Fine Particle Air Pollution (PM 2.5) and Cardiovascular Hospitalization in Isfahan in 2012: CAPACITY Study

Document Type : Original Article

Authors

1 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IR Iran.

2 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IR Iran.

3 Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, IR Iran.

4 Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IR Iran.

5 Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IR Iran.

6 Road Traffic Injury Research Center and Department of Statistics and Epidemiology, School of Health, Tabriz University of Medical Sciences, Tabriz, IR Iran.

7 Isfahan Disaster Management Office, Isfahan Governer’s Office, Isfahan, IR Iran.

8 Khouzestan Department of Environment, Ahvaz, IR Iran.

9 Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran.

10 Information Technology Offices, Isfahan University of Medical Sciences, Isfahan, IR Iran.

Abstract

Background: This study aimed to evaluate the relationship between exposure to PM2.5 and the number of hospital admissions due to cardiovascular diseases.
Methods: The present time-series, case-crossover study is a part of the CAPACITY study on patients admitted to 15 hospitals in the Iranian city of Isfahan because of cardiovascular diseases in 2012. PM2.5 concentrations were calculated in air pollution monitoring stations and divided into 3 groups of good or moderate, unhealthy for sensitive people, and unhealthy or hazardous. The relationship between the number of admissions and fine particle concentrations was assessed.
Results: This study evaluated 15752 participants at a mean age of 59 ± 19.4 years. Men accounted for 52.6% (n = 8282) of the study population. The mean concentration of fine particles was 53.77 ± 29.65 micrometers. In most days of the year, the concentration of PM2.5 was at an unhealthy level for sensitive people. Poisson regression analysis showed a significant correlation between the number of hospital admissions due to cardiovascular diseases and ischemic heart diseases and fine particle concentrations in the unhealthy level for sensitive people (P = 0.001, P = 0.001, and P = 0.002). There was a significant correlation between PM2.5 concentrations and the number of admissions due to conductive heart diseases and heart blocks in unhealthy or hazardous levels (P = 0.02 and
P = 0.04).
Conclusions: The number of hospital admissions due to cardiovascular diseases can increase during air pollution, especially when the concentrations of PM2.5 are elevated.

Keywords


1. Brunekreef B, Holgate ST. Air pollution and
health. The lancet. 2002;360(9341):1233-42.
2. Hetland R, Cassee F, Refsnes M, Schwarze
P, Låg M, Boere A, et al. Release of
inflammatory cytokines, cell toxicity and
apoptosis in epithelial lung cells after
exposure to ambient air particles of different
size fractions. Toxicology in Vitro.
2004;18(2):203-12.
3. Franklin BA, Brook R, Pope CA. Air
pollution and cardiovascular disease.
Current problems in cardiology.
2015;40(5):207-38.
4. Franchini M, Mannucci P. Short‐term effects
of air pollution on cardiovascular diseases:
outcomes and mechanisms. Journal of
Thrombosis and Haemostasis.
2007;5(11):2169-74.
5. Franchini M, Mannucci PM, editors.
Particulate air pollution and cardiovascular
risk: short-term and long-term effects.
Seminars in thrombosis and hemostasis;
2009: © Thieme Medical Publishers.

6. Pope CA, Burnett RT, Thurston GD, Thun
MJ, Calle EE, Krewski D, et al.
Cardiovascular mortality and long-term
exposure to particulate air pollution:
epidemiological evidence of general
pathophysiological pathways of disease.
Circulation. 2004;109(1):71-7.
7. Hoek G, Brunekreef B, Fischer P, van
Wijnen J. The association between air
pollution and heart failure, arrhythmia,
embolism, thrombosis, and other
cardiovascular causes of death in a time
series study. Epidemiology. 2001;12(3):355-
7.
8. Franchini M, Mannucci PM. Air pollution
and cardiovascular disease. Thrombosis
research. 2012;129(3):230-4.
9. Peters A, Dockery DW, Muller JE,
Mittleman MA. Increased particulate air
pollution and the triggering of myocardial
infarction. Circulation. 2001;103(23):2810-
5.
10. Simkhovich BZ, Kleinman MT, Kloner RA.
Particulate air pollution and coronary heart
disease. Current opinion in cardiology.
2009;24(6):604-9.
11. Simkhovich BZ, Kleinman MT, Kloner RA.
Air pollution and cardiovascular injury:
epidemiology, toxicology, and mechanisms.
Journal of the American College of
Cardiology. 2008;52(9):719-26.
12. Sadeghi M, Talaei M, Oveisgharan S, Rabiei
K, Dianatkhah M, Bahonar A,et al. The
cumulative incidence of conventional risk
factors of cardiovascular disease and their
population attributable risk in an Iranian
population: The Isfahan Cohort Study. Adv
Biomed Res. 2014 Nov 29;3:242.
13. Iranica E. Isfahan xiv. modern economy and
industries (2) Isfahan City: xiv. Modern
Economy and Industries 2016 [Available
from:
http://www.iranicaonline.org/articles/isfahan
-xiv2-industries-of-isfahan-city.
14. Abbasnia M, Khosravi M, Toros H, Tavousi
T. Comparative assessment between
historical and future trends in the daily
maximum temperature parameter over
selected stations of Iran. Natural
Environment Change. 2016;2(2):89-98.
15. Turpin BJ, Lim H-J. Species contributions to
PM2. 5 mass concentrations: Revisiting
common assumptions for estimating organic
mass. Aerosol Science & Technology.
2001;35(1):602-10.
16. Rabiei K, Hosseini SM, Sadeghi E, JafariKoushki T, Rahimi M, Shishehforoush M, et
al. Air pollution and cardiovascular and
respiratory disease: Rational and
methodology of CAPACITY study. ARYA
Atheroscler. 2017;13(6):264-73.
17. Chen H, Copes R. Review of Air Quality
Index and Air Quality Health Index:
Environmental and Occupation Health:
Public Health Ontario; 2013.
18. Dominici F, Peng RD, Bell ML, Pham L,
McDermott A, Zeger SL, et al. Fine
particulate air pollution and hospital
admission for cardiovascular and respiratory
diseases. Jama. 2006;295(10):1127-34.
19. Wellenius GA, Schwartz J, Mittleman MA.
Particulate air pollution and hospital
admissions for congestive heart failure in
seven United States cities. American Journal
of Cardiology. 2006;97(3):404-8.
20. Pope CA, Muhlestein JB, May HT, Renlund
DG, Anderson JL, Horne BD. Ischemic
heart disease events triggered by short-term
exposure to fine particulate air pollution.
Circulation. 2006;114(23):2443-8.
21. Naddafi K, Hassanvand MS, Yunesian M,
Momeniha F, Nabizadeh R, Faridi S, et al.
Health impact assessment of air pollution in
megacity of Tehran, Iran. Iranian journal of
environmental health science & engineering.
2012;9(1):28.
22. Nogueira JB. Air pollution and
cardiovascular disease. Revista portuguesa
de cardiologia: orgao oficial da Sociedade
Portuguesa de Cardiologia= Portuguese
journal of cardiology: an official journal of
the Portuguese Society of Cardiology.
2009;28(6):715-33.