect 114(1):29–33PubMedCrossRefGoogle Scholar
  12. 12.
    Host S, Larrieu S, Pascal L et al (2008) Short-term associations between fine and coarse particles and hospital admissions for cardiorespiratory diseases in six French cities. Occup Environ Med 65:544–551PubMedCrossRefGoogle Scholar
  13. 13.
    Chock DP, Winkler SL, Chen C (2000) A study of the association between daily mortality and ambient air pollutant concentrations in Pittsburgh, Pennsylvania. J Air Waste Manag Assoc 50:1481–1500PubMedCrossRefGoogle Scholar
  14. 14.
    Katsuoyanni K, Samet JM (2009) Air pollution and health: a European and North American Approach (APHENA). Health Effects Institute; Number 142Google Scholar
  15. 15.
    Larrieu S, Jusot J-F, Blanchard M et al (2007) Short-term effects of air pollution on hospitalizations for cardiovascular diseases in eight French cities: the PSAS program. Sci Total Environ 387:105–112PubMedCrossRefGoogle Scholar
  16. 16.
    Franklin M, Zeka A, Schwartz J (2007) Association between PM2.5 and all-cause and specific-cause mortality in 27 US communities. J Expo Sci Environ Epidemiol 17:279–287PubMedCrossRefGoogle Scholar
  17. 17.
    Zeka A, Zanobetti A, Schwartz J (2006) Individual-level modifiers of the effects of particulate matter on daily mortality. Am J Epidemiol 163:849–859PubMedCrossRefGoogle Scholar
  18. 18.
    Pope C, Renlund D, Kfoury A, May H, Horne B (2008) Relation of heart failure hospitalizations to exposure to fine particulate air pollution. Am J Cardiol 102:1230–1234PubMedCrossRefGoogle Scholar
  19. 19.
    Devlin RB, Ghio AJ, Kehrl H, Sanders G, Cascio W (2003) Elderly humans exposed to concentrated air pollution particles have decreased heart rate variability. Eur Respir J 40:765–805Google Scholar
  20. 20.
    Nadziejko C, Fang K, Narciso S et al (2004) Effect of particulate and gaseous pollutants on spontaneous arrhythmias in aged rats. Inhal Toxicol 16:373–380PubMedCrossRefGoogle Scholar
  21. 21.
    Tankersley CG, Champion HC, Takimoto E et al (2008) Exposure to inhaled particulate matter impairs cardiac function in senescent mice. Am J Physiol Regul Integr Comp Physiol 295:R252–R263PubMedCrossRefGoogle Scholar
  22. 22.
    Naess O, Nafstad P, Aamodt G, Claussen B, Rosland P (2007) Relation between concentration of air pollution and cause-specific mortality: four-year exposures to nitrogen dioxide and particulate matter pollutants in 470 neighborhoods in Oslo, Norway. Am J Epidemiol 165:435–443PubMedCrossRefGoogle Scholar
  23. 23.
    Zeger SL, Dominici F, McDermott A, Samet JM (2008) Mortality in the Medicare population and chronic exposure to fine particulate air pollution in urban centers (2000–2005). Environ Health Perspect 116:1614–1619PubMedCrossRefGoogle Scholar
  24. 24.
    US EPA (2010) Integrated science assessment for carbon monoxide. EPA/600/R-09/019F, National Center for Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle ParkGoogle Scholar
  25. 25.
    Allred EN, Bleecker ER, Chaitman BR et al (1989) Short-term effects of carbon monoxide exposure on the exercise performance of subjects with coronary artery disease. N Engl J Med 321:1426–1432PubMedCrossRefGoogle Scholar
  26. 26.
    Zanobetti A, Schwartz J (2008) Is there adaptation in the ozone mortality relationship: a multi-city case-crossover analysis. Environ Health 7:22PubMedCrossRefGoogle Scholar
  27. 27.
    Medina-Ramon M, Schwartz J (2008) Who is more vulnerable to die from ozone air pollution? Epidemiology 19:672–679PubMedCrossRefGoogle Scholar
  28. 28.
    Lipfert FW, Morris SC, Wyzga RE (2000) Daily mortality in the Philadelphia metropolitan area and size—classified particulate matter. J Air Waste Manag Assoc 50:1501–1513PubMedCrossRefGoogle Scholar
  29. 29.
    Cakmak S, Dales RE, Vidal CB (2007) Air pollution and mortality in Chile: susceptibility among the elderly. Environ Health Perspect 115:524–527PubMedCrossRefGoogle Scholar
  30. 30.
    McDonnell WF, Stewart PW, Smith MV, Pan WK, Pan J (1999) Ozone-induced respiratory symptoms: exposure-response models and association with lung function. Eur Respir J 14:845–853PubMedCrossRefGoogle Scholar
  31. 31.
    Hazucha MJ, Folinsbee LJ, Bromberg PA (2003) Distribution of reproducibility of spirometric response to ozone by gender and age. J Appl Physiol 95:1917–1925PubMedGoogle Scholar
  32. 32.
    Weaver VM, Jarr BG, Schwartz BS et al (2005) Associations among lead dose biomarkers, uric acid, and renal function in Korean lead workers. Environ Health Perspect 113:36–42PubMedCrossRefGoogle Scholar
  33. 33.
    Gonick HC, Behari JR (2002) Is lead exposure the principal cause of essential hypertension? Med Hypotheses 59:239–246PubMedCrossRefGoogle Scholar
  34. 34.
    Weisskopf MG, Wright RO, Schwartz J et al (2004) Cumulative lead exposure and prospective change in cognition among elderly men: the VA Normative Aging Study. Am J Epidemiol 160:1184–1193PubMedCrossRefGoogle Scholar
  35. 35.
    Schwartz BS, Lee BK, Bandeen-Roche K et al (2005) Occupational lead exposure and longitudinal decline in neurobehavioral test scores. Epidemiology 16:106–113PubMedCrossRefGoogle Scholar
  36. 36.
    Han S, Qiao X, Kemp FW, Bogden JD (1997) Lead exposure at an early age substantially increases lead retention in the rat. Environ Health Perspect 105:412–417PubMedCrossRefGoogle Scholar
  37. 37.
    Drasch GA, Bohm J, Baur C (1987) Lead in human bones investigations on an occupationally non-exposed population in southern Bavaria (F. R. G.) I. Adults. Sci Total Environ 64:303–315PubMedCrossRefGoogle Scholar
  38. 38.
    Cory-Slechta DA (1989) The lessons of lead for behavioral toxicology. In: Smith MA, Grant LD, Sors AI (eds) Lead exposure and child development: an international assessment [workshop organized by the Commission of the European Communities and the US Environmental Protection Agency. September 1986; Edinburgh]. Kluwer Academic, LondonGoogle Scholar
  39. 39.
    US EPA (2008) Nitrogen oxides (NOx) (Primary—Health Criteria) Integrated Science Assessment. EPA/600/R-08/071, National Center for Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle ParkGoogle Scholar
  40. 40.
    Migliaretti G, Cadum E, Migliore E, Cavallo F (2005) Traffic air pollution and hospital admissions for asthma: a case-control approach in a Turin (Italy) population. Int Arch Occup Environ Health 78:164–169PubMedCrossRefGoogle Scholar
  41. 41.
    Prescott GJ, Cohen GR, Elton RA, Fowkes FGR, Agius RM (1998) Urban air pollution and cardiopulmonary ill health: a 14.5 year time series study. Occup Environ Med 55:697–704PubMedCrossRefGoogle Scholar
  42. 42.
    Burnett RT, Stieb D, Brook JR et al (2004) Associations between short-term changes in nitrogen dioxide and mortality in Canadian cities. Arch Environ Occup Health 59:228–236CrossRefGoogle Scholar
  43. 43.
    Johns DO, Linn WS (2011) A review of controlled human SO2 exposure studies contributing to the US EPA integrated science assessment for sulfur oxides. Inhal Toxicol 23(1):33–43PubMedCrossRefGoogle Scholar
  44. 44.
    US EPA (2008) Sulfur oxides (SOx) (Primary—Health Criteria) Integrated Science Assessment. EPA/600/R-08/047F, National Center for Environmental Assessment, Office of Research and Development, US Environmental Protection Agency, Research Triangle ParkGoogle Scholar
  45. 45.
    Spix C, Anderson HR, Schwartz J et al (1998) Short-term effects of air pollution on hospital admissions of respiratory diseases in Europe: a quantitative summary of APHEA study results. Arch Environ Occup Health 53:54–64CrossRefGoogle Scholar
  46. 46.
    Wilson AM, Wake CP, Kelly T, Salloway JC (2005) Air pollution, weather, and respiratory emergency room visits in two northern New England cities: an ecological time-series study. Environ Res 97:312–321PubMedCrossRefGoogle Scholar
  47. 47.
    The European Commission. Implementation of ambient air quality legislation: public information. http://ec.europa.eu/environment/air/quality/legislation/public_info.htm. Accessed April 22, 2011
  48. 48.
    Moretti E, Neidell M (2011) Pollution, health, and avoidance behavior: evidence from the ports of Los Angeles. J Hum Resour 46(1):154–175CrossRefGoogle Scholar
  49. 49.
    Neidell M (2009) Information, avoidance behavior, and health: the effect of ozone on asthma hospitalizations. J Hum Resour 44(2):451–478Google Scholar
  50. 50.
    Neidell M (2010) Air quality warnings and outdoor activities: evidence from southern California using a regression discontinuity design. J Epidemiol Commun Health 64:921–926CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  • Kathryn L. Shumake
    • 1
  • Jason D. Sacks
    • 2
    Email author
  • Janice S. Lee
    • 2
  • Douglas O. Johns
    • 2
  1. 1.Oak Ridge Institute for Science and Education, at National Center for Environmental Assessment, Office of Research and DevelopmentUS Environmental Protection AgencyResearch Triangle ParkUSA
  2. 2.National Center for Environmental Assessment, Office of Research and DevelopmentUS Environmental Protection AgencyResearch Triangle ParkUSA

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