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August 2009 Environmental Hazards Weigh Heavy on the Heart Information for Older Adults and Sheet Their Caregivers id you know that environmen and stroke, but inhaling the same dose tal hazards can contribute to of secondhand smoke and smoke from heart disease and stroke? This active smoking is equally detrimental. fact sheet summarizes envi D Wood burning stoves and fireplaces can ronmental factors and how they can generate smoke containing fine carbon act affect the health of older adults. It also particles. These particles may trigger suggests how older adults can minimize chest pain and palpitations, shortness of F their exposure to air and water pollut breath, and fatigue, especially in older ants that contribute to heart disease and adults with heart disease.2 stroke or worsen their symptoms. Heart disease, the leading cause of Household Products: When used death in the United States, and stroke, improperly, some household products the third most frequent cause of death, can be very dangerous for people with cost the nation hundreds of billions of heart conditions. Vapors from cleaning dollars each year. According to the CDC, products, paint solvents, and pesticides in 2005, heart disease killed 652,091 require proper ventilation and limited people, which represented 27.1% of all exposure to minimize detrimental deaths in the U.S.1 effects. Fumes from paint solvents, such as Environmental Factors Contribute mineral spirits, turpentine, methanol, Environmental to Heart Disease and Stroke and xylene, stress the lungs and heart, contributing to irregular heartbeat. hazards can Indoor Air Pollution Although leadbased paints are now People who spend long periods of time banned, many homes built before contribute to heart indoors are often the most susceptible 1978 used leadcontaining paints. to the effects of indoor air pollution. Take appropriate precautions during disease and stroke. Studies suggest that older adults renovations to minimize paint chips or spend up to 90% of their time indoors. dust generated that pose serious health Older adults should Indoor air is comprised of a mixture hazards, including high blood pressure. of contaminants penetrating from the minimize exposure Pesticide poisonings often result outdoors and those generated indoors. from exposure to toxic fumigants or Indoor air can contain secondhand to environmental insecticides. Symptoms of this type of smoke, fumes from household cleaning poisoning include arrhythmia or a very products, and even carbon monoxide. 3 hazards such as slow pulse. In severe cases, exposure These indoor contaminants can be can contribute to a heart attack or even air pollution, dangerously toxic, especially to those at death. risk of stroke and heart disease. Carbon Monoxide: Carbon monoxide Smoke: Secondhand smoke is one of arsenic, lead, and (CO), an invisible and odorless gas, the worst indoor air pollutants. Smoking is a dangerous pollutant because it excessive heat. is known to contribute to heart disease is difficult to detect. It is particularly harmful to people with heart disease, clogged Arsenic: Longterm exposure to high levels of arteries, or congestive heart failure because it arsenic, a natural element found in drinking significantly limits the blood’s ability to carry water in some areas of the country, can harm oxygen. For a person with heart disease, exposure the heart. EPA has a drinking water standard to even low levels of CO may cause chest pain, for public drinking water systems to ensure that people are not exposed to high levels of arsenic. increased heart rhythm irregularities and make it difficult to exercise.4 Sources of CO include If you obtain your water from a private well or fumes from furnaces, gas water heaters, ranges, small water system, see the “Steps You Can Take” dryers, space heaters, fireplaces, wood stoves, and section for more information about actions to exhaust from cars idling in enclosed garages. limit your exposure. Outdoor Air Pollution Excessive Heat Events Older adults who are at risk for heart disease and Heat events are described as prolonged periods stroke may benefit from lowering their contact when temperatures reach at least 10º F. (5.5ºC.) with air polluted with particulates and vehicular above a region’s average high temperature. Heat exhaust. stroke is the most serious of a range of health Particle Pollution: Small soot particles found effects associated with excessive heat exposure. in outdoor air can be hazardous and the risk It occurs when the body’s temperature control is greatest among people with heart disease, system fails causing a rapid rise in core body chronic obstructive lung disease and asthma. temperature. Heat stroke is characterized by hot, dry, and red skin, and a lack of perspiration. Other Particles originate from a variety of sources including vehicles, power plants, industrial warning signs are confusion and hallucinations. smokestacks, and fires. Some particles are Heat stroke is a serious condition requiring immediate medical attention (call 911 or take the emitted into the air directly, but others form as a result of complicated chemical reactions in person to an emergency room). Left untreated, the atmosphere. Particles can travel hundreds to heat stroke can cause severe and permanent thousands of miles downwind, affecting people damage to vital organs, permanent disability, or death. far from the sources. Traffic: Time spent in traffic has also been Persons with heart disease and stroke have impaired cooling mechanisms and are more associated with the onset of a heart attack.5 It is not known whether this is due to trafficrelated vulnerable during heat events. The use of air pollution (e.g., particle pollution, CO), the some medications can make individuals more susceptible to heat events for example, anti stress of being caught in traffic, or some other risk depressants and some circulatory medications. factor. Pollutant Gases: Ozone, sulfur dioxide, and During heat events, airconditioning is the best nitrogen dioxide are also important components protection against heatrelated illness and death. of air pollution and are associated with adverse Even a few hours a day in airconditioning can health effects. Ozone is a strong irritant to the greatly reduce the risk. Research indicates electric fans are only effective if the ambient temperature lungs and airways and can cause chest pain that can be mistaken for a heart attack. is lower than the body temperature. Electric fans may provide comfort, but when temperatures are Drinking Water in the high 90s, fans do not prevent heatrelated There is evidence that several metals found in illness and could actually be harmful. drinking water may contribute to heart disease or Encourage Your Local Government to aggravate its symptoms. Take Action Lead: Exposure to lead can increase blood Local governments should take these simple pressure. While people are primarily exposed steps to reduce hazards and publicize precautions to lead through paint dust, drinking water is older adults can take. another source of lead exposure. While water • Promote smoke-free policies in public from a community’s public water supply must places: By keeping public places (restaurants, meet EPA standards for lead, tap water may still bars, and parks) smokefree, communities can contain lead exceeding the allowable levels due limit exposure to secondhand smoke. to the presence of older leadcontaining plumbing materials. Steps You Can Take to • Reduce exposure to traffic and outdoor air pollution: Pay attention to Air Quality Help Control Heart Disease Index (AQI) forecasts to know when the and Stroke air is unhealthy for sensitive groups. Check with your physician about lowering your A healthy lifestyle is the best way to prevent activity level when the AQI is high. Put air heart disease and stroke. In addition, conditioning on the recirculate mode and older adults should limit their contact with keep windows closed during smoke events environmental risk factors and encourage from fires in buildings or forests. Reduce your local governments to take action to reduce time in traffic. Avoid physical activity and limit environmental hazards. exercise near busy roads. Limit Contact With Environmental Factors • Prevent heat stress: Use your airconditioner or go to airconditioned buildings in your • Keep smoke out of indoor spaces: Avoid smoke from tobacco. Encourage smokers to community. Take a cool shower or bath. Wear lightweight, lightcolored, and loosefitting smoke outdoors. Avoid restaurants, bars, and clothing. Ask your doctor if your medications other public places where people smoke. Do not use, or limit use of, woodburning stoves increase your susceptibility to heatrelated illness. and fireplaces. Drink lots of fluids, but avoid beverages • Use caution when working around the house: Improve ventilation when painting by containing caffeine, alcohol, or large amounts of sugar. These drinks cause dehydration. If a scheduling indoor painting for times when doctor limits your fluid intake, be sure to ask windows can be left open and by using fans. Take frequent fresh air breaks when painting; how much to drink when it’s hot. • Drink clean water: To limit your exposure to avoid painted rooms for several days. lead through your water, run cold water for at Before renovating a home built before 978, take precautions to avoid lead paint least 30 seconds, preferably 2 to 3 minutes 1 exposure. Do not use a beltsander, propane before drinking. Testing for lead also may be advisable for people who get their water from torch, heat gun, dry scraper, or dry sandpaper to remove leadbased paint because these municipal sources and live in older homes with lead service lines. If you receive your actions generate unacceptable amounts of water from a municipal system, you should lead dust and fumes. first request information from your municipal system for results of federally mandated If you must use pesticides, always read labels first and follow all precautions and testing for lead and copper, particularly in homes from the area where you live. restrictions. When handling pesticides, take protective measures; follow directions and wear impermeable gloves, long pants, EPA’s arsenic standard exempts small water systems that annually provide fewer than 15 and longsleeved shirts. Change clothes and wash your hands immediately after “hookups” or serve fewer than 25 people. If your water supply is from a private well or a applying pesticides. Wash clothes exposed to small system that is exempted from testing pesticides separately. and you live in an area where high levels of • Avoid carbon monoxide poisoning: Never arsenic have been reported in the ground leave a car running in a garage, even with water, you may want to have your water tested for arsenic. the garage door open. Keep gas appliances properly adjusted. Install and use exhaust fans. Have a trained professional inspect, The best source of specific information about our drinking water is your water supplier. y clean, and tuneup your central heating Water suppliers that serve the same people system (furnaces, flues, and chimneys) yearround are required to send their custom every fall. Install carbon monoxide detectors ers an annual water quality report (some throughout your home. times called a consumer confidence report). Contact your water supplier to get a copy. • Promote Active Heat Health Watch/Warning Centers for Disease Control and Prevention Systems: These systems can help identify Heart Disease: http://www.cdc.gov/HeartDisease/ when a heatrelated threat is likely, alert Physical Fitness Guidelines: residents, and provide assistance to atrisk http://www.cdc.gov/physicalactivity/everyone/ individuals. • Ensure that Air Quality Index forecasts are guidelines/olderadults.html publicized and followed: EPA’s Air Quality Federal Emergency Management Index is an index for reporting daily air quality. Administration: See www.epa.gov/airnow. Extreme Heat: http://www.fema.gov/hazard/heat/ • Promote public transit options that reduce index.shtm traffic and air pollution: Public transit is National Weather Service the best way to alleviate road congestion, air http://www.nws.noaa.gov/om/brochures/heat_ pollution, and stress. • Locate parks, bike paths, and trails away wave.shtml from major roads: Physical activity is one American Heart Association of the best ways to lower your risk for heart http://www.americanheart.org/ disease and stroke. Exercise away from roads Health Effects Institute and traffic pollution. http://www.healtheffects.org/about.htm Control Your Major Risk Factors for Heart Disease and Stroke The environment is just one factor that influences Learn More a person’s susceptibility to heart disease and The EPA Aging Initiative works to protect the stroke. The most important steps you can take to health of older adults through the coordination reduce risk factors for heart disease and stroke of research, prevention strategies, and public include: education on environmental factors. For more • Avoid smoke from tobacco information, or to join the EPA Aging Initiative • Schedule time for regular physical activity 30 listserv, visit: www.epa.gov/aging. minutes per day at least 5 days a week • Follow the 2005 Dietary Guidelines for Americans Endnotes • See your health care provider regularly to 1 Kung HC, Hoyert DL, Xu J, Murphy SL. Deaths: final data for screen for and treat high blood pressure, 2005. National Vital Statistics Reports. 2008;56(10). diabetes, and hyperlipidemia (elevated levels 2 U.S. Environmental Protection Agency. Air Quality Guide for of lipids in the bloodstream) Particle Pollution. http://www.epa.gov/airnow//aqi_cl.pdf 3 U.S. Environmental Protection Agency. Regulation and Resources Management of Pesticide Poisonings. 1999. http://www.epa. gov/pesticides/safety/healthcare/handbook/Index1.pdf Environmental Protection Agency 4 U.S. Environmental Protection Agency. Air Quality Criteria for Air Quality Index: http://airnow.gov/ Carbon Monoxide, EPA 600P99001F. Research Triangle Park, NC: U.S. Environmental Protection Agency, Office Research and Indoor Air Quality: http://www.epa.gov/iaq/ Development, National Center for Environmental Assessment. June 2000. Lead: http://www.epa.gov/lead/ 5 Peters, A., S. von Klot, M. Heier, I. Trentinaglia, H. Ines, A. Painting: http://www.epa.gov/iaq/homes/ Hormann, H.E. Erich, H. Lowel. “Exposure to Traffic and the Onset of Myocardial Infarction.” The New England Journal of Medicine. hippainting.html Oct 21, 2004. 351 (17): 172130. Pesticides: http://www.epa.gov/pesticides/ Smoke Free Homes and Cars: http://www.epa. gov/smokefree/ Health and Human Services Dietary Guidelines: http://www.health.gov/ DietaryGuidelines/ Publication Number EPA 100F09043
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