Effects of exposure to air pollution on acute cardiovascular and respiratory admissions to the hospital and early mortality at emergency department

Adv Clin Exp Med. 2022 Oct;31(10):1129-1138. doi: 10.17219/acem/149400.

Abstract

Background: Particulate matter (PM) and NO2 induce pathophysiological changes which contribute to an increased incidence of acute cardiovascular (CV) and respiratory (Rp) events.

Objectives: To analyze the relationship between air quality and the frequency of admissions to the emergency department (ED) due to the CV diseases and Rp causes.

Material and methods: The study analyzed the reasons for admissions to the ED during the cold periods from January 2017 to January 2020. These data were combined with the average daily concentrations of NO2, PM2.5 and PM10, and the individual air quality indexes (IAQIs) for these pollutants.

Results: Our analyses have shown that 3468 (11.4%) and 1053 (3.46%) of all 30,419 analyzed patients were admitted to the ED for CV and Rp reasons, respectively. Cardiovascular patients were significantly more often admitted to the ED when the IAQI for NO2 was worse than very good, and the IAQI for PM2.5 or PM10 was worse than good. In such periods, diagnoses such as ischemic heart disease (IHD) or syncope were statistically more common and the risk of admission of a patient with a diagnosis such as IHD, heart failure (HF), syncope, stroke, or transient ischemic attack (TIA) was increased. Registered deaths occurred significantly more often among patients admitted on days with moderate or worse than moderate air quality determined in relation to PM10 in comparison to days with very good or good air quality (0.35% and 0.23%, respectively, p = 0.04).

Conclusions: Air quality significantly affects the admissions to the ED for CV and Rp reasons and has an impact on mortality.

Keywords: air pollution; cardiovascular diseases; emergency department; particulate matter; respiratory tract diseases.

MeSH terms

  • Air Pollution* / adverse effects
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / etiology
  • Emergency Service, Hospital
  • Environmental Pollutants* / analysis
  • Hospitals
  • Humans
  • Myocardial Ischemia*
  • Nitrogen Dioxide / analysis
  • Particulate Matter / adverse effects
  • Syncope

Substances

  • Nitrogen Dioxide
  • Particulate Matter
  • Environmental Pollutants