Hava kirliliği ve kardiyovasküler sistem

Toplum sağlığını tehdit eden çevresel sorunların başında hava kirliliği gelmektedir. Normalde soluduğumuz hava bir gaz karışımından oluşmaktadır. Hava kirliliği ise, insan ve diğer canlılara zarar verecek miktardaki kirleticilerin doğal aktiviteler veya insan aktiviteleri sonucu atmosfere karışması ve bu gaz oranlarının değişmesidir. Kirliliğe neden olan partikülün sağlık üzerindeki olumsuz etkisi; partikülün kimyasal yapısı, fibrotik reaksiyona yol açıp açmaması, partikülün amorf bir şekle sahip olup olmaması ve partikülün aerodinamik çapı ile yakından ilişkilidir. Aerodinamik çapı 10 mikrondan daha büyük olan partiküller, solunum yollarına girdikleri halde alveollere kadar ulaşamazlar, mukosiliyer sistem tarafından tutulur ve geri atılırlar. 10 mikrondan daha küçük olan partiküller ise, alveollere kadar ulaşabilirler ve bu partiküller kardiyovasküler sistem mortalite ve morbiditesi ile ilişkilidir. Bu boyuttaki partiküllerin solunan havadaki konsantrasyonu kirliliğin derecesini belirler ve hava kalitesi indeksinin belirlenmesinde kullanılır. Hava kirliliği, kardiyovasküler sistem üzerinde kan basıncı değişikliği, ateroskleroz, endotel disfonksiyonu, otonomik disfonksiyon, inflamasyon, oksidatif stres, hemostatik sistem ve kalp hızı değişkenliği gibi birçok mekanizmada rol alarak çeşitli klinik olayların oluşmasına neden olabilmektedir. Konuyla ilgili yapılmış çok sayıdaki çalışma da hava kirliliği ile birçok klinik olay arasında ilişki bulmuştur. Dolayısıyla, hastalıkların tedavileri ve prognozlarında çevresel etkenlerin yeri unutulmamalıdır. Bu nedenle, her geçen gün artan dünya nüfusu ve çevresel sorunlardan dolayı daha da kirlenecek olan soluduğumuz havanın, sağlıklı seviyelerde tutulması için yapılması gerekenler önemlidir.

[Air pollution and cardiovascular system]

Air pollution is one of the environmental problems that threaten the public health. The air is a gas mixture. Air pollution is defined as the existence in the amount of pollutants harmful to humans and other organisms in the atmosphere as a result of the natural or human activity thereby changing to the gas rates in the air. The negative effects of pollution-causing particles on the health are closely related to the chemical structure of particles, whether causing a fibrotic reaction, whether having an amorphous shape and the aerodynamic diameters of particles. The particles larger than 10 microns in aerodynamic diameter can not reach up to the alveoli, and can be removed by mucociliary system. If the particles are smaller than 10 microns, these particles can reach to the alveoli, and are closely associated with the cardiovascular mortality and morbidity. The concentration of these particles (PM10) is used as an indicator of pollution, and creates the basis of air quality index. Air pollution has several negative effects such as blood pressure changes, atherosclerosis, endothelial dysfunction, autonomic dysfunction, inflammation, oxidative stress etc. In this review, the effects of air pollution on the cardiovascular system will be examined, and the importance of this issue will be emphasized.

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