Impacts of Exposure to Black Carbon, Elemental Carbon, and Ultrafine Particles From Indoor and Outdoor Sources on Blood Pressure in Adults: A Review of Epidemiological Evidence

Environ Res. 2018 Feb;161:345-353. doi: 10.1016/j.envres.2017.11.030. Epub 2017 Nov 28.


Introduction: Ambient particulate air pollution is known to have detrimental effects on cardiovascular health but less is known about the specific effects of black carbon or elemental carbon (BC/EC) and ultrafine particles (UFP).

Methods: We present a narrative review of the epidemiological evidence related to the impact of exposure to BC/EC and UFP on blood pressure in adults. We searched PubMed and EMBASE in September 2017, using a predefined search strategy. Abstracts were screened using predefined inclusion criteria. Data collection was completed using a standard data extraction form. We focused on main effect estimates for associations between short (≤7 days) and long-term exposures to BC/EC and UFP and systolic (SBP) and diastolic blood pressure (DBP). Effect estimates were rescaled to enable direct comparisons between studies.

Results: Thirty publications were included in the review: 19 studies examined outdoor exposure to BC/EC, 11 examined outdoor UFP, three studies examined indoor BC and one study examined indoor UFP. In general, existing evidence supports a positive association between BC/EC and blood pressure. Evidence for outdoor UFP exposures were less clear as effect estimates were small in magnitude and confidence intervals often included the null.

Conclusions: Existing evidence supports a positive association between BC/EC and blood pressure in adults, whereas UFPs do not appear to have a meaningful impact on blood pressure.

Keywords: Air pollution; Black carbon; Blood pressure; Epidemiology; Ultrafine particles.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Air Pollutants* / adverse effects
  • Air Pollution, Indoor* / adverse effects
  • Blood Pressure* / drug effects
  • Carbon
  • Humans
  • Particle Size
  • Particulate Matter* / adverse effects


  • Air Pollutants
  • Particulate Matter
  • Carbon

Grant support