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C. Arden Pope, III,¹ Delbert J. Eatough,¹ Diane R. Gold,² Yanbo Pang,¹ Karen R. Nielsen,³ Prema Nath,⁴ Richard L. Verrier,⁵ and Richard E. Kanner⁶

¹Department of Chemistry & Biochemistry and Department of Economics, Brigham Young University, Provo, Utah; ²Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; ³Cardiovascular Genetic Research Clinic, University of Utah School of Medicine, Salt Lake City, Utah, USA; ⁴University of Utah Hospital and Clinics, Salt Lake City, Utah, USA; ⁵Institute for Prevention of Cardiovascular Disease, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA; ⁶Division of Respiratory, Critical Care and Occupational Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA

Abstract

Environmental tobacco smoke (ETS) has been associated with cardiovascular mortality. Pathophysiologic pathways leading from ETS exposure to cardiopulmonary disease are still being explored. Reduced cardiac autonomic function, as measured by heart rate variability (HRV) , has been associated with cardiac vulnerability and may represent an important pathophysiologic mechanism linking ETS and risk of cardiac mortality. In this study we evaluated acute ETS exposure in a commercial airport with changes in HRV in 16 adult nonsmokers. We conducted ambulatory electrocardiographic (ECG) monitoring for 8-hr periods while participants alternated 2 hr in nonsmoking and smoking areas. Nicotine and respirable suspended particle concentrations and participants' blood oxygen saturation were also monitored. We calculated time and frequency domain measures of HRV for periods in and out of the smoking area, and we evaluated associations with ETS using comparative statistics and regression modeling. ETS exposure was negatively associated with all measures of HRV. During exposure periods, we observed an average decrement of approximately 12% in the standard deviation of all normal-to-normal heart beat intervals (an estimate of overall HRV) . ETS exposures were not associated with mean heart rate or blood oxygen saturation. Altered cardiac autonomic function, assessed by decrements in HRV, is associated with acute exposure to ETS and may be part of the pathophysiologic mechanisms linking ETS exposure and increased cardiac vulnerability. Key words: autonomic function, cardiovascular disease, environmental tobacco smoke, heart rate variability, particulate matter, passive cigarette smoke. Environ Health Perspect 109:711-716 (2001) . [Online 3 July 2001]

http://ehpnet1.niehs.nih.gov/docs/2001/109p711-716pope/ abstract.html

Address correspondence to C.A. Pope, III, 142 FOB, Brigham Young University, Provo, UT 84602 USA. Fax: (801) 378-2844. Telephone: (801) 378-2157. E-mail: cap3@email.byu.edu

Received 17 November 2000 ; accepted 9 January 2001.