Exposure to Volatile Organic Compounds and Cardiovascular Diseases: A Systematic Review and Meta-Analysis Publisher Pubmed



Goodarzi S ; Fakouri M ; Shahirroudi E ; Naimijoubani M ; Djalalinia S ; Pourabbas R ; Dehghannayeri A ; Mahdavigorabi A ; Semnani K ; Esmaeili S ; Qorbani M
Source: Journal of the American Heart Association Published:2026

Abstract

BACKGROUND: Environmental pollution is an often-neglected contributor to cardiovascular disease (CVD). Volatile organic compounds (VOCs) are a subset of ubiquitous pollutants. Recent evidence has suggested exposure to VOCs as a possible contributor to CVD. We aimed to review the evidence for such a link between VOC exposure and cardiovascular outcomes. METHODS: PubMed, Web of Science, and Scopus were systematically searched for ecological and observational studies evaluating associations between exposure to VOCs and cardiovascular outcomes. The available evidence was synthesized qualitatively, and meta-analyses were conducted wherever multiple estimates were identified for a shared association. Sensitivity analyses were performed to evaluate the influence of individual studies on the pooled estimates. RESULTS: Thirty-six studies were included in the review. Pooled random-effects estimates for associations between VOC mixtures (odds ratio, 1.57 [95% CI, 0.79–3.11])/toluene, ethylbenzene, and xylene and CVD trended toward a positive effect while being imprecise. The pooled estimate for the association between exposure to benzene and CVD death also trended toward a positive effect (meta relative risk, 1.09 [95% CI, 0.99–1.21]; I2=91.4 [95% prediction interval, 0.82–1.46]). However, serious inconsistencies were noted on the significance and the magnitude of association. Fixed-effect analyses indicated significant positive effects in all evaluated associations. CONCLUSIONS: Evidence from studies evaluating ambient and individual VOC exposures suggests a possible association with increased CVD and CVD death. However, the heterogeneity noted between specific VOCs’ effects, possible confounding, limited long-term exposure assessment, and sparse evaluation of mixture/copollutant effects warrant cautious interpretation of these findings and highlight the need for future high-quality prospective studies. © 2026 The Author(s).