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Kuźma Ł, Dąbrowski EJ, Kurasz A, Święczkowski M, Jemielita P, Kowalewski M, Wańha W, Kralisz P, Tomaszuk-Kazberuk A, Bachórzewska-Gajewska H, Dobrzycki S, Lip GY. Effect of air pollution exposure on risk of acute coronary syndromes in Poland: a nationwide population-based study (EP-PARTICLES study). THE LANCET REGIONAL HEALTH. EUROPE 2024; 41:100910. [PMID: 38665621 PMCID: PMC11041836 DOI: 10.1016/j.lanepe.2024.100910] [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: 01/30/2024] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024]
Abstract
Background Air pollution (AP) is linked up to 20% of cardiovascular deaths. The aim of this nationwide study was to investigate subpopulations vulnerable to AP for non-ST- (NSTEMI) and ST-elevation myocardial infarction (STEMI) incidence. Methods We analysed short- (lags up to seven days) and mid-term (0-30 days moving average) influence of particulate matter (PM2.5), sulphur dioxide (SO2), nitrogen dioxide (NO2) and benzo(a)pyrene (BaP) on hospitalizations due NSTEMI and STEMI in 2011-2020. Data on AP concentrations were derived using GEM-AQ model. Study included residents of five voivodeships in eastern Poland, inhabited by over 8,000,000 individuals. Findings Higher NO2 and PM2.5 concentrations increased mid-term risk of NSTEMI in patients aged < 65 years by 1.3-5.7%. Increased SO2 and PM2.5 concentration triggered STEMI in the short- (SO2, PM2.5) and mid-term (PM2.5) amongst those aged ≥ 65 years. In the short- and mid-term, women were more susceptible to PM2.5 and BaP influence resulting in increased STEMI incidence. In rural regions, STEMI risk was triggered by SO2, PM2.5 and BaP. Income-based stratification showed disproportions regarding influence of BaP concentrations on NSTEMI incidence based on gross domestic product (up to 1.4%). Interpretation There are significant disparities in the influence of air pollution depending on the demographic and socio-economic factors. AP exposure is associated with the threat of a higher risks of NSTEMI and STEMI, especially to younger people, women, residents of rural areas and those with lower income. Funding National Science Center and Medical University of Bialystok, Poland.
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Affiliation(s)
- Łukasz Kuźma
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Emil J. Dąbrowski
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Anna Kurasz
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Michał Święczkowski
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Piotr Jemielita
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Mariusz Kowalewski
- Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, 137 Wołoska St., Warszawa 02-507, Poland
- Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), Cardiovascular Research Centre Maastricht (CARIM), P. Debyelaan 25, Maastricht 6229 HX, the Netherlands
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, 1 Via Tricomi, Palermo 90127, Italy
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, 13/15 Jagiellońska St., Bydgoszcz 85-067, Poland
| | - Wojciech Wańha
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, 13/15 Jagiellońska St., Bydgoszcz 85-067, Poland
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 15 Poniatowskiego St., Katowice 40-055, Poland
| | - Paweł Kralisz
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Anna Tomaszuk-Kazberuk
- Department of Cardiology, Lipidology and Internal Medicine with Intensive Coronary Care Unit, Medical University of Bialystok, 14 Żurawia St., Białystok 15-540, Poland
| | - Hanna Bachórzewska-Gajewska
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Sławomir Dobrzycki
- Department of Invasive Cardiology, Medical University of Białystok, 1 Kilinskiego St., Białystok 15-089, Poland
| | - Gregory Y.H. Lip
- Department of Cardiology, Lipidology and Internal Medicine with Intensive Coronary Care Unit, Medical University of Bialystok, 14 Żurawia St., Białystok 15-540, Poland
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Egerton Court, 2 Rodney St, Liverpool L3 5UX, United Kingdom
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Fredrik Bajers Vej 7K, Aalborg 9220, Denmark
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Strobl K, Irfan SA, Masood H, Latif N, Kurmi O. Association between PM10 exposure and risk of myocardial infarction in adults: A systematic review and meta-analysis. PLoS One 2024; 19:e0301374. [PMID: 38691568 PMCID: PMC11062553 DOI: 10.1371/journal.pone.0301374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 03/11/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Air pollution has several negative health effects. Particulate matter (PM) is a pollutant that is often linked to health adversities. PM2.5 (PM with an aerodynamic diameter of ≤2.5μm) exposure has been associated with negative cardiovascular (CV) outcomes. However, the impact of PM10 (PM with an aerodynamic diameter of ≤10μm) exposure is often overlooked due to its limited ability to pass the alveolar barrier. This study aims to assess the association between PM10 exposure and risk of myocardial infarction (MI) amongst adults (≥18 years of age) as this has been poorly studied. METHODS The study protocol was published on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023409796) on March 31, 2023. Literature searches were conducted on 4 databases (Ovid Medline, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Web of Science) on January 17, 2023, for studies looking at associations between PM and MI. English studies from all time periods were assessed. Studies selected for review were time-series, case-crossover, and cohort studies which investigated the risk of MI as an outcome upon PM10 exposure. The quality of evidence was assessed using Cochrane's Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Data for different risk outcomes (risk ratio (RR), odds ratio (OR), hazard ratio (HR)) and 3 lags was meta-analyzed using an inverse variance statistical analysis using a random effects model. The pooled effect sizes and the 95% confidence intervals (CIs) were reported in forest plots. RESULTS Among the 1,099 studies identified, 41 were included for review and 23 were deemed eligible for meta-analysis. Our analysis revealed that there is an increased risk (OR = 1.01; 95% CI:1.00-1.02) of MI with a 10 μg/m3 increase in PM10 after a lag 0 and lag 1 delay. CONCLUSIONS Our findings indicate that PM10 exposure is associated with an increased risk of MI. This can aid in informing environmental policy-making, personal-level preventative measures, and global public health action.
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Affiliation(s)
- Kleiton Strobl
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Syed Asad Irfan
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Hassan Masood
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Noor Latif
- Faculty of Science, McMaster University, Hamilton, Canada
| | - Om Kurmi
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
- Faculty Research Centre for Healthcare and Communities, Coventry University, Coventry, United Kingdom
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Święczkowski M, Dobrzycki S, Kuźma Ł. Multi-City Analysis of the Acute Effect of Polish Smog on Cause-Specific Mortality (EP-PARTICLES Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085566. [PMID: 37107848 PMCID: PMC10139136 DOI: 10.3390/ijerph20085566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 05/11/2023]
Abstract
Polish smog is a specific type of air pollution present in Eastern Poland, which may cause particularly adverse cardiovascular effects. It is characterized primarily by high concentrations of particulate matter (PM) and different favorable conditions of formation. Our study aimed to assess whether PM and nitrogen dioxide (NO2) have a short-term impact on mortality due to acute coronary syndrome (ACS) and ischemic stroke (IS). The study covered the years 2016-2020, a total of 6 million person-years from five main cities in Eastern Poland. To evaluate the association between air pollution and cause-specific mortality, a case-crossover study design with conditional logistic regression was used at days with LAG from 0 to 2. We recorded 87,990 all-cause deaths, including 9688 and 3776 deaths due to ACS and IS, respectively. A 10 μg/m3 increase in air pollutants was associated with an increase in mortality due to ACS (PM2.5 OR = 1.029, 95%CI 1.011-1.047, p = 0.002; PM10 OR = 1.015, 95%CI 1-1.029, p = 0.049) on LAG 0. On LAG 1 we recorded an increase in both IS (PM2.5 OR = 1.03, 95%CI 1.001-1.058, p = 0.04) and ACS (PM2.5 OR = 1.028, 95%CI 1.01-1.047, p = 0.003; PM10 OR = 1.026, 95%CI 1.011-1.041, p = 0.001; NO2 OR = 1.036, 95%CI 1.003-1.07, p = 0.04). There was a strong association between air pollution and cause-specific mortality in women (ACS: PM2.5 OR = 1.032, 95%CI 1.006-1.058, p = 0.01; PM10 OR = 1.028, 95%CI 1.008-1.05, p = 0.01) and elderly (ACS: PM2.5 OR = 1.03, 95%CI 1.01-1.05, p = 0.003; PM10 OR = 1.027, 95% CI 1.011-1.043, p < 0.001 and IS: PM2.5 OR = 1.037, 95%CI 1.007-1.069, p = 0.01; PM10 OR = 1.025, 95%CI 1.001-1.05, p = 0.04). The negative influence of PMs was observed on mortality due to ACS and IS. NO2 was associated with only ACS-related mortality. The most vulnerable subgroups were women and the elderly.
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Ambient Air Pollution and Risk for Stroke Hospitalization: Impact on Susceptible Groups. TOXICS 2022; 10:toxics10070350. [PMID: 35878255 PMCID: PMC9324267 DOI: 10.3390/toxics10070350] [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: 05/26/2022] [Revised: 06/15/2022] [Accepted: 06/22/2022] [Indexed: 02/05/2023]
Abstract
Stroke is a leading cause of death, and air pollution is associated with stroke hospitalization. However, the susceptibility factors are unclear. Retrospective studies from 2014 to 2018 in Kaohsiung, Taiwan, were analyzed. Adult patients (>17 years) admitted to a medical center with stroke diagnosis were enrolled and patient characteristics and comorbidities were recorded. Air pollutant measurements, including those of particulate matter (PM) with aerodynamic diameters < 10 μm (PM10) and < 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3), were collected from air quality monitoring stations. During the study period, interquartile range (IQR) increments in PM2.5 on lag3 and lag4 were 12.3% (95% CI, 1.1−24.7%) and 11.5% (95% CI, 0.3−23.9%) concerning the risk of stroke hospitalization, respectively. Subgroup analysis revealed that the risk of stroke hospitalization after exposure to PM2.5 was greater for those with advanced age (≥80 years, interaction p = 0.045) and hypertension (interaction p = 0.034), after adjusting for temperature and humidity. A dose-dependent effect of PM2.5 on stroke hospitalization was evident. This is one of few studies focusing on the health effects of PM2.5 for patients with risk factors of stroke. We found that patients with risk factors, such as advanced age and hypertension, are more susceptible to PM2.5 impacts on stroke hospitalization.
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Arrivi A, Dominici M, Bier N, Truglio M, Vaudo G, Pucci G. Association Between Air Pollution and Acute Coronary Syndromes During Lockdown for COVID-19: Results From the Terni Hub Center. Front Public Health 2021; 9:683683. [PMID: 34249847 PMCID: PMC8264185 DOI: 10.3389/fpubh.2021.683683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background: During the lockdown for COVID-19, a massive decrease in hospital admissions for acute coronary syndrome (ACS) and a drop in air pollution were both detected in Italy. Our aim was to investigate the possible association between these two events at the Province of Terni, one of the most polluted urban and industrial area in Central Italy. Methods: We analyzed data of daily 24-h urban air concentrations of particulate matter (PM)10 and PM2.5 from fixed station monitoring network located in the main city centers of the Terni province, and accesses for ACS at the catheterization laboratory of the Cardiological Hub Center of the Terni University Hospital during lockdown. A comparison was made with data corresponding to the same lockdown time period of years 2019, 2018, and 2017. Results: Invasive procedures for ACS decreased in 2020 (n = 49) as compared with previous years (n = 93 in 2019, n = 109 in 2018, and n = 89 in 2017, p < 0.001). Conversely, reductions in average PM10 (20.7 μg/m3) and PM2.5 (14.7 μg/m3) in 2020 were consistent with a long-term decreasing trend, being comparable to those recorded in 2019 and 2018 (all p > 0.05) and slightly lower than 2017 (p < 0.05). The Granger-causality test demonstrated the lack of association between time-varying changes in air pollution and the number of procedures for ACS. Conclusions: Our results did not support the hypothesis that reduction in invasive procedures for ACS during lockdown was linked to an air cleaning effect. Reasons other than reduced air pollution should be sought to explain the observed decrease in ACS procedures.
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Affiliation(s)
- Alessio Arrivi
- Interventional Cardiology Unit, "Santa Maria" University Hospital, Terni, Italy
| | - Marcello Dominici
- Interventional Cardiology Unit, "Santa Maria" University Hospital, Terni, Italy.,Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Nicola Bier
- Interventional Cardiology Unit, "Santa Maria" University Hospital, Terni, Italy.,Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Mauro Truglio
- Laboratory of Cutaneous Physiopathology, San Gallicano Dermatological Institute Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Gaetano Vaudo
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy.,Unit of Internal Medicine, "Santa Maria" University Hospital, Terni, Italy
| | - Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy.,Unit of Internal Medicine, "Santa Maria" University Hospital, Terni, Italy
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Shin J, Oh J, Kang IS, Ha E, Pyun WB. Effect of Short-Term Exposure to Fine Particulate Matter and Temperature on Acute Myocardial Infarction in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4822. [PMID: 33946492 PMCID: PMC8124364 DOI: 10.3390/ijerph18094822] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIM Previous studies have suggested that the short-term ambient air pollution and temperature are associated with myocardial infarction. In this study, we aimed to conduct a time-series analysis to assess the impact of fine particulate matter (PM2.5) and temperature on acute myocardial infarction (AMI) among adults over 20 years of age in Korea by using the data from the Korean National Health Information Database (KNHID). METHODS The daily data of 192,567 AMI cases in Seoul were collected from the nationwide, population-based KNHID from 2005 to 2014. The monitoring data of ambient PM2.5 from the Seoul Research Institute of Public Health and Environment were also collected. A generalized additive model (GAM) that allowed for a quasi-Poisson distribution was used to analyze the effects of PM2.5 and temperature on the incidence of AMI. RESULTS The models with PM2.5 lag structures of lag 0 and 2-day averages of lag 0 and 1 (lag 01) showed significant associations with AMI (Relative risk [RR]: 1.011, CI: 1.003-1.020 for lag 0, RR: 1.010, CI: 1.000-1.020 for lag 01) after adjusting the covariates. Stratification analysis conducted in the cold season (October-April) and the warm season (May-September) showed a significant lag 0 effect for AMI cases in the cold season only. CONCLUSIONS In conclusion, acute exposure to PM2.5 was significantly associated with AMI morbidity at lag 0 in Seoul, Korea. This increased risk was also observed at low temperatures.
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Affiliation(s)
- Jiyoung Shin
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (J.S.); (J.O.)
- Inflammation-Cancer Microenvironment Research Center, College of Medicine, Ewha Womans University, Seoul 07804, Korea
| | - Jongmin Oh
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (J.S.); (J.O.)
| | - In-Sook Kang
- Department of Internal Medicine, Division of Cardiology, College of Medicine, Ewha Womans University, Seoul 07804, Korea;
| | - Eunhee Ha
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Korea; (J.S.); (J.O.)
- Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul 07804, Korea
| | - Wook-Bum Pyun
- Department of Internal Medicine, Division of Cardiology, College of Medicine, Ewha Womans University, Seoul 07804, Korea;
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Scheers H, Nawrot TS, Nemery B, De Troeyer K, Callens M, De Smet F, Van Nieuwenhuyse A, Casas L. Antithrombotic medication and endovascular interventions associated with short-term exposure to particulate air pollution: A nationwide case-crossover study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 266:115130. [PMID: 32652373 DOI: 10.1016/j.envpol.2020.115130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 01/31/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
Short-term exposure to air pollution has pro-thrombotic effects and triggers thrombo-embolic events such as myocardial infarction or stroke in adults. This study evaluates the association between short-term variation in air pollution and treatments for acute thrombo-embolic events among the whole Belgian population. In a bidirectional time-stratified case-crossover design, we included 227,861 events treated with endovascular intervention and 74,942 with antithrombotic enzymes that were reimbursed by the Belgian Social Security between January 1st, 2009 and December 31st, 2013. We compared the concentrations of particulate matter (PM) air pollution (PM10 and PM2.5), as estimated at the municipality level on the day of the event (lag 0) and two days earlier (lag 1 and lag 2) with those of control days from the same month, matched by temperature and accounting for day of the week (weekend vs week days). We applied conditional logistic regression models to obtain odds ratios (OR) and their 95% CI for an increase of 10 μg/m3 (PM10) or 5 μg/m3 (PM2.5) in pollutant concentrations over three lag days (lag 0, 1 and 2). We observed significant associations of PM10 and PM2.5 with treatment of acute thrombo-embolic events at the three lags. The strongest associations were observed for air pollution concentrations on the day of the event (lag0). Increases of 10 μg/m3 PM10 and 5 μg/m3 PM2.5 on lag0 increased the odds of events treated with endovascular intervention by 2.7% (95%CI:2.3%-3.2%) and 1.3% (95%CI:1%-1.5%), respectively, and they increased the odds of events treated with antithrombotic enzymes by 1.9% (95%CI:1.1-2.7%) and 1.2% (95%CI:0.7%-1.6%), respectively. The associations were generally stronger during autumn months and among children. Our nationwide study confirms that acute exposure to outdoor air pollutants such as PM10 or PM2.5 increase the use of medication and interventions to treat thrombo-embolic events.
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Affiliation(s)
- Hans Scheers
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Centre for Evidence-Based Practice, Rode Kruis-Vlaanderen, Mechelen, Belgium
| | - Tim S Nawrot
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Centre for Environmental Sciences, Hasselt University, Agoralaan Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - Benoit Nemery
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Katrien De Troeyer
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | | | - Frank De Smet
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; IMA-AIM, Tervurenlaan 188A - box 9, 1150 Brussel, Belgium
| | - An Van Nieuwenhuyse
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Department of Health Protection, Laboratoire National de Santé (LNS), Dudelange, Luxembourg
| | - Lidia Casas
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Epidemiology and Health Policy, Department of Epidemiology and Social Medicine, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
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Ho AFW, Zheng H, Earnest A, Cheong KH, Pek PP, Seok JY, Liu N, Kwan YH, Tan JWC, Wong TH, Hausenloy DJ, Foo LL, Tan BYQ, Ong MEH. Time-Stratified Case Crossover Study of the Association of Outdoor Ambient Air Pollution With the Risk of Acute Myocardial Infarction in the Context of Seasonal Exposure to the Southeast Asian Haze Problem. J Am Heart Assoc 2020; 8:e011272. [PMID: 31112443 PMCID: PMC6475051 DOI: 10.1161/jaha.118.011272] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background Prior studies have demonstrated the association of air pollution with cardiovascular deaths. Singapore experiences seasonal transboundary haze. We investigated the association between air pollution and acute myocardial infarction (AMI) incidence in Singapore. Methods and Results We performed a time‐stratified case‐crossover study on all AMI cases in the Singapore Myocardial Infarction Registry (2010–2015). Exposure on days where AMI occurred (case days) were compared with the exposure on days where AMI did not occur (control days). Control days were chosen on the same day of the week earlier and later in the same month and year. We fitted conditional Poisson regression models to daily AMI incidence to include confounders such as ambient temperature, rainfall, wind‐speed, and Pollutant Standards Index. We assessed relationships between AMI incidence and Pollutant Standards Index in the entire cohort and subgroups of individual‐level characteristics. There were 53 948 cases. Each 30‐unit increase in Pollutant Standards Index was association with AMI incidence (incidence risk ratio [IRR] 1.04, 95% CI 1.03–1.06). In the subgroup of ST‐segment–elevation myocardial infarction the IRR was 1.00, 95% CI 0.98 to 1.03, while for non–ST‐segment–elevation myocardial infarction, the IRR was 1.08, 95% CI 1.05 to 1.10. Subgroup analyses showed generally significant. Moderate/unhealthy Pollutant Standards Index showed association with AMI occurrence with IRR 1.08, 95% CI 1.05 to 1.11 and IRR 1.09, 95% CI 1.01 to 1.18, respectively. Excess risk remained elevated through the day of exposure and for >2 years after. Conclusions We found an effect of short‐term air pollution on AMI incidence, especially non–ST‐segment–elevation myocardial infarction and inpatient AMI. These findings have public health implications for primary prevention and emergency health services during haze.
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Affiliation(s)
- Andrew Fu Wah Ho
- 1 SingHealth Duke-NUS Emergency Medicine Academic Clinical Programme Singapore.,2 SingHealth Emergency Medicine Residency Programme Singapore.,3 Cardiovascular & Metabolic Disorders Program Duke-National University of Singapore Medical School Singapore.,4 Department of Emergency Medicine Singapore General Hospital Singapore
| | - Huili Zheng
- 6 National Registry of Diseases Office Health Promotion Board Singapore
| | - Arul Earnest
- 7 Department of Epidemiology and Preventive Medicine School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia
| | - Kang Hao Cheong
- 8 Engineering Cluster Singapore Institute of Technology Singapore.,9 Science and Math Cluster Singapore University of Technology and Design Singapore
| | - Pin Pin Pek
- 4 Department of Emergency Medicine Singapore General Hospital Singapore.,10 Saw Swee Hock School of Public Health National University of Singapore Singapore
| | - Jeon Young Seok
- 10 Saw Swee Hock School of Public Health National University of Singapore Singapore
| | - Nan Liu
- 11 Health Services Research Centre Singapore Health Services Singapore.,12 Centre for Quantitative Medicine Duke-NUS Medical School Singapore
| | - Yu Heng Kwan
- 13 Program in Health Services and Systems Research Duke-NUS Medical School Singapore
| | | | - Ting Hway Wong
- 5 Department of General Surgery Singapore General Hospital Singapore
| | - Derek J Hausenloy
- 3 Cardiovascular & Metabolic Disorders Program Duke-National University of Singapore Medical School Singapore.,15 National Heart Research Institute Singapore National Heart Centre Singapore.,16 Yong Loo Lin School of Medicine National University Singapore Singapore.,17 The Hatter Cardiovascular Institute University College London London United Kingdom.,18 The National Institute of Health Research University College London Hospitals Biomedical Research Centre, Research & Development London United Kingdom.,19 Department of Cardiology Barts Heart Centre St Bartholomew's Hospital London United Kingdom
| | - Ling Li Foo
- 6 National Registry of Diseases Office Health Promotion Board Singapore
| | | | - Marcus Eng Hock Ong
- 4 Department of Emergency Medicine Singapore General Hospital Singapore.,11 Health Services Research Centre Singapore Health Services Singapore
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Short-Term Effects of Ambient Air Pollution on ST-Elevation Myocardial Infarction Events: Are There Potentially Susceptible Groups? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193760. [PMID: 31591299 PMCID: PMC6801768 DOI: 10.3390/ijerph16193760] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 09/29/2019] [Accepted: 10/02/2019] [Indexed: 11/17/2022]
Abstract
Background: Air pollution exposure is associated with greater risk for cardiovascular events. This study aims to examine the effects of increased exposure to short-term air pollutants on ST-segment elevation myocardial infarction (STEMI) and determine the susceptible groups. Methods: Data on particulate matter PM2.5 and PM10 and other air pollutants, measured at each of the 11 air-quality monitoring stations in Kaohsiung City, were collected between 2011 and 2016. The medical records of non-trauma adult (>17 years) patients who had visited the emergency department (ED) with a typical electrocardiogram change of STEMI were extracted. A time-stratified and case-crossover study design was used to examine the relationship between air pollutants and daily ED visits for STEMI. Results: An interquartile range increment in PM2.5 on lag 0 was associated with an increment of 25.5% (95% confidence interval, 2.6%–53.4%) in the risk of STEMI ED visits. Men and persons with ≥3 risk factors (male sex, age, hypertension, diabetes, current smoker, dyslipidemia, history of myocardial infarction, and high body mass index) for myocardial infarction (MI) were more sensitive to the hazardous effects of PM2.5 (interaction: p = 0.039 and p = 0.018, respectively). The associations between PM10, NO2, and O3 and STEMI did not achieve statistical significance. Conclusion: PM2.5 may play an important role in STEMI events on the day of exposure in Kaohsiung. Men and persons with ≥3 risk factors of MI are more susceptible to the adverse effects of PM2.5 on STEMI.
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Air pollution increases the risk of SSNHL: A nested case-control study using meteorological data and national sample cohort data. Sci Rep 2019; 9:8270. [PMID: 31164673 PMCID: PMC6547844 DOI: 10.1038/s41598-019-44618-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 05/21/2019] [Indexed: 01/12/2023] Open
Abstract
This study aimed to evaluate the impact of weather conditions and air pollution on the onset of sudden sensorineural hearing loss (SSNHL). The Korean Health Insurance Review and Assessment Service - National Sample Cohort (HIRA-NSC) from 2002 through 2013 was used. A total of 5,200 participants with SSNHL were matched 1:4 for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia with 20,800 control participants. Meteorological data included daily mean temperature (°C), daily highest temperature (°C), daily lowest temperature (°C), daily temperature difference (°C), relative humidity (%), ambient atmospheric pressure (hPa), pressure, SO2 (ppm), NO2 (ppm), O3 (ppm), CO (ppm), and PM10 (μg/m3) of a mean of 60 days, 30 days, 14 days, 7 days, and 3 days before SSNHL were analyzed. Hourly measurements were taken from 94 places to assess the temperature, humidity, and atmospheric pressure and from 273 places to determine SO2, NO2, O3, CO, and PM10. Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of meteorological data for SSNHL were analyzed using unconditional logistic regression analyses. Subgroup analyses were conducted by age and sex. The mean NO2 and O3 concentrations 14 days before the index date were different in the SSNHL group compared to those in the control group (P < 0.001 for NO2 and P = 0.021 for O3). The adjusted 14-day OR for NO2 (0.1 ppm) exposure was 3.12 in the SSNHL group compared to that in the control group (95% CI = 2.16–4.49, P < 0.001). The increased odds of NO2 exposure for 14 days in the SSNHL group persisted in the age group older than 30 years for both sexes. Other meteorological conditions did not show differences between the SSNHL and control groups. SSNHL was associated with high concentrations of NO2.
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Wilson SR, Madronich S, Longstreth JD, Solomon KR. Interactive effects of changing stratospheric ozone and climate on tropospheric composition and air quality, and the consequences for human and ecosystem health. Photochem Photobiol Sci 2019; 18:775-803. [PMID: 30810564 DOI: 10.1039/c8pp90064g] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The composition of the air we breathe is determined by emissions, weather, and photochemical transformations induced by solar UV radiation. Photochemical reactions of many emitted chemical compounds can generate important (secondary) pollutants including ground-level ozone (O3) and some particulate matter, known to be detrimental to human health and ecosystems. Poor air quality is the major environmental cause of premature deaths globally, and even a small decrease in air quality can translate into a large increase in the number of deaths. In many regions of the globe, changes in emissions of pollutants have caused significant changes in air quality. Short-term variability in the weather as well as long-term climatic trends can affect ground-level pollution through several mechanisms. These include large-scale changes in the transport of O3 from the stratosphere to the troposphere, winds, clouds, and patterns of precipitation. Long-term trends in UV radiation, particularly related to the depletion and recovery of stratospheric ozone, are also expected to result in changes in air quality as well as the self-cleaning capacity of the global atmosphere. The increased use of substitutes for ozone-depleting substances, in response to the Montreal Protocol, does not currently pose a significant risk to the environment. This includes both the direct emissions of substitutes during use and their atmospheric degradation products (e.g. trifluoroacetic acid, TFA).
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Affiliation(s)
- S R Wilson
- Centre for Atmospheric Chemistry, School of Earth, Atmosphere and Life Sciences, University of Wollongong, NSW, Australia.
| | - S Madronich
- National Center for Atmospheric Research, Boulder, CO, USA
| | - J D Longstreth
- The Institute for Global Risk Research, LLC, Bethesda, MD, USA and Emergent BioSolutions, Gaithersburg, MD, USA
| | - K R Solomon
- Centre for Toxicology and School of Environmental Sciences, University of Guelph, ON, Canada
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