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September 2001, Vol 91, No. 9 | American Journal of Public Health 1345-1346
© 2001 American Public Health Association

LETTER

AIR POLLUTION, WEATHER STRESS, AND BLOOD PRESSURE

William S. Linn, MA and Henry Gong, Jr, MD

William S. Linn and Henry Gong Jr are with the Environmental Health Service, Rancho Los Amigos National Rehabilitation Center, Downey, Calif, and the Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles. Henry Gong Jr is also with the Department of Medicine, Rancho Los Amigos National Rehabilitation Center, and the Department of Medicine, Keck School of Medicine.

Correspondence: Requests for reprints should be sent to William S. Linn, MA, 51 Medical Science Building, Rancho Los Amigos National Rehabilitation Center, 7601 East Imperial Highway, Downey, CA 90242 (e-mail: linn{at}hsc.usc.edu).

Ibald-Mulli et al. recently reported a potentially important association between particulate air pollution and increased blood pressure and stated that this had not been documented previously.1 In fact, our research group previously reported a positive longitudinal relation between blood pressure and ambient particulate pollution.2 Our study differed markedly from Ibald-Mulli's in scale, duration, location, atmospheric conditions, and subject characteristics, as shown in Table 1.Go Nevertheless, certain key results—regression slopes (b) for blood pressure vs particulate pollution concentration—in the 2 studies were similar for our panel with chronic obstructive pulmonary disease (COPD) and for Ibald-Mulli's subgroups with identified risk factors (high plasma viscosity or heart rate). Our modestly larger values might reflect our measurement of particles with aerodynamic diameter <10 µm (PM10) rather than total suspended particles (TSP).


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  		TABLE 1—— Effects of Air Pollution on Health: Comparative Results in Ibald-Mulli et al.1 and Linn et al.2
 
As Ibald-Mulli et al. pointed out, weather stresses or gaseous pollutants may confound particle–health relationships. Although we could not study confounders in detail, we found that our subjects' blood pressure appeared to respond to PM10 as measured in the outdoor background urban air environment, even though they spent most of their time inside their homes, where particle mass and chemical composition were noticeably different. Again, this seems consistent with the findings of Ibald-Mulli et al., based on outdoor background pollution measurements.

On the basis of this evidence, we recommend wider use of simple noninvasive cardiovascular measurements in studies of air pollution and weather stresses. Increased understanding of response mechanisms, and clearer identification of populations at risk, should result.

References

1. Ibald-Mulli A, Stieber J, Wichmann HE, Koenig W, Peters A. Effects of air pollution on blood pressure: a population-based approach. Am. J Public Health.2001;91:571–577.

2. Linn WS, Gong H, Clark KW, Anderson KR. Day-to-day particulate exposures and health changes in Los Angeles area residents with severe lung disease. J Air Waste Manag Assoc. 1999;49:PM108–PM115.




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