Department of Occupational and Environmental Health, Peking University School of Public Health, ScD, 38 College Road, Haidian District, Beijing 100191, China.
Department of Occupational and Environmental Health, Peking University School of Public Health, ScD, 38 College Road, Haidian District, Beijing 100191, China; Institute for Risk Assessment Sciences, University Utrecht, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 80178, 3508 TD, Utrecht, the Netherlands.
Environ Res. 2018 Nov;167:632-638. doi: 10.1016/j.envres.2018.08.026. Epub 2018 Aug 23.
Adverse cardiovascular effects associated with air pollution exposure have been widely demonstrated. However, inconsistent cardiovascular responses were observed from reducing indoor air pollution exposure. We aimed to assess whether short-term air filtration intervention could benefit cardiovascular health in elderly living in high pollution area.
A randomized crossover intervention study of short-term indoor air filtration intervention on cardiovascular health was conducted among 35 non-smoking elderly participants living in Beijing in the winter of 2013, as part of Beijing Indoor Air Purifier StudY (BIAPSY). Portable air filtration units were randomly allocated to active filtration for 2 weeks and sham filtration for 2 weeks in the households. Twelve-hour daytime ambulatory heart rate variability (HRV) and blood pressure (ABP) were measured during active and sham filtration. Concurrently, real-time indoor and outdoor particulate matter with diameter less than 2.5 µm (PM) and indoor black carbon (BC) concentrations were measured. We applied generalized additive mixed models to evaluate the associations of 1- to 10-h moving average (MA) exposures of indoor PM and BC with HRV and ABP indices, and to explore whether these associations could be modified by air filtration.
We observed decreases of 34.8% in indoor PM and 35.3% in indoor BC concentrations during active filtration. Indoor PM and BC exposures were significantly associated with reduced HRV and increased ABP indices, and greater changes were observed during sham filtration. In specific, each 10 μg/m increase in indoor PM at MA8-h was associated with a significant reduction of 1.34% (95% CI: -2.42, -0.26) in SDNN during sham filtration, compared with a non-significant reduction of 0.81% (95% CI: -6.00, 4.68) during active filtration (P< 0.001). Each 1 μg/m increase in indoor BC at MA8-h was associated with a significant increase of 2.41% (95% CI: 0.38, 4.47) in SBP during sham filtration, compared with a non-significant increase of -1.09% (95% CI: -4.06, 1.96) during active filtration (P = 0.135). Nonlinear inverse exposure-response relationships of indoor air pollution exposures with predicted HRV and ABP indices also confirmed some cardiovascular benefits of short-term air filtration intervention.
Our results suggested that short-term indoor air filtration intervention can be of some cardiovascular benefits in elderly living with high pollution episodes.
已有大量研究证明，与空气污染暴露相关的心血管不良影响。然而，减少室内空气污染暴露对心血管的反应并不一致。我们旨在评估短期室内空气过滤干预是否有益于生活在高污染地区的老年人的心血管健康。
2013 年冬季，在北京进行了一项针对短期室内空气过滤干预对心血管健康影响的随机交叉干预研究，作为北京室内空气净化器研究（BIAPSY）的一部分。在家庭中，便携式空气过滤装置被随机分配到主动过滤 2 周和假过滤 2 周。在主动和假过滤期间，测量 12 小时白天动态心率变异性（HRV）和血压（ABP）。同时，实时测量室内外直径小于 2.5 µm（PM）和室内黑碳（BC）的颗粒物浓度。我们应用广义加性混合模型来评估室内 PM 和 BC 的 1 至 10 小时移动平均值（MA）暴露与 HRV 和 ABP 指数的关联，并探讨这些关联是否可以通过空气过滤来改变。
我们观察到主动过滤期间室内 PM 和室内 BC 浓度分别降低了 34.8%和 35.3%。室内 PM 和 BC 暴露与 HRV 降低和 ABP 指数升高显著相关，而在假过滤期间观察到更大的变化。具体来说，MA8-h 室内 PM 每增加 10μg/m，与假过滤期间 SDNN 显著降低 1.34%（95% CI：-2.42，-0.26），而与主动过滤期间 SDNN 非显著降低 0.81%（95% CI：-6.00，4.68）（P<0.001）。MA8-h 室内 BC 每增加 1μg/m，与假过滤期间 SBP 显著升高 2.41%（95% CI：0.38，4.47）相关，而与主动过滤期间 SBP 非显著升高-1.09%（95% CI：-4.06，1.96）相关（P=0.135）。室内空气污染暴露与预测 HRV 和 ABP 指数的非线性逆暴露反应关系也证实了短期室内空气过滤干预对心血管的一些益处。
我们的结果表明，短期室内空气过滤干预对生活在高污染环境中的老年人有一定的心血管益处。
