Abstract 15149: Short-term Exposure to Fine Particulate Matter Air Pollution Preferentially Increases the Risk of ST-Elevation Acute Coronary Events

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kent G Meredith ◽  
C A Pope ◽  
Joseph B Muhlestein ◽  
Jeffrey L Anderson ◽  
John B Cannon ◽  
...  

Introduction: Air pollution is associated with greater cardiovascular event risk, but which types of events and the specific at-risk individuals remain unknown. Hypothesis: Short-term exposure to fine particulate matter (PM 2.5 ) is associated with greater risk of acute coronary syndromes (ACS), including ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), and unstable angina (USA). Methods: ACS events treated at Intermountain Healthcare hospitals in Utah’s urban Wasatch Front region between September 10, 1993 and May 15, 2014 were included if the patient resided in that area (N=16,314). A time-stratified case-crossover design was performed matching the PM 2.5 exposure at the time of event with periods when the event did not occur (referent), for STEMI, NSTEMI, and USA. Patients served as their own controls. Odds ratios (OR) were determined for exposure threshold versus linear, non-threshold models. Results: In STEMI, NSTEMI, and USA patients, age averaged 62, 64, and 63 years; males constituted 73%, 66%, and 68%; current or past smoking was prevalent in 33%, 25%, and 26%; and significant coronary artery disease (CAD) (defined as ≥1 coronary with ≥70% stenosis) was found among 95%, 75%, and 74%, respectively. Short-term PM 2.5 exposure was associated with ACS events (Table). Conclusions: Short-term exposure of PM 2.5 was strongly associated with greater risk of STEMI, especially in patients with angiographic CAD. No association with NSTEMI was found, and only a weak effect for USA. This study supports a PM 2.5 exposure threshold of 25 μg/m 3 , below which little exposure effect is seen, while the effect is linear above that level.

Author(s):  
Jiyoung Shin ◽  
Jongmin Oh ◽  
In Sook Kang ◽  
Eunhee Ha ◽  
Wook Bum Pyun

Background/Aim: Previous studies have suggested that the short-term ambient air pollution and temperature are associated with myocardial infarction. In this study, we aimed to conduct a time-series analysis to assess the impact of fine particulate matter (PM2.5) and temperature on acute myocardial infarction (AMI) among adults over 20 years of age in Korea by using the data from the Korean National Health Information Database (KNHID). Methods: The daily data of 192,567 AMI cases in Seoul were collected from the nationwide, population-based KNHID from 2005 to 2014. The monitoring data of ambient PM2.5 from the Seoul Research Institute of Public Health and Environment were also collected. A generalized additive model (GAM) that allowed for a quasi-Poisson distribution was used to analyze the effects of PM2.5 and temperature on the incidence of AMI. Results: The models with PM2.5 lag structures of lag 0 and 2-day averages of lag 0 and 1 (lag 01) showed significant associations with AMI (Relative risk [RR]: 1.011, CI: 1.003–1.020 for lag 0, RR: 1.010, CI: 1.000–1.020 for lag 01) after adjusting the covariates. Stratification analysis conducted in the cold season (October–April) and the warm season (May–September) showed a significant lag 0 effect for AMI cases in the cold season only. Conclusions: In conclusion, acute exposure to PM2.5 was significantly associated with AMI morbidity at lag 0 in Seoul, Korea. This increased risk was also observed at low temperatures.


2021 ◽  
Author(s):  
Jiyoung Shin ◽  
Jongmin Oh ◽  
In Sook Kang ◽  
Eunhee Ha ◽  
Wook Bum Pyun

Abstract Background/Aim: Previous studies have suggested that the short-term ambient air pollution and temperature are associated with myocardial infarction. In this study, we aimed to conduct a time-series analysis to assess the impact of fine particulate matter (PM2.5) and temperature on acute myocardial infarction (AMI) among adults over 20 years of age in Korea by using the data from the Korean National Health Information Database (KNHID).Methods: Daily data of 197,940 AMI cases in Seoul were collected from the nationwide, population-based KNHID from 2005 to 2014. Monitoring data of ambient PM2.5 from the Seoul Research Institute of Public Health and Environment were also collected. A generalized additive model (GAM) that allowed for a quasi-Poisson distribution was used to analyze the effects of PM2.5 and temperature on the incidence of AMI.Results: The models with PM2.5 lag structures of lag 0 and 2-day averages of lag 0 and 1 (lag 01) showed significant associations with AMI (Relative risk [RR]: 1.011, CI: 1.003–1.020 for lag 0, RR: 1.010, CI: 1.000–1.020 for lag 01) after adjusting the covariates. Stratification analysis conducted in the cold season (October–April) and the warm season (May–September) showed a significant lag 0 effect for AMI cases in the cold season only.Conclusions: In conclusion, acute exposure to PM2.5 was significantly associated with AMI morbidity at lag 0 in Seoul, Korea. This increased risk was also observed at low temperatures.


Author(s):  
Earthea Nance

National environmental regulations lack short-term standards for variability in fine particulate matter (PM 2.5 ); they depend soley on concentration-based standards. Twenty-five years of research has linked short-term PM 2.5 ; that is, increases of at least 10 ug/m 3 that can occur in-between regulatory readings, to increased mortality (Di et al, 2017; Staniswalis et al, 2005; Conroy et al, 2001; Schwartz, 1994). Even as new technologies have emerged that could readily monitor short-term PM 2.5 , such as real-time monitoring and mobile monitoring, their primary application has been for research, not for air quality management. The Gulf oil spill offers a strategic setting in which regulatory monitoring, computer modeling, and stationary monitoring could be directly compared to mobile monitoring. Mobile monitoring was found to best capture the variability of PM 2.5 during the disaster. The research also found that each short-term increase (10-μg/m 3) in fine particulate matter was associated with a statistically significant increase of 0.105 deaths (p<0.001) in people aged 65 and over, a result that is in line with other studies. These findings contribute to understanding the effects of PM 2.5 on mortality during a disaster, and they provide justification for environmental managers to monitor the variability of PM 2.5, not only the concentration.


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