Ecology of the cardiovascular system: Part II - A focus on non-air related pollutants.

An integrated exposomic view of the relation between environment and cardiovascular health should consider the effects of both air and non-air related environmental stressors. Cardiovascular impacts of ambient air temperature, indoor and outdoor air pollution were recently reviewed. We aim, in this second part, to address the cardiovascular effects of noise, food pollutants, radiation, and some other emerging environmental factors. Road traffic noise exposure is associated with increased risk of premature arteriosclerosis, coronary artery disease, and stroke. Numerous studies report an increased prevalence of hypertension in people exposed to noise, especially while sleeping. Sleep disturbances generated by nocturnal noise are followed by a neuroendocrine stress response. Some oxidative and inflammatory endothelial reactions are observed during experimental session of noise exposure. Moreover, throughout the alimentation, the cardiovascular system is exposed to persistent organic pollutants (POPs) as dioxins or pesticides, and plastic associated chemicals (PACs), such as bisphenol A. Epidemiological studies show positive associations of exposures to POPs and PACs with diabetes, arteriosclerosis and cardiovascular disease incidence. POPs and PACS share some abilities to interact with nuclear receptors activating different pathways leading to oxidative stress, insulin resistance and angiotensin potentiation. Regarding radiation, survivors of nuclear explosion have an excess risk of cardiovascular disease. Dose-effect relationships remain debated, but an increased cardiovascular risk at low dose of radiation exposure may be of concern. Some emerging environmental factors like electromagnetic fields, greenspace and light exposure may also require further attention. Non-air related environmental stressors also play an important role in the burden of cardiovascular disease. Specific methodologies should be developed to assess the interactions between air and non-air related pollutants.