Researchers Examine Impact of Air Pollution on Respiratory and Cardiovascular Health


The risk of cardiovascular hospitalizations was associated with increasing PM10 at lag 0.

Salvatore Fasola

While it is clear that air pollution has an negative impact on the overall health of individuals, it is not entirely clear how air pollution is associated with urgent hospitalizations.

A team, led by Salvatore Fasola, Institute for Biomedical Research and Innovation (CNR-IRIB), deepened the knowledge of the impact of air pollution on acute health effects using a BigData approach linking pollutant exposure estimates and data on urgent respiratory and cardiovascular hospitalizations in a poster presented at the European Respiratory Society International Congress 2020 (ERS 2020).

In a previous cross-sectional study, investigators examined the chronic health effects of air pollution in Pisa-Cascina based on self-reported symptoms and diseases, as well as a proxy of traffic-related exposure.

The investigators examined 1585 individuals from a 2009-2011 survey in Pisa-Cascina for the longitudinal study. The team collected data on urgent respiratory and cardiovascular hospitalizations between 2013-2015 and estimated daily mean concentrations of PM10, PM2.5, O2, O3 (μg/m3) at residential addresses (1-km2 resolution) through Random Forests.

The investigators also used a case-crossover approach by matching the event days (Y = 1) and 2 control days (Y = 0: -7 and +7 days). The research team estimated pollutant effects up to lag 6 (linear lag) through conditional logistic regression models (for 10-μg/m3 increase), stratified by residential area was only performed for CHs due to the low number of respiratory hospitalizations.

The risk of urgent respiratory hospitalizations (76 events) was significantly linked to increasing NO2 at lag 4 (OR, 1.26; 95% CI, 1.02-1.56), lag 5 (OR, 1.45; 95% CI, 1.05-2.01), and lag 6 (OR, 1.67; 95% CI, 1.05-2.65).

The risk of cardiovascular hospitalizations were also associated with increasing PM10 at lag 0 (OR, 1.77; 95% CI, 1.11-2.82) and up to lag 3 in Pisa (55 events), and with increasing NO2 at lag 0 (OR, 1.80; 95% CI,1.07-3.01) and lag 1 (OR, 1.50; 95% CI, 1.04-2.17) in Cascina (82 events).

“Linking Random-Forest-estimated pollutant concentrations to RH and CH may provide new insights about the acute health effects of air pollution in epidemiological studies,” the authors wrote.

In a separate study, researchers found children exposed to higher levels of PM2.5 are more likely to develop asthma and persistent wheezing than those who are not exposed.

In an effort to better understand and assess family-related factors, the investigators got information about parental asthma from the Danish National Patient Register based on asthma diagnosis and a minimum of 2 prescriptions of asthma medicine. A birth registry provided information on mothers’ reported smoking.

More than 3 million children were included in the study and 122,842 were identified as having asthma and persistent wheezing. A majority of the cases (83%) occurred in children younger than 3 years old with a mean age of 1.9 years old for developing asthma and wheezing.

For air pollutant associations, findings of initial analyses indicated PM2.5, PM10, nitrate, ammonium, and secondary inorganic aerosols were positively associated with asthma and persistent wheezing. Nitrogen dioxide, sulphur dioxide, elemental carbon, and organic carbon were inversely associated with asthma and persistent wheezing.

The study, “Acute effects of air pollution on urgent hospitalizations on a general population sample: a case-cross over study,” was published online by ERS 2020.

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