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Wu S, Guo J, Chen X, Wang J, Zhao G, Ma S, Hao T, Tan J, Li Y. Rapid weather changes are associated with daily hospital visitors for atrial fibrillation accompanied by abnormal ECG repolarization: a case-crossover study. Eur J Med Res 2024; 29:62. [PMID: 38245805 PMCID: PMC10799445 DOI: 10.1186/s40001-023-01632-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/30/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is highly prevalent in the population, yet the factors contributing to AF events in susceptible individuals remain partially understood. The potential relationship between meteorological factors and AF, particularly with abnormal electrocardiograph (ECG) repolarization, has not been adequately studied. This case-crossover study aims to investigate the association between meteorological factors and daily hospital visits for AF with abnormal ECG repolarization in Shanghai, China. METHODS The study cohort comprised 10,325 patients with ECG-confirmed AF who sought treatment at Shanghai Sixth People's Hospital between 2015 and 2018. Meteorological and air pollutant concentration data were matched with the patient records. Using a case-crossover design, we analyzed the association between meteorological factors and the daily count of hospital visitors for AF with abnormal ECG repolarization at our AF center. Lag analysis models were applied to examine the temporal relationship between meteorological factors and AF events. RESULTS The analysis revealed statistically significant associations between AF occurrence and specific meteorological factors. AF events were significantly associated with average atmospheric pressure (lag 0 day, OR 0.9901, 95% CI 0.9825-0.9977, P < 0.05), average temperature (lag 1 day, OR 0.9890, 95% CI 0.9789-0.9992, P < 0.05), daily pressure range (lag 7 days, OR 1.0195, 95% CI 1.0079-1.0312, P < 0.01), and daily temperature range (lag 5 days, OR 1.0208, 95% CI 1.0087-1.0331, P < 0.01). Moreover, a significant correlation was observed between daily pressure range and daily temperature range with AF patients, particularly those with abnormal ECG repolarization, as evident in the case-crossover analysis. CONCLUSION This study highlights a significant correlation between meteorological factors and daily hospital visits for AF accompanied by abnormal ECG repolarization in Shanghai, China. In addition, AF patients with abnormal ECG repolarization were found to be more vulnerable to rapid daily changes in pressure and temperature compared to AF patients without such repolarization abnormalities.
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Affiliation(s)
- Shanmei Wu
- Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, People's Republic of China
| | - Jingyi Guo
- Clinical Research Center, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Xin Chen
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, People's Republic of China
| | - Jie Wang
- Department of General Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Gang Zhao
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, People's Republic of China
| | - Shixin Ma
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, People's Republic of China
| | - Tianzheng Hao
- Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jianguo Tan
- Shanghai Meteorological IT Support Center, Shanghai, People's Republic of China.
- Key Laboratory of Urban Meteorology, China Meteorological Administration, Beijing, People's Republic of China.
| | - Yongguang Li
- Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, People's Republic of China.
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Sun W, Han X, Cao M, Pan Z, Guo J, Huang D, Mi J, Liu Y, Guan T, Li P, Huang C, Wang M, Xue T. Middle-term nitrogen dioxide exposure and electrocardiogram abnormalities: A nationwide longitudinal study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 266:115562. [PMID: 37866032 DOI: 10.1016/j.ecoenv.2023.115562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/03/2023] [Accepted: 10/07/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Recently, professionals, such as those from the World Health Organization, have recommended a rigorous standard for nitrogen dioxide (NO2), a typical urban air pollutant affected by regular traffic emissions, based on its short-term and long-term cardiorespiratory effects. However, the association between middle-term NO2 exposure and cardiovascular disorders remains unknown. OBJECTIVES This study was conducted to examine the relationship between NO2 exposure and its middle-term cardiovascular risks indicated by electrocardiogram (ECG) abnormalities. METHOD We included 61,094 subjects (132,249 visits) with repeated ECG observations based on longitudinal data from the China National Stroke Screening Survey (CNSSS). The NO2 exposure concentration was derived from a predictive model, measured as the monthly average concentration in the 6 months of preceding the ECG measurement. We used the generalized estimation equation to assess the association between NO2 exposure and ECG abnormalities. RESULT For each 10 µg/m3 increase in monthly average NO2 concentration, the odds ratio of ECG abnormalities was 1.10 (95% confidence interval [CI] 1.09-1.12) after multiple adjustments. Stratified regression analyses of urban and rural residents showed associations between middle-term NO2 exposure and ECG abnormalities in urban (OR 1.09 [95% CI 1.08-1.11]) and rural residents (OR 1.14 [95% CI 1.10-1.19]). The association was robust within different subpopulations. Associations generally remained statistically significant (OR 1.03 [95% CI 1.02-1.05]) after extra adjustment for PM2.5. Exposure-response relationship analysis revealed a nearly linear relationship between NO2 exposure and the risk for ECG abnormalities. CONCLUSION Using the variation in ECG signals as a potentially reversible indicator for subclinical risk in cardiovascular systems, our study provides additional evidence on the increased risk posed by middle-term NO2 exposure. Our study showed that policies controlling for NO2 concentrations are beneficial to prevent cardiovascular diseases among Chinese adults.
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Affiliation(s)
- Wei Sun
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Xueyan Han
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Man Cao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Zhaoyang Pan
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Jian Guo
- Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China; Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Dengmin Huang
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Jiarun Mi
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Tianjia Guan
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
| | - Pengfei Li
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China
| | - Conghong Huang
- College of Land Management, Nanjing Agricultural University, Nanjing 210095, China
| | - Meng Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, United States
| | - Tao Xue
- Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing 100191, China; Advanced Institute of Information Technology, Peking University, Hangzhou, Zhejiang, China; State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management and Center for Environment and Health, Peking University, Beijing, China.
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Vishram-Nielsen JK, Mueller B, Ross HJ, Fan CP, Rubin B, Alba AC, Manlhiot C. Association Between the Incidence of Hospitalizations for Acute Cardiovascular Events, Weather, and Air Pollution. JACC. ADVANCES 2023; 2:100334. [PMID: 38938234 PMCID: PMC11198195 DOI: 10.1016/j.jacadv.2023.100334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 03/03/2023] [Accepted: 03/10/2023] [Indexed: 06/29/2024]
Abstract
Background The incidence of hospitalizations for cardiovascular events has been associated with specific weather conditions and air pollution. A comprehensive model including the interactions between various environmental factors remains to be developed. Objectives The purpose of this study was to develop a comprehensive model of the association between weather patterns and the incidence of cardiovascular events and use this model to forecast near-term spatiotemporal risk. Methods We present a spatiotemporal analysis of the association between atmospheric data and the incidence rate of hospital admissions related to heart failure (922,132 episodes), myocardial infarction (521,988 episodes), and ischemic stroke (263,529 episodes) in ∼24 million people in Canada between 2007 and 2017. Our hierarchical Bayesian model captured the spatiotemporal distribution of hospitalizations and identified weather and air pollution-related factors that could partially explain fluctuations in incidence. Results Models that included weather and air pollution variables outperformed models without those covariates for most event types. Our results suggest that environmental factors may interact in complex ways on human physiology. The impact of environmental factors was magnified with increasing age. The weather and air pollution variables included in our models were predictive of the future incidence of heart failure, myocardial infarction, and ischemic strokes. Conclusions The increasing importance of environmental factors on cardiovascular events with increasing age raises the need for the development of educational materials for older patients to recognize environmental conditions where exacerbations are more likely. This model could be the basis of a forecasting system used for local, short-term clinical resource planning based on the anticipated incidence of events.
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Affiliation(s)
- Julie K.K. Vishram-Nielsen
- Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of Cardiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Brigitte Mueller
- Ted Rogers Computational Program, Ted Rogers Centre for Heart Research, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Heather J. Ross
- Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Chun-Po Fan
- Ted Rogers Computational Program, Ted Rogers Centre for Heart Research, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Barry Rubin
- Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Ana Carolina Alba
- Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Cedric Manlhiot
- Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Blalock-Taussig-Thomas Pediatric and Congenital Heart Center, John Hopkins University School of Medicine, Baltimore, Maryland, USA
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Influence of Carbon Sorbent Quantity on Breakthrough Time in Absorbent Filters for Antismog Half Mask Application. MATERIALS 2022; 15:ma15020584. [PMID: 35057301 PMCID: PMC8781268 DOI: 10.3390/ma15020584] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/24/2022]
Abstract
In this article, we present polymer non-woven fabrics with the addition of carbon sorbents being tested to estimate the breakthrough time and efficient protection against vapors present in smog. For this purpose, three substances were selected, which constitute an inhalation hazard and are smog components: cyclohexane, toluene, and sulfur dioxide. It was demonstrated that an increased quantity of carbon sorbent in polymeric filters significantly prolongs the breakthrough time. However, high sorbent quantities may increase the filter surface mass and air flow resistance. To optimize the protective parameters with functionality, a compromise between the two has to be found. By comparing the breakthrough times for different carbon sorbent quantities, the optimal filter composition was elaborated. The analyzed non-woven fabrics were manufactured by the melt-blown process and filled with ball-milled carbon sorbents supplied directly into the fabric blowing nozzle. Both protective performance and textural properties were analyzed for two commercially available carbon sorbents. Furthermore, it was proven that high values of sorbent-specific surface area translates directly into greater filter performance.
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Halldorsdottir S, Finnbjornsdottir RG, Elvarsson BT, Gudmundsson G, Rafnsson V. Ambient nitrogen dioxide is associated with emergency hospital visits for atrial fibrillation: a population-based case-crossover study in Reykjavik, Iceland. Environ Health 2022; 21:2. [PMID: 34980118 PMCID: PMC8722049 DOI: 10.1186/s12940-021-00817-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 12/09/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND In Iceland air quality is generally good; however, previous studies indicate that there is an association between air pollution in Reykjavik and adverse health effects as measured by dispensing of medications, mortality, and increase in health care utilisation. The aim was to study the association between traffic-related ambient air pollution in the Reykjavik capital area and emergency hospital visits for heart diseases and particularly atrial fibrillation and flutter (AF). METHODS A multivariate time-stratified case-crossover design was used to study the association. Cases were those patients aged 18 years or older living in the Reykjavik capital area during the study period, 2006-2017, who made emergency visits to Landspitali University Hospital for heart diseases. In this population-based study, the primary discharge diagnoses were registered according to International Classification of Diseases, 10th edition (ICD-10). The pollutants studied were NO2, PM10, PM2.5, and SO2, with adjustment for H2S, temperature, and relative humidity. The 24-h mean of pollutants was used with lag 0 to lag 4. RESULTS During the study period 9536 cases of AF were identified. The 24-h mean NO2 was 20.7 μg/m3. Each 10 μg/m3 increase in NO2 was associated with increased risk of heart diseases (ICD-10: I20-I25, I44-I50), odds ratio (OR) 1.023 (95% CI 1.012-1.034) at lag 0. Each 10 μg/m3 increase in NO2 was associated with an increased risk of AF (ICD-10: I48) on the same day, OR 1.030 (95% CI: 1.011-1.049). Females were at higher risk for AF, OR 1.051 (95% CI 1.019-1.083) at lag 0, and OR 1.050 (95% CI 1.019-1.083) at lag 1. Females aged younger than 71 years had even higher risk for AF, OR 1.077 (95% CI: 1.025-1.131) at lag 0. Significant associations were found for other pollutants and emergency hospital visits, but they were weaker and did not show a discernable pattern. CONCLUSIONS Short-term increase in NO2 concentrations was associated with heart diseases, more precisely with AF. The associations were stronger among females, and among females at younger age. This is the first study in Iceland that finds an association between air pollution and cardiac arrhythmias, so the results should be interpreted with caution.
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Affiliation(s)
| | | | | | - Gunnar Gudmundsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Respiratory Medicine & Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Vilhjalmur Rafnsson
- University of Iceland, Department of Preventive Medicine, Reykjavik, Iceland
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Pallikadavath S, Vali Z, Patel R, Mavilakandy A, Peckham N, Clegg M, Sandilands AJ, Ng GA. The Influence of Environmental Air Pollution on Ventricular Arrhythmias: A Scoping Review. Curr Cardiol Rev 2022; 18:e160422203685. [PMID: 35430968 PMCID: PMC9893149 DOI: 10.2174/1573403x18666220416203716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/07/2021] [Accepted: 01/16/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Exposure to air pollution is a recognised risk factor for cardiovascular disease and has been associated with supraventricular arrhythmias. The effect of air pollution on ventricular arrhythmias is less clear. This scoping review assessed the effects of particulate and gaseous air pollutants on the incidence of ventricular arrhythmias. METHODS MEDLINE and EMBASE databases were searched for studies assessing the effects of air pollutants on ventricular tachycardia and ventricular fibrillation. These pollutants were particulate matter (PM) 2.5, PM10, Nitrogen Dioxide (NO2), Carbon Monoxide (CO), Sulphur Dioxide (SO2), and Ozone (O3). RESULTS This review identified 27 studies: nine in individuals with implantable cardioverter defibrillators, five in those with ischaemic heart disease, and 13 in the general population. Those with ischaemic heart disease appear to have the strongest association with ventricular arrhythmias in both gaseous and particulate pollution, with all three studies assessing the effects of PM2.5 demonstrating some association with ventricular arrythmia. Results in the general and ICD population were less consistent. CONCLUSION Individuals with ischaemic heart disease may be at an increased risk of ventricular arrhythmias following exposure to air pollution.
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Affiliation(s)
- Susil Pallikadavath
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Zakariyya Vali
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Roshan Patel
- Leicester Medical School, College of Life Sciences, University of Leicester, UK
| | - Akash Mavilakandy
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Nicholas Peckham
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Matt Clegg
- Department of Geography, University of Birmingham, Birmingham, UK
| | - Alastair J. Sandilands
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - G. André Ng
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
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Leili M, Nadali A, Karami M, Bahrami A, Afkhami A. Short-term effect of multi-pollutant air quality indexes and PM 2.5 on cardiovascular hospitalization in Hamadan, Iran: a time-series analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:53653-53667. [PMID: 34036506 DOI: 10.1007/s11356-021-14386-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/10/2021] [Indexed: 06/12/2023]
Abstract
Air pollutants are the most important environmental factors that contributed to cardiovascular disease (CVD). The present study aimed to investigate the number of hospitalization due to heart failure (HF) and myocardial infarction (MI) following the air pollutant exposure using a time-series regression analysis with a distributed lag model in Hamadan, Iran (2015-2019). A total of 2091 cases of CVD were registered. Based on the findings, the highest health effects on HF hospitalization were observed with air quality health index (AQHI) at lag 9 (RR = 1.043, 95% CI 0.991-1.098), and air quality index (AQI) at lags 2, 7, and 9 (RR = 1.001, 95% CI 0.998-1.002), for an increase in 1 unit of the indexes, and with PM2.5 at lag 0 (RR = 1.001, 95% CI 0.996-1.004) for 10 μg/m3 increase in PM2.5 levels. The highest health effects on MI hospitalization were calculated with AQHI at lag 10 (RR = 1.059, 95% CI 1.001-1.121) and AQI at lags 1 and 2 (RR = 1.001, 95% CI 0.998-1.002), for an increase in 1 unit of the indexes, and with PM2.5 at lag 8 (RR = 1.002, 95% CI 0.997-1.005) for 10 μg/m3 increase in PM2.5 levels. According to a seasonal classification, results showed that hospitalization in the warm season was higher than that of the cold season. Based on our knowledge, the current study is the first study that investigated the effect of air quality indexes on hospitalization due to HF and MI in Iran. Findings can provide basic information to plan preventive measures for reducing exposure chance and hospitalization rate in high-risk people.
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Affiliation(s)
- Mostafa Leili
- Department of Environmental Health Engineering, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Azam Nadali
- Department of Environmental Health Engineering, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Manoochehr Karami
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abdolrahman Bahrami
- Department of Occupational Health, Faculty of Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Abbas Afkhami
- Faculty of Chemistry, Bu-Ali Sina University, Fahmideh Av, Hamadan, 65174, Iran
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Wang F, Ahat X, Liang Q, Ma Y, Sun M, Lin L, Li T, Duan J, Sun Z. The relationship between exposure to PM 2.5 and atrial fibrillation in older adults: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 784:147106. [PMID: 34088062 DOI: 10.1016/j.scitotenv.2021.147106] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/16/2021] [Accepted: 04/09/2021] [Indexed: 06/12/2023]
Abstract
Fine particle matter (PM2.5) is recognized as atrial fibrillation (AF) risk factor, especially for older adults. However, studies on the relationship between PM2.5 and AF were inconsistent. Herein, we present a systematic review to further assess the correlation between PM2.5 and AF in older adults (average age > 50 years old). A comprehensive search was conducted with the keywords in PubMed (675 records), Web of Science (1130 records), Embase (82 records), and the Cochrane Library (42 records). Using Stata12.0 software to test the heterogeneity between studies, and select the corresponding model to calculate the comprehensive effect value, odds ratio (OR, odds ratio), the pooled %-change (percentage change) and its 95% confidence interval (CL, confidence interval). A total of 16 observational studies were included, involving 10,580,394 participants, the results showed that PM2.5 had an adverse effects on AF in older adults. An association was found between exposure to PM2.5 (per 10 μg/m3 increase) and AF in older adults, with the corresponding pooled OR (1.11, 95% CI: 1.03-1.19) and pooled %-change (1.01%, 95% CI: 0.14%-1.88%). Our study indicated that PM2.5 exposure was significantly related to increased incidence of AF in older adults. Both the pooled OR and %-change value were higher in areas with higher levels of PM2.5(≥25 μg/m3).
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Affiliation(s)
- Fenghong Wang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China; Sinopharm North Hospital, Baotou 014040, PR China
| | - Xapkat Ahat
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Qingqing Liang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Yuexiao Ma
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Mengqi Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Lisen Lin
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Tianyu Li
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China
| | - Junchao Duan
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, PR China.
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Miarimbola R, Collart P, Casado-Arroyo R, Coppieters Y. [Air pollution and heart rhythm disturbance: A retrospective study]. Ann Cardiol Angeiol (Paris) 2021; 70:203-209. [PMID: 34274112 DOI: 10.1016/j.ancard.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/08/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION According to many studies, exposure to air pollution increases cardiovascular morbidity and mortality. It has also been shown that the frequency of heart rhythm disorders in Region wallonne is very high. OBJECTIVES The objective of this study is to test the hypothesis of a link between rhythm disorders measured by cardiac holters and data from devices measuring the concentration of air pollutants present in ambient air. METHODOLOGY The health data were obtained via the Erasme hospital's cardiology center. This is a retrospective data collection over the last 2 to 5 years. The environmental data are: PM2.5, PM10, NO2, O3 and temperature. The statistical models were based on "cross-case" analyses. RESULTS An association between PM10 and the number of ESAs was observed. An increase of 10μg/m3 of PM10 increases the number of ESAs by 20% (P=0.040). The number of ESAs increases with age (63% more ESAs when age increases by 10 years). A history of intervention also decreases the number of ESAs (-35%), the same phenomenon is observed for pacemaker wearers (-66%). The strongest association observed between NO2 and ESA with an OR of 1.37 (P=0.027) in the final model. No significant association was observed between the effects of air pollution and VPCs. CONCLUSION Our analyses resume the effects of the different pollutants on rhythm disorders, the effects adjusted for treatment and co-morbidities. They open the door to other more refined studies based on individual measurements.
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Affiliation(s)
- R Miarimbola
- Centre de recherche épidémiologie, biostatistiques et recherche clinique, école de santé publique, université libre de Bruxelles (ULB), Route de Lennik 808, CP 596, 1070 Bruxelles, Belgique.
| | - P Collart
- Centre de recherche épidémiologie, biostatistiques et recherche clinique, école de santé publique, université libre de Bruxelles (ULB), Route de Lennik 808, CP 596, 1070 Bruxelles, Belgique
| | - R Casado-Arroyo
- Unité d'électrophysiologie et stimulation cardiaque, CHU Erasme, Bruxelles, Belgique
| | - Y Coppieters
- Centre de recherche épidémiologie, biostatistiques et recherche clinique, école de santé publique, université libre de Bruxelles (ULB), Route de Lennik 808, CP 596, 1070 Bruxelles, Belgique
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Rajagopalan S, Brauer M, Bhatnagar A, Bhatt DL, Brook JR, Huang W, Münzel T, Newby D, Siegel J, Brook RD. Personal-Level Protective Actions Against Particulate Matter Air Pollution Exposure: A Scientific Statement From the American Heart Association. Circulation 2020; 142:e411-e431. [PMID: 33150789 DOI: 10.1161/cir.0000000000000931] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Since the publication of the last American Heart Association scientific statement on air pollution and cardiovascular disease in 2010, unequivocal evidence of the causal role of fine particulate matter air pollution (PM2.5, or particulate matter ≤2.5 μm in diameter) in cardiovascular disease has emerged. There is a compelling case to provide the public with practical personalized approaches to reduce the health effects of PM2.5. Such interventions would be applicable not only to individuals in heavily polluted countries, high-risk or susceptible individuals living in cleaner environments, and microenvironments with higher pollution exposures, but also to those traveling to locations with high levels of PM2.5. The overarching motivation for this document is to summarize the current evidence supporting personal-level strategies to prevent the adverse cardiovascular effects of PM2.5, guide the use of the most proven/viable approaches, obviate the use of ineffective measures, and avoid unwarranted interventions. The significance of this statement relates not only to the global importance of PM2.5, but also to its focus on the most tested interventions and viable approaches directed at particulate matter air pollution. The writing group sought to provide expert consensus opinions on personal-level measures recognizing the current uncertainty and limited evidence base for many interventions. In doing so, the writing group acknowledges that its intent is to assist other agencies charged with protecting public health, without minimizing the personal choice considerations of an individual who may decide to use these interventions in the face of ongoing air pollution exposure.
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Dales R, Lee DS, Wang X, Cakmak S, Szyszkowicz M, Shutt R, Birnie D. Do acute changes in ambient air pollution increase the risk of potentially fatal cardiac arrhythmias in patients with implantable cardioverter defibrillators? Environ Health 2020; 19:72. [PMID: 32552837 PMCID: PMC7301471 DOI: 10.1186/s12940-020-00622-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 06/08/2020] [Indexed: 05/15/2023]
Abstract
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 (PM2.5), 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 PM2.5, 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.
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Affiliation(s)
- Robert Dales
- Environmental Health Science and Research Bureau, Health Canada, and Ottawa Hospital Research Institute, University of Ottawa, 101 Tunney’s Pasture Driveway, Ottawa, ON K1A 0K9 Canada
| | - Douglas S. Lee
- ICES, Peter Munk Cardiac Centre of University Health Network, University of Toronto, Toronto, Canada
| | | | - Sabit Cakmak
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
| | | | - Robin Shutt
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
| | - David Birnie
- Arrhythmia Service, Department of Medicine, Heart Institute, University of Ottawa, Ottawa, Canada
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Yang M, Zhou R, Qiu X, Feng X, Sun J, Wang Q, Lu Q, Zhang P, Liu B, Li W, Chen M, Zhao Y, Mo B, Zhou X, Zhang X, Hua Y, Guo J, Bi F, Cao Y, Ling F, Shi S, Li YG. Artificial intelligence-assisted analysis on the association between exposure to ambient fine particulate matter and incidence of arrhythmias in outpatients of Shanghai community hospitals. ENVIRONMENT INTERNATIONAL 2020; 139:105745. [PMID: 32334122 DOI: 10.1016/j.envint.2020.105745] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Recently, the impact of fine particulate matter pollution on cardiovascular system is drawing considerable concern worldwide. The association between ambient fine particulate and the cardiac arrhythmias is not clear now. OBJECTIVE To study associations of ambient fine particulate with incidence of arrhythmias in outpatients. METHODS Data was collected from the remote electrocardiogram (ECG) system covering 282 community hospitals in Shanghai from June 24th, 2014 to June 23rd, 2016. ECG was performed for patients admitted to above hospitals with complaining of chest discomfort or palpitation, or for regular check-ups. Air quality data during this time period was obtained from China National Environment Monitoring Center. A generalized additive quasi-Poisson model was established to examine the associations between PM2.5 and cardiac arrhythmias. RESULTS Cardiac arrhythmias were detected in 202,661 out of 1,016,579 outpatients (19.9%) and fine particulate matter ranged from 6 to 219 μg/m3 during this period. Positive associations were evidenced between fine particulate matter level and prevalence of cardiac arrhythmia by different lag models. Per 10 μg/m3 increase in fine particulate matter was associated with a 0.584%(95%CI:0.346-0.689%, p < 0.001) increase of cardiac arrhythmia detected in these patient cohort at lag0-2. For different types of cardiac arrhythmias, an immediate arrhythmogenic effect of fine particulate matter (increase of the estimates of cardiac arrhythmia prevalence detected in daily outpatient visits) was found with paroxysmal supraventricular tachycardia; a lag effect was found with atrial fibrillation; and both immediate and lag effect was found with premature atrial contractions or atrial tachycardia, atrioventricular block. Moreover, the impact of fine particulate matter on cardiac arrhythmias was significantly greater in women (lag3 and lag0-4), and in people aged <65 years (lag0). CONCLUSION Ambient exposure to fine particulate matter is linked with increased risk of arrhythmias in outpatients visiting Shanghai community hospitals, with an immediate or lag effect. The arrhythmogenic effect varies among different types of cardiac arrhythmias.
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Affiliation(s)
- Mei Yang
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Runze Zhou
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Department of Cardiology, East Hospital, Tongji University, Shanghai, China
| | | | - Xiangfei Feng
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jian Sun
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qunshan Wang
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qiufen Lu
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Pengpai Zhang
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bo Liu
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Li
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mu Chen
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Zhao
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Binfeng Mo
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xin Zhou
- Clinical Research Unit, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xi Zhang
- Clinical Research Unit, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yingxue Hua
- Pudong New Area Heqing Community Health Center, Shanghai, China
| | - Jin Guo
- Shanghai Huangpu Bund Subdistrict Community Health Center, Shanghai, China
| | - Fangfang Bi
- Changning Tianshan Community Health Center, Shanghai, China
| | - Yajun Cao
- Pudong New Area Sunqiao Community Health Center, Shanghai, China
| | - Feng Ling
- Shanghai Lingyun Community Health Center, Shanghai, China
| | - Shengming Shi
- Shangnail Xinhua Street Community Health Service Center, Shanghai, China
| | - Yi-Gang Li
- Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Yao J, Stieb DM, Taylor E, Henderson SB. Assessment of the Air Quality Health Index (AQHI) and four alternate AQHI-Plus amendments for wildfire seasons in British Columbia. Canadian Journal of Public Health 2019; 111:96-106. [PMID: 31286460 DOI: 10.17269/s41997-019-00237-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/04/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Wildfire smoke is an important source of air pollution associated with a range of cardiopulmonary health conditions. The Air Quality Health Index (AQHI) is the most widely used tool in Canada to communicate with the public about air pollution, but it may not adequately reflect health risks from wildfire smoke. The objective of this study was to evaluate the ability of the AQHI and four alternate AQHI-Plus amendments to predict adverse population health effects from wildfire smoke. METHODS The maximum 1-h values of the AQHI and the four amendments were calculated for each 48-h period of the wildfire seasons from 2010 to 2017 for 32 health units in British Columbia. Generalized Poisson models were used to estimate the association between these values and daily counts of five health outcomes: all-cause mortality; physician visits for all circulatory causes; visits for all respiratory causes, including asthma; asthma-specific visits; and dispensations of salbutamol sulfate (i.e., Ventolin®). Model fit was evaluated with the Akaike information criterion. RESULTS The AQHI and the four amendments were all associated with all five health outcomes. The AQHI exhibited best fit to the all-cause mortality and circulatory physician visits during all wildfire seasons, while the 1-h PM2.5Only AQHI-Plus exhibited best fit to the asthma-related outcomes during all wildfire seasons. CONCLUSION Individuals with common respiratory conditions such as asthma and chronic obstructive pulmonary disease are particularly susceptible to wildfire smoke. As such, the 1-h PM2.5Only AQHI-Plus amendment was recommended for communicating about potential health effects of air quality during wildfire seasons in BC.
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Affiliation(s)
- Jiayun Yao
- Environmental Health Services, British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
| | - Dave M Stieb
- Environmental Health Science and Research Bureau, Health Canada, 420-757 West Hastings St. - Federal Tower, Vancouver, BC, V6C 1A1, Canada
| | - Eric Taylor
- BC Ministry of Environment and Climate Change Strategy, 525 Superior St., Victoria, BC, V8V 1T7, Canada
| | - Sarah B Henderson
- Environmental Health Services, British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada.
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Ambient fine particulate matter induce toxicity in lung epithelial-endothelial co-culture models. Toxicol Lett 2019; 301:133-145. [DOI: 10.1016/j.toxlet.2018.11.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 11/13/2018] [Accepted: 11/22/2018] [Indexed: 01/09/2023]
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Molina-Sotomayor E, González Orb M, Pradas de la Fuente F, Carozzi Figueroa G, Sánchez-Oliver AJ, González-Jurado JA. Effects of Cardiorespiratory Exercise on Cognition in Older Women Exposed to Air Pollution. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020245. [PMID: 30654519 PMCID: PMC6352227 DOI: 10.3390/ijerph16020245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/08/2019] [Accepted: 01/12/2019] [Indexed: 12/22/2022]
Abstract
The aim was to analyze the effects of cardiorespiratory exercise and air pollution on cognition and cardiovascular markers in four groups of older women: the active/clean air group (AC), the active/polluted air group (AP), the sedentary/clean air group (SC), and the sedentary/polluted air group (SP). Active groups performed a training task based on progressive walking. Prior to and after the experiment, the following parameters were assessed: cognition, by Mini Mental State Examination (MMSE); maximum oxygen uptake (VO2max), estimated by the Six-Minute Walk Test (6mWT); heart rate (HR); and oxygen saturation (SpO2). There were significant differences (p < 0.05) between the AC and the SP in all the MMSE dimensions except “Registration”, and in all the physiological variables (VO2max, SpO2, HR). Aerobic exercise may be a protective factor against the effects that pollution have on cognition and on the mechanisms of oxygen transport.
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Affiliation(s)
- Edgardo Molina-Sotomayor
- Departamento de Educación Física, Universidad Metropolitana de Ciencias de la Educación, Santiago 7760197, Chile.
| | - Marcelo González Orb
- Departamento de Educación Física, Universidad Metropolitana de Ciencias de la Educación, Santiago 7760197, Chile.
| | | | - Giovanni Carozzi Figueroa
- Departamento de Educación Física, Universidad San Sebastián-Chile, Recoleta, Santiago 8420000, Chile.
| | - Antonio Jesús Sánchez-Oliver
- Facultad de Ciencias del Deporte, Universidad Pablo de Olavide, Sevilla 41013, Spain.
- Área de Motricidad Humana y Rendimiento Deportivo, Universidad de Sevilla, Sevilla 41013, Spain.
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Liu X, Kong D, Liu Y, Fu J, Gao P, Chen T, Fang Q, Cheng K, Fan Z. Effects of the short-term exposure to ambient air pollution on atrial fibrillation. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2018; 41:1441-1446. [PMID: 30225893 DOI: 10.1111/pace.13500] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 07/25/2018] [Accepted: 09/05/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Xiaole Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College; Chinese Academy of Medical Sciences; Beijing China
| | - Dehui Kong
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College; Chinese Academy of Medical Sciences; Beijing China
| | - Yanbo Liu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College; Chinese Academy of Medical Sciences; Beijing China
| | - Jia Fu
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College; Chinese Academy of Medical Sciences; Beijing China
| | - Peng Gao
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College; Chinese Academy of Medical Sciences; Beijing China
| | - Taibo Chen
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College; Chinese Academy of Medical Sciences; Beijing China
| | - Quan Fang
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College; Chinese Academy of Medical Sciences; Beijing China
| | - Kang'an Cheng
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College; Chinese Academy of Medical Sciences; Beijing China
| | - Zhongjie Fan
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College; Chinese Academy of Medical Sciences; Beijing China
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Stergiopoulou A, Katavoutas G, Samoli E, Dimakopoulou K, Papageorgiou I, Karagianni P, Flocas H, Katsouyanni K. Assessing the associations of daily respiratory symptoms and lung function in schoolchildren using an Air Quality Index for ozone: Results from the RESPOZE panel study in Athens, Greece. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 633:492-499. [PMID: 29579660 DOI: 10.1016/j.scitotenv.2018.03.159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/13/2018] [Accepted: 03/15/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Air Quality indicators or indices (AQIs) are mainly used for communicating the air pollution levels and risk to the general population. However, very few epidemiological studies have used AQIs for characterizing exposure. OBJECTIVE In the framework of the RESPOZE panel study we evaluated the association of daily ozone AQI levels with the daily occurrence of respiratory symptoms and Peak Expiratory Flow (PEF) and compared the effects with those estimated using measurements from fixed outdoor monitoring sites, in the city of Athens, Greece. MATERIALS AND METHODS A panel of 97 children, aged 10-11years, was followed intensively for 35days (5weeks) during the academic year 2013-14. PEF and symptoms were recorded daily by each child. Two ozone AQIs classifying the air quality into 7 categories of increasing severity, were calculated; one characterizing the whole Athens area and one the local area around the child's residence and school. Measurements from fixed sites were also used. Mixed effects models for repeated measurements were applied, adjusting for several confounders. RESULTS Increasing ozone levels were associated with increased incidence of symptoms, but the strongest and most statistically significant associations were found with the local air quality characterization with the AQI. Specifically, an increase in AQI-local by one category was associated with 34% (95% CI: 9%, 64%) increased odds of stuffy nose. When the AQI categories were "Bad" and "Severe", an increase in the incidence of cough was observed (OR 3.05 (95% CI: 1.29, 7.22) and 6.42 (95% CI: 1.47, 28.03) respectively). We did not observe a statistically significant association between AQI and PEF. CONCLUSION Our results show that the use of an AQI based on local conditions may be advantageous over the use of only measurements when investigating the effects of air pollution on health outcomes for improving communication of risk to the public.
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Affiliation(s)
- Aravella Stergiopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - George Katavoutas
- Department of Physics, Section of Environmental Physics-Meteorology, National and Kapodistrian University of Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Konstantina Dimakopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Ifigeneia Papageorgiou
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Pinelopi Karagianni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Helena Flocas
- Department of Physics, Section of Environmental Physics-Meteorology, National and Kapodistrian University of Athens, Greece
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens Medical School, Athens, Greece; School of Population Health and Environmental Sciences, King's College London, UK.
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Cardiorespiratory Effects of Air Pollution in a Panel Study of Winter Outdoor Physical Activity in Older Adults. J Occup Environ Med 2018; 60:673-682. [DOI: 10.1097/jom.0000000000001334] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Babadjouni RM, Hodis DM, Radwanski R, Durazo R, Patel A, Liu Q, Mack WJ. Clinical effects of air pollution on the central nervous system; a review. J Clin Neurosci 2017; 43:16-24. [PMID: 28528896 PMCID: PMC5544553 DOI: 10.1016/j.jocn.2017.04.028] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/22/2017] [Indexed: 12/20/2022]
Abstract
The purpose of this review is to describe recent clinical and epidemiological studies examining the adverse effects of urban air pollution on the central nervous system (CNS). Air pollution and particulate matter (PM) are associated with neuroinflammation and reactive oxygen species (ROS). These processes affect multiple CNS pathways. The conceptual framework of this review focuses on adverse effects of air pollution with respect to neurocognition, white matter disease, stroke, and carotid artery disease. Both children and older individuals exposed to air pollution exhibit signs of cognitive dysfunction. However, evidence on middle-aged cohorts is lacking. White matter injury secondary to air pollution exposure is a putative mechanism for neurocognitive decline. Air pollution is associated with exacerbations of neurodegenerative conditions such as Alzheimer's and Parkinson's diseases. Increases in stroke incidences and mortalities are seen in the setting of air pollution exposure and CNS pathology is robust. Large populations living in highly polluted environments are at risk. This review aims to outline current knowledge of air pollution exposure effects on neurological health.
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Affiliation(s)
- Robin M Babadjouni
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States; Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Drew M Hodis
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Ryan Radwanski
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Ramon Durazo
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States; Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Arati Patel
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States; Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Qinghai Liu
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - William J Mack
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States; Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
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Association between Air Pollution and Emergency Room Visits for Atrial Fibrillation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017. [PMID: 28632149 PMCID: PMC5486347 DOI: 10.3390/ijerph14060661] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Despite the large prevalence in the population, possible factors responsible for the induction of atrial fibrillation (AF) events in susceptible individuals remain incompletely understood. We investigated the association between air pollution levels and emergency department admissions for AF in Rome. We conducted a 14 years’ time-series study to evaluate the association between the daily levels of air pollution (particulate matter, PM10 and PM2.5, and nitrogen dioxide, NO2) and the daily count of emergency accesses for AF (ICD-9 code: 427.31). We applied an over-dispersed conditional Poisson model to analyze the associations at different lags after controlling for time, influenza epidemics, holiday periods, temperature, and relative humidity. Additionally, we evaluated bi-pollutant models by including the other pollutant and the influence of several effect modifiers such as personal characteristics and pre-existing medical conditions. In the period of study, 79,892 individuals were admitted to the emergency departments of Rome hospitals because of AF (on average, 15.6 patients per day: min = 1, max = 36). Air pollution levels were associated with increased AF emergency visits within 24 h of exposure. Effect estimates ranged between 1.4% (0.7–2.3) for a 10 µg/m3 increase of PM10 to 3% (1.4–4.7) for a 10 µg/m3 increase of PM2.5 at lag 0–1 day. Those effects were higher in patients ≥75 years for all pollutants, male patients for PM10, and female patients for NO2. The presence of previous cardiovascular conditions, but not other effect modifiers, increase the pollution effects by 5–8% depending on the lag. This study found evidence that air pollution is associated with AF emergency visits in the short term.
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Shutt RH, Kauri LM, Weichenthal S, Kumarathasan P, Vincent R, Thomson EM, Liu L, Mahmud M, Cakmak S, Dales R. Exposure to air pollution near a steel plant is associated with reduced heart rate variability: a randomised crossover study. Environ Health 2017; 16:4. [PMID: 28129768 PMCID: PMC5273798 DOI: 10.1186/s12940-016-0206-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 12/03/2016] [Indexed: 05/27/2023]
Abstract
BACKGROUND Epidemiological studies have shown that as ambient air pollution (AP) increases the risk of cardiovascular mortality also increases. The mechanisms of this effect may be linked to alterations in autonomic nervous system function. We wished to examine the effects of industrial AP on heart rate variability (HRV), a measure of subtle changes in heart rate and rhythm representing autonomic input to the heart. METHODS Sixty healthy adults were randomized to spend five consecutive 8-h days outdoors in one of two locations: (1) adjacent to a steel plant in the Bayview neighbourhood in Sault Ste Marie Ontario or (2) at a College campus, several kilometers from the plant. Following a 9-16 day washout period, participants spent five consecutive days at the other site. Ambient AP levels and ambulatory electrocardiogram recordings were collected daily. HRV analysis was undertaken on a segment of the ambulatory ECG recording during a 15 min rest period, near the end of the 8-h on-site day. Standard HRV parameters from both time and frequency domains were measured. Ambient AP was measured with fixed site monitors at both sites. Statistical analysis was completed using mixed-effects models. RESULTS Compared to the College site, HRV was statistically significantly reduced at the Bayview site by 13% (95%CI 3.6,19.2) for the standard deviation of normal to normal, 8% (95%CI 0.1, 4.9) for the percent normal to normal intervals differing by more than 50 ms, and 15% (95%CI 74.9, 571.2) for low frequency power. Levels of carbon monoxide, sulphur dioxide, nitrogen dioxide, and fine and ultrafine particulates were slightly, but statistically significantly, elevated at Bayview when compared to College. Interquartile range changes in individual air pollutants were significantly associated with reductions in HRV measured on the same day. The patterns of effect showed a high degree of consistency, with nearly all pollutants significantly inversely associated with at least one measure of HRV. CONCLUSIONS The significant associations between AP and changes in HRV suggest that ambient AP near a steel plant may impact autonomic nervous system control of the heart.
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Affiliation(s)
- Robin H. Shutt
- Population Studies Division, Environmental Health Science Research Bureaum Health Canada, 50 Colombine Driveway, Ottawa, ON K1A 0 K9 Canada
| | - Lisa Marie Kauri
- Population Studies Division, Environmental Health Science Research Bureaum Health Canada, 50 Colombine Driveway, Ottawa, ON K1A 0 K9 Canada
| | - Scott Weichenthal
- Air Health Sciences Division, Water and Air Quality Bureau, Health Canada, 269 Laurier Ave W, Ottawa, ON K1A 0 K9 Canada
| | - Premkumari Kumarathasan
- Mechanistic Studies Division, Environmental Health Science Research Bureau, Health Canada, 50 Colombine Driveway, Ottawa, ON K1A 0 K9 Canada
| | - Renaud Vincent
- Hazard Identification Division, Environmental Health Science Research Bureau, Health Canada, 50 Colombine Driveway, Ottawa, ON K1A 0 K9 Canada
| | - Errol M. Thomson
- Hazard Identification Division, Environmental Health Science Research Bureau, Health Canada, 50 Colombine Driveway, Ottawa, ON K1A 0 K9 Canada
| | - Ling Liu
- Population Studies Division, Environmental Health Science Research Bureaum Health Canada, 50 Colombine Driveway, Ottawa, ON K1A 0 K9 Canada
| | - Mamun Mahmud
- Population Studies Division, Environmental Health Science Research Bureaum Health Canada, 50 Colombine Driveway, Ottawa, ON K1A 0 K9 Canada
| | - Sabit Cakmak
- Population Studies Division, Environmental Health Science Research Bureaum Health Canada, 50 Colombine Driveway, Ottawa, ON K1A 0 K9 Canada
| | - Robert Dales
- Population Studies Division, Environmental Health Science Research Bureaum Health Canada, 50 Colombine Driveway, Ottawa, ON K1A 0 K9 Canada
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22
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Shao Q, Liu T, Korantzopoulos P, Zhang Z, Zhao J, Li G. Association between air pollution and development of atrial fibrillation: A meta-analysis of observational studies. Heart Lung 2016; 45:557-562. [PMID: 27590407 DOI: 10.1016/j.hrtlng.2016.08.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 07/25/2016] [Accepted: 08/01/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Current evidence suggests that gaseous or particulate pollutants may increase the risk of atrial fibrillation (AF), although this association is still uncertain. METHODS We conducted a systematic review of literature using PubMed, Ovid, Embase and Web of Science to identify studies reporting on the association between gaseous (ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide) or particulate matter 2.5 (PM2.5) and AF risk published until March 2015. The overall effect estimate was presented as the population-attributable risks with 95% CI. We used both fix-effects and random effects models to calculate the overall effect estimate. RESULTS We retrieved 4 studies, involving 461,441 participants. There was a statistically significant association between AF development and all gaseous pollutant as well as PM2.5 [NO: 1.19% (0.70-1.67%), CO: 0.60 (0.20-1.09), SO2: 0.90 (0.60-1.28), O3: 1.09 (0.20-1.86), PM2.5: 0.89 (0.20-1.57)]. CONCLUSIONS Our comprehensive meta-analysis suggests that gaseous or particulate pollutants are associated with the increased risk of AF.
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Affiliation(s)
- Qingmiao Shao
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People's Republic of China
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People's Republic of China.
| | | | - Zhiwei Zhang
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People's Republic of China
| | - Jianping Zhao
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People's Republic of China
| | - Guangping Li
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People's Republic of China.
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23
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Cakmak S, Hebbern C, Vanos J, Crouse DL, Burnett R. Ozone exposure and cardiovascular-related mortality in the Canadian Census Health and Environment Cohort (CANCHEC) by spatial synoptic classification zone. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2016; 214:589-599. [PMID: 27131819 DOI: 10.1016/j.envpol.2016.04.067] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 04/16/2016] [Accepted: 04/17/2016] [Indexed: 05/29/2023]
Abstract
Our objective is to analyse the association between long term ozone exposure and cardiovascular related mortality while accounting for climate, location, and socioeconomic factors. We assigned subjects with 16 years of follow-up in the Canadian Census Health and Environment Cohort (CanCHEC) to one of seven regions based on spatial synoptic classification (SSC) weather types and examined the interaction of exposure to both fine particulate matter (PM2.5) and ground level ozone and cause of death using survival analysis, while adjusting for socioeconomic characteristics and individual confounders. Correlations between ozone and PM2.5 varied across SSC zones from -0.02 to 0.7. Comparing zones using the most populated SSC zone as a reference, a 10 ppb increase in ozone exposure was associated with increases in hazard ratios (HRs) that ranged from 1.007 (95% CI 0.99, 1.015) to 1.03 (95% CI 1.02, 1.041) for cardiovascular disease, 1.013 (95% CI 0.996, 1.03) to 1.058 (95% CI 1.034, 1.082) for cerebrovascular disease, and 1.02 (95% CI 1.006, 1.034) for ischemic heart disease. HRs remained significant after adjustment for PM2.5. Long term exposure to ozone is related to an increased risk of mortality from cardiovascular and cerebrovascular diseases; the risk varies by location across Canada and is not attenuated by adjustment for PM2.5. This research shows that the SSC can be used to define geographic regions and it demonstrates the importance of accounting for that spatial variability when studying the long term health effects of air pollution.
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Affiliation(s)
- Sabit Cakmak
- Population Studies Division, Environmental Health Science & Research Bureau, Health Canada, 50 Columbine Driveway, Ottawa, ON K1A 0K9, Canada.
| | - Chris Hebbern
- Population Studies Division, Environmental Health Science & Research Bureau, Health Canada, 50 Columbine Driveway, Ottawa, ON K1A 0K9, Canada
| | - Jennifer Vanos
- Department of Geosciences, Texas Tech University, Box 41053, Lubbock, TX 79409-1053, USA
| | - Dan L Crouse
- Department of Sociology, University of New Brunswick, PO Box 4400, Fredericton, NB E3B 5A3, Canada
| | - Rick Burnett
- Population Studies Division, Environmental Health Science & Research Bureau, Health Canada, 50 Columbine Driveway, Ottawa, ON K1A 0K9, Canada
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24
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Matz CJ, Stieb DM, Brion O. Urban-rural differences in daily time-activity patterns, occupational activity and housing characteristics. Environ Health 2015; 14:88. [PMID: 26566986 PMCID: PMC4644325 DOI: 10.1186/s12940-015-0075-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 11/03/2015] [Indexed: 05/19/2023]
Abstract
BACKGROUND There is evidence that rural residents experience a health disadvantage compared to urban residents, associated with a greater prevalence of health risk factors and socioeconomic differences. We examined differences between urban and rural Canadians using data from the Canadian Human Activity Pattern Survey (CHAPS) 2. METHODS Data were collected from 1460 respondents in two rural areas (Haldimand-Norfolk, Ontario and Annapolis Valley-Kings County, Nova Scotia) and 3551 respondents in five urban areas (Vancouver, Edmonton, Toronto, Montreal, and Halifax) using a 24-h recall diary and supplementary questionnaires administered using computer-assisted telephone interviews. We evaluated differences in time-activity patterns, occupational activity, and housing characteristics between rural and urban populations using multivariable linear and logistic regression models adjusted for design as well as demographic and socioeconomic covariates. Taylor linearization method and design-adjusted Wald tests were used to test statistical significance. RESULTS After adjustment for demographic and socioeconomic covariates, rural children, adults and seniors spent on average 0.7 (p < 0.05), 1.2 (p < 0.001), and 0.9 (p < 0.001) more hours outdoors per day respectively than urban counterparts. 23.1% (95% CI: 19.0-27.2%) of urban and 37.8% (95% CI: 31.2-44.4%) of rural employed populations reported working outdoors and the distributions of job skill level and industry differed significantly (p < 0.001) between urban and rural residents. In particular, 11.4% of rural residents vs. 4.9% of urban residents were employed in unskilled jobs, and 11.5% of rural residents vs. <0.5% of urban residents were employ in primary industry. Rural residents were also more likely than urban residents to report spending time near gas or diesel powered equipment other than vehicles (16.9% vs. 5.2%, p < 0.001), more likely to report wood as a heating fuel (9.8% vs. <0.1%; p < 0.001 for difference in distribution of heating fuels), less likely to have an air conditioner (43.0% vs. 57.2%, p < 0.001), and more likely to smoke (29.1% vs. 19.0 %, p < 0.001). Private wells were the main water source in rural areas (68.6%) in contrast to public water systems (97.6%) in urban areas (p < 0.001). Despite these differences, no differences in self-reported health status were observed between urban and rural residents. CONCLUSIONS We identified a number of differences between urban and rural residents, which provide evidence pertinent to the urban-rural health disparity.
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Affiliation(s)
- Carlyn J Matz
- Air Health Effects Assessment Division, Health Canada, 269 Laurier Ave W, PL 4903C, Ottawa, ON, K1A 0K9, Canada.
| | - David M Stieb
- Population Studies Division, Health Canada, 445-757 West Hasting St., Federal Tower, Vancouver, BC, V6C 1A1, Canada.
| | - Orly Brion
- Population Studies Division, Health Canada, 50 Colombine Driveway, Tunney's Pasture, PL 0801A, Ottawa, ON, K1A 0K9, Canada.
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