서울 일부 지역 고령자들에서 휘발성유기화합물과 포름알데히드가 심박동변이에 미치는 영향

Effects of Volatile Organic Compounds, and Formaldehyde on Heart Rate Variability among Elderly People in Seoul

  • 서정철 (서울대학교 의과대학 예방의학교실) ;
  • 강모열 (서울대학교 의과대학 예방의학교실) ;
  • 조수헌 (서울대학교 의과대학 예방의학교실) ;
  • 임연희 (서울대학교 보건대학원 보건학과) ;
  • 김진희 (서울대학교 의학연구원 환경의학연구소) ;
  • 손종렬 (고려대학교 보건과학대학 환경보건학과) ;
  • 홍윤철 (서울대학교 의과대학 예방의학교실)
  • Seo, Jeong-Cheol (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Kang, Mo-Yeol (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Cho, Soo-Hun (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Lim, Youn-Hee (Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University) ;
  • Kim, Jin-Hee (Institute of Environmental Medicine, Seoul National University Medical Research Center) ;
  • Sohn, Jong-Ryeul (Department of Environmental Health, College of Health Sciences, Korea University) ;
  • Hong, Yun-Chul (Department of Preventive Medicine, Seoul National University College of Medicine)
  • 발행 : 2011.09.30

초록

목적: 대기 오염물질에 취약한 인구 집단인 노령 인구를 대상으로 대표적인 실내 공기 오염물질인 휘발성유기 화합물과 포름알데히드가 심박동변이에 미치는 영향을 평가하기 위하여 수행되었다. 방법: 2009년 5월부터 8월까지 서울에 거주하는 만 60세 이상의 노령 인구 57명을 대상자로 선정하였다. 대상자의 일반적인 특성은 설문을 통하여 조사하였고, 신체측정, 혈압 측정, 심전도 검사, 혈액 검사, 소변 검사 등을 수행하였다. 실내 공기 오염물질의 노출 평가는 대상자의 호흡기 반경 30 cm 내에 휘발성유기화합물과 포름알데히드의 passive sampler을 부착하여 실시하였다. 심박동변이는 조용한 방에서 앉은 자세로 5분간 시간 범위와 주파수 범위를 측정하였다. 심박동변이에 영향을 미치는 요인을 보정한 상태에서 휘발성유기화합물, 포름알데히드와 심박동변이와의 관계를 분석하였다. 결과: 벤젠에 대한 노출이 증가할수록 LF, HF가 유의하게 감소하였다. 톨루엔에 대한 노출이 증가함에 따라서 박동변이 지표 중 SDNN, LF가 유의하게 감소하였다. 에틸벤젠에서는 SDNN, LF가 유의하게 감소되는 것이 관찰되었다. 총휘발성유기화합물, 자이렌, 포름알데히드는 심박동변이 지표와의 유의한 관계가 관찰되지 않았다. 결론: 본 연구를 통하여 직업적 혹은 고농도 노출이 아니더라도 대기 오염물질에 취약한 서울 일부 지역 고령자에서는 저농도의 노출이 심혈관계에 영향을 준다는 사실을 확인하였다.

Objectives: The purpose of the present study was to investigate the effects of volatile organic compounds, and formaldehyde on heart rate variability among elderly people who are vulnerable to ambient pollution. Methods: From May to August of 2009, 57 subjects older than 60 years were recruited in this study. Indoor air pollutants (volatile organic compounds and formaldehyde) were measured by a personal passive sampler. Heart rate variability (HRV) was measured in the sitting position for five minutes and assessed by time-domain and frequency-domain. Results: Multiple linear regression analysis showed significantly less low-frequency (LF) and high-frequency (HF) associated with elevated benzene levels. Exposure to toluene was associated with decreases in the Standard deviation of the NN intervals (SDNN) and LF. SDNN and LF were negatively associated with the increment of ethylbenzene levels. Conclusions: An adverse effect on cardiovascular function caused by volatile organic compounds was observed among the elderly people of Seoul even though indoor air pollutant levels were lower than the yearly average guideline for indoor air quality in Korea.

키워드

참고문헌

  1. Ren C and Tong S. Health effects of ambient air pollution recent research development and contemporary methodological challenges. Environ Health 2008;7:56. https://doi.org/10.1186/1476-069X-7-56
  2. Platts-Mills TA, Woodfolk JA, Chapman MD and Heymann PW. Changing concepts of allergic disease: the attempt to keep up with real changes in lifestyles. J Allergy Clin Immunol 1996;98(Suppl):297-306.
  3. Klepeis NE, Nelson WC, Ott WR, Robinson JP, Tsang AM, Switzer P, Behar JV, Hern SC and Engelmann WH. The National Human Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants. J Expo Anal Environ Epidemiol 2001;11(3):231-52. https://doi.org/10.1038/sj.jea.7500165
  4. Jang SK, Lim HJ, Park SY, Yoo JH, Jeon JY, Yun SR. The characterization of indoor air quality in nursing care center for the senior. Environmental Health Research Department National Institute of Environmental Research. 2007. pp 1-4. (Korean)
  5. Fuselli S, De Felice M, Morlino R, Turrio-Baldassarri L. A three year study on 14 VOCs at one site in Rome: Levels, seasonal variations, indoor/outdoor ratio and teporal trends. Int J Environ Res Public Health 2010;7:3792-803. https://doi.org/10.3390/ijerph7103792
  6. Wallace LA. Comparison of risks from outdoor and indoor exposure to toxic chemicals. Environ Health Perspect 1991;95:7-13.
  7. WHO. Guidelines for air quality. 2000. pp 72-9.
  8. Jones AP. Indoor air quality and health. Atmospheric Environment 1999; 33(28):4535-64. https://doi.org/10.1016/S1352-2310(99)00272-1
  9. Theophanides M, Anastassopoulou J, Vasilakos C, Maggos T, Theophanides T. Mortality and pollution in several Greek cities. J Environ Sci Health A 2007;42(6):741-6.
  10. Katz A, Liberty IF, Porath A, Ovsyshcher I and Prystowsky EN. A simple bedside test of 1-minute heart rate variability during deep breathing as a prognostic index after myocardial infarction. Am Heart J 1999;138:32-8. https://doi.org/10.1016/S0002-8703(99)70242-5
  11. Tapanainen JM, Thomsen PE, Kober L, Torp-Pedersen C, Makikallio TH, Still AM, Lindgren KS and Huikuri HV. Fractal analysis of heart rate variability and mortality after an acute myocardial infarction. Am J Cardiol 2002;90(4):347-52. https://doi.org/10.1016/S0002-9149(02)02488-8
  12. Arad M, Abboud S, Radai MM and Adunsky A. Heart rate variability parameters correlate with functional independence measures in ischemic stroke patients. J Electrocardiol 2002;35 (Suppl):243-6.
  13. Aronson D, Burger AJ. Effect of nesiritide (human b-type natriuretic peptide) and dobutamine on heart rate variability in decompensated heart failure. Am Heart J 2004;148(5):e16.
  14. Gold DR, Litonjua A, Schwartz J, Lovett E, Larson A, Nearing B, Allen G, Verrier M, Cherry R, Verrier R. Ambient pollution and heart rate variability. Circulation 2000;101(11):1267-73. https://doi.org/10.1161/01.CIR.101.11.1267
  15. Kim ST, Yim BB, Jeong JH. Development of a Passive Sampler using 4-amino-3- hydrazino-5-mercapto-1, 2, 4-triazole for Measuring Indoor Formaldehyde. J KOSAE 2005;21(6):593-603. (Korean)
  16. Kleiger RE, Stein PK and Bigger JT, Jr. Heart rate variability: measurement and clinical utility. Ann Noninvasive Electrocardiol 2005;10(1):88-101. https://doi.org/10.1111/j.1542-474X.2005.10101.x
  17. Malik M, Bigger JT, Camm AJ, Kleiger RE, Malliani A, Moss AJ, Schwartz PJ. Heart rate variability standards of measurement, physiological interpretation, and clinical use. Task force of the european society of cardiology and the north american society of pacing and electrophysiology. Eur Heart J 1996;17:354-81. https://doi.org/10.1093/oxfordjournals.eurheartj.a014868
  18. Hemingway H, Shipley M, Brunner E, Britton A, Malik M, Marmot M. Does autonomic function link social position to coronary risk? The Whitehall II study. Circulation 2005;111(23):3071-7. https://doi.org/10.1161/CIRCULATIONAHA.104.497347
  19. Kim YS, Roh YM, Lee CM, Kim KY, Kim JC, Jun HJ. Pattern Classification of Volatile Organic Compounds in Various Indoor Environment. Kor J Env Hlth 2007;33(1):49-56. (Korean)
  20. Yoon CS, Park DU, Park DY. Concentration of Benzene and Volatile Organic compounds in Indoor Air of Preschool Facilities. J Korean Soc Occup Environ Hyg 2004;14(2):175-80. (Korean)
  21. Coelho C, Steers M, Lutzler P and Schriver-Mazzuoli L. Indoor air pollution in old people's homes related to some health problems: a survey study. Indoor Air 2005;15(4):267-74. https://doi.org/10.1111/j.1600-0668.2005.00371.x
  22. Dekker JM, Schouten EG, Klootwijk P, Pool J, Swenne CA, Kromhout D. Heart rate variability from short electrocardiographic recordings predicts mortality from all causes in middle-aged and elderly men. Am J Epidemiol 1997;145(10):899-908. https://doi.org/10.1093/oxfordjournals.aje.a009049
  23. Tsuji H, Larson MG, Venditti FJ Jr, Manders ES, Evans JC, Feldman CL, Levy D. Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation 1996;94(11):2850-5. https://doi.org/10.1161/01.CIR.94.11.2850
  24. Tsuji H, Venditti FJ Jr, Manders ES, Evans JC, Larson MG, Feldman CL, Levy D. Reduced heart rate variability and mortality risk in an elderly cohort. The Framingham Heart Study. Circulation 1994;90(2):878-83. https://doi.org/10.1161/01.CIR.90.2.878
  25. Seppalainen AM, Husman K, and Martenson C. Neurophysiological Effects of Long-Term Exposure to a Mixture of Organic Solvents. Scand J Work Environ Health 1978;4:304-14. https://doi.org/10.5271/sjweh.2695
  26. Streicher HZ, Gabow PA, Moss AH. Syndromes of Toluene Sniffing in Adults. Ann Intern Med 1981;94:758-62. https://doi.org/10.7326/0003-4819-94-6-758
  27. Matsushita T, Arimatsu Y, Ueda A. Hematological and Neuro-Muscular Response of Workers Exposed to Low Concentrations of Toluene Vapors. Ind Health 1975;13:115-21. https://doi.org/10.2486/indhealth.13.115
  28. Ma CM, Lin LY, Chen HW, Huang LC, Li JF and Chuang KJ. Volatile organic compounds exposure and cardiovascular effects in hair salons. Occupational medicine 2010;60:624-30. https://doi.org/10.1093/occmed/kqq128
  29. Brook RD, Franklin B, Cascio W, Hong Y, Howard G, Lipsett M, Luepker R, Mittleman M, Samet J, Smith SC, Tager I. Air pollution and cardiovascular disease: a statement for healthcare professionals from the Expert Panel on Population and Prevention Science of the American Heart Association. Circulation 2004;109(21):2655-71. https://doi.org/10.1161/01.CIR.0000128587.30041.C8
  30. Maroni M, Seifert B, Lindvall T. Indoor Air Quality a Comprehensive Reference Book. Elsevier. Amsterdam. 1995. pp 29-58.
  31. Harrison PTC. Health impacts of indoor air pollution. Chemistry and Industry 1997;17: 677-81.
  32. Wallace LA. Personal exposure to 25 volatile organic compounds. EPA's 1987 team study in Los Angeles, California. Toxicol Ind Health 1991;7(5-6):203-8.
  33. Mizukoshi A, Kumagai K, Yamamoto N, Noguchi M, Yoshiuchi K, Kumano H, Yanagisawa Y. A novel methodology to evaluate health impacts caused by VOC exposures using real-time VOC and Holter monitors. Int J Environ Res Public Health 2010;7(12):4127-38. https://doi.org/10.3390/ijerph7124127
  34. Min KB, Min JY, Paek DM, Cho SI, Son MA. Is 5-minute heart rate variability a useful measure for monitoring the autonomic nervous system of workers? Int Heart J 2008;49(2):175-81. https://doi.org/10.1536/ihj.49.175