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Study provides more insight into air pollution mechanisms that cause cardiovascular diseases

Air pollution, and fine dust in particular, is calculated to contribute to more than four million deaths each year. Almost 60% of deaths occur as a result of cardiovascular diseases. Scientists around Professor Thomas Münzel, Director of Cardiology I at the Department of Cardiology at the Medical Center Mainz of Johannes Gutenberg University Mainz (JGU), reviewed the mechanisms responsible for vascular damage from air pollution together with scientists from the UK and the US.

The findings have been published in an open-access paper in the European Heart Journal.

While the mechanisms by which air pollutants cause cardiovascular events is undergoing continual refinement, the preponderant evidence support rapid effects of a diversity of pollutants including all particulate pollutants (e.g. course, fine, ultrafine particles) and gaseous pollutants such as ozone, on vascular function. Indeed alterations in endothelial function seem to be critically important in transducing signals and eventually promoting cardiovascular disorders such as hypertension, diabetes, and atherosclerosis. Here, we provide an updated overview of the impact of particulate and gaseous pollutants on endothelial function from human and animal studies.

—Münzel et al.

Key research questions focused on components of air pollution (particulate matter, ozone, nitrogen dioxide, carbon monoxide, and sulfur dioxide) that are particularly damaging to the cardiovascular system and mechanisms that damage the vessels.

When ultrafine matter is inhaled, it immediately enters the bloodstream through the lungs, is taken up by the vessels, and causes local inflammation. Ultimately, this causes more atherosclerosis (vascular calcification) and thus leads to more cardiovascular diseases such as myocardial infarction, acute myocardial infarction, heart failure, and cardiac arrhythmias. Of particular interest is the fact that with regard to the much-discussed diesel exhaust emissions, particulate matter and not nitrogen dioxide (NO2 ), both of which are produced by burning diesel fuel, have a negative effect on vascular function. In summary, it can be said that in relation to the vascular damaging effect of air pollution, particulate matter plays a prominent role.

—Thomas Münzel

Other participants in the expert group include the world-renowned particulate matter researcher Professor Sanjay Rajagopalan of the UH Cleveland Medical Center, the vascular researcher and cardiologist Professor John Deanfield of the Institute of Cardiovascular Science at University College London, Professor Andreas Daiber, Head of Molecular Cardiology at the Mainz University Medical Center, and Professor Jos Lelieveld from the Max Planck Institute for Chemistry (MPIC) in Mainz.

The fine dust particles are chemically formed mainly in the atmosphere from emissions from traffic, industry, and agriculture. In order to achieve low, harmless concentrations, emissions from all these sources need to be reduced.

—Professor Jos Lelieveld


  • Thomas Münzel, Tommaso Gori, Sadeer Al-Kindi, John Deanfield, Jos Lelieveld, Andreas Daiber, Sanjay Rajagopalan (2018) “Effects of gaseous and solid constituents of air pollution on endothelial function,” European Heart Journal doi: 10.1093/eurheartj/ehy481



With more than 4 million death per year from fine particles/pollution, and going up rapidly, will may soon need more legal/illegal immigration to keep the effective work force from dropping.

Who is going to pay for direct/indirect medical care and associated lost of productivity? Medical care will cost a fortune?

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