This article is a commentary on the following studies: "Repolarization changes induced by air pollution in patients with ischemic heart disease." Henneberger A, Zareba W, Ibald-Mulli A, Ruckerl R, Cyrys J, Couderc JP et al. Environ Health Perspect. 2005;113(4):440-446; "Air pollution and markers of inflammation and coagulation in patients with coronary heart disease." Ruckerl R, Ibald-Mulli A, Koenig W, Schneider A, Woelke G, Cyrys J et al. Am J Respir Crit Care Med. 2006;173(4):432-441 and "Ultrafine particles and platelet activation in patients with coronary heart disease - results from a prospective panel study". Ruckerl R, Phipps RP, Schneider A, Frampton M, Cyrys J, Oberdorster G et al. Part Fibre Toxicol. 2007;4:1.