Physiological and perceived health effects from daily changes in air pollution and weather among persons with heart failure: a panel study

We carried out this daily diary panel study in Montreal, Quebec, to determine whether oxygen saturation, pulse rate, blood pressure, self-rated health, and shortness of breath at night were associated with concentrations of indoor carbon monoxide (CO), and indoor and outdoor fine particles (PM2.5), temperature, and relative humidity. Over a 2-month consecutive period between 2008 and 2010, we measured daily indoor and outdoor levels of the air pollutants and weather variables and 55 subjects measured their daily health and other variables. To estimate the associations between the health outcomes and the environmental exposures, we used a mixed effects regression model using an autoregressive model of order-one and we adjusted for month and day and personal variables. The general pattern of associations can be summarized as follows: oxygen saturation was reduced for increases in indoor- and outdoor-PM2.5 and temperature. Pulse rate increased on the concurrent day for increases in indoor CO and PM2.5. Diastolic blood pressure increased with increasing indoor and outdoor PM2.5 and relative humidity. Systolic blood pressure increased with indoor PM2.5 and decreased with increasing indoor and outdoor temperature. Self-rated health diminished with increases in outdoor PM2.5 and indoor and outdoor temperature. Self-reported shortness of breath at night increased with increasing indoor and outdoor temperatures. Health in heart failure is affected in the short term by personal and environmental conditions that are manifest in intermediate physiological parameters.