Guo Tongjun, Wang Wanzhou, Chen Xi, Guo Huaqi, Wang Kai, Ma Yating, Deng Hongyan, Li Xianggui, Shan Anqi, Wu Qian, Li Yaoyan, Li Hongyu, Liu Qisijing, Chen Juan, Lan Yang, Lei Jian, Deng Furong, Sun Zhiwei, Guo Xinbiao, Wang Yan, Tang Naijun, Wu Shaowei
Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China.
Environ Health (Wash). 2023 Dec 29;2(1):11-22. doi: 10.1021/envhealth.3c00104. eCollection 2024 Jan 19.
Previous studies have shown that exposure to black carbon (BC, a tracer of traffic-related air pollution) and psychosocial stress are both associated with adverse cardiac effects, but whether psychosocial stress could modify the cardiac effects of BC is unclear. To investigate the potential modifying effect of psychosocial stress on the associations between acute exposure to BC and typical cardiac health variables, real-time personal 24 h measurements were conducted in a repeated-measure study among adults with elevated blood pressure (high-risk group) and a panel study among normal adults (low-risk group) in China. Measured cardiac health variables included ST-segment depression events, heart rate, and heart rate variability (HRV) variables. Perceived Stress Scale, State Anxiety Inventory and Self-rating Depression Scale were used to assess the recent psychosocial stress status of the participants, and a composite stress index was established based on these scales. Generalized linear mixed-effects model was used to analyze the associations between BC exposure and cardiac health variables and potential effect modification by psychosocial stress. A total of 97 24 h measurements among 97 participants in the repeated-measure study and 202 24 h measurements among 87 participants in the panel study were included in the final analysis. Acute BC exposure was significantly associated with increased ST-segment depression events and heart rate and decreases in HRV in both studies. The marginal effects of acute BC exposure on most cardiac health variables generally tended to be amplified under higher vs low levels of psychosocial stress in both studies, with the composite stress index apparently modifying the associations of BC exposure with most ST-segment depression events and HRV variables. These findings suggest that psychosocial stress may increase the participants' cardiac susceptibility to BC exposure, which could be helpful for the identification of susceptible individuals in the context of traffic-related air pollution.
以往研究表明，接触黑碳（BC，交通相关空气污染的一种示踪物）和心理社会压力均与不良心脏效应有关，但心理社会压力是否会改变BC对心脏的影响尚不清楚。为了研究心理社会压力对急性接触BC与典型心脏健康变量之间关联的潜在调节作用，在中国对血压升高的成年人（高危组）进行了一项重复测量研究，并对正常成年人（低危组）进行了一项队列研究，对个人进行实时24小时测量。测量的心脏健康变量包括ST段压低事件、心率和心率变异性（HRV）变量。使用感知压力量表、状态焦虑量表和自评抑郁量表评估参与者近期的心理社会压力状况，并基于这些量表建立了一个综合压力指数。采用广义线性混合效应模型分析BC暴露与心脏健康变量之间的关联以及心理社会压力的潜在效应修正作用。重复测量研究中的97名参与者共进行了97次24小时测量，队列研究中的87名参与者共进行了202次24小时测量，最终纳入分析。在两项研究中，急性BC暴露均与ST段压低事件增加、心率加快以及HRV降低显著相关。在两项研究中，与低水平心理社会压力相比，在高水平心理社会压力下，急性BC暴露对大多数心脏健康变量的边际效应通常倾向于增强，综合压力指数明显改变了BC暴露与大多数ST段压低事件和HRV变量之间的关联。这些发现表明，心理社会压力可能会增加参与者对BC暴露的心脏易感性，这可能有助于在交通相关空气污染背景下识别易感个体。
