Association between exposure to particulate matter and heart rate variability in vulnerable and susceptible individuals: Application of the Bayesian kernel machine regression model

Association between exposure to particulate matter and heart rate variability in vulnerable and susceptible individuals: Application of the Bayesian kernel machine regression model | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Association between exposure to particulate matter and heart rate variability in vulnerable and susceptible individuals: Application of the Bayesian kernel machine regression model Yong Whi Jeong, Hayon Michelle Choi, Youhyun Park, Yongjin Lee, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4983192/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 24 Jan, 2025 Read the published version in npj Digital Medicine → Version 1 posted 11 You are reading this latest preprint version Abstract Particulate matter (PM) has various health effects, and individuals are simultaneously exposed to these factors. Vulnerable and susceptible individuals are more sensitive to environmental factors than nonvulnerable individuals. Exposure to PM causes cardiovascular diseases. Heart rate variability (HRV) is a biomarker that may be used to identify cardiovascular diseases, and sensitive monitoring of HRV is required. Most previous studies have evaluated exposure using environmental pollution monitoring devices located in various districts. There is a lack of research exploring the relationship between environmental pollutant exposure in personal living spaces and HRV using both indoor and outdoor measurement devices. This study aimed to investigate the association between exposure to PM and HRV using a model capable of multi-substance analysis in short-term exposures, in vulnerable and susceptible individuals, including patients with environmental disease (patients with arrhythmia, chronic airway disease, and stroke patients) and vulnerable populations (residents of an industrial complex area, the elderly). We measured PM 1.0 , PM 2.5 , PM 10 , and digital biomarkers in 97 participants. We evaluated the impact of short-term PM exposure on 24-h HRV over five days by measuring indoor and outdoor exposure using personalized monitoring equipment and ECG monitoring via wearable devices. The PM was calculated as a daily cumulative value and divided into days with high and low cumulative concentrations. The association between exposure to single particulate and complex mixtures and HRV was compared using multiple linear regression and Bayesian kernel machine regression (BKMR). This study found that HRV showed a negative trend with increased PM exposure on days with high cumulative PM concentrations, with statistically significant associations observed between higher PM concentrations and decreased HRV on days with high exposure. The subgroup analysis revealed that patients with chronic airway disease and residents of industrial complex areas exhibited stronger negative correlations between exposure to PM and HRV. These associations were more pronounced with complex exposure to PM 1.0 , PM 2.5 , and PM 10 . In short-term exposure, it was confirmed that exposure to single and complex PM is negatively associated with HRV, and this relationship varies depending on the sensitive characteristics of individuals. Integrating indoor and outdoor personalized exposure assessments with 24-hour ECG monitoring has reinforced our understanding of the complex interactions between PM and health. Our findings indicate that even 'acceptable' PM levels can harm HRV, suggesting that current thresholds may not adequately protect sensitive individuals. This highlights the need for more stringent, particle size-specific standards for at-risk groups. Earth and environmental sciences/Environmental sciences Health sciences/Biomarkers Health sciences/Medical research Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementaryFigure1.tif SupplementaryFigure2.tif SupplementaryTable1.docx SupplementaryTable2.docx Cite Share Download PDF Status: Published Journal Publication published 24 Jan, 2025 Read the published version in npj Digital Medicine → Version 1 posted Editorial decision: Revision requested 21 Oct, 2024 Reviews received at journal 18 Oct, 2024 Reviewers agreed at journal 16 Oct, 2024 Reviews received at journal 21 Sep, 2024 Reviewers agreed at journal 11 Sep, 2024 Reviewers agreed at journal 10 Sep, 2024 Reviewers agreed at journal 07 Sep, 2024 Reviewers invited by journal 05 Sep, 2024 Editor assigned by journal 28 Aug, 2024 Submission checks completed at journal 28 Aug, 2024 First submitted to journal 27 Aug, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4983192","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":357295927,"identity":"18269098-6526-45d9-b16b-32989ee09b2f","order_by":0,"name":"Yong Whi Jeong","email":"","orcid":"","institution":"Yonsei University","correspondingAuthor":false,"prefix":"","firstName":"Yong","middleName":"Whi","lastName":"Jeong","suffix":""},{"id":357295928,"identity":"a6eb07a6-9aed-47cc-a658-6b6233e5ac6a","order_by":1,"name":"Hayon Michelle Choi","email":"","orcid":"","institution":"Harvard T.H. Chan School of Public Health","correspondingAuthor":false,"prefix":"","firstName":"Hayon","middleName":"Michelle","lastName":"Choi","suffix":""},{"id":357295929,"identity":"0083120c-446d-4c0a-b966-08988f8f2baa","order_by":2,"name":"Youhyun Park","email":"","orcid":"","institution":"Yonsei University","correspondingAuthor":false,"prefix":"","firstName":"Youhyun","middleName":"","lastName":"Park","suffix":""},{"id":357295930,"identity":"910dc50e-367e-4540-806b-af0ca51c2605","order_by":3,"name":"Yongjin Lee","email":"","orcid":"","institution":"Yonsei University College of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Yongjin","middleName":"","lastName":"Lee","suffix":""},{"id":357295931,"identity":"5219bd0e-d95f-4467-a7f2-b7cc58b9f93c","order_by":4,"name":"Ji Ye Jung","email":"","orcid":"","institution":"Yonsei University College of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Ji","middleName":"Ye","lastName":"Jung","suffix":""},{"id":357295932,"identity":"932265b3-e8cf-489d-9e10-385a53eda45b","order_by":5,"name":"Dae Ryong Kang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7klEQVRIiWNgGAWjYDCCAwzMIEoOwjMAEWzEaTEmXUtiA0KIgBa+2weYDX7uqE3fcLz38IcPBQzy/A1saR/waZE8l8Cc2HvmeO6GM+fSJGcYMBjOOMB2eAY+LQZnGJgP8LYdy91wI8eMmceAgXEDA3szXoeBtBz823Ys3eBGjvHnPwYM9kRpSeZtq0kAajGQBoZY4gYGtsN4tUieYWw2lm07YDjzzBkzyR4DieQZh9mS8WrhO8N8WPJtW5083/Ee4w8//tjY9re3GePVwsDA2AAkDjMoHADzJBgg8UQY1DHINxCnchSMglEwCkYgAAAbU0g1R0r1YwAAAABJRU5ErkJggg==","orcid":"","institution":"Wonju College of Medicine, Yonsei University","correspondingAuthor":true,"prefix":"","firstName":"Dae","middleName":"Ryong","lastName":"Kang","suffix":""}],"badges":[],"createdAt":"2024-08-27 09:15:35","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4983192/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4983192/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1038/s41746-024-01373-5","type":"published","date":"2025-01-24T15:57:12+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":74859399,"identity":"bb5e545c-021b-44f1-87c2-2076916e5a14","added_by":"auto","created_at":"2025-01-27 16:14:18","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1053492,"visible":true,"origin":"","legend":"","description":"","filename":"Manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4983192/v1_covered_0be42835-caa1-42d0-8c71-cdd13f29e783.pdf"},{"id":65455048,"identity":"0084f90a-0e81-47f3-a102-5b3f37da7c85","added_by":"auto","created_at":"2024-09-27 15:56:40","extension":"tif","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":5852740,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryFigure1.tif","url":"https://assets-eu.researchsquare.com/files/rs-4983192/v1/58417c47b4056d729c03eaa3.tif"},{"id":65455046,"identity":"144dc6a0-31cd-40de-bad8-bdd5948ba7eb","added_by":"auto","created_at":"2024-09-27 15:56:39","extension":"tif","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":2484858,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryFigure2.tif","url":"https://assets-eu.researchsquare.com/files/rs-4983192/v1/efaaf59b16eaa96520f53f6b.tif"},{"id":65455045,"identity":"4fed2ffe-57e3-4a27-8739-e1deda26d096","added_by":"auto","created_at":"2024-09-27 15:56:39","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":26821,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryTable1.docx","url":"https://assets-eu.researchsquare.com/files/rs-4983192/v1/9d11760629622e0831277cc0.docx"},{"id":65455240,"identity":"ef982e61-9602-480d-a080-20476b9fbd66","added_by":"auto","created_at":"2024-09-27 16:04:39","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":26652,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryTable2.docx","url":"https://assets-eu.researchsquare.com/files/rs-4983192/v1/135144077e7cd1df6156166e.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Association between exposure to particulate matter and heart rate variability in vulnerable and susceptible individuals: Application of the Bayesian kernel machine regression model","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"npj-digital-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"npjdigitalmed","sideBox":"Learn more about [npj Digital Medicine](http://www.nature.com/npjdigitalmed/)","snPcode":"41746","submissionUrl":"https://submission.springernature.com/new-submission/41746/3","title":"npj Digital Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"NPJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-4983192/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4983192/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eParticulate matter (PM) has various health effects, and individuals are simultaneously exposed to these factors. Vulnerable and susceptible individuals are more sensitive to environmental factors than nonvulnerable individuals. Exposure to PM causes cardiovascular diseases. Heart rate variability (HRV) is a biomarker that may be used to identify cardiovascular diseases, and sensitive monitoring of HRV is required. Most previous studies have evaluated exposure using environmental pollution monitoring devices located in various districts. There is a lack of research exploring the relationship between environmental pollutant exposure in personal living spaces and HRV using both indoor and outdoor measurement devices. This study aimed to investigate the association between exposure to PM and HRV using a model capable of multi-substance analysis in short-term exposures, in vulnerable and susceptible individuals, including patients with environmental disease (patients with arrhythmia, chronic airway disease, and stroke patients) and vulnerable populations (residents of an industrial complex area, the elderly). We measured PM\u003csub\u003e1.0\u003c/sub\u003e, PM\u003csub\u003e2.5\u003c/sub\u003e, PM\u003csub\u003e10\u003c/sub\u003e, and digital biomarkers in 97 participants. We evaluated the impact of short-term PM exposure on 24-h HRV over five days by measuring indoor and outdoor exposure using personalized monitoring equipment and ECG monitoring via wearable devices. The PM was calculated as a daily cumulative value and divided into days with high and low cumulative concentrations. The association between exposure to single particulate and complex mixtures and HRV was compared using multiple linear regression and Bayesian kernel machine regression (BKMR). This study found that HRV showed a negative trend with increased PM exposure on days with high cumulative PM concentrations, with statistically significant associations observed between higher PM concentrations and decreased HRV on days with high exposure. The subgroup analysis revealed that patients with chronic airway disease and residents of industrial complex areas exhibited stronger negative correlations between exposure to PM and HRV. These associations were more pronounced with complex exposure to PM\u003csub\u003e1.0\u003c/sub\u003e, PM\u003csub\u003e2.5\u003c/sub\u003e, and PM\u003csub\u003e10\u003c/sub\u003e. In short-term exposure, it was confirmed that exposure to single and complex PM is negatively associated with HRV, and this relationship varies depending on the sensitive characteristics of individuals. Integrating indoor and outdoor personalized exposure assessments with 24-hour ECG monitoring has reinforced our understanding of the complex interactions between PM and health. Our findings indicate that even 'acceptable' PM levels can harm HRV, suggesting that current thresholds may not adequately protect sensitive individuals. This highlights the need for more stringent, particle size-specific standards for at-risk groups.\u003c/p\u003e","manuscriptTitle":"Association between exposure to particulate matter and heart rate variability in vulnerable and susceptible individuals: Application of the Bayesian kernel machine regression model","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-27 15:56:34","doi":"10.21203/rs.3.rs-4983192/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-10-21T18:02:49+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-10-19T03:46:24+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"66744123253688952935710964446774598283","date":"2024-10-16T23:16:34+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-21T12:33:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"310616019825036690129960586023870669437","date":"2024-09-11T06:17:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"55245134747717420943653237772232807670","date":"2024-09-10T07:01:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"258332869917471263014185006877729985110","date":"2024-09-07T23:25:06+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-09-05T17:52:25+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-08-29T00:37:46+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-08-28T12:53:47+00:00","index":"","fulltext":""},{"type":"submitted","content":"npj Digital Medicine","date":"2024-08-27T09:14:09+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"npj-digital-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"npjdigitalmed","sideBox":"Learn more about [npj Digital Medicine](http://www.nature.com/npjdigitalmed/)","snPcode":"41746","submissionUrl":"https://submission.springernature.com/new-submission/41746/3","title":"npj Digital Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"NPJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"123c172f-a9ed-44a6-a500-714ebcb42136","owner":[],"postedDate":"September 27th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":38009122,"name":"Earth and environmental sciences/Environmental sciences"},{"id":38009123,"name":"Health sciences/Biomarkers"},{"id":38009124,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2025-01-27T16:11:37+00:00","versionOfRecord":{"articleIdentity":"rs-4983192","link":"https://doi.org/10.1038/s41746-024-01373-5","journal":{"identity":"npj-digital-medicine","isVorOnly":false,"title":"npj Digital Medicine"},"publishedOn":"2025-01-24 15:57:12","publishedOnDateReadable":"January 24th, 2025"},"versionCreatedAt":"2024-09-27 15:56:34","video":"","vorDoi":"10.1038/s41746-024-01373-5","vorDoiUrl":"https://doi.org/10.1038/s41746-024-01373-5","workflowStages":[]},"version":"v1","identity":"rs-4983192","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4983192","identity":"rs-4983192","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}