Air pollution is a key risk factor for cardiovascular disease, and a major contributor to the global burden of disease. In addition, air pollution contributes to co-morbidities that are known to worsen outcomes among those infected with COVID-19, according to a joint statement released Jan. 28 by the ACC, World Heart Federation (WHF), American Heart Association (AHA) and European Society of Cardiology (ESC).

The statement urges the medical community and health authorities to mitigate the impact of air pollution on people's health. The authors explain that in 2019, an estimated 6.7 million deaths, or 12% of all deaths worldwide, were attributable to outdoor or household air pollution. As many as half of these were due to cardiovascular disease.

Specifically, the statement calls for structural actions to reduce emissions of air pollutants and harmful exposure. It also highlights the important role that health care providers play in preventing illnesses related to air pollution, including:

• Advocating for air pollution mitigation as a health measure, further research on air quality and its impact on cardiovascular disease, and interventions to reduce air pollution and its effect on noncommunicable diseases
• Providing patients with personal measures to reduce exposure, such as room air filtration systems
• Integrating air pollution into disease management approaches, for example through the use of air quality indices
• Participating in the development of guidelines on air pollution and cardiovascular disease
• Supporting ministries of environment, energy, and transportation in their mitigation efforts
• Working to educate and raise awareness on the cardiovascular benefits of clean air
• Collaborating with senior decision-makers in national, regional, and global governmental institutions to make air pollution-related cardiovascular disease a priority

"Even before the COVID-19 pandemic, air pollution was an issue of growing concern due to its impact on people's health, although it was frequently overlooked as a risk factor for cardiovascular disease. COVID-19 has brought a new, deadly factor to the equation, and the time has come for the health community to speak up and take action," said Michael Brauer, chair of the World Heart Federation Air Pollution Expert Group and lead author.

"Clinicians have a responsibility to educate their patients, their colleagues and their communities at large on the connection between air pollution and cardiovascular disease risk," explains Richard J. Kovacs, MD, MACC, senior author and immediate past president of the ACC. "By advocating for recognition of air pollution as a health factor, working individually with our patients to reduce exposure and associated risks, and integrating air pollution into broader disease management approaches, the health care community can provide support for larger pollution mitigation efforts."

The statement will be published simultaneously in the Journal of the American College of Cardiology, the Journal of the American Heart Association, the European Heart Journal and Global Heart.

Clinical Topics: COVID-19 Hub

Keywords: ACC International, COVID-19, Air Pollutants, Cardiovascular Diseases, Air Pollution, Cardiovascular System, Risk Factors, Disease Management, Health Personnel, Morbidity, Delivery of Health Care

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