Article Content

As we discuss nursing care for the cardiac patient with nursing students, nurse educators include risk factors related to the development of this significant health problem. However, most of us are not likely to include the risks related to air pollution. In January 2012, the Environmental Protection Agency (EPA) presented "Green Heart: U.S. EPA Webinair on Air Pollution and the Heart," designed to familiarize health professionals with the link between air quality and heart disease. Information associated with this presentation can be reviewed at


Environmental factors that have been shown to be linked to heart disease and stroke include exposure to traffic and outdoor air pollutants, tobacco smoke, paint and paint solvents, and carbon monoxide generated from indoor gas appliances. In August 2009, the EPA published a Fact Sheet entitled "Environmental Hazards Weigh Heavy on the Heart." Nurse educators, practicing nurses, and nursing students can access the Fact Sheet at The document focuses on the vulnerability of older adults, but the associations between various air pollutants and heart disease are relevant for all. Smoke from cigarettes, wood burning stoves, and fireplaces can trigger shortness of breath, fatigue, and chest pain. Products used for household cleaning or maintenance can also be problematic. When using cleaning products, paint solvents and pesticides, areas need to be properly ventilated to reduce associated health risks. Paint solvents lead to respiratory and cardiovascular stress and are associated with cardiac irregularities. Pesticide exposures can lead to various arrhythmias, including bradycardia. Persons with preexisting heart disease have experienced chest pain after exposure to carbon monoxide. Fumes from furnaces, gas water heaters, ovens, clothes dryers, space heaters, and automobile exhaust all contain carbon monoxide. Outdoor pollutants including ozone, sulfur dioxide, and nitrogen dioxide all contribute to respiratory and cardiovascular stress. Evidence relates ozone directly to chest pain.


To effectively present cardiac risk factors to our students, we need to include risks related to air pollution. As our students become more familiar with these risk factors, they can better advise patients and serve as patient advocates to reduce risks.


Source: Secrest E. EPA webinair on link between air pollution and heart disease. January 13, 2011. Message posted to electronic mailing list.


Submitted by: Robin E. Pattillo, PhD, RN, CNL, News Editor at