Dataset Information

Short-Term Effects of PM₁₀, NO₂, SO₂ and O₃ on Cardio-Respiratory Mortality in Cape Town, South Africa, 2006-2015.

ABSTRACT:

Background

The health effect of air pollution is rarely quantified in Africa, and this is evident in global systematic reviews and multi-city studies which only includes South Africa.

Methods

A time-series analysis was conducted on daily mortality (cardiovascular (CVD) and respiratory diseases (RD)) and air pollution from 2006-2015 for the city of Cape Town. We fitted single- and multi-pollutant models to test the independent effects of particulate matter (PM₁₀), nitrogen dioxide (NO₂), sulphur dioxide (SO₂) and ozone (O₃) from co-pollutants.

Results

daily average concentrations per interquartile range (IQR) increase of 16.4 µg/m³ PM₁₀, 10.7 µg/m³ NO₂, 6 µg/m³ SO₂ and 15.6 µg/m³ O₃ lag 0-1 were positively associated with CVD, with an increased risk of 2.4% (95% CI: 0.9-3.9%), 2.2 (95% CI: 0.4-4.1%), 1.4% (95% CI: 0-2.8%) and 2.5% (95% CI: 0.2-4.8%), respectively. For RD, only NO₂ showed a significant positive association with a 4.5% (95% CI: 1.4-7.6%) increase per IQR. In multi-pollutant models, associations of NO₂ with RD remained unchanged when adjusted for PM₁₀ and SO₂ but was weakened for O₃. In CVD, O₃ estimates were insensitive to other pollutants showing an increased risk. Interestingly, CVD and RD lag structures of PM₁₀, showed significant acute effect with evidence of mortality displacement.

Conclusion

The findings suggest that air pollution is associated with mortality, and exposure to PM₁₀ advances the death of frail population.

SUBMITTER: Adebayo-Ojo TC

PROVIDER: S-EPMC9265394 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Pulmonary endarterectomy (PEA) is the only definitive and potentially curative therapy for chronic thromboembolic pulmonary hypertension (CTEPH), associated with impressive improvements in symptoms and haemodynamics. However, it is only offered at a few centres in South Africa. The characteristics and outcomes of patients undergoing PEA in Cape Town have not been reported previously. To assess the difference in World Health Organization functional class (WHO-FC) before and at least 6 weeks after surgery. We interrogated the adult cardiothoracic surgery database at the University of Cape Town between December 2005 and April 2021 for patients undergoing PEA at Groote Schuur Hospital and a private hospital. A total of 32 patients underwent PEA, of whom 8 were excluded from the final analysis owing to incomplete data or a histological diagnosis other than CTEPH. The work-up of these patients for surgery was variable: all had a computed tomography pulmonary angiogram, 7 (29%) had a ventilation/perfusion scan, 5 (21%) underwent right heart catheterisation, and none had a pulmonary angiogram. The perioperative mortality was 4/24 (17%): 1 patient (4%) had a cardiac arrest on induction of anaesthesia, 2 patients (8%) died of postoperative pulmonary haemorrhage, and 1 patient (4%) died of septic complications in the intensive care unit. Among the survivors, the median (interquartile range) improvement in WHO-FC was 2 (1 - 3) classes (p=0.0004); 10/16 patients (63%) returned to a normal baseline (WHO-FC I). Even in a low-volume centre, PEA is associated with significant improvements in WHO-FC and a return to a normal baseline in survivors. What the study adds. South African patients undergoing pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH) have a marked improvement in functional status, with many returning to a normal functional baseline. However, the small number of patients included in this study indicates that PEA is probably underutilised. Pre- and postoperative assessment is inconsistent, despite availability of established guidelines.Implications of the findings. More patients should be referred to specialist centres for assessment for this potentially curative procedure. Use of guidelines to standardise investigations and monitoring of patients with CTEPH may improve patient selection for surgery.

Dataset Information

Short-Term Effects of PM₁₀, NO₂, SO₂ and O₃ on Cardio-Respiratory Mortality in Cape Town, South Africa, 2006-2015.

Background

Methods

Results

Conclusion

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Short-Term Effects of PM10, NO2, SO2 and O3 on Cardio-Respiratory Mortality in Cape Town, South Africa, 2006-2015.

Background

Methods

Results

Conclusion

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OmicsDI is part of the ELIXIR infrastructure

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Short-Term Effects of PM₁₀, NO₂, SO₂ and O₃ on Cardio-Respiratory Mortality in Cape Town, South Africa, 2006-2015.