August 2009 Environmental Hazards Weigh Heavy on the Heart Information for Older Adults and Their Caregivers id you know that environmen­ and stroke, but inhaling the same dose tal hazards can contribute to of secondhand smoke and smoke from heart disease and stroke? This active smoking is equally detrimental. fact sheet summarizes envi­ Wood burning stoves and fireplaces can ronmentalD factors and how they can generate smoke containing fine carbon affect the health of older adults. It also particles. These particles may trigger suggests how older adults can minimize chest pain and palpitations, shortness of their exposure to air and water pollut­ breath, and fatigue, especially in older Fact Fact Sheet ants that contribute to heart disease and 2 adults with heart disease. stroke or worsen their symptoms. Household Products: When used Heart disease, the leading cause of improperly, some household products death in the United States, and stroke, can be very dangerous for people with the third most frequent cause of death, heart conditions. Vapors from cleaning cost the nation hundreds of billions of products, paint solvents, and pesticides dollars each year. According to the CDC, require proper ventilation and limited in 2005, heart disease killed 652,091 exposure to minimize detrimental people, which represented 27.1% of all effects. deaths in the U.S.1 Fumes from paint solvents, such as Environmental Factors Contribute mineral spirits, turpentine, methanol, Environmental and xylene, stress the lungs and heart, to Heart Disease and Stroke contributing to irregular heartbeat. hazards can Indoor Air Pollution Although lead-based paints are now People who spend long periods of time banned, many homes built before contribute to heart indoors are often the most susceptible 1978 used lead-containing paints. to the effects of indoor air pollution. Take appropriate precautions during disease and stroke. Studies suggest that older adults renovations to minimize paint chips or spend up to 90% of their time indoors. dust generated that pose serious health Older adults should Indoor air is comprised of a mixture hazards, including high blood pressure. of contaminants penetrating from the Pesticide poisonings often result minimize exposure outdoors and those generated indoors. from exposure to toxic fumigants or Indoor air can contain secondhand insecticides. Symptoms of this type of to environmental smoke, fumes from household cleaning poisoning include arrhythmia or a very products, and even carbon monoxide. slow pulse.3 In severe cases, exposure hazards such as These indoor contaminants can be can contribute to a heart attack or even dangerously toxic, especially to those at death. air pollution, risk of stroke and heart disease. Carbon Monoxide: Carbon monoxide arsenic, lead, and Smoke: Secondhand smoke is one of (CO), an invisible and odorless gas, the worst indoor air pollutants. Smoking is a dangerous pollutant because it excessive heat. is known to contribute to heart disease is difficult to detect. It is particularly harmful to people with heart disease, clogged Arsenic: Long-term exposure to high levels of arteries, or congestive heart failure because it arsenic, a natural element found in drinking significantly limits the blood’s ability to carry water in some areas of the country, can harm oxygen. For a person with heart disease, exposure the heart. EPA has a drinking water standard to even low levels of CO may cause chest pain, for public drinking water systems to ensure that increased heart rhythm irregularities and make people are not exposed to high levels of arsenic. it difficult to exercise.4 Sources of CO include If you obtain your water from a private well or fumes from furnaces, gas water heaters, ranges, small water system, see the “Steps You Can Take” dryers, space heaters, fireplaces, wood stoves, and section for more information about actions to exhaust from cars idling in enclosed garages. limit your exposure. Outdoor Air Pollution Excessive Heat Events Older adults who are at risk for heart disease and Heat events are described as prolonged periods stroke may benefit from lowering their contact when temperatures reach at least 10º F. (5.5ºC.) with air polluted with particulates and vehicular above a region’s average high temperature. Heat exhaust. stroke is the most serious of a range of health Particle Pollution: Small soot particles found effects associated with excessive heat exposure. in outdoor air can be hazardous and the risk It occurs when the body’s temperature control is greatest among people with heart disease, system fails causing a rapid rise in core body chronic obstructive lung disease and asthma. temperature. Heat stroke is characterized by hot, Particles originate from a variety of sources dry, and red skin, and a lack of perspiration. Other including vehicles, power plants, industrial warning signs are confusion and hallucinations. smokestacks, and fires. Some particles are Heat stroke is a serious condition requiring emitted into the air directly, but others form as immediate medical attention (call 911 or take the a result of complicated chemical reactions in person to an emergency room). Left untreated, the atmosphere. Particles can travel hundreds to heat stroke can cause severe and permanent thousands of miles downwind, affecting people damage to vital organs, permanent disability, or far from the sources. death. Traffic: Time spent in traffic has also been Persons with heart disease and stroke have associated with the onset of a heart attack.5 It is impaired cooling mechanisms and are more not known whether this is due to traffic-related vulnerable during heat events. The use of air pollution (e.g., particle pollution, CO), the some medications can make individuals more stress of being caught in traffic, or some other risk susceptible to heat events for example, anti­ factor. depressants and some circulatory medications. Pollutant Gases: Ozone, sulfur dioxide, and During heat events, air-conditioning is the best nitrogen dioxide are also important components protection against heat-related illness and death. of air pollution and are associated with adverse Even a few hours a day in air-conditioning can health effects. Ozone is a strong irritant to the greatly reduce the risk. Research indicates electric lungs and airways and can cause chest pain that fans are only effective if the ambient temperature can be mistaken for a heart attack. is lower than the body temperature. Electric fans may provide comfort, but when temperatures are Drinking Water in the high 90s, fans do not prevent heat-related illness and could actually be harmful. There is evidence that several metals found in drinking water may contribute to heart disease or Encourage Your Local Government to aggravate its symptoms. Take Action Lead: Exposure to lead can increase blood Local governments should take these simple pressure. While people are primarily exposed steps to reduce hazards and publicize precautions to lead through paint dust, drinking water is older adults can take. another source of lead exposure. While water • Promote smoke-free policies in public from a community’s public water supply must places: By keeping public places (restaurants, meet EPA standards for lead, tap water may still bars, and parks) smoke-free, communities can contain lead exceeding the allowable levels due limit exposure to secondhand smoke. to the presence of older lead-containing plumbing materials. • Reduce exposure to traffic and outdoor Steps You Can Take to air pollution: Pay attention to Air Quality Help Control Heart Disease Index (AQI) forecasts to know when the air is unhealthy for sensitive groups. Check and Stroke with your physician about lowering your A healthy lifestyle is the best way to prevent activity level when the AQI is high. Put air heart disease and stroke. In addition, conditioning on the re-circulate mode and older adults should limit their contact with keep windows closed during smoke events environmental risk factors and encourage from fires in buildings or forests. Reduce your local governments to take action to reduce time in traffic. Avoid physical activity and limit environmental hazards. exercise near busy roads. • Prevent heat stress: Use your air-conditioner Limit Contact With Environmental Factors or go to air-conditioned buildings in your • Keep smoke out of indoor spaces: Avoid community. Take a cool shower or bath. Wear smoke from tobacco. Encourage smokers to lightweight, light-colored, and loose-fitting smoke outdoors. Avoid restaurants, bars, and clothing. Ask your doctor if your medications other public places where people smoke. Do increase your susceptibility to heat-related not use, or limit use of, wood-burning stoves illness. and fireplaces. Drink lots of fluids, but avoid beverages • Use caution when working around the containing caffeine, alcohol, or large amounts house: Improve ventilation when painting by of sugar. These drinks cause dehydration. If a scheduling indoor painting for times when doctor limits your fluid intake, be sure to ask windows can be left open and by using fans. how much to drink when it’s hot. Take frequent fresh air breaks when painting; avoid painted rooms for several days. • Drink clean water: To limit your exposure to lead through your water, run cold water for at Before renovating a home built before least 30 seconds, preferably 2 to 3 minutes 1978, take precautions to avoid lead paint before drinking. Testing for lead also may be exposure. Do not use a belt-sander, propane advisable for people who get their water from torch, heat gun, dry scraper, or dry sandpaper municipal sources and live in older homes to remove lead-based paint because these with lead service lines. If you receive your actions generate unacceptable amounts of water from a municipal system, you should lead dust and fumes. first request information from your municipal If you must use pesticides, always read system for results of federally mandated labels first and follow all precautions and testing for lead and copper, particularly in restrictions.