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Short-Term Effects of Air Pollution on Cardiovascular Hospitalizations in the Pisan Longitudinal Study.

ABSTRACT: Air pollution effects on cardiovascular hospitalizations in small urban/suburban areas have been scantly investigated. Such effects were assessed among the participants in the analytical epidemiological survey carried out in Pisa and Cascina, Tuscany, Italy (2009-2011). Cardiovascular hospitalizations from 1585 subjects were followed up (2011-2015). Daily mean pollutant concentrations were estimated through random forests at 1 km (particulate matter: PM₁₀, 2011-2015; PM_2.5, 2013-2015) and 200 m (PM₁₀, PM_2.5, NO₂, O₃, 2013-2015) resolutions. Exposure effects were estimated using the case-crossover design and conditional logistic regression (odds ratio-OR-and 95% confidence interval-CI-for 10 ?g/m³ increase; lag 0-6). During the period 2011-2015 (137 hospitalizations), a significant effect at lag 0 was observed for PM₁₀ (OR = 1.137, CI: 1.023-1.264) at 1 km resolution. During the period 2013-2015 (69 hospitalizations), significant effects at lag 0 were observed for PM₁₀ (OR = 1.268, CI: 1.085-1.483) and PM_2.5 (OR = 1.273, CI: 1.053-1.540) at 1 km resolution, as well as for PM₁₀ (OR = 1.365, CI: 1.103-1.690), PM_2.5 (OR = 1.264, CI: 1.006-1.589) and NO₂ (OR = 1.477, CI: 1.058-2.061) at 200 m resolution; significant effects were observed up to lag 2. Larger ORs were observed in males and in subjects reporting pre-existent cardiovascular/respiratory diseases. Combining analytical and routine epidemiological data with high-resolution pollutant estimates provides new insights on acute cardiovascular effects in the general population and in potentially susceptible subgroups living in small urban/suburban areas.

SUBMITTER: Fasola S

PROVIDER: S-EPMC7908381 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Short-Term Effects of Air Pollution on Cardiovascular Hospitalizations in the Pisan Longitudinal Study.

Fasola Salvatore S Maio Sara S Baldacci Sandra S La Grutta Stefania S Ferrante Giuliana G Forastiere Francesco F Stafoggia Massimo M Gariazzo Claudio C Silibello Camillo C Carlino Giuseppe G Viegi Giovanni G Group On Behalf Of The Beep Collaborative OBOTBC

International journal of environmental research and public health 20210128 3

Air pollution effects on cardiovascular hospitalizations in small urban/suburban areas have been scantly investigated. Such effects were assessed among the participants in the analytical epidemiological survey carried out in Pisa and Cascina, Tuscany, Italy (2009-2011). Cardiovascular hospitalizations from 1585 subjects were followed up (2011-2015). Daily mean pollutant concentrations were estimated through random forests at 1 km (particulate matter: PM<sub>10</sub>, 2011-2015; PM<sub>2.5</sub>, ...[more]

PMID: 33525695

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Project description:BackgroundAir pollution is a major risk factor for planetary health and has long been suspected of predisposing humans to respiratory diseases induced by pathogens like influenza viruses. However, epidemiological evidence remains elusive due to lack of longitudinal data from large cohorts.ObjectiveOur aim is to quantify the short-term association of influenza incidence with exposure to ambient air pollutants in Chinese cities.MethodsBased on air pollutant data and influenza surveillance data from 82 cities in China over a period of 5 years, we applied a two-stage time series analysis to assess the association of daily incidence of reported influenza cases with six common air pollutants [particulate matter with aerodynamic diameter ≤2.5μm (PM2.5), particulate matter with aerodynamic diameter ≤10μm (PM10), NO2, SO2, CO, and O3], while adjusting for potential confounders including temperature, relative humidity, seasonality, and holiday effects. We built a distributed lag Poisson model for one or multiple pollutants in each individual city in the first stage and conducted a meta-analysis to pool city-specific estimates in the second stage.ResultsA total of 3,735,934 influenza cases were reported in 82 cities from 2015 to 2019, accounting for 72.71% of the overall case number reported in the mainland of China. The time series models for each pollutant alone showed that the daily incidence of reported influenza cases was positively associated with almost all air pollutants except for ozone. The most prominent short-term associations were found for SO2 and NO2 with cumulative risk ratios of 1.094 [95% confidence interval (CI): 1.054, 1.136] and 1.093 (95% CI: 1.067, 1.119), respectively, for each 10 μg/m3 increase in the concentration at each of the lags of 1-7 d. Only NO2 showed a significant association with the daily incidence of influenza cases in the multipollutant model that adjusts all six air pollutants together. The impact of air pollutants on influenza was generally found to be greater in children, in subtropical cities, and during cold months.DiscussionIncreased exposure to ambient air pollutants, particularly NO2, is associated with a higher risk of influenza-associated illness. Policies on reducing air pollution levels may help alleviate the disease burden due to influenza infection. https://doi.org/10.1289/EHP12146.

Dataset Information

Short-Term Effects of Air Pollution on Cardiovascular Hospitalizations in the Pisan Longitudinal Study.

Publications

Short-Term Effects of Air Pollution on Cardiovascular Hospitalizations in the Pisan Longitudinal Study.

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