December 2005
Environmental Hazards
Weigh Heavy on the Heart
Information for Older Americans and
their Caregivers
Environmental
hazards can
contribute to heart
disease and stroke.
Older adults should
limit exposure
to air pollution,
arsenic, lead, and
excessive heat.
Did you know that environmental
hazards can contribute to heart
disease and stroke? Factors in
the environment, such as pol-
lutants in the air and water, are known or
thought to affect heart disease and stroke.
The purpose of this fact sheet is to make
older people in particular aware of some
of these factors. It is also intended to help
older persons reduce their exposure to
these factors. By controlling factors in your
environment, you may be able to protect
yourself and your loved ones.
Heart disease is the leading cause of
death in the United States, and stroke
is the third highest cause of death.
They cost the nation hundreds of
billions of dollars each year. In 2001,
heart disease killed 700,000 people in
the US.
What in the Environment can
Contribute to Heart Disease and
Stroke Problems?
Indoor Air Pollution
People who spend long periods
of time indoors may be the most
affected by indoor air pollution.
Studies suggest that older adults
spend up to 90% of their time
indoors. Indoor air can contain toxic
pollution that comes from both
indoors and outdoors. Pollutants that
people are exposed to outdoors are
described later in this fact sheet
Indoor air pollution can come from:
• secondhand smoke
fumes from household
cleaning products
carbon monoxide
Smoke: Secondhand smoke is one
of the worst indoor air pollutants.
Smoking is known to be bad for the
heart. Breathing secondhand smoke
can be just as harmful. Smoke from
wood burning stoves and fireplaces
are also hazardous. Smoke contains
particles that can cause chest pain and
shortness of breath. For older persons
with heart disease smoke can also
make people feel tired.
Household Products: Fumes
from paints, pesticides, and cleaning
products can place stress on the lungs
and heart To stay safe, older adults
should limit the time they spend
around these fumes and keep their
indoors full of fresh air.
Many homes built before 1978 used
paints that contained lead. Breathing in
small amounts of lead dust can cause
serious health problems including high
blood pressure. If you are renovating
your home, make sure to limit your
exposure to lead found in paint chips
and dust
Pesticide poisonings often result from
breathing in toxic fumes or insect
repellants. Be careful when you or a
hired professional sprays pesticides
in or around your home. Signs of
poisoning include irregular heart beats
or a very slow pulse.
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Carbon Monoxide: Carbon monoxide (CO), a
gas that you can't see or smell, is a dangerous
pollutant because it is difficult to detect. It is very
harmful to people with heart disease, clogged
arteries, or heart failure because it limits the
blood's ability to carry oxygen. For a person with
heart disease, exposure to even low levels of CO
may cause chest pain, or irregular heart beats. It
may also make exercising difficult. Sources of CO
include fumes from furnaces, gas water heaters,
ranges, dryers, space heaters, fireplaces, wood
stoves, and exhaust from cars left running in
enclosed garages.
Outdoor Air Pollution
Older adults who are at risk for heart disease
and stroke may benefit from less contact with
pollutants in the air and car exhaust.
Particle Pollution: Small soot particles found
in the air outdoors can be hazardous and the
risk is greatest among people with heart disease,
emphysema, chronic bronchitis, and asthma.
These particles come from many sources such
as vehicles, power plants, industrial smokestacks,
and fires. Particles can travel hundreds to
thousands of miles downwind, and affect people
far from the sources.
Traffic: Time spent in traffic has also been
associated with the start of a heart attack. It
is not known if this is due to traffic-related air
pollution (e.g., particle pollution, CO), the stress
of being in traffic, or some other risk factor.
Pollutant Gases: Ozone, sulfur dioxide, and
nitrogen dioxide are gases that can cause
negative health effects. Ozone can bother the
lungs and airways causing chest pains that can
be mistaken for a heart attack.
Drinking Water
Some metals found in drinking water may cause
heart disease or worsen its symptoms.
Lead: Exposure to lead can increase blood
pressure. Both paint dust and drinking water are
sources of lead exposure. Old lead plumbing
may contaminate the clean drinking water in
your community.
Arsenic: Arsenic is a natural element found in
drinking water in some areas of the country.
Long-term exposure to high levels of arsenic
can harm the heart. If your water comes from a
private well or small water system, see the "Steps
You Can Take" section for more information on
how to limit exposure.
Excessive Heat Events
Heat events are when temperatures reach at
least 10° F (5.5°C.) above a region's average
high temperature for long periods of time.
Excessive heat can cause heat stroke. When
the body's temperature control system fails, the
core temperature in your body rises. Symptoms
of heat stroke are hot, dry, red skin, and a
lack of perspiration. Other warning signs are
confusion and hallucinations. Heat stroke is a
serious condition and needs immediate medical
attention (call 911 or take the person to an
emergency room). Left untreated, heat stroke
can cause severe and permanent damage to vital
organs. It can also lead to permanent disability,
or even death.
People with heart disease and stroke do not
cool down easily during heat events. The use of
some medications such as anti-depressants and
some circulatory medications can make a person
exposed to excessive heat more at risk.
Air-conditioning is the best protection against
heat-related illness and death. Even a few hours
a day in air-conditioning can greatly reduce the
risk. While electric fans may provide comfort, but
when temperatures are in the high 90s, (35°C or
higher) fans do not prevent heat-related illness
and could actually be harmful.
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Steps You Can Take to Help
Control Heart Disease and
Stroke
A healthy lifestyle is the best way to prevent
heart disease and stroke. Also, older adults
should stay away from environmental
hazards and ask local governments to take
action to reduce these hazards.
Limit Contact with Environmental
Factors
• Keep smoke out of indoor spaces:
Stay away from tobacco smoke and
places where people smoke. Try not to
use wood-burning stoves and fireplaces.
• Use caution when working around
the house: Keep fresh air moving when
painting by leaving windows open and
by using fans. Take many fresh air breaks
when painting; stay away from painted
rooms for several days.
Before renovating a home built before
1978, take precautions to avoid lead
paint exposure. Do not use a belt-sander,
propane torch, heat gun, dry scraper, or dry
sandpaper to remove lead-based paint.
If you use pesticides, always read labels
first and follow all precautions and
restrictions. Follow all directions and wear
rubber gloves, long pants, and long-
sleeved shirts. Change clothes and wash
your hands immediately after applying
pesticides. Wash clothes that have
pesticides on them separately.
Avoid carbon monoxide poisoning:
Never leave a car running in a garage,
even with the garage door open. Take
care of gas appliances. Install and use
exhaust fans. Have a trained professional
inspect, clean, and tune-up your furnaces
and chimneys every fall. Install carbon
monoxide detectors around the home.
Prevent heat stress: Use your air-
conditioner or go to air-conditioned
buildings in your community. Take a cool
shower or bath. Wear lightweight, light-
colored, and loose-fitting clothes. Ask your
doctor if your medications may increase
your chance of getting a heat-related
illness when it is hot. Drink lots of water. If
a doctor limits how much you can drink,
be sure to ask what is okay when it's hot.
Drink clean water: Run cold water for
at least 30 seconds, preferably 2 to 3
minutes before drinking to help limit your
risk of lead poisoning. For extra protection
test your drinking water for lead and
arsenic, and ask for test results and more
information from your water supplier.
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Stay away from traffic and outdoor
air pollution: Watch the Air Quality Index
(AQI) to know when the air is unhealthy
for sensitive groups. Check with your
doctor about being less active when the
AQI is high. Reduce your time in traffic
and try not to exercise near busy roads.
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Encourage Your Local Government
to Take Action
Local governments should take these simple
steps to reduce hazards and inform older adults
of precautions they can take.
• Promote smoke-free policies in public
places: By keeping public places (restaurants,
bars, and parks) smoke-free, communities can
limit exposure to secondhand smoke.
• Promote Active Heat Health Watch
Warning and Response Systems: These
systems can help identify when a heat-related
threat is likely, alert residents, and provide
assistance to at-risk individuals.
• Ensure that Air Quality Index forecasts
are publicized and followed: EPA's Air
Quality Index is an index for reporting daily air
quality. See www.epa.gov/airnow.
• Promote public transit options that
reduce traffic and air pollution: Public
transit is the best way to avoid road
congestion, air pollution, and stress.
• Locate parks, bike paths, and trails away
from major roads: Physical activity is one
of the best ways to lower your risk for heart
disease and stroke. Exercise away from roads
and traffic pollution.
Control Your Major Risk Factors for
Heart Disease and Stroke
The environment is just one factor that affects
a person's risk for heart disease and stroke. The
most important steps you can take to reduce risk
factors for heart disease and stroke include:
• Avoid smoke from tobacco
• Schedule time for regular physical activity
30 minutes per day at least 5 days a
week
• Follow the 2005 Dietary Guidelines for
Americans
• See your health care provider regularly to
screen for and treat high blood pressure,
diabetes, and hyperlipidemia (high levels
of lipids in the bloodstream)
Additional Resources
Environmental Protection Agency
Air Quality Index: www.airnow.gov
Arsenic: www.epa.gov/safewater/arsenic.html
Indoor Air Quality: www.epa.gov/iaq/
Lead: www.epa.gov/lead
Painting: www.epa.gov/iaq/homes/hip-painting.html
Pesticides: www.epa.gov/pesticide/
Smoke free homes: www.epa.gov/smokefree/
Centers for Disease Control and Prevention
Cardiovascular health: www.cdc.gov/cvh/
Physical Fitness Guidelines: www.cdc.gov/
nccdphp/dnpa/physical/recommendations/
older_adults.htm
Dietary Guidelines for Americans
www.health.gov/dietaryguidelines/
Federal Emergency Management Administration
www.fema.gov/hazards/extremeheat/heat.shtm
National Weather Service: www.nws.noaa.
gov/om/brochures/heat_wave.shtml
American Heart Association:
www.americanheart.org/
Health Effects Institute:
www.healtheffects.org/about.htm
Learn More
The EPA Aging Initiative works to protect
the health of older adults through research,
prevention suggestions, and public
education. For more information, or to join
the EPA Aging Initiative listserve visit: www.
epa.gov/aging. Older adults can improve
their health and quality of life by being
aware of environmental contributors to heart
disease and stroke and controlling major
non-environmental risk factors.
Footnotes
1 U.S. Environmental Protection Agency. Air Quality Guide for
Particle Pollution. http://www.epa.gOV/airnow//aqLcl.pdf
2 U.S. Environmental Protection Agency. Regulation and
Management of Pesticide Poisonings. 1999. http://www.epa.
gov/pestiddes/safety/healthcare/handbook/lndexl.pdf
3 U.S. Environmental Protection Agency. Air Quality Criteria for
Carbon Monoxide, EPA 600-P-99-001F. Research Triangle Park,
NC: U.S. Environmental Protection Agency, Office Research and
Development, National Center for Environmental Assessment.
June 2000.
4 Peters, A., S. von Klot, M. Heier, I. Trentinaglia, H. Ines, A.
Hermann, H.E. Erich, H. Lowel. "Exposure to Traffic and the Onset
of Myocardial Infarction." The New England Journal of Medicine.
Oct 21, 2004. 351 (17): 1721-30.
Publication Number
EPA 100-F-05-025
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