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European Heart Journal Advance Access published online on December 3, 2004
European Heart Journal, doi:10.1093/eurheartj/ehi035
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European Heart Journal © The European Society of Cardiology 2004; all rights reserved

Clinical research

Effects of air pollution on blood pressure and heart rate variability: a panel study of vehicular traffic controllers in the city of São Paulo, Brazil

Ubiratan de Paula Santos 1*, Alfésio Luís Ferreira Braga 2, Dante Marcelo Artigas Giorgi 3, Luiz Alberto Amador Pereira 4, César Jose Grupi 5, Chin An Lin 4, Marcos Antonio Bussacos 6, Dirce Maria Trevisan Zanetta 7, Paulo Hilário do Nascimento Saldiva 4, and Mario Terra Filho 1

1 Divisão de Pneumologia, Instituto do Coração (InCor), Av. Dr Enéas de Carvalho Aguiar, 44, CEP 05403-000, São Paulo, SP, Brazil
2 Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Medical School, São Paulo, Brazil; Environmental Pediatrics Program, University of Santo Amaro Medical School, São Paulo, Brazil
3 Hypertension Unit, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
4 Laboratory of Experimental Air Pollution, Department of Pathology, University of São Paulo Medical School, São Paulo, Brazil
5 Eletrocardiology Unit, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
6 Division of Occupational Health, FUNDACENTRO, São Paulo, Brazil
7 Department of Epidemiology and Public Health, São José do Rio Preto Medical School, São José do Rio Preto, Brazil

* To whom correspondence should be addressed.
Ubiratan de Paula Santos, E-mail: pneubiratan{at}incor.usp.br


  Abstract

Aims Evaluating the effects of air pollution on São Paulo city's vehicular traffic controllers by means of risk indicators for cardiovascular diseases.

Methods and results Twenty-four hour blood pressure recordings and an electrocardiogram were obtained in 48 healthy, non-smoking vehicular traffic controllers, aged 31-55 years, during three periods: winter 2000, summer 2001, and winter 2001. Effects of air pollutants on the outcomes were estimated using linear regression based on generalized estimated equations, controlling for age, body mass index, humidity, and temperature. An interquartile range (IQR) increase in CO (1.1p.p.m.) was associated with increases of 2.6mmHg (95% CI 1.0, 4.2), 1.8mmHg (95% CI 0.8, 2.8), and 2.4mmHg (95% CI 1.1, 3.6) in systolic, diastolic, and mean 24h ambulatory blood pressures. SO2 also had relevant effects on blood pressure. On heart rate variability, an IQR increase of SO2 (9.6µg/m3) was negatively associated with the standard deviation (SD) of normal RR intervals (SDNN) -7.93ms (95% CI -15.3, -0.6).

Conclusion This study supplies biological plausibility for observational studies on air pollution-related cardiovascular morbidity and mortality.

Keywords: Panel study; Air pollution; Blood pressure; Heart rate variability.
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