Air pollution, cardiovascular endpoints and susceptibility by stress and material resources: a systematic review of the evidence.

• Type of Material: Article
• Authors: Christina H. Fuller, Georgia State University; Karla R. Feeser, Georgia State University; Jeremy Sarnat, Emory University; Marie S. O'Neill, University of Michigan
• Language: English
• Date: 2017-06-14
• Publisher: Springer Verlag (Germany)
• Publication Version: Final Published Version
• Copyright Statement: Copyright © The Author(s). 2017
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s12940-017-0270-0
• Title of Journal or Parent Work: Environmental Health and Preventive Medicine
• ISSN: 1342-078X
• Volume: 16
• Issue: 1
• Start Page: 58
• End Page: 58
• Grant/Funding Information: unding for this work was provided by the JPB Environmental Health Fellows Program.
• Keywords: Effect modification; Particulate matter; Socioeconomic; Traffic; Air pollution; Cardiovascular; Stress; Susceptibility
• Research Categories: Environmental Sciences; Health Sciences, Public Health

Abstract

BACKGROUND AND METHODS: Evidence shows that both the physical and social environments play a role in the development of cardiovascular disease. The purpose of this systematic review is two-fold: First, we summarize research from the past 12 years from the growing number of studies focused on effect modification of the relationships between air pollution and cardiovascular disease (CVD) outcomes by socioeconomic position (SEP) and; second, we identify research gaps throughout the published literature on this topic and opportunities for addressing these gaps in future study designs. RESULTS: We identified 30 articles that examined the modifying effects of either material resources or psychosocial stress (both related to SEP) on associations between short and long-term air pollution exposure and CVD endpoints. Although 18 articles identified at least one interaction between an air pollutant and material resource indicator, 11 others did not. Support for susceptibility to air pollution by psychosocial stress was weaker; however, only three articles tested this hypothesis. Further studies are warranted to investigate how air pollution and SEP together may influence CVD. CONCLUSIONS: We recommend that such research include thorough assessment of air pollution and SEP correlations, including spatial correlation; investigate air pollution indices or multi-pollutant models; use standardized metrics of SEP to enhance comparability across studies; and evaluate potentially susceptible populations.