The association between air pollution parameters and emergency department visits and hospitalizations due to cardiovascular and respiratory diseases: a time-series analysis

Int Arch Occup Environ Health. 2022 Apr;95(3):599-606. doi: 10.1007/s00420-021-01769-w. Epub 2021 Oct 6.

Abstract

Objective: In this study, the association between cardiovascular and respiratory Emergency Department (ED) visits and hospitalizations and Sulfur Dioxide (SO2) and particulate matter with an aerodynamic diameter ≤ 10 µm (PM10) was determined.

Methods: The records of a total of 632,223 people diagnosed with cardiovascular diseases (ICD-10 code I00-I99) and respiratory diseases (ICD-10 code J00-J99) at and over the age of 18 between 2012 and 2018 in three hospitals in Karaman in Turkey were examined in the present study. The daily 24-h averages for SO2 and PM10 concentrations were acquired in National Air Quality Monitoring. A time-series analysis with Poisson Generalized Linear Model was used.

Results: Among the air pollution parameters, the mean ± standard deviation of SO2 and PM10 were 16.2 ± 22.1 and 75.8 ± 48.2 μg/m3, respectively. An increase of 10 μg/m3 in SO2 was associated with a 3% [Relative Risk (RR), 95% Confidence Interval (CI): 2-4)] increase in cardiovascular ED visit and 2% (RR, 95% CI 2-3) increase in respiratory ED visit, and 1% (RR, 95% CI 1-3) increase in respiratory hospitalizations. An increase of 10 μg/m3 in PM10 was associated with a 1% (RR, 95% CI 1-2) increase in cardiovascular hospitalizations.

Conclusions: Increases in SO2 are a risk factor for cardiovascular and respiratory ED visits, and respiratory hospitalizations. Increases in PM10 are a risk factor for cardiovascular hospitalizations.

Keywords: Cardiovascular diseases; Emergency department visit; Hospitalization; Particulate matter; Respiratory diseases; Sulfur dioxide.

MeSH terms

  • Adult
  • Air Pollutants* / analysis
  • Air Pollutants* / toxicity
  • Air Pollution* / analysis
  • Air Pollution* / statistics & numerical data
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / etiology
  • Emergency Service, Hospital
  • Hospitalization
  • Humans
  • Middle Aged
  • Particulate Matter / analysis
  • Particulate Matter / toxicity
  • Sulfur Dioxide / analysis

Substances

  • Air Pollutants
  • Particulate Matter
  • Sulfur Dioxide