Top Things to Know: Personal-Level Protective Actions Against Particulate Matter Air Pollution Exposure

Published: November 05, 2020

  1. Since the publication of the last American Heart Association (AHA) scientific statement on air pollution and cardiovascular disease (CVD) in 2010, unequivocal evidence has documented the causal role of fine particulate matter air pollution in CVD.
  2. This scientific statement addresses the global importance of particulate matter ≤ 2.5 microns in diameter (PM2.5) and focuses on the most tested interventions and viable approaches to mitigate particulate matter air pollution. It provides expert consensus opinions on personal-level measures recognizing the current uncertainty and limited evidence-base for many interventions.
  3. Personalized medicine approaches can provide a significant opportunity to link the external environment with cardiovascular health.
  4. PM2.5 inhalation elicits oxidative stress and inflammatory responses that can damage the lungs and reach the systemic circulation as well as relevant organs/tissues. The pathways are complex and likely influenced by the composition of the particles, co-pollutants, and the susceptibility of the host.
  5. For optimal impact, the personal approach to mitigate air pollution exposure should be: (1) practical, safe and low-cost or no-cost; (2) congruent with the risk of the patient (susceptible populations) and exposure (vulnerable populations), and 3) feasible to be applied equitably.
  6. Portable Air Cleaners (PAC) can reduce indoor PM2.5 by as much as 50-60%. Given their affordability and potential benefits in reducing cardiopulmonary outcomes, intervention with a PAC may have a favorable benefit-cost ratio for alleviating outdoor air pollutant concentrations.
  7. Currently, clinical evidence is insufficient to support or prescribe against the use of simple face masks as protection against PM2.5, but the COVID-19 pandemic will likely lower barriers to societal acceptance of wearing an N95 respirator or facial masks in public.
  8. Epidemiological studies support the long-term health benefits of routine exercise or physical activity; those benefits persist even in environments with chronically high levels of outdoor ambient air pollution.
  9. Neither over the counter drugs nor medications are suggested to protect against the adverse health effects of air pollution.
  10. Individualized reduction in exposure to PM2.5 offers a major opportunity for improving global health. A better understanding of susceptible populations is needed to facilitate progress. Impactful trials can and should be designed to further test how a personal approach to protection from air pollution can lower CVD among individuals in the most susceptible groups.


Rajagopalan S, Brauer M, Bhatnagar A, Bhatt DL, Brook JR, Huang W, Munzel T, Newby D, Siegel J, Brook RD; on behalf of the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; and Stroke Council. Personal level protective actions against particulate matter air pollution exposure: a scientific statement from the American Heart Association [published online ahead of print November 5, 2020]. Circulation. doi: 10.1161/CIR.0000000000000931