Fine particulate matter ambient air pollution and cardiovascular disease

This dissertation sought to examine the effect of exposure to fine particulate matter ambient air pollution (PM2.5) on cardiovascular disease and biological pathways linking them.\ud In the first manuscript, PM2.5 air pollution was significantly associated with IHD and PVD mortality in Allegheny County, PA at a lag of 5 days, for the period 1999-2011. The risk of IHD mortality due to PM2.5 was significantly greater for individuals who died outside of a hospital or nursing home compared to deaths in the hospital or nursing home. \ud In the second manuscript, overall, there were no appreciable effects of short and long-term exposure to PM2.5 air pollution with regard to biomarkers of cardiovascular risk i.e. CRP, WBC count, homocysteine and fibrinogen, after adjusting for demographic and cardiovascular risk factors in adult NHANES participants for the period 2001-2008. However, we did find some evidence suggesting stronger associations of PM2.5 with biomarkers of cardiovascular risk in participants with elements of metabolic syndrome e.g., obesity, diabetes, hypertension and smokers.\ud In the third manuscript, individuals with preexisting metabolic syndrome compared to individuals without preexisting metabolic syndrome, showed a stronger positive response in systemic inflammation, as manifested by CRP and WBC count, in association with PM2.5 air pollution (both short term and long term), after adjusting for demographic and cardiovascular risk factors in adult NHANES participants for the period 2001-2008 \ud Further research is warranted to confirm these findings in large cohorts. With one third of the U.S. population compromised by metabolic syndrome, the health impact of particulate air pollution in this sensitive population is likely to be significant and emphasizes the public health importance of this body of work. \u