Main air pollutants and ventricular arrhythmias in patients with implantable cardioverter-defibrillators: A systematic review and meta-analysis

Integrated Mobile Laboratory for Air Pollution Assessment: Literature Review and cc-TrAIRer Design

To promote research studies on air pollution and climate change, the mobile laboratory cc-TrAIRer (Climate Change—TRailer for AIR and Environmental Research) was designed and built. It consists of a trailer which affords particles, gas, meteorological and noise measurements. Thanks to its structure and its versatility, it can easily conduct field campaigns in remote areas. The literature review presented in this paper shows the main characteristics of the existing mobile laboratories. The cc-TrAIRer was built by evaluating technical aspects, instrumentations and auxiliary systems that emerged from previous studies in the literature. Some of the studies conducted in heterogeneous topography areas, such as the Po Valley and the Alps, using instruments that were chosen to be located on the mobile laboratory are here reported. The preliminary results highlight the future applications of the trailer and the importance of high temporal resolution data acquisition for the characterization of pollution phenomena. The potential applications of the cc-TrAIRer concern different fields, such as complex terrain, emergency situations, worksite and local source impacts and temporal and spatial distributions of atmospheric compounds. The integrated use of gas and particle analysers, a weather station and environment monitoring systems in a single easily transportable vehicle will contribute to research studies on global aspects of climate change.

Do acute changes in ambient air pollution increase the risk of potentially fatal cardiac arrhythmias in patients with implantable cardioverter defibrillators?

BACKGROUND

Daily changes in ambient air pollution have been associated with cardiac morbidity and mortality. Precipitating a cardiac arrhythmia in susceptible individuals may be one mechanism. We investigated the influence of daily changes in air pollution in the Province of Ontario, Canada on the frequency of discharges from implantable cardio defibrillators (ICDs) which occur in response to potentially life threatening arrhythmias.

METHODS

Using a case- crossover design, we compared ambient air pollution concentrations on the day of an ICD discharge to other days in the same month and year in 1952 patients. We adjusted for weather, lagged the exposure data from 0 to 3 days, and stratified the results by several patient-related characteristics.

RESULTS

Median (interquartile range) for ozone (O₃), fine particulate matter (PM_2.5), sulphur dioxide (SO₂) and nitrogen dioxide (NO₂) were 26.0 ppb (19.4, 33.0), 6.6 μg/m³ (4.3, 10.6), 1.00 ppb (0.4,2.1), 10.0 ppb (6.0,15.3) respectively. Unlagged odds ratios (95%) for an ICD discharge associated with an interquartile range increase in pollutant were 0.97 (0.86, 1.09) for O₃, 0.99 (0.92, 1.06) for PM_2.5, 0.97 (0.91, 1.03) for SO₂, and 1.00 (0.89, 1.12) for NO₂.

CONCLUSION

We found no evidence that the concentrations of ambient air pollution observed in our study were a risk factor for potentially fatal cardiac arrhythmias in patients with ICDs.