B P1 C3 Impact of the Environment on Cardiovascular Health Flashcards
The term “_____” is a useful encompassing term that refers to the aggregate of all exposures in the air, soil, and water (or indoor physical environment) that one is exposed to.
Pollutome
The pollutome in turn is a subset of the exposome (i.e., the sum totality of all exposures)
Framework of understanding pollutomes in terms of zones
Zone 1 - pollutants with well-characterized health effects
Zone 2 - pollutants with emerging, but not yet definite, health effects (known and some unknowns)
Zone 3 - pollutants with inadequately characterized health effects (known unknowns)
Zone 4 - include unknown chemical exposures that are not yet recognized
The phrase “_____” infers that the direction and magnitude of the clinical effect that a genetic variant has on the disease phenotype can vary as the environment changes and importantly acknowledges the importance of genetic predisposition in determining the magnitude of effects.
Gene-environment interaction
The GBD estimates are based on a more limited inventory of risk factors including air pollution:
(1) Household, ambient (fine particulate matter [PM2.5], and tropospheric ozone pollution)
(2) Water pollution: unsafe sanitation and unsafe water sources
(3) Soil, chemical, and heavy metal pollution: lead (including contaminated sites polluted by lead from battery recycling operations),and mercury from gold mining;
(4) Occupational pollution: occupational carcinogens, and occupational particulates, gases, and fumes.
_____ is estimated to contribute to approximately 20% of all cardiovascular disease and 25% of ischemic heart diseases (IHDs) of which air pollution is the largest contributor, responsible for over 6 million deaths annually worldwide.
Total pollution
_____ are the only three risk factors among 87 others that account for greater than 1% of DALYs and continue in prevalence by greater than 1% per year.
Air pollution
High bBMI
High Glucose
Although many gaseous pollutants have been linked with health effects (e.g.,ozone,nitrogen oxides, sulfur oxides), _____, principally derived from fossil fuel combustion (for the purposes of power, residential energy use, and industry) is the most extensively implicated component, and has a disproportionate impact on adverse health effects.
Fine PM (particles ≤2.5 μm, PM2.5)
_____ air pollutants are those that are released directly into the atmosphere, including both gaseous and particulates
Primary
_____ pollutants are formed through chemical transformation through interaction with other constituents and/or in response to prevalent atmospheric conditions (sunlight, water, vapor, etc.).
Secondary
_____ air pollution is by far the most studied and with the most evidence for health effects.
PM
_____ is the most studied gaseous pollutant with respect to health effects. It is a secondary pollutant which is created through reaction between nitrogen oxide and volatile organic compounds, facilitated by sunlight.
Ground level ozone (O3)
Traffic air pollution peaks during the _____, with PM0.1 and gaseous components demonstrating substantial variation within a span of 400 m.
Late morning and evening rush hours
Both short-term and long-term exposure to PM2.5 has been linked with the development of _____.
(1) Cardiovascular, renal, and metabolic disorders, including
(2) Hypertension Type 2 diabetes
Three early meta-analyses between 2012 and 2016 demonstrated that _____ was associated with cardiovascular mortality.
PM2.5
In at least one study, an increase of _____ μg/m3 of PM2.5 from use of CT was associated with a 62% increased incidence of “high-risk” plaque (plaque with low attenuation, spotty calcium, and positive remodel- ing) at follow-up.
1 μg/m3
