Risk of Cardiovascular Hospitalizations from Exposure to Coarse Particulate Matter (PM10) Below the European Union Safety Threshold

• Published in: The American journal of cardiology 2016-04, Vol.117 (8), p.1231-1235
• Main Authors: Vaduganathan, Muthiah, MD MPH, De Palma, Giuseppe, MD PhD, Manerba, Alessandra, MD, Goldoni, Matteo, PhD, Triggiani, Marco, MD, Apostoli, Pietro, MD, Dei Cas, Livio, MD, Nodari, Savina, MD
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Age; Aged; Air pollution; Atmospheric pressure; Cardiac arrhythmia; Cardiovascular; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - therapy; Confidence intervals; Cross-Sectional Studies; European Union; Female; Follow-Up Studies; Gender; Generalized linear models; Heart attacks; Heart failure; Heart rate; Hospitalization; Hospitalization - statistics & numerical data; Hospitals; Humans; Incidence; Industrial development; Italy - epidemiology; Male; Mortality; Outdoor air quality; Particulate Matter - adverse effects; Retrospective Studies; Risk Assessment - methods; Risk Factors; Safety - standards; Seasons; Time Factors; Variables
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2016.01.041

Abstract The association between exposure to air pollution and acute cardiovascular (CV) events is well documented, however limited data are available evaluating the public health safety of various “doses” of particular matter (PM) below currently accepted safety thresholds. We explored the cross-sectional association between PM with aerodynamic diameter less than 10 μm (PM10) and daily CV hospitalizations in Brescia, Italy using Poisson regression models adjusted for age, sex, and meteorological indices. Average daily exposure to PM10 obtained from arithmetic means of air pollution data were captured by 4 selected monitoring stations. PM10 data were expressed as daily mean (lag 0-day) or 3-day moving average (lag 3-day), and categorized according to the European Union daily limit value of 50 μg/m3 . From September 2004 to September 2007, data from 6,000 acute CV admissions to a tertiary referral center were collected. An increase of 1μg/m3 PM10 at lag 0-day was independently associated with higher rates of acute hospitalizations for composite CV-related events (RR 1.003, 95% CI 1.002-1.005), acute heart failure (RR 1.004, 95% CI 1.001-1.008), acute coronary syndromes (RR 1.002, 95% CI 0.999-1.005), malignant ventricular arrhythmias (RR 1.004, 95% CI 0.999-1.010), and atrial fibrillation (RR 1.008, 95% CI 1.003-1.012). Similar results were obtained using PM10 lag 3-day data. The excess PM10 CV hospitalization risk (by lag 0-day and lag 3-day) did not vary significantly above and below the 50 μg/m3 safety threshold or by age and sex. In conclusion, increased levels of PM10, even below the current limits set by the European Union, were associated with excess risk for admissions for acute CV events.