Psychosocial Stress Modifies the Acute Cardiac Health Effects of Traffic-Related Air Pollution

Tongjun Guo; Wanzhou Wang; Xi Chen; Huaqi Guo; Kai Wang; Yating Ma; Hongyan Deng; Xianggui Li; Anqi Shan; Qian Wu; Yaoyan Li; Hongyu Li; Qisijing Liu; Juan Chen; Yang Lan; Jian Lei; Furong Deng; Zhiwei Sun; Xinbiao Guo; Yan Wang; Naijun Tang; Shaowei Wu

doi:10.1021/envhealth.3c00104

Psychosocial Stress Modifies the Acute Cardiac Health Effects of Traffic-Related Air Pollution

Environ Health (Wash). 2023 Dec 29;2(1):11-22. doi: 10.1021/envhealth.3c00104. eCollection 2024 Jan 19.

Authors

Tongjun Guo¹, Wanzhou Wang¹, Xi Chen², Huaqi Guo³, Kai Wang^{4

5

6}, Yating Ma⁷, Hongyan Deng⁸, Xianggui Li^{4

9

5

6}, Anqi Shan², Qian Wu¹⁰, Yaoyan Li¹¹, Hongyu Li¹², Qisijing Liu¹³, Juan Chen^{4

9

5

6}, Yang Lan^{4

9

5

6}, Jian Lei^{4

9

5

6}, Furong Deng¹, Zhiwei Sun^{14

15}, Xinbiao Guo¹, Yan Wang¹⁶, Naijun Tang², Shaowei Wu^{4

9

5

6}

Affiliations

¹ Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
² Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, 300070, China.
³ Department of Respiratory and Critical Care Medicine, The Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
⁴ Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710049, China.
⁵ Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi 710049, China.
⁶ Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi 710049, China.
⁷ Institute of Social Psychology, School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, China.
⁸ Qinglongqiao Community Health Service Centre, Beijing,100091, China.
⁹ Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, 710061, China.
¹⁰ School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
¹¹ Department of HAI Management, Tianjin Huanhu Hospital, Tianjin 300060, China.
¹² Office for National Clinical Research Center for Geriatric Diseases, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100005, China.
¹³ Research Institute of Public Health, School of Medicine, Nankai University, 300071 Tianjin, China.
¹⁴ Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, China.
¹⁵ Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China.
¹⁶ The Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.

Abstract

Previous studies have shown that exposure to black carbon (BC, a tracer of traffic-related air pollution) and psychosocial stress are both associated with adverse cardiac effects, but whether psychosocial stress could modify the cardiac effects of BC is unclear. To investigate the potential modifying effect of psychosocial stress on the associations between acute exposure to BC and typical cardiac health variables, real-time personal 24 h measurements were conducted in a repeated-measure study among adults with elevated blood pressure (high-risk group) and a panel study among normal adults (low-risk group) in China. Measured cardiac health variables included ST-segment depression events, heart rate, and heart rate variability (HRV) variables. Perceived Stress Scale, State Anxiety Inventory and Self-rating Depression Scale were used to assess the recent psychosocial stress status of the participants, and a composite stress index was established based on these scales. Generalized linear mixed-effects model was used to analyze the associations between BC exposure and cardiac health variables and potential effect modification by psychosocial stress. A total of 97 24 h measurements among 97 participants in the repeated-measure study and 202 24 h measurements among 87 participants in the panel study were included in the final analysis. Acute BC exposure was significantly associated with increased ST-segment depression events and heart rate and decreases in HRV in both studies. The marginal effects of acute BC exposure on most cardiac health variables generally tended to be amplified under higher vs low levels of psychosocial stress in both studies, with the composite stress index apparently modifying the associations of BC exposure with most ST-segment depression events and HRV variables. These findings suggest that psychosocial stress may increase the participants' cardiac susceptibility to BC exposure, which could be helpful for the identification of susceptible individuals in the context of traffic-related air pollution.