Every Breath You Take
The particles found in pollution can hurt your heart as well as your lungs.
By Jodi Helmer
It is hard to avoid air pollution: Clouds of black smoke hang over factories, buses and automobiles spew exhaust fumes, pesticides and fertilizers float through the air. Air pollution is so common that most people never think about it.
Air pollution was the last thing Mellanie True Hills thought about when she was rushed to the hospital for heart trouble in 2003.
A corporate executive turned health advocate, Hills was traveling for work when she felt tightness in her chest and found it difficult to breathe. In the emergency room, doctors discovered that Hills had a 95% blockage in a coronary artery and needed angioplasty and a stent. Just seven months later, a racing heart and shortness of breath led Hills back to the hospital in her hometown of Decatur, Texas, where doctors had more bad news: She had atrial fibrillation, an irregular heartbeat, and underwent a procedure to correct it.
“I had a high-stress job, I was traveling a lot and thought that was the cause; it never occurred to me that air pollution might have contributed” to heart disease, says Hills, 60. “I started doing research and the pieces started to fall into place.”
Hills eventually recognized a lifelong link between exposure to exhaust fumes and intense physical symptoms: Riding the bus, traveling on a plane or sitting in traffic triggered intense nausea, often vomiting.
“I realized air pollution had always been a trigger, always made me feel sick,” she says.
In addition to causing the headaches and nausea that Hills experienced, air pollution has been linked to asthma, bronchitis, pneumonia, lung cancer and brain damage, according to the Lawrence Berkley National Laboratory, a California-based organization operated by the Department of Energy.
Air pollution is also a significant contributor to heart disease. Research published in The Journal of the American Medical Association in 2012 found that pollutants such as carbon monoxide and nitrogen dioxide increased the risk of having a heart attack. Some of the most common pollutants, including traffic emissions, are among the most dangerous.
Pollution from auto emissions increased the odds of having a stroke up to 30%, even on days when the Environmental Protection Agency (EPA) rated pollution levels as moderate on their Air Quality Index, according to a study published in the Archives of Internal Medicine.
“Unless you have asthma and start wheezing when there is a smog alert, the effects of air pollution are silent,” explains Russell Luepker MD, Mayo professor of public health at the University of Minnesota. “Up to 50% of all heart disease patients have sudden death as their first presenting symptom.”
The tiny particles released into the air from industrial operations, pesticide applications and vehicle emissions are too small for the lungs to filter. Once they enter the body, Luepker cites several potential impacts: increased inflammation, increased heart rate and thickened blood, and promotion of blood clots and advanced progression of atherosclerosis, or hardening of the arteries.
Cardiac patients who resided in high-pollution areas were 40% more likely to experience a second heart attack or stroke and were 35% more likely to die in the 20-year period following their first heart attack when compared with those who lived in areas with lower levels of air pollution, according to a 2012 study by researchers at Tel Aviv University.
“We’re not just talking about the risk of heart attack and stroke, there are also increased rates of [death] associated with air pollution,” says Shyla High MD, a cardiologist at Baylor Heart and Vascular Institute in Dallas, Texas, and author of Why Most Women Die (Jackpot). “Most of the time, the cause is more than one thing—motor vehicle emissions, pollen, smelting, industrial combustion—and it’s hard to get away from it.
“Even though the risk is well established, little has been done to reduce the sources of air pollution,” High adds.
Clearing the Air
To reduce the health and environmental impacts of air pollution, the EPA implemented the Clean Air Act in 1970 to regulate pollution on both state and federal levels. Despite the success of the regulations, air pollution remains a serious health threat.
Unlike other risk factors for heart disease, including diet, exercise and stress, exposure to air pollution is impossible to control.
“Even if you’re aware of the risk, you can’t do much about it,” says Luepker. “People aren’t going to de-populate [cities] or abandon motor vehicles.”
Paying attention to EPA Air Quality Index alerts and remaining indoors when pollution levels are high, as well as avoiding secondhand smoke, can help. In addition, Chinese researchers have found that wearing face masks can help filter out up to 97% of airborne pollutants.
“In our industrialized society, we have more exposure to pollutants than ever before [because] we live longer and exposure continues over many years,” Luepker says. “We need to do what we can to reduce our risks.”
After undergoing two surgeries to address heart disease in 2003, Hills took steps to minimize her risk factors, including reducing her exposure to air pollution: She steers clear of restaurants that allow smoking, refuses to sit over the engines on an airplane or near the tailpipe on public buses and avoids big cities when she can. Her experiences led Hills to organize the American Foundation for Women’s Health, and she travels around the county speaking to women about heart disease.
“Being a heart patient, I am much more vulnerable,” Hills says. “I’ll do anything to avoid risk factors. My health has to come first.”