Environmental Exposures and Pediatric Cardiology: A Scientific Statement From the American Heart Association

Abstract

Environmental toxicants and pollutants are causes of adverse health consequences, including well-established associations between environmental exposures and cardiovascular diseases. Environmental degradation is widely prevalent and has a long latency period between exposure and health outcome, potentially placing a large number of individuals at risk of these health consequences. Emerging evidence suggests that environmental exposures in early life may be key risk factors for cardiovascular conditions across the life span. Children are a particularly sensitive population for the detrimental effects of environmental toxicants and pollutants given the long-term cumulative effects of early-life exposures on health outcomes, including congenital heart disease, acquired cardiac diseases, and accumulation of cardiovascular disease risk factors. This scientific statement highlights representative examples for each of these cardiovascular disease subtypes and their determinants, focusing specifically on the associations between climate change and congenital heart disease, airborne particulate matter and Kawasaki disease, blood lead levels and blood pressure, and endocrine-disrupting chemicals with cardiometabolic risk factors. Because children are particularly dependent on their caregivers to address their health concerns, this scientific statement highlights the need for clinicians, research scientists, and policymakers to focus more on the linkages of environmental exposures with cardiovascular conditions in children and adolescents.

Keywords: AHA Scientific Statements; endocrine disruptors; environmental pollutants; heart defects, congenital; heart disease risk factors; metals, heavy; mucocutaneous lymph node syndrome.

Figure.

Environmental exposures, including climate change, airborne pollution, lead, and endocrine-disrupting chemicals, such as phenols and phthalates, influence multiple cardiovascular health outcomes, including congenital structural heart disease, Kawasaki disease, arterial hypertension, and atherosclerosis, across the life course from fetal life and beyond.