ABSTRACT
Exposure to carbon nanotubes (CNTs) causes concern for risk of cardiovascular diseases because inhalation of air pollution particles has been linked to increased risk of morbidity and mortality.1 Cardiovascular diseases have been categorized by the International Classication of Disease (ICD), convened by the World Health Organization. Epidemiological studies use these classications as disease outcome, whereas they are typically not used in particle toxicology. Table 17.1 lists the individual categories in the ICD-9 classication, which encompass diseases of the circulatory system in codes 390-459. Some of the classes are clearly not relevant for particle toxicology (e.g., codes 390-398), whereas diseases in the vasculature are relevant in regard to particle exposure. The development and use of CNTs is still relatively new and there are no epidemiological studies investigating the adverse health effects in exposed humans. Therefore, the hazards of CNTs are presently best assessed by animal exposure models, supported by observations from in vitro studies. Animal studies on associations between exposure to particles and cardiovascular effects have mainly focused on atherosclerosis in the peripheral blood vessels (code 440) and thrombosis (code 444).
