Fine Particulate Pollution Exposure Increases Risk for Arrhythmias Among Adolescents

Fine particulate matter pollution affects ventricular contraction counts in adolescent patients within 2 hours of exposure.

A population-based cohort study published in the Journal of the American Heart Association found that fine particulate matter pollution increases premature ventricular contraction (PVC) counts within 2 hours of exposure among adolescents.

Data for this study were sourced from the Penn State Child Cohort (PSCC) study which recruited children aged 6 to 12 years attending 3 school districts in the Harrisburg metropolitan area between 2002 and 2006. In 2010 to 2013, participants (n=322) were evaluated using a Holter electrocardiograph and given a personal fine particle with aerodynamic diameter 2.5 mm or less (PM2.5) monitor. Risk for arrhythmia on the basis of exposure to air pollution was assessed.

The study population comprised 55.9% boys or men who were aged mean 16.95±2.25 years and 79.19% were White. Environmental factors were PM2.5 levels of 17.13±38.55 mg/m3, temperatures of 22.24±3.56°C, and relative humidity of 43.71%±11.75%. A total of 254 individuals had arrhythmia. The individuals with arrhythmia were exposed to higher PM2.5 levels (mean, 21.54 vs 16.34 mg/m3; P <.01), temperatures (mean, 22.34°C vs 21.72°C; P <.01), and humidity (mean, 43.96% vs 42.29%; P <.01) compared with the cohort without arrhythmia, respectively.

Among the arrhythmia cohort, 40.2% had only premature atrial contractions (PACs), 11.8% had only PVCs, and 48.0% had both PACs and PVCs.

Importantly, such an adverse health effect of PM2.5 on cardiac arrhythmia was observed in this low-risk population in an environment with PM2.5 concentrations well below the US Environmental Protection Agency–mandated, health-based air quality standards.

For PVC, increased risk was associated with a 0.5 to 1.0 hour lag (rate ratio [RR], 1.015; 95% CI, 1.004-1.027; P <.01), 1.0 to 1.5 hour lag (RR, 1.022; 95% CI, 1.011-1.033; P <.01), and 1.5 to 2.0 hour lag (RR, 1.016; 95% CI, 1.002-1.029; P =.02) after PM2.5 exposure, as well as the cumulative risk within 2 hours of exposure (RR, 1.051; 95% CI, 1.002-1.102; P =.04).

These relationships were robust when excluding segments with more than 60 PVCs or more than 30 PVCs and when using a third-degree polynomial model.

A potential limitation of this study is that although participants were instructed to bring their air pollution monitor with them throughout monitoring days, it may be possible that some individuals forgot to bring their monitor with them.

“…our study results suggest that PM2.5 air pollution is associated with an acute increase in the numbers of ventricular arrhythmias among otherwise healthy adolescents,” the study authors wrote. “Although pending confirmation, such an acute impact of particulate air pollution on ventricular arrhythmias during adolescence may increase the risk of SCD [sudden cardiac death] during early adulthood.”

References:

He F, Yanosky JD, Fernandez-Mendoza J, et al. Acute impact of fine particulate air pollution on cardiac arrhythmias in a population-based sample of adolescents: the Penn State child cohort. J Am Heart Assoc. Published online September 14, 2022. doi:10.1161/JAHA.122.026370