The US economy may still be running fast and strong, but its risk of suddenly falling into a recession still looms large, despite the Federal Reserve’s efforts, former Treasury Secretary Larry Summers warned Monday.
Summers told CNN’s Poppy Harlow in an interview that he expects the Fed will have to raise its benchmark interest rate higher than expected and that central bank’s “push and push” to combat inflation will soon trigger a downturn.
“The process of bringing down inflation will bring on a recession at some stage, as it almost always has in the past,” Summers said.
And for the US economy, it could likely mean a “Wile E. Coyote moment,” Summers said, referencing the cartoon canine’s relentless — yet futile — pursuit of the speedy Roadrunner off a cliff and into mid-air.
Gravity eventually could win out.
“The economy could hit an air pocket in a few months,” he said.
For the past year, the Fed has enacted a series of interest rate hikes aimed at chilling demand and cooling down historically high inflation. In recent months, as the pace of price increases has moderated, the central bank has eased off the gas pedal.
In February, the Fed’s policymaking committee approved a quarter-point interest rate hike — its smallest increase in several months.
But in the weeks following that meeting, there was a barrage of surprisingly strong economic data, showing blockbuster job gains, hearty consumer spending and unyielding inflation.
“I don’t think there’s any question that we do not yet have inflation on a secure glide path anywhere near down to the 2{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} [Fed target] level,” Summers said. “And until the Fed can be confident of that, it’s going to have to be tightening rather than easing.”
Some Fed members agree.
Federal Reserve Chairman Jerome Powell has cautioned that bringing down inflation will take a “significant period of time,” while other Fed leaders have indicated they’re open to larger interest rate hikes.
As of Monday, markets are expecting the Fed to make another quarter-point raise: The CME FedWatch Tool is showing a 69.4{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} probability of such a hike; however, the perceived chances of a half-point increase (at 30.6{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}) have grown considerably during the past few weeks. One month ago, the probability for a half-point increase was 3.3{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, according to the CME FedWatch Tool.
Summers said his best guess would be for the fed funds rate to grow from its current range (4.5{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} to 4.75{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}) to 5.5{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, but noted he “wouldn’t be amazed” if it were to hit 6{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, given the uncertainties in the economy.
“Hope for the best but plan for the worst, I think is the right advice,” Summers said.
Share on PinterestResearchers say children in urban areas may be more prone to asthma attacks during to air pollutants. ED JONES/AFP via Getty Images
Asthma attacks, which involve the worsening of the inflammation and narrowing of the lung airways, are commonly caused by viral respiratory infections but can also be caused by non-viral factors.
Higher exposure to air pollutants is associated with an increased risk of asthma attacks, but the molecular mechanisms underlying the ability of air pollutants to trigger asthma attacks are not well understood.
A new study shows that higher levels of air pollutants, particularly ozone and fine particulate matter, were associated with an increased risk of asthma attacks in children residing in urban centers.
Viral respiratory infections are the most common cause of asthma attacks, but nonviral factors such as air pollutants are also associated with the flare-up of asthma symptoms.
A recent study published in the journal Lancet Planetary Health reports that higher air pollution levels, particularly ozone and fine particulate matter concentrations, were associated with asthma attacks and a decline in lung function in children living in urban centers.
Researchers also noted that these air pollutants could trigger asthma attacks even when their concentrations were below national air quality standards.
The researchers added that higher ozone and fine particulate matter concentrations were associated with the activation of specific inflammatory pathways in the airways, helping to understand how higher pollutant levels may lead to an increased risk of asthma attacks in children living in urban areas.
“I think that this paper is very interesting and important because they were able not only to look at asthma exacerbation but also had data on the absence of respiratory virus and examined other outcomes,” said Dr. Antonella Zanobetti, an environmental health researcher at Harvard T.H. Chan School of Public Health in Boston.
“They show an association between air pollution and asthma exacerbations occurring in the absence of a provoking respiratory virus; therefore, air pollution in this study was a trigger of asthma exacerbations independently of respiratory viral infections, which in turn is important to understand the biological mechanisms,” he told Medical News Today.
“Their study went much further than many other studies in that they carefully analyzed the relationship between air pollution and asthma exacerbations regardless of whether these events occurred during viral infections or not,” added Dr. Allen Dozor, a professor of pediatrics and division chief of Pulmonology at New York Medical College.
“Viral infections are very common in children and most severe asthma events are associated with upper respiratory tract infections (URIs) or colds,” he told Medical News Today. “Children catch an amazing number of colds each year, but for many children, particularly in areas with high levels of air pollution, colds frequently lead to severe asthma attacks. It is important to emphasize that high levels of air pollution worsen both viral-associated and non-viral-associated asthma attacks.”
Asthma is a chronic condition characterized by the inflammation and narrowing of the bronchi, the main airways in the lungs, and its branches.
The symptoms of asthma include chest tightness, breathlessness, coughing, and wheezing that tend to worsen during an asthma exacerbation.
An asthma exacerbation, also known as an asthma attack, involves a further narrowing of the lung airways due to the inflammation of the cells of the airways and the contraction of bronchial muscles. This is accompanied by the production of excess mucus that also leads to the obstruction of airways.
Respiratory tract viral infections are one of the most common causes of asthma exacerbation in both children and adults. However, an asthma exacerbation can also occur due to non-viral causes, such as non-viral infections, allergens, pollen, and pet hair.
In addition, several epidemiological studies have shown a link between air pollutant levels and the occurrence of asthma attacks. Higher levels of several air pollutants, such as fine particulate matter, ozone, nitrogen dioxide, and sulfur dioxide, have been linked to the occurrence of asthma attacks.
Asthma is one of the most common chronic conditions in children. Moreover, studies suggest that children residing in low socioeconomic and urban neighborhoods show higher asthma morbidity and prevalence. Higher air pollution levels are characteristic of these neighborhoods and may explain the greater prevalence and severity of asthma in children living in low-income urban areas.
However, the molecular mechanisms underlying asthma exacerbation during non-viral respiratory illnesses, especially in vulnerable populations such as children with severe asthma, are not well understood. In addition, the differences in the mechanisms that underlie asthma exacerbations caused due to air pollutants and viral infections have not been characterized.
In the new study, the researchers initially examined the association between air pollutant levels and asthma exacerbation in children and adolescents residing in urban neighborhoods.
The researchers analyzed data from a previous observational study titled “Mechanisms Underlying Asthma Exacerbations Prevented and Persistent with Immune-based Therapy Part 1 (MUPPITS1).”
That study’s authors had previously used data from MUPPITS1 to examine the molecular mechanisms underlying viral and non-viral asthma exacerbations.
The aim of the new study was to use the MUPPITS1 data to specifically understand the molecular basis of non-viral asthma exacerbations caused due to air pollutants.
MUPPITS1 included 208 children aged 6 to 17 years with exacerbation-prone asthma residing in low-income neighborhoods in nine United States cities. The study collected data on lung function and nasal samples from these participants after the onset of symptoms of an episode of respiratory illness.
The researchers used the nasal samples to determine whether the respiratory illness was caused due to a viral infection or due to non-viral factors. They also further classified participants on the basis of whether they did or did not have an asthma exacerbation during the illness.
The researchers then used data on the Air Quality Index and the concentrations of individual pollutants collected by the Environmental Protection Agency (EPA) for each geographical area included in the study. These air pollution data were matched with each participant’s location and date of illness.
The researchers reported that the Air Quality Index values were higher nine days before and after the onset of symptoms in participants with a non-viral asthma exacerbation than those with a viral asthma exacerbation. In addition, the Air Quality Index values were negatively correlated with lung function in the participants with non-viral asthma exacerbations.
A similar association between Air Quality Index and non-viral asthma exacerbations was also observed using data from a different study involving 419 individuals aged between 6 to 20 years residing in low-income households in eight major US cities.
Data from both studies showed that ozone and fine particulate matter (PM2.5) concentrations were higher during episodes of non-viral asthma exacerbation. Moreover, ozone concentrations were associated with a decline in lung function.
The Air Quality Index values and ozone concentrations did not exceed the national air quality standards. The fine particulate matter concentrations only exceeded the standard ambient values in some instances.
The study authors said that this could suggest that exposure to low levels of air pollutants over multiple days could be adequate to cause an asthma attack. They also noted that the regional EPA values might not capture high levels of these pollutants in specific urban localities. Moreover, personal exposure to air pollutants may vary even for individuals residing in the same location.
The researchers then examined differences in gene expression using the nasal samples from the MUPPITS1 study.
The Air Quality Index was associated with common gene expression patterns in both viral and non-viral asthma exacerbations, suggesting the presence of core pathways that underlie asthma attacks. In addition, Air Quality Index values were associated with changes in the gene expression profile that were specific to non-viral asthma exacerbations.
At the level of individual air pollutants, fine particulate matter levels were specifically correlated with an increase in the expression of genes associated with excessive mucus secretion and proinflammatory cytokines, a class of signaling proteins, in non-viral asthma exacerbations.
Fine particulate matter concentrations were also positively correlated with the expression of tissue kallikreins, a group of enzymes that are involved in inflammation and are elevated in asthma.
The epithelial cells form the lining of most of the respiratory tract and protect against inhaled infectious agents, allergens, and debris that can harm the respiratory system. The levels of fine particulate matter were also associated with the expression of genes that are involved in epithelial cell barrier function.
In individuals with non-viral asthma exacerbations, the concentration of ozone was correlated with genes associated with type-2 inflammation, a type of inflammatory response typically observed in asthma.
Researchers said the molecular pathways involved in asthma exacerbation associated with specific air pollutants could explain the higher asthma prevalence and morbidity in children living in urban centers.
The identification of pathways that are specific to asthma exacerbations caused due to higher air pollutant levels could also help devise interventions targeting these molecular pathways.
In addition, personal devices that help monitor air quality levels and the use of air filters during high levels of air pollution could help lower the risk of pollution-associated asthma exacerbations.
The authors cautioned that the study was observational in nature and did not establish causation between air pollutants and the incidence of asthma exacerbations.
Zanobetti also noted that “the study had a low number of subjects and used air pollution from monitors. In addition, they examined air pollution in the days just before the event, which means focusing on acute effects and not chronic ones. Therefore more studies, with more data and better spatial air pollution resolution, are needed.”
Air India has been blasted as “unprofessional” and “devoid of empathy” above its dealing with of just one of two modern incidents that noticed male passengers urinating on fellow extended-haul tourists.
India’s aviation regulator, the Directorate Standard of Civil Aviation (DGCA), claimed Thursday that Air India experienced not adopted protocol when a disorderly male passenger on a Nov. 26 flight from New York to Delhi urinated on an elderly woman who was also traveling onboard.
He was traveling in business enterprise class, the Hindustan Moments reported.
Air India—which is owned by Tata Group—said on Wednesday that it had banned the male passenger from its flights for a thirty day period as needed by restrictions, and experienced noted the incident to the DGCA.
Nevertheless, DGCA explained in its assertion that the male, who was said to be intoxicated when the incident happened, was not dealt with by Air India personnel in a way that complied with provisions for handling unruly air travellers.
“The perform of the involved airline seems to be unprofessional and has led to a systemic failure,” DGCA explained, as noted by area information shops in India.
DGCA said it experienced issued notices to Air India’s director of inflight providers as very well as the pilots and cabin crew who have been doing the job on the flight in concern demanding them to make clear why no further more action need to be taken in opposition to them for the “dereliction of their regulatory obligations.”
It also accused the Air India team included with the incident of being “devoid of empathy.”
Spokespeople for Air India and DGCA have been not instantly out there for comment when contacted by Fortune.
On Thursday, Air India reported a 2nd incident all through a Dec. 6 flight between Paris and Delhi, information agency Reutersclaimed, which noticed yet another male passenger urinate on an vacant seat and the blanket of a fellow passenger. Air India reportedly said the passenger on the Paris flight experienced been arrested on arrival at Delhi but was released by law enforcement right after coming to an understanding with the sufferer.
In accordance to Indian media, the man accused of urinating on a girl on the Nov. 26 flight is wanted for arrest by the New Delhi law enforcement.
Below new specifications that arrived into pressure in India in 2017, unruly travellers are banned from flying for between three months and about two a long time based on the severity of their offense.
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‘In the Air and Past – A Lucid Start Event’ to spotlight new styles that spherical out the entire Air lineup, most recent developments for Air Sapphire, and Lucid’s reimagining of the luxury SUV section
Lucid Air Pure and Air Touring to debut in an online world wide start occasion on Tuesday, November 15, together with announcements about the Lucid business enterprise and foreseeable future styles, such as updates on Lucid’s subsequent power of character, the Challenge Gravity SUV
The total Air lineup will be dwell in community for the to start with time, with Lucid Air Pure and Air Touring showing up alongside Air Grand Touring, Grand Touring Functionality, and the extremely-superior-general performance Air Sapphire at the Lucid Studio Beverly Hills
Lucid to sponsor CDN’s LA Style and design Evening on Thursday, November 17, throughout Automobility LA, exhibiting the recently unveiled Lucid Air Pure together with Air Sapphire, the world’s most strong sedan
NEWARK, Calif., Nov. 3, 2022 /PRNewswire/ — Lucid Group, Inc. (NASDAQ: LCID), location new standards with the longest-array, speediest-charging electric powered car or truck on the industry with the award-successful Lucid Air, now announced that Lucid Air Pure and Air Touring will be unveiled throughout an on the internet global launch function entitled In the Air and Beyond – A Lucid Launch Event, having area on Tuesday, November 15 at 10:00am PST/1:00pm EST, ahead of the 1st Air Touring shipping and delivery taking place that exact night at the company’s Beverly Hills Studio. In addition, the on-line party will also feature enjoyable bulletins about the Lucid enterprise and long run products, including the Project Gravity SUV that reimagines the luxurious SUV with the exact same in-home created technology that underpins the groundbreaking Lucid Air sedan.
In the Air and Outside of – A Lucid Launch Celebration
In the Air and Beyond – A Lucid Launch Function
Lucid Air Pure and Air Touring will make their general public debut the exact same week at the firm’s Beverly Hills Studio and at CDN Designer Night time, getting their spot in the Air lineup along with Lucid Air Grand Touring, the 1050-hp Air Grand Touring Overall performance, and the recently debuted extremely-substantial-efficiency Air Sapphire, the world’s most effective sedan. Buyers and lovers can sign-up to be a part of the debut at dreamahead.com.
Lucid Air Pure
Air Pure, the elemental Lucid Air, has a starting cost of $87,400 and is distinguished by its metal roof and Mojave PurLux inside. Air Pure will in the beginning launch with a twin-motor, all-wheel-drive configuration, with whole specs which include EPA-estimated range and more facts on the product to be shared on November 15.
Lucid Air Touring
Lucid Air Touring, with an MSRP of $107,400, is the quintessential Air, showcasing a fantastic equilibrium of general performance, luxury, design and style, and area. As these, it can be optioned with the exceptional Glass Canopy – a single piece of glass that reaches from the base of the windshield to around the heads of the entrance passengers for an unobstructed look at, as very well as DreamDrive Pro, Lucid’s advanced driver support method. Full specs and further information for Lucid Air Touring will also be shared on November 15.
Lucid Things to do In the course of LA Auto Show 7 days
In addition to the on the web debut occasion for Lucid Air Pure and Air Touring, Lucid will be existing at a number of functions in and all over Los Angeles to rejoice the entire Air lineup.
During the 7 days of November 15, all five trim levels – from Air Pure to Air Sapphire – will be on show for media, consumers, and admirers at the Lucid Studio Beverly Hills. Lucid will also rejoice the international premiere at the Beverly Hills Studio the night of Tuesday, November 15, with a celebration occasion for decide on media, customers, and VIPs.
Derek Jenkins, Senior Vice President of Style and design and Brand, will be showcased at CDN Forum LA taking location through Automobility at the Los Angeles Automobile Clearly show on Thursday, November 17. Lucid is also a sponsor of CDN’s LA Design Evening that evening at the Los Angeles Convention Heart. Equally the recently unveiled Lucid Air Pure and Air Sapphire, the world’s most impressive sedan, will be on display.
Peter Rawlinson, CEO and CTO, will produce the opening keynote at the Automotive Information Entire world Congress on Friday, November 18, speaking about why efficiency is the new vital for electric powered motor vehicles and how it has been central to all facets of the advancement of just about every Lucid auto.
About Lucid Group Lucid’s mission is to inspire the adoption of sustainable power by generating advanced systems and the most fascinating luxurious electric motor vehicles centered about the human working experience. The firm’s initially car, Lucid Air, is a point out-of-the-art luxury sedan with a California-motivated style and design that attributes magnificent full-size interior space in a mid-size exterior footprint. Lucid Air Grand Touring attributes an official EPA-approximated 516 miles of array or 1,050 horsepower. Deliveries of Lucid Air, which is developed at Lucid’s manufacturing facility in Casa Grande, Arizona, are now underway to U.S. and Canadian prospects.
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Share on PinterestAccording to a long-term study, air pollution increases the risk of having a first stroke, additional strokes, and death. Fairfax Media Archives/Getty Images
A new study tracked the effect of air pollution on the risk of having a first and subsequent stroke and of dying from resulting cardiovascular issues.
Researchers tracked the health records of a large number of people and their exposure to air pollutants.
The study focuses on PM 2.5 pollution, tiny air particles that are hazardous to human health.
New research from the Sun Yat-sen University School of Public Health in Guangzhou, China, amplifies how air pollution could affect the trajectory of health from stroke to subsequent death.
The study, recently published in Neurology, focused on the health impacts of PM 2.5 granules. This fine particulate matter (PM) is harmful to human health and has a diameter of fewer than 2.5 microns, about 30 times smaller than a single human hair.
Researchers also looked at nitrogen dioxide (NO₂) and nitrogen oxides (NO𝑥) levels in polluted air and measured air pollutant levels by their weight in micrograms — 1-millionth of a gram — per 1 cubic meter of air, expressed as μg/m3.
The study shows that for every PM 2.5 increase of 5 μg/m3, the risk of a first stroke rose by 24{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, and the risk of a first fatal stroke increased by 30{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}.
Each increase of 5 μg/m3 of NO₂ and NO𝑥 was associated with a small risk of a first stroke — 0.2{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} and 0.1{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, respectively.
The pollutants also caused a slight increase in the risk of cardiovascular mortality for people who have already had a stroke. This was especially true of NO₂, which increased mortality risk by 0.04{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, although this effect tapered off with time.
Dr. Franco Folino, Ph.D., research cardiologist in the department of Cardiac, Thoracic and Vascular Sciences at the University of Padova in Italy, not involved in the study, told Medical News Today:
“Despite the many studies that have shown the harmful effects of pollution on health, there still seems to be little awareness on the need to take adequate measures to reduce exposure to pollutants, particularly in populations at greater risk.”
“Just like climate change still fails to induce significant changes in environmental policies, the effects of air pollution on health are largely underestimated.”
– Dr. Franco Folino, Ph.D., research cardiologist
The observational study is based on an analysis of the health records of 318,752 people in the UKBiobank and several years of UKBiobank air pollution data.
The researchers tracked the health progress of these individuals for 3,765,630 person-years of follow-up. During that time, 5,967 people experienced first or incident strokes. In addition, 2,985 individuals had post-stroke cardiovascular effects, and there were 1,020 subsequent deaths.
The researchers also used 1 year of air pollution data to estimate exposure based on where people lived. They modeled each individual’s exposure to pollutants based on land use, traffic, population, and topography data.
The data show that people who had strokes during the study had an average exposure of 10.03 µg/m3 of PM 2.5. For people who did not have a stroke, the exposure was 9.97 µg/m3.
“This new study tries to evaluate the ‘dynamic’ effects of pollution on stroke risk and mortality in a large population during a very long follow-up period,” Dr. Folino said.
“In essence, this is another demonstration of the long-term harmful effects of pollution, and in particular of fine particles and nitrogen oxides, on [the] cardiovascular system.”
Outdoors, PM 2.5 comes mostly from fossil-fuel-burning vehicles such as cars, trucks, buses, traditional trains, snowmobiles, and construction equipment. Any process involving burning wood, oil, gasoline, or coal may also contribute, including power plants.
In addition, these small yet dangerous particles can travel in the air, so natural events such as forest fires and volcanos distribute them over long distances.
Inside the home, PM 2.5 may come from cigarettes, burning candles, cooking on a stove or in an oven, fireplaces, and space heaters that burn fuel.
“When we consider air pollution, we do not have to think only of the quality of air we breathe outdoors. Very often, pollution can be greater at home,” Dr. Folino said, adding that people could also consume PM 2.5 in water and food.
“PM 2.5 seems particularly harmful because its small size allows it to enter more deeply into the smallest bronchi, where it can induce the inflammatory phenomena that seem to be largely responsible for the harmful effects of particulate matter.”
– Dr. Franco Folino, Ph.D., research cardiologist
Dr. Adi Iyer, a neurosurgeon at the Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, CA, told MNT that PM 2.5 could become lodged in the lungs’ alveoli. This could “cause blockage of the oxygenation process of blood, which can lead to all sorts of other issues, from having low oxygen levels, they can lead to pneumonia [or] respiratory infections,” he explained.
Dr. Folino added that “a particulate with greater size is more easily intercepted in the large airways, in the nose, and in the trachea, and is then eliminated with the mucus.”
In the United States, websites such as the federal government’s AirNow provide an assessment of current local air quality. If you have an iPhone, you may be able to view a general assessment of your area’s air quality in the Weather app.
On days when air quality reaches moderate to dangerous levels, the study authors suggest that people should reduce their outside activities, including exercise, and consider wearing masks and using HEPA air purifiers.
“All people, but especially those with a high cardiovascular risk, should avoid exposure to high pollution levels,” Dr. Folino said. “We have to carry out physical activities in healthy areas and pay attention to the possible polluting sources inside [the] home.”
Of course, Dr. Iyer noted that people living in densely populated urban areas aren’t necessarily able to avoid air pollution.
“Take care of your health in other ways to make sure that you have strong lungs by exercising, staying physically fit, having a good diet, and not smoking. Those are all things to mitigate and offset the exposure to particulate matter, air pollution.”
Share on PinterestHigh levels of air pollution could worsen the symptoms of some health conditions. Getty Images
Researchers decided to explore the connection between heart health and air pollution after seeing that more heart patients made emergency room visits on days of bad air quality.
They found that the risk of abnormal heartbeats (ventricular arrhythmias) was raised even on days when the average air quality was slightly degraded.
The study’s authors recommend that people with implanted defibrillation devices keep an eye on daily pollution levels and plan their exposure accordingly.
An implanted cardioverter defibrillator (ICD) does more than reset a heart’s rhythm to a healthy beat. It also provides researchers with a way of monitoring the occurrence of arrhythmias, or abnormal heartbeats, in hopes of identifying what factors are likely to trigger one.
New research, presented at the European Society of Cardiology’s (ESC) Heart Failure 2022 congress, compared days on which patients experienced higher numbers of ventricular arrhythmias with days scientists recorded higher levels of air pollution.
The researchers found a correlation: The days with high levels of air pollution were when most arrhythmias occurred.
Dr. Franco Folino, of the Department of Cardiac, Thoracic and Vascular Sciences at the University of Padova, Italy, told Medical News Today about the value of ICDs for research.
“These devices, as well as many pacemakers, are formidable devices not only for the treatment of arrhythmias but also for their ability to monitor heart rhythm 24 hours a day. Therefore, they represent an ideal tool for comparing arrhythmic profiles with data from the monitoring station for air quality,” he said.
However, Dr. Folino, who was not involved in the study, noted that the patients observed may be at a higher risk of pollution-related health problems.
“The research conducted on patients with ICDs, who are implanted in patients with major heart diseases, explore a population at high cardiovascular risk, highlighting that in these subjects the effects of pollution are even more pronounced,” he pointed out.
The study took place in the city of Piacenza in the Emilia Romagna region of northern Italy. In 2021, in a ranking by the European Environment Agency of European cities with the greatest levels of air pollution, Piacenza ranked near the bottom—just 16 cities were comparatively worse. The average annual concentration of particulate matter (PM) 2.5 in Piacenza was listed as 20.8 μg/m3.
The World Health Organization considers a level of 10 μg/m3 of PM 2.5 or less to be good air quality.
Piacenza landed squarely in the WHO’s “poor” air quality category.
“We had observed that emergency room visits for arrhythmias in patients with ICDs tended to cluster on days with particularly high air pollution. We, therefore, decided to compare the concentration of air pollutants on days when patients had an arrhythmia versus pollution levels on days without an arrhythmia.”
Dr. Zanni explained to MNT that implantable cardioverter-defibrillator (ICD) therapy is currently the only prevention tool for potentially fatal arrhythmias such as ventricular tachycardia (VT) and ventricular fibrillation (VF).
“The difference [between the two conditions] is that during VT, the heart can still pump some blood and the patient could still be conscious, while during VF the heart is almost still, causing a cardiac arrest,” she said.
She then went on to explain the pacing-or-shock mechanism behind ICDs.
“An ICD is capable of terminating ventricular arrhythmias by anti-tachycardia pacing (ATP), shock, or both. ATP is used for VT and tries to pace the heart faster than the arrhythmia in order to block the pathological circuit, take the lead of the heart rhythm, and then slow down the pacing until a normal heart rate is obtained,” she said.
Dr. Zanni said ICDs managed to stop ventricular tachycardia in approximately 90{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of patients. Where it fails, the shock system kicks in:
“If the ATP fails, or a VF occurs, the ICD delivers a high-voltage shock that immediately stop the arrhythmia. Usually, ATP is not perceived by the patient, while the shock can be felt, even violently.”
The study tracked the ICD activity in 146 individuals who had received an implant between January 2013 and December 2017. Of this group, 67 people had experienced a previous ventricular arrhythmia, and 79 had not.
The Regional Environmental Agency provided the researchers with daily figures for PM 2.5, PM 10, carbon monoxide (CO), nitrogen oxide (NO2), and ozone (O3).
During the study, the researchers recorded 440 ventricular arrhythmias. ATP sufficed for 322 of these, while ICDs delivered a shock in 118 cases.
The study found that every 1 μg/m3 increase in PM2.5 levels corresponded with a 1.5{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} increased risk of arrhythmias requiring a shock.
When PM 2.5 concentrations remained elevated by 1 μg/m3 over the course of a week, ventricular arrhythmias were 2.4{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} more frequent. For PM 10 concentrations, a weekly increase by the same amount corresponded to 2.1{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} more ventricular arrhythmias.
Dr. Folino said that the study highlights the need to categorize air pollution as a risk factor for cardiovascular health.
“Air pollution must be considered in the same way as any other cardiovascular risk factor, such as smoking, hypertension, or hypercholesterolemia,” he said.
“As we fight these risk factors, in the same way, we must act to prevent people in general, but particularly those at high cardiovascular risk, from being exposed to high levels of air pollution,” he added.
Dr. Zanni also shared with the ESC some precautions heart patients can take in their everyday lives.
“When particulate matter (PM) 2.5 and PM 10 concentrations are high (above 35 μg/m3 and 50 μg/m3, respectively), it would be sensible to stay indoors as much as possible and wear an N95 mask outside, particularly in areas of heavy traffic. An air purifier can be used at home.” — Dr. Alessia Zanni
