Partikel in der Außenluft erhöhen das Risiko für Herz-Kreislauf-Erkrankungen

Zusammenfassung

Seit Mitte der 90er-Jahre wurde vermutet, dass Partikel in der Außenluft nicht nur Gesundheitsauswirkungen auf die Atemwege, sondern auch auf das Herz-Kreislauf-System haben könnten. Ziel der hier beschriebenen Untersuchungen war es, die Auswirkungen der Smogepisode im Januar 1985 auf das Risikoprofil im Rahmen des MONICA-Surveys S1 (1984/85) zu untersuchen. Während einer 13-tägigen Periode Anfang Januar vervierfachten sich die Schwefeldioxidkonzentrationen und verdoppelten sich die Schwebstaubkonzentrationen. Die Auswirkungen dieses Zeitraumes auf die Plasmaviskosität, das C-reaktive Protein, die Herzrate und den Blutdruck wurden untersucht. In den Regressionsmodellen wurden individuelle Prädiktoren, zu denen Geschlecht, Alter, Bodymass-Index (definiert als Körpergewicht/Größe²), Serum-Cholesterin- und HDL-Cholesterin-Werte, Rauchen, sportliche Aktivitäten und medikamentöse Behandlung von Herz-Kreislauf-Erkrankungen gehörten, und die meteorologischen Bedingungen berücksichtigt. Während der Episode wurde ein Anstieg der Plasmaviskosität, des C-reaktiven Proteins im Plasma und der Herzrate festgestellt. Der Blutdruck stieg ebenfalls an, was anscheinend allerdings auf das Wetter zurückzuführen war. Alle untersuchten Faktoren zeigten eine Abhängigkeit von den Schwefeldioxidkonzentrationen und dem Schwebstaub. Damit weisen diese Ergebnisse daraufhin, dass die Partikel in der Lage sind, sowohl systemische Reaktionen auszulösen, als auch eine Modulation der autonomen Kontrolle des Herzens zu bewirken. Möglicherweise sind diese Pathomechanismen entscheidend für die beobachtete Assoziation zwischen Luftschadstoffen, insbesondere Partikeln in der Außenluft, und vermehrten Krankenhauseinweisungen und Sterbefällen aufgrund von Herz-Kreislauf-Erkrankungen.

Abstract

Evidence accumulated during the mid-1990 s that ambient particulate air pollution aerosol particles may not only exacerbate respiratory diseases but also be a risk factor for cardiovascular disease exacerbation. The aim of the studies described here was to assess the impact of the 1985 smog episode on the risk factor profile in the randomly selected population - based sample of the MONICA survey 1984/85 (S1). During a 13-day period in January 1985 sulphur dioxide concentrations increased four times and concentrations of total suspended atmospheric particles doubled. The impact of this time period on plasma viscosity, plasma C-reactive protein concentrations, heart rate and blood pressure was investigated. Regression models were used to assess these associations adjusting for individual risk factors such as gender, age, body mass index, serum total cholesterol and HDL-cholesterol, smoking, physical activity and medication for cardiovascular diseases and for weather conditions during the survey period. An increase in plasma viscosity, C-reactive protein and heart rate was estimated during the air pollution episode. There was also an increase in blood pressure, but this appeared to be attributable to the weather conditions during the air pollution episode. All the four outcomes were associated with the sulphur dioxide concentrations and the total suspended particle concentrations during the survey. These results indicate that ambient air pollution, particularly ambient particulate air pollution may induce systemic inflammation and modulate the autonomic function of the heart. These pathomechanisms may contribute to the observed associations between ambient air pollution concentrations and cardiovascular disease exacerbation such as hospitalisation and mortality due to cardiovascular diseases.

Schlüsselwörter

Luftschadstoffe - Herz-Kreislauf-Erkrankungen - Risikofaktoren - Smog - Staubpartikel

Key words

Air pollution - cardiovascular disease - particulate matter - risk factors - smog episode

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2 Die MONICA/KORA-Studiengruppe besteht aus: KORA: H.-E. Wichmann (Sprecher), H. Löwel, C. Meisinger, T. Illig, R. Holle, J. John und deren Mitarbeitern, die verantwortlich für das Design und die Durchführung der KORA-Studien sind; MONICA: U. Keil (Studienleiter), A. Döring, B. Filipiak, H. W. Hense, H. Löwel, J. Stieber und den Mitarbeitern, die verantwortlich für das Design und die Durchführung der MONICA-Studien waren.