100F10034
December 2010
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 envi-
ronmental hazards can
contribute to heart disease
and stroke? Factors in the
environment, such as pollutants
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 fac-
tors 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
2005, heart disease killed 652,091
people, which represented 27.1% of
all deaths in the U.S.1
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.2
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
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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.3
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.4 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.5 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.
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.
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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.
• 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.
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 if 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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• Promote an Active Heat Health Watch/
Warning System: 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
Air Quality Index: http://airnow.gov/
Indoor Air Quality: http://www.epa.gov/iaq/
Lead: http://www.epa.gov/lead/
Painting: http://www.epa.gov/iaq/homes/hip-
painting.html
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/
Centers for Disease Control and Prevention
Heart Disease:
http://www.cdc.gov/HeartDisease/
Physical Fitness Guidelines:
http://www.cdc.gov/physicalactivity/everyone/
guidelines/olderadults.html
Federal Emergency Management Administration:
Extreme Heat:
http://www.fema.gov/hazard/heat/index.shtm
National Weather Service
http://www.nws.noaa.gov/om/brochures/heat_
wave.shtml
American Heart Association
http://www.americanheart.org/
Health Effects Institute
http://www.healtheffects.org/about.htm
Learn A/lore
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.
Endnotes
1 Kung HC, Hoyert DL, Xu J, Murphy SL Deaths: final data for
2005. National Vital Statistics Reports. 2008;56(10).
2 National Pesticide Telecommunications Network. Pesticides in
Drinking Water, http://npic.orst.edu/factsheets/drinkingwater.pdf
3 U.S. Environmental Protection Agency. Regulation and
Management of Pesticide Poisonings. 1999. http://www.epa.
gov/pesticides/safety/healthcare/handbook/lndexl.pdf
4 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.
5 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.
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Protecting the Health
of Older Americans
Publication Number EPA 100-F-l0-034
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