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August 2009
Environmental Hazards
Weigh Heavy on the Heart
Information for Older Adults and
Sheet 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
D Wood burning stoves and fireplaces can
ronmental factors and how they can generate smoke containing fine carbon
act 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
F their exposure to air and water pollut breath, and fatigue, especially in older
ants that contribute to heart disease and adults with heart disease.2
stroke or worsen their symptoms.
Heart disease, the leading cause of Household Products: When used
death in the United States, and stroke, improperly, some household products
the third most frequent cause of death, can be very dangerous for people with
cost the nation hundreds of billions of heart conditions. Vapors from cleaning
dollars each year. According to the CDC, products, paint solvents, and pesticides
in 2005, heart disease killed 652,091 require proper ventilation and limited
people, which represented 27.1% of all exposure to minimize detrimental
deaths in the U.S.1 effects.
Fumes from paint solvents, such as
Environmental Factors Contribute mineral spirits, turpentine, methanol,
Environmental to Heart Disease and Stroke and xylene, stress the lungs and heart,
contributing to irregular heartbeat.
hazards can Indoor Air Pollution Although leadbased 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 leadcontaining 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
minimize exposure Pesticide poisonings often result
outdoors and those generated indoors. from exposure to toxic fumigants or
Indoor air can contain secondhand
to environmental insecticides. Symptoms of this type of
smoke, fumes from household cleaning
poisoning include arrhythmia or a very
products, and even carbon monoxide. 3
hazards such as slow pulse. In severe cases, exposure
These indoor contaminants can be
can contribute to a heart attack or even
air pollution, dangerously toxic, especially to those at death.
risk of stroke and heart disease. Carbon Monoxide: Carbon monoxide
Smoke: Secondhand smoke is one of
arsenic, lead, and (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: Longterm 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
people are not exposed to high levels of arsenic.
increased heart rhythm irregularities and make
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,
dry, and red skin, and a lack of perspiration. Other
Particles originate from a variety of sources
including vehicles, power plants, industrial warning signs are confusion and hallucinations.
smokestacks, and fires. Some particles are Heat stroke is a serious condition requiring
immediate medical attention (call 911 or take the
emitted into the air directly, but others form as
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
death.
far from the sources.
Traffic: Time spent in traffic has also been Persons with heart disease and stroke have
impaired cooling mechanisms and are more
associated with the onset of a heart attack.5 It is
not known whether this is due to trafficrelated vulnerable during heat events. The use of
air pollution (e.g., particle pollution, CO), the some medications can make individuals more
susceptible to heat events for example, anti
stress of being caught in traffic, or some other risk
depressants and some circulatory medications.
factor.
Pollutant Gases: Ozone, sulfur dioxide, and During heat events, airconditioning is the best
nitrogen dioxide are also important components protection against heatrelated illness and death.
of air pollution and are associated with adverse Even a few hours a day in airconditioning can
health effects. Ozone is a strong irritant to the greatly reduce the risk. Research indicates electric
fans are only effective if the ambient temperature
lungs and airways and can cause chest pain that
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 heatrelated
There is evidence that several metals found in illness and could actually be harmful.
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) smokefree, communities can
contain lead exceeding the allowable levels due limit exposure to secondhand smoke.
to the presence of older leadcontaining plumbing
materials.
Steps You Can Take to • Reduce exposure to traffic and outdoor
air pollution: Pay attention to Air Quality
Help Control Heart Disease Index (AQI) forecasts to know when the
and Stroke air is unhealthy for sensitive groups. Check
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 recirculate 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.
Limit Contact With Environmental Factors • Prevent heat stress: Use your airconditioner
or go to airconditioned buildings in your
• Keep smoke out of indoor spaces: Avoid
smoke from tobacco. Encourage smokers to community. Take a cool shower or bath. Wear
lightweight, lightcolored, and loosefitting
smoke outdoors. Avoid restaurants, bars, and clothing. Ask your doctor if your medications
other public places where people smoke. Do
not use, or limit use of, woodburning stoves increase your susceptibility to heatrelated
illness.
and fireplaces. Drink lots of fluids, but avoid beverages
• Use caution when working around the
house: Improve ventilation when painting by containing caffeine, alcohol, or large amounts
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.
Take frequent fresh air breaks when painting; how much to drink when it’s hot.
• Drink clean water: To limit your exposure to
avoid painted rooms for several days.
lead through your water, run cold water for at
Before renovating a home built before
978, take precautions to avoid lead paint least 30 seconds, preferably 2 to 3 minutes
1
exposure. Do not use a beltsander, propane before drinking. Testing for lead also may be
advisable for people who get their water from
torch, heat gun, dry scraper, or dry sandpaper
to remove leadbased paint because these municipal sources and live in older homes
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
system for results of federally mandated
If you must use pesticides, always read
labels first and follow all precautions and testing for lead and copper, particularly in
homes from the area where you live.
restrictions. When handling pesticides,
take protective measures; follow directions
and wear impermeable gloves, long pants, EPA’s arsenic standard exempts small water
systems that annually provide fewer than 15
and longsleeved shirts. Change clothes
and wash your hands immediately after “hookups” or serve fewer than 25 people. If
your water supply is from a private well or a
applying pesticides. Wash clothes exposed to small system that is exempted from testing
pesticides separately.
and you live in an area where high levels of
• Avoid carbon monoxide poisoning: Never arsenic have been reported in the ground
leave a car running in a garage, even with water, you may want to have your water
tested for arsenic.
the garage door open. Keep gas appliances
properly adjusted. Install and use exhaust
fans. Have a trained professional inspect, The best source of specific information about
our drinking water is your water supplier.
y
clean, and tuneup your central heating Water suppliers that serve the same people
system (furnaces, flues, and chimneys) yearround are required to send their custom
every fall. Install carbon monoxide detectors ers an annual water quality report (some
throughout your home. times called a consumer confidence report).
Contact your water supplier to get a copy.
• Promote Active Heat Health Watch/Warning Centers for Disease Control and Prevention
Systems: These systems can help identify Heart Disease: http://www.cdc.gov/HeartDisease/
when a heatrelated threat is likely, alert Physical Fitness Guidelines:
residents, and provide assistance to atrisk http://www.cdc.gov/physicalactivity/everyone/
individuals.
• Ensure that Air Quality Index forecasts are guidelines/olderadults.html
publicized and followed: EPA’s Air Quality Federal Emergency Management
Index is an index for reporting daily air quality. Administration:
See www.epa.gov/airnow. Extreme Heat: http://www.fema.gov/hazard/heat/
• Promote public transit options that reduce index.shtm
traffic and air pollution: Public transit is National Weather Service
the best way to alleviate road congestion, air http://www.nws.noaa.gov/om/brochures/heat_
pollution, and stress.
• Locate parks, bike paths, and trails away wave.shtml
from major roads: Physical activity is one American Heart Association
of the best ways to lower your risk for heart http://www.americanheart.org/
disease and stroke. Exercise away from roads Health Effects Institute
and traffic pollution.
http://www.healtheffects.org/about.htm
Control Your Major Risk Factors for Heart
Disease and Stroke
The environment is just one factor that influences Learn More
a person’s susceptibility to heart disease and The EPA Aging Initiative works to protect the
stroke. The most important steps you can take to health of older adults through the coordination
reduce risk factors for heart disease and stroke of research, prevention strategies, and public
include: education on environmental factors. For more
• Avoid smoke from tobacco information, or to join the EPA Aging Initiative
• Schedule time for regular physical activity 30 listserv, visit: www.epa.gov/aging.
minutes per day at least 5 days a week
• Follow the 2005 Dietary Guidelines for
Americans Endnotes
• See your health care provider regularly to 1 Kung HC, Hoyert DL, Xu J, Murphy SL. Deaths: final data for
screen for and treat high blood pressure, 2005. National Vital Statistics Reports. 2008;56(10).
diabetes, and hyperlipidemia (elevated levels 2 U.S. Environmental Protection Agency. Air Quality Guide for
of lipids in the bloodstream) Particle Pollution. http://www.epa.gov/airnow//aqi_cl.pdf
3 U.S. Environmental Protection Agency. Regulation and
Resources Management of Pesticide Poisonings. 1999. http://www.epa.
gov/pesticides/safety/healthcare/handbook/Index1.pdf
Environmental Protection Agency 4 U.S. Environmental Protection Agency. Air Quality Criteria for
Air Quality Index: http://airnow.gov/ Carbon Monoxide, EPA 600P99001F. Research Triangle Park,
NC: U.S. Environmental Protection Agency, Office Research and
Indoor Air Quality: http://www.epa.gov/iaq/ Development, National Center for Environmental Assessment.
June 2000.
Lead: http://www.epa.gov/lead/ 5 Peters, A., S. von Klot, M. Heier, I. Trentinaglia, H. Ines, A.
Painting: http://www.epa.gov/iaq/homes/ Hormann, H.E. Erich, H. Lowel. “Exposure to Traffic and the Onset
of Myocardial Infarction.” The New England Journal of Medicine.
hippainting.html Oct 21, 2004. 351 (17): 172130.
Pesticides: http://www.epa.gov/pesticides/
Smoke Free Homes and Cars: http://www.epa.
gov/smokefree/
Health and Human Services
Dietary Guidelines: http://www.health.gov/
DietaryGuidelines/ Publication Number EPA 100F09043
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