Encourage Your Local Government to 

Take Action

Local governments should take these simple steps to 

reduce hazards and publicize precautions older adults 

can take.

• Promote smoke-free policies in public places:

By keeping public places (restaurants, bars, and 

parks) smoke-free, communities can limit exposure 

to secondhand smoke. 

• Promote Active Heat Health Watch Warning 

and Response Systems: These systems can 

help identify when a heat-related threat is likely, 

alert residents, and provide assistance to at-risk 

individuals. 

• Ensure that Air Quality Index forecasts are 

publicized and followed: EPA’s Air Quality Index 

is an index for reporting daily air quality. See www.

epa.gov/airnow. 

• Promote public transit options that reduce 

traffic and air pollution: Public transit is the best 

way to alleviate road congestion, air pollution, and 

stress.

• Locate parks, bike paths, and trails away 

from major roads: Physical activity is one of 

the best ways to lower your risk for heart disease 

and stroke. Exercise away from roads and traffic 

pollution.

Control Your Major Risk Factors for Heart 

Disease and Stroke

The environment is just one factor that influences a 

person’s susceptibility to heart disease and stroke. 

The most important steps you can take to reduce risk 

factors for heart disease and stroke include: 

• Avoid smoke from tobacco

• Schedule time for regular physical activity 30 

minutes per day at least 5 days a week

• Follow the 2005 Dietary Guidelines for 

Americans

• See your health care provider regularly to 

screen for and treat high blood pressure, 

diabetes, and hyperlipidemia (elevated levels 

of lipids in the bloodstream)

Additional Resources

Environmental Protection Agency 

Air Quality Index: www.airnow.gov

Arsenic: www.epa.gov/safewater/arsenic.html

Indoor Air Quality: www.epa.gov/iaq/

Lead: www.epa.gov/lead

Painting: www.epa.gov/iaq/homes/hip-painting.html

Pesticides: www.epa.gov/pesticides/

Smoke free homes: www.epa.gov/smokefree/

Centers for Disease Control and Prevention 

Cardiovascular health: www.cdc.gov/cvh/ 

Physical Fitness Guidelines:http://www.cdc.gov/

nccdphp/dnpa/physical/recommendations/older_

adults.htm

Dietary Guidelines for Americans 

www.health.gov/dietaryguidelines/

Federal Emergency Management Administration 

www.fema.gov/hazards/extremeheat/heat.shtm

National Weather Service: www.nws.noaa.gov/

om/brochures/heat_wave.shtml

American Heart Association: www.americanheart.org 

Health Effects Institute 

www.healtheffects.org/about.htm

Footnotes

1 U.S. Environmental Protection Agency. Air Quality Guide for 

Particle Pollution. http://www.epa.gov/airnow//aqi_cl.pdf

2 U.S. Environmental Protection Agency. Regulation and 

Management of Pesticide Poisonings. 1999. http://www.epa.gov/

pesticides/safety/healthcare/handbook/Index1.pdf

3 U.S. Environmental Protection Agency. Air Quality Criteria for 

Carbon Monoxide, EPA 600-P-99-001F. Research Triangle Park, 

NC: U.S. Environmental Protection Agency, Office Research and 

Development, National Center for Environmental Assessment. 

June 2000.

4 Peters, A., S. von Klot, M. Heier, I. Trentinaglia, H. Ines, A. 

Hormann, H.E. Erich, H. Lowel. “Exposure to Traffic and the Onset 

of Myocardial Infarction.” The New England Journal of Medicine. 

Oct 21, 2004. 351 (17): 1721-30.

Learn More

The EPA Aging Initiative works to protect the 

health of older adults through the coordination 

of research, prevention strategies, and public 

education on environmental factors. For more 

information, or to join the EPA Aging Initiative 

listserve visit: www.epa.gov/aging. Older adults 

can improve their health and quality of life by 

being aware of environmental contributors to 

heart disease and stroke and controlling major 

non-environmental risk factors.

Publication Number 

EPA 100-F-05-020
ability to carry oxygen. For a person with heart 

disease, exposure to even low levels of CO may 

cause chest pain, increased heart rhythm irregularities 

and make it difficult to exercise.3 Sources of CO 

include fumes from furnaces, gas water heaters, 

ranges, dryers, space heaters, fireplaces, wood stoves, 

and exhaust from cars idling in enclosed garages. 

Outdoor Air Pollution

Older adults who are at risk for heart disease and 

stroke may benefit from lowering their contact with 

air polluted with particulates and vehicular exhaust.

Particle Pollution: Small soot particles found in 

outdoor air can be hazardous and the risk is greatest 

among people with heart disease, chronic obstructive 

lung disease and asthma. Particles originate from a 

variety of sources including vehicles, power plants, 

industrial smokestacks, and fires. Some particles 

are emitted into the air directly, but others form 

as a result of complicated chemical reactions in 

the atmosphere. Particles can travel hundreds to 

thousands of miles downwind, affecting people far 

from the sources. 

Traffic: Time spent in traffic has also been associated 

with the onset of a heart attack.4 It is not known 

whether this is due to traffic-related air pollution (e.g., 

particle pollution, CO), the stress of being caught in 

traffic, or some other risk factor.

Pollutant Gases: Ozone, sulfur dioxide, and 

nitrogen dioxide are also important components 

of air pollution and are associated with adverse 

health effects. Ozone is a strong irritant to the lungs 

and airways and can cause chest pain that can be 

mistaken for a heart attack. 

Drinking Water

There is evidence that several metals found in 

drinking water may contribute to heart disease or 

aggravate its symptoms. 

Lead: Exposure to lead can increase blood pressure. 

While people are primarily exposed to lead through 

paint dust, drinking water is another source of lead 

exposure. While water from a community’s public 

water supply must meet EPA standards for lead, tap 

water may still contain lead exceeding the allowable 

levels due to the presence of older lead-containing 

plumbing materials. 

Arsenic: Long-term exposure to high levels of 

arsenic, a natural element found in drinking water 

in some areas of the country, can harm the heart. 

EPA has a drinking water standard for public drinking 

water systems to ensure that people are not exposed 

to high levels of arsenic. If you obtain your water 

from a private well or small water system, see the 

“Steps You Can Take” section for more information 

about actions to limit your exposure.

Excessive Heat Events

Heat events are described as prolonged periods 

when temperatures reach at least 10o F. (5.5oC.) 

above a region’s average high temperature. Heat 

stroke is the most serious of a range of health effects 

associated with excessive heat exposure. It occurs 

when the body’s temperature control system fails 

causing a rapid rise in core body temperature. Heat 

stroke is characterized by hot, dry, and red skin, 

and a lack of perspiration. Other warning signs are 

confusion and hallucinations. Heat stroke is a serious 

condition requiring immediate medical attention (call 

911 or take the person to an emergency room). 

Left untreated, heat stroke can cause severe and 

permanent damage to vital organs, permanent 

disability, or death.

Persons with heart disease and stroke have impaired 

cooling mechanisms and are more vulnerable during 

heat events. The use of some medications can 

make individuals more susceptible to heat events 

for example, anti-depressants and some circulatory 

medications.

During heat events, air-conditioning is the best 

protection against heat-related illness and death. 

Even a few hours a day in air-conditioning can greatly 

reduce the risk. Research indicates electric fans are 

only effective if the ambient temperature is lower 

than the body temperature. Electric fans may provide 

comfort, but when temperatures are in the high 90s, 

fans do not prevent heat-related illness and could 

actually be harmful. 
ability to carry oxygen. For a person with heart 

disease, exposure to even low levels of CO may 

cause chest pain, increased heart rhythm irregularities 

and make it difficult to exercise.3 Sources of CO 

include fumes from furnaces, gas water heaters, 

ranges, dryers, space heaters, fireplaces, wood stoves, 

and exhaust from cars idling in enclosed garages. 

Outdoor Air Pollution

Older adults who are at risk for heart disease and 

stroke may benefit from lowering their contact with 

air polluted with particulates and vehicular exhaust.

Particle Pollution: Small soot particles found in 

outdoor air can be hazardous and the risk is greatest 

among people with heart disease, chronic obstructive 

lung disease and asthma. Particles originate from a 

variety of sources including vehicles, power plants, 

industrial smokestacks, and fires. Some particles 

are emitted into the air directly, but others form 

as a result of complicated chemical reactions in 

the atmosphere. Particles can travel hundreds to 

thousands of miles downwind, affecting people far 

from the sources. 

Traffic: Time spent in traffic has also been associated 

with the onset of a heart attack.4 It is not known 

whether this is due to traffic-related air pollution (e.g., 

particle pollution, CO), the stress of being caught in 

traffic, or some other risk factor.

Pollutant Gases: Ozone, sulfur dioxide, and 

nitrogen dioxide are also important components 

of air pollution and are associated with adverse 

health effects. Ozone is a strong irritant to the lungs 

and airways and can cause chest pain that can be 

mistaken for a heart attack. 

Drinking Water

There is evidence that several metals found in 

drinking water may contribute to heart disease or 

aggravate its symptoms. 

Lead: Exposure to lead can increase blood pressure. 

While people are primarily exposed to lead through 

paint dust, drinking water is another source of lead 

exposure. While water from a community’s public 

water supply must meet EPA standards for lead, tap 

water may still contain lead exceeding the allowable 

levels due to the presence of older lead-containing 

plumbing materials. 

Arsenic: Long-term exposure to high levels of 

arsenic, a natural element found in drinking water 

in some areas of the country, can harm the heart. 

EPA has a drinking water standard for public drinking 

water systems to ensure that people are not exposed 

to high levels of arsenic. If you obtain your water 

from a private well or small water system, see the 

“Steps You Can Take” section for more information 

about actions to limit your exposure.

Excessive Heat Events

Heat events are described as prolonged periods 

when temperatures reach at least 10o F. (5.5oC.) 

above a region’s average high temperature. Heat 

stroke is the most serious of a range of health effects 

associated with excessive heat exposure. It occurs 

when the body’s temperature control system fails 

causing a rapid rise in core body temperature. Heat 

stroke is characterized by hot, dry, and red skin, 

and a lack of perspiration. Other warning signs are 

confusion and hallucinations. Heat stroke is a serious 

condition requiring immediate medical attention (call 

911 or take the person to an emergency room). 

Left untreated, heat stroke can cause severe and 

permanent damage to vital organs, permanent 

disability, or death.

Persons with heart disease and stroke have impaired 

cooling mechanisms and are more vulnerable during 

heat events. The use of some medications can 

make individuals more susceptible to heat events 

for example, anti-depressants and some circulatory 

medications.

During heat events, air-conditioning is the best 

protection against heat-related illness and death. 

Even a few hours a day in air-conditioning can greatly 

reduce the risk. Research indicates electric fans are 

only effective if the ambient temperature is lower 

than the body temperature. Electric fans may provide 

comfort, but when temperatures are in the high 90s, 

fans do not prevent heat-related illness and could 

actually be harmful. 
Encourage Your Local Government to 

Take Action

Local governments should take these simple steps to 

reduce hazards and publicize precautions older adults 

can take.

• Promote smoke-free policies in public places:

By keeping public places (restaurants, bars, and 

parks) smoke-free, communities can limit exposure 

to secondhand smoke. 

• Promote Active Heat Health Watch Warning 

and Response Systems: These systems can 

help identify when a heat-related threat is likely, 

alert residents, and provide assistance to at-risk 

individuals. 

• Ensure that Air Quality Index forecasts are 

publicized and followed: EPA’s Air Quality Index 

is an index for reporting daily air quality. See www.

epa.gov/airnow. 

• Promote public transit options that reduce 

traffic and air pollution: Public transit is the best 

way to alleviate road congestion, air pollution, and 

stress.

• Locate parks, bike paths, and trails away 

from major roads: Physical activity is one of 

the best ways to lower your risk for heart disease 

and stroke. Exercise away from roads and traffic 

pollution.

Control Your Major Risk Factors for Heart 

Disease and Stroke

The environment is just one factor that influences a 

person’s susceptibility to heart disease and stroke. 

The most important steps you can take to reduce risk 

factors for heart disease and stroke include: 

• Avoid smoke from tobacco

• Schedule time for regular physical activity 30 

minutes per day at least 5 days a week

• Follow the 2005 Dietary Guidelines for 

Americans

• See your health care provider regularly to 

screen for and treat high blood pressure, 

diabetes, and hyperlipidemia (elevated levels 

of lipids in the bloodstream)

Additional Resources

Environmental Protection Agency 

Air Quality Index: www.airnow.gov

Arsenic: www.epa.gov/safewater/arsenic.html

Indoor Air Quality: www.epa.gov/iaq/

Lead: www.epa.gov/lead

Painting: www.epa.gov/iaq/homes/hip-painting.html

Pesticides: www.epa.gov/pesticides/

Smoke free homes: www.epa.gov/smokefree/

Centers for Disease Control and Prevention 

Cardiovascular health: www.cdc.gov/cvh/ 

Physical Fitness Guidelines:http://www.cdc.gov/

nccdphp/dnpa/physical/recommendations/older_

adults.htm

Dietary Guidelines for Americans 

www.health.gov/dietaryguidelines/

Federal Emergency Management Administration 

www.fema.gov/hazards/extremeheat/heat.shtm

National Weather Service: www.nws.noaa.gov/

om/brochures/heat_wave.shtml

American Heart Association: www.americanheart.org 

Health Effects Institute 

www.healtheffects.org/about.htm

Footnotes

1 U.S. Environmental Protection Agency. Air Quality Guide for 

Particle Pollution. http://www.epa.gov/airnow//aqi_cl.pdf

2 U.S. Environmental Protection Agency. Regulation and 

Management of Pesticide Poisonings. 1999. http://www.epa.gov/

pesticides/safety/healthcare/handbook/Index1.pdf

3 U.S. Environmental Protection Agency. Air Quality Criteria for 

Carbon Monoxide, EPA 600-P-99-001F. Research Triangle Park, 

NC: U.S. Environmental Protection Agency, Office Research and 

Development, National Center for Environmental Assessment. 

June 2000.

4 Peters, A., S. von Klot, M. Heier, I. Trentinaglia, H. Ines, A. 

Hormann, H.E. Erich, H. Lowel. “Exposure to Traffic and the Onset 

of Myocardial Infarction.” The New England Journal of Medicine. 

Oct 21, 2004. 351 (17): 1721-30.

Learn More

The EPA Aging Initiative works to protect the 

health of older adults through the coordination 

of research, prevention strategies, and public 

education on environmental factors. For more 

information, or to join the EPA Aging Initiative 

listserve visit: www.epa.gov/aging. Older adults 

can improve their health and quality of life by 

being aware of environmental contributors to 

heart disease and stroke and controlling major 

non-environmental risk factors.

Publication Number 

EPA 100-F-05-020