United States
  Environmental Protection
  Agency
AMERICAN
COLLEGE of
CARDIOLOGY
                                                                                «t
American Heart American Stroke
  Association® Association^
Heart Disease, Stroke, and  Outdoor Air Pollution
   Did you know that air pollution can
   trigger heart attacks, stroke, and
   other health effects?
   Medical studies show that air pollution can
   trigger heart attacks, stroke, and irregular
   heart rhythms—especially in people who are
   already at risk for these conditions. Also, for
   people with a medical condition called heart
   failure, air pollution can further reduce the ability
   of the heart to pump blood the way that it should.
   Very small particles are the pollutants of
   greatest concern for triggering these effects.
   Particle pollution is found in haze, smoke, and
   dust—and sometimes in air that looks clean.
   This fact sheet tells you how you can:
   • Get up-to-date information about your
     local air quality.
   • Protect your health when particle pollution is
     at unhealthy levels.

   Are you at higher risk?
   For most people, the risk is small. Older
   adults and people with risk factors for heart
   disease or stroke may be at greater risk.  You
   are at greater risk if you:
   • Have had a heart attack, angina, bypass
     surgery, angioplasty with or without a stent, a
     stroke, blockages in the neck or leg arteries,
     heart failure, heart rhythm problems, diabetes,
     or chronic obstructive lung disease.
   You may be at greater risk of heart disease
   or stroke (and therefore at greater risk from
   particle pollution) if any of these apply:
   • You are  a man 45 years or older, or a woman
     55 years or older.
   • You have a family history of stroke or early
     heart disease (father or brother diagnosed
     before age 55; mother or sister diagnosed
     before age 65).
   • You have high blood pressure or high  blood
     cholesterol.
   • You are  overweight or not physically active.
   • You smoke cigarettes.
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      How can you protect your health?

      Regular exercise is important for staying
      healthy, especially if you have heart disease.
      By adjusting when and where you exercise,
      you can lead a healthier lifestyle and help
      reduce your risk of heart problems or stroke
      triggered by air pollution. In addition:

      • If you have heart disease or have
        experienced a stroke, check with your
        health care provider about the best ways to
        protect your health when the air quality is
        unhealthy.

      • If you're at risk of heart disease or stroke
        and plan to exercise more than usual,
        discuss this with your health care provider.

      ^ Know when and where particle pollution
        levels may be unhealthy.

        Particle pollution levels can be high any
        time of year. Levels can be especially high
        when the weather is calm, allowing air
        pollution to build up. Particle levels can
        also be high:

        • Near busy roads, in urban areas (especially
          during rush hour), and in industrial areas.

        • When there is smoke in the air from wood
          stoves, fireplaces, burning vegetation, or
          forest fires.

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 Plan activities when and where pollution
 levels are lower.

 « Avoid exercising near busy roads or
  industrial areas.
 • When particle levels outdoors are unhealthy,
  delay your activity until the air is cleaner or
  move your activity indoors.
 Change your            When the air is
 polluted, take it a little easier. This will reduce
 how much pollution you breathe. For example,
 go for a walk instead of a jog.
 Reduce your overall risk of heart
 or stroke.
 • Make lifestyle changes like eating healthy
  foods, exercising more, and stopping
  smoking.
 « Work with your health care provider to
  treat  conditions that increase your risk of
  heart disease and stroke.
      the warning      of heart attack and
               below). If you feel symptoms,
 even if they go away, stop your activity and
 seek medical help immediately!
                  air

     Sometimes you can tell that the air is polluted™
     for example, on a smoggy or hazy day. But
     often you can't see the pollution. In many areas,
     you can find air quality forecasts and reports
     on local TV, radio, or in the newspaper. These
     reports use the Air Quality Index, or AQI, a
     simple color scale, to tell you how clean or
     polluted the air is. You can also find these
     reports on the Internet at: www.airnow.gov.

     You can sign up for email notification at
     www.enviroflash.info. This free service will
     alert you when your local air quality reaches
     levels of concern and can help you plan your
     daily activities.
0
     Air quality and health:

     • AIRNow at www.airnow.gov
     • Call 1-800-490-9198 for a free EPA brochure on
      Particle Pollution and Your Health.
     Heart         and stroke:
     « American Heart Association at
      www.americanheart.org
     • American Stroke Association at
      www.strokeassociation.org
     « National Heart Lung and Blood Institute
      at www.nhlbi.nih.gov
Know the warning signs of a heart
f  Chest discomfort—uncomfortable pressure,
   fullness, squeezing, or pain in the center of
   the chest that lasts more than a few minutes,
   or goes away and comes back.
f  Discomfort in other areas of the upper body—
   pain or discomfort in one or both arms, the
   back, neck, jaw or stomach.
f  Shortness of breath—often comes with or
   without chest discomfort
f  Other signs—may include breaking out in a
   cold sweat, nausea, or light-headedness.
   ICnow the warning signs of stroke:
   f Sudden numbness or weakness—in the face,
     arm, or leg especially on one side of the
     body.
   f Sudden confusion, trouble speaking or
     understanding.
   f Sudden problems seeing in one eye or both eyes.
   f Sudden dizziness, loss of balance or coordination,
     or trouble walking.
   f Sudden severe headache with no known cause.

               Reprinted with permission
          © 2009 American Heart Association, Inc.
                       U.S. Environmental Protection Agency .  EPA-452/F-10-001

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