People with heart disease should avoid being outside during rush hour traffic, experts have said.

Over three million deaths worldwide are caused by air pollution every year and as many as one in three Europeans living in urban areas are exposed to air pollution levels that are considered above safe EU standards.

According to experts from the European Society of Cardiology (ESC), who have written a position paper on heart disease and air pollution, ‘there is now ample evidence that air pollution is associated with cardiovascular morbidity and mortality'.

"It not only makes existing heart conditions worse but also contributes to development of the disease. Avoiding air pollution where possible may help to reduce cardiovascular risk and cardiologists should incorporate this information into lifestyle advice for their patients," they commented.

They recommended a number of actions to reduce exposure to air pollution, including:
-Walk, cycle or use public transport, rather than taking the car or a motorbike
-Avoid walking and cycling on streets with high traffic intensity, especially during rush hour
-Exercise in gardens and parks, not near major traffic roads
-Time spent outside during periods of high pollution should be limited, especially among children, older people and those with heart or respiratory conditions.

The experts said that those at high risk of developing heart disease are especially urged to follow this advice.

They also said that there is a need to ‘increase pressure on policy makers to reduce levels of air pollution'. They emphasised that fossil fuels are a major source of air pollution and greenhouse gases.

"Moving away from the use of fossil fuels for energy production will result in major benefits to human health, both from reduced exposure to air pollution and from mitigation of climate change," the experts said.

They added that air pollution is ranked ninth worldwide among the modifiable disease risk factors, ahead of low physical activity, high cholesterol and drug use.

"Air pollution should be considered one of the major modifiable risk factors to prevent and manage cardiovascular disease. Individuals, especially those with or at risk of cardiovascular disease, can take measures to reduce their exposure and doctors should include these in lifestyle advice. Policy makers urgently need to reduce levels of air pollution and this should be backed up by legislation."

The experts' position paper is published in the European Heart Journal.

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