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World: Air Pollution Can Cause Heart Attacks

A recently published report cautions that air pollution can trigger heart attacks and that the risk lasts for more than 24 hours after exposure. Also in this week's health report, correspondent Julie Moffett says tuberculosis remains a global threat and reports on the use of antibiotics in Europe.


Air Pollution Can Trigger Heart Attacks

Washington, 10 July 2001 (RFE/RL) -- A new report says high levels of air pollution can trigger a heart attack within two hours of exposure and the risk can last for more than 24 hours.

Murray Mittleman, a physician at Harvard University, and a team of researchers discovered the correlation during a study of 772 patients in the northeastern city of Boston, Massachusetts.

In an interview with RFE/RL, Mittleman said that exposure to high levels of tiny particles of air pollutants increased the risk of a heart attack by 50 to 70 percent.

"The groups of people who are most vulnerable are those already at risk for heart disease. This would include elderly individuals and also people who have other risk factors for heart disease, including people who are overweight, smoke cigarettes, people who have a poor diet -- particularly high in fat -- and people who know they have high blood pressure."

Mittleman says the mechanisms involved in triggering heart attacks are "quite complicated," but likely involve changes in the blood that cause inflammation or hamper the body's ability to form clots.

In the U.S., the Environmental Protection Agency (EPA) is responsible for monitoring the level of pollution and setting a standard regulating particulate matter, even that measuring as small as 2.5 microns. Currently the U.S. standard is that no one should be exposed to more than 65 microns of pollutants per cubic meter of air during a 24-hour period. Also, states are required to notify residents by broadcasting air pollution alerts on television and radio when air quality is poor.

But Mittleman says this practice is not standard across the globe. He says not all countries measure and regulate pollutant particle levels. Of those that do, he says, many have set standards that involve much larger particles, such as those bigger than 2.5 microns. As a result, Mittleman says those nations are ignoring the most dangerous particles, those small enough to trigger deadly heart attacks.

"It would be prudent for people who understand that they have a high risk for a heart attack, even in the absence of this air pollution association, to try to avoid excessive exposure to outdoor air on those days when the air quality is poor. This would include on days when it is very hot and humid. In the summer, really limited outdoor activities on those days would be very valuable for those individuals."

Mittleman notes that based on his study and that of other researchers the EPA is currently re-evaluating their pollutant standards.


Tuberculosis Remains a Global Threat

According to a recently released report by the U.S. Centers for Disease Control and Prevention (CDC), incidents of tuberculosis continue to rise worldwide despite efforts to control and eradicate the malady. The CDC says approximately eight million cases are diagnosed each year with a death toll of about two million people annually.

Tuberculosis is a bacterial infection that typically originates in the lungs. It is often treatable with the use of antibiotics. However, many strains of the disease have become resistant to the most widely available antibiotics, causing a rise in the number of cases around the world.

According to the World Health Organization (WHO), the nations with the highest number of tuberculosis cases are in Africa and Latin America, but significant numbers of people are also infected in Russia, Ukraine, and China.

The U.S. is one of the few countries where the tuberculosis rate is actually declining. According to the CDC, the U.S. tuberculosis rate dropped seven percent from 1999 to 2000, the eighth consecutive year the disease has been in decline. But Jeffrey Koplan, director of the CDC, said in a written statement that tuberculosis still remains a serious health threat in many communities in the United States.

Earlier this year, the U.S. Congress submitted legislation that would authorize $200 million to be given to the WHO to fight the disease, and to the CDC to help improve tuberculosis screening and treatment.


European Nations Vary Greatly in Use of Antibiotics

A study conducted by the Swedish Institute for Infectious Diseases has provided data on how often and what type of antibiotics Europeans most widely use.

The study of 15 European countries was based on the sales of antibiotics. The researchers discovered that use of the drug varied greatly across Europe. France was found to have the highest rate of sales, followed by Spain, Portugal, and Belgium. The lowest sales occurred in the Netherlands. Other countries such as Germany, Sweden, and Austria fell somewhere in the middle.

Researchers noted that it was of interest that neighboring countries such as Belgium and the Netherlands differed so greatly in their use of the drug. For example, Belgium had sales of approximately 27 antibiotic doses per 1,000 people every day, whereas the Netherlands had just 9 doses.

Broad-spectrum penicillin was the most commonly used antibiotic in the countries. The nations that showed the greatest increase in the use of antibiotics over the course of the study were Italy (a 35 percent increase) and Luxembourg (a 12 percent increase). The study noted that over-prescribing antibiotics could lead to the emergence of drug-resistant bacteria, a growing problem around the world.