Patel Vivek, Kantipudi Neha, Jones Graham, Upton Adrian, Kamath Markad V
Departments of Biology & Medicine, McMaster University, Hamilton, ON, L8S 4K1, Ontario, Canada.
Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8N 3Z5 Canada.
Crit Rev Biomed Eng. 2016;44(5):327-346. doi: 10.1615/CritRevBiomedEng.2017019768.
Air pollution is comprised of different compounds and particulate matter (PM) of sizes 2.5 and 10 μm, with the former size posing the greatest danger to humans. Evidence suggests that the global rise in air pollution levels during the past century is correlated with the increased incidence of diseases of the cardiovascular system. On a global scale, 7 million individuals died as a result of the effects of air pollution in 2012. Air pollution leads to tremendous amounts of financial burden (in 2010, $16 trillion in the US and Europe) on the health-care system. The severity of effects experienced by varying populations due to air pollution can differ due to locale, length of exposure, weather conditions, residential proximity to major highways or factories, and soil aridity. Pollutants affect the heart, blood vessels, and blood at a molecular level through proinflammatory or oxidative stress response, autonomic nervous system imbalance, and the direct permeation of harmful compounds into the tissue. The dysfunction of cells and biological processes of the cardiovascular system due to PM leads to an increased prevalence of cardiovascular diseases (CVDs) such as atherosclerosis, hypertension, myocardial infarction, thrombosis, and restricted valve motion. Studies in countries such as China have shown an increase of 0.25% in ischemic heart disease (IHD) mortality and a 0.27% increase in IHD morbidity due to a 10 μg/m3 increase in PM. In a study conducted in the US, PM2.5 concentrations ranged from 9.2-22.6 μg/m3, and every 5-μg/m3 increase in PM2.5 caused coronary calcification to increase by 4.1 Agatston units/yr. Studies on traffic-related air pollution found that nonhypertensive participants residing within 100 m of major roadways experienced an increase in systolic (0.35 mmHg) and diastolic (0.22 mmHg) blood pressure as a result of increases in traffic. The progression of CVD due to pollution has been found to fluctuate within individuals based on age, gender, location of exercise, smoking, pregnancy, diabetes, preexisting cardiovascular or pulmonary diseases, and other factors. Considering the number of individuals affected by pollution on a daily basis and the burden that this places on society through the health-care system, immediate preventive measures are needed to address these problems. Increased knowledge about the widespread effects of pollution on human physiological systems should aid in remediating the problem across the globe. Biomedical engineers can have a great positive impact in developing better instrumentation to measure discrete pollutants and characterizing their harmful effects on physiological systems.
空气污染由不同的化合物和粒径为2.5微米及10微米的颗粒物（PM）组成，其中前者对人类危害最大。有证据表明，过去一个世纪全球空气污染水平的上升与心血管系统疾病发病率的增加相关。在全球范围内，2012年有700万人死于空气污染的影响。空气污染给医疗保健系统带来了巨大的经济负担（2010年，美国和欧洲为16万亿美元）。由于地区、暴露时间长短、天气状况、住宅与主要公路或工厂的距离以及土壤干旱程度等因素，不同人群因空气污染所经历的影响严重程度可能有所不同。污染物通过促炎或氧化应激反应、自主神经系统失衡以及有害化合物直接渗透到组织中，在分子水平上影响心脏、血管和血液。由于细颗粒物导致的心血管系统细胞和生物过程功能障碍，会使心血管疾病（CVD）如动脉粥样硬化、高血压、心肌梗死、血栓形成和瓣膜运动受限的患病率增加。在中国等国家的研究表明，细颗粒物每增加10微克/立方米，缺血性心脏病（IHD）死亡率增加0.25%，IHD发病率增加0.27%。在美国进行的一项研究中，细颗粒物2.5浓度范围为9.2 - 22.6微克/立方米，细颗粒物2.5每增加5微克/立方米，冠状动脉钙化每年增加4.1阿加斯顿单位。对与交通相关的空气污染的研究发现，居住在主要道路100米范围内的非高血压参与者，由于交通量增加，收缩压（0.35毫米汞柱）和舒张压（0.22毫米汞柱）有所升高。已发现由于污染导致的心血管疾病进展在个体内部会因年龄、性别、运动地点、吸烟、怀孕、糖尿病、既往心血管或肺部疾病以及其他因素而有所波动。考虑到每天受污染影响的人数以及这通过医疗保健系统给社会带来的负担，需要立即采取预防措施来解决这些问题。对污染对人体生理系统广泛影响的更多了解应有助于在全球范围内解决这一问题。生物医学工程师在开发更好的仪器以测量离散污染物并表征其对生理系统的有害影响方面可以产生巨大的积极影响。
