Physicians' Academy for Cardiovascular Education

Short-term exposure to diesel fumes affects vascular properties and inflammation markers

Acute exposure to diesel affects inflammation and vascular function

Literature - Tousoulis D, Fountoulakis P, Oikonomou E et al., - Eur J Prev Cardiol. 2020, doi: 10.1177/2047487319898020

Introduction and methods

Diesel exhaust fumes are thought to contribute to over 50% of atmospheric particles with a mass of <10 µM average aerodynamic diameter and thereby represent one of the most common pollutants [1,2]. Epidemiological studies have demonstrated that occupational exposure to diesel exhaust fumes can lead to high rates of CV morbidity, and acute and chronic respiratory disease [3,4]. Animal studies have shown that exposure to diluted diesel fumes accelerates atherosclerosis and impairs left ventricle systolic performance, sympathetic drive and fibrosis/fibrinolysis [5,6].

However, it remains unclear whether only long-term exposure or also short-term exposure to diesel fumes can affect inflammatory responses, endothelial function and vessel wall properties. This study investigated the impact of short-term exposure to diesel exhaust fumes on arterial elasticity, vascular function and inflammatory biomarkers.

This proof-of-principle, randomized, crossover study included 40 healthy volunteers. Average age was 41±13 years, 25 participants were male and 15 were active smokers. Participants were randomized in a 1:1 ratio to be exposed to controlled amounts of filtered air and diesel exhaust fumes in two 2-hour sessions with an interval of 4 weeks (one session with filtered air and one session with diesel exhaust fumes). Endothelial function was estimated by flow mediated dilation (FMD). Carotid-femoral pulse wave velocity (PWV) as an index of aortic stiffness, and augmentation index (Aix) of the central aortic pressure waveform were also measured. Protein C plasma levels, protein S activity, serum C-reactive protein (CRP) and fibrinogen were measured from fasting venous blood samples. All measurements were performed before exposure (T0), at the end of the 2h exposure period (T2) and 24h after the end of exposure (T24).

Main results


This proof-of-concept study showed that short-term 2h exposure to diesel exhaust fumes has an adverse impact on endothelial function and vascular wall properties. Fibrinolysis markers decreased while inflammation marker CRP increased after 2-h exposure to diesel fumes, compared to exposure to filtered air. These effects were consistent 24h after the end of exposure to diesel fumes.


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Find this article online at European Journal of Preventive Cardiology

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