Background:

The CONTOUR BGMS exceeded both the minimum acceptable accuracy based on ISO 15197:2003 and the more stringent accuracy criteria.

Background In Iceland air quality is generally good; however, previous studies indicate that there is an association between air pollution in Reykjavik and adverse health effects as measured by dispensing of medications, mortality, and increase in health care utilisation. The aim was to study the association between traffic-related ambient air pollution in the Reykjavik capital area and emergency hospital visits for heart diseases and particularly atrial fibrillation and flutter (AF). Methods A multivariate time-stratified case-crossover design was used to study the association. Cases were those patients aged 18 years or older living in the Reykjavik capital area during the study period, 2006–2017, who made emergency visits to Landspitali University Hospital for heart diseases. In this population-based study, the primary discharge diagnoses were registered according to International Classification of Diseases, 10th edition (ICD-10). The pollutants studied were NO2, PM10, PM2.5, and SO2, with adjustment for H2S, temperature, and relative humidity. The 24-h mean of pollutants was used with lag 0 to lag 4. Results During the study period 9536 cases of AF were identified. The 24-h mean NO2 was 20.7 μg/m3. Each 10 μg/m3 increase in NO2 was associated with increased risk of heart diseases (ICD-10: I20-I25, I44-I50), odds ratio (OR) 1.023 (95% CI 1.012–1.034) at lag 0. Each 10 μg/m3 increase in NO2 was associated with an increased risk of AF (ICD-10: I48) on the same day, OR 1.030 (95% CI: 1.011–1.049). Females were at higher risk for AF, OR 1.051 (95% CI 1.019–1.083) at lag 0, and OR 1.050 (95% CI 1.019–1.083) at lag 1. Females aged younger than 71 years had even higher risk for AF, OR 1.077 (95% CI: 1.025–1.131) at lag 0. Significant associations were found for other pollutants and emergency hospital visits, but they were weaker and did not show a discernable pattern. Conclusions Short-term increase in NO2 concentrations was associated with heart diseases, more precisely with AF. The associations were stronger among females, and among females at younger age. This is the first study in Iceland that finds an association between air pollution and cardiac arrhythmias, so the results should be interpreted with caution.

ObjectivesTo assess the association between traffic-related ambient air pollution and emergency hospital visits for cardiac arrest.DesignCase–crossover design was used with a lag time to 4 days.SettingThe Reykjavik capital area and the study population was the inhabitants 18 years and older identified by encrypted personal identification numbers and zip codes.Participants and exposureCases were those with emergency visits to Landspitali University Hospital during the period 2006–2017 and who were given the primary discharge diagnosis of cardiac arrest according to the International Classification of Diseases 10th edition (ICD-10) code I46. The pollutants were nitrogen dioxide (NO2), particulate matter with aerodynamic diameter less than 10 µm (PM10), particulate matter with aerodynamic diameter less than 2.5 µm (PM2.5) and sulfur dioxide (SO2) with adjustment for hydrogen sulfide (H2S), temperature and relative humidity.Main outcome measureOR and 95% CIs per 10 µg/m3increase in concentration of pollutants.ResultsThe 24-hour mean NO2was 20.7 µg/m3, mean PM10was 20.5 µg/m3, mean PM2.5was 12.5 µg/m3and mean SO2was 2.5 µg/m3. PM10level was positively associated with the number of emergency hospital visits (n=453) for cardiac arrest. Each 10 µg/m3increase in PM10was associated with increased risk of cardiac arrest (ICD-10: I46), OR 1.096 (95% CI 1.033 to 1.162) on lag 2, OR 1.118 (95% CI 1.031 to 1.212) on lag 0–2, OR 1.150 (95% CI 1.050 to 1.261) on lag 0–3 and OR 1.168 (95% CI 1.054 to 1.295) on lag 0–4. Significant associations were shown between exposure to PM10on lag 2 and lag 0–2 and increased risk of cardiac arrest in the age, gender and season strata.ConclusionsA new endpoint was used for the first time in this study: cardiac arrest (ICD-10 code: I46) according to hospital discharge registry. Short-term increase in PM10concentrations was associated with cardiac arrest. Future ecological studies of this type and their related discussions should perhaps concentrate more on precisely defined endpoints.

Background The association between ambient air pollution and cardiac arrhythmia has been explored in numerous studies; however, the small subgroup of cardiac arrest has not been closely studied thus far. The aim of the present study was to assess the association between traffic-related ambient air pollution and emergency hospital visits for cardiac arrest. Methods A bidirectional time-stratified case-crossover design was used. The setting was the Reykjavik capital area and the study population were the inhabitants 18 years and older identified by zip codes. Cases were those who had made emergency visits to Landspitali University Hospital during the period 2006 to 2017 and who were given the primary discharge diagnosis of cardiac arrest according to The International Classification of Diseases 10th edition (ICD-10), code I46. The pollutants were NO2, PM10, PM2.5, and SO2 with adjustment for H2S, temperature and relative humidity. Results The 24-h mean NO2 was 20.7 µg/m3, mean PM10 was 20.5 µg/m3, mean PM2.5 was 12.5 µg/m3, and mean SO2 was 2.5 µg/m3. PM10 level was positively associated with the number of emergency hospital visits (n = 453) for cardiac arrest. Each 10 µg/m3 increase in PM10 was associated with increased risk of cardiac arrest (ICD-10: I46), odds ratio (OR) 1.093 (95%CI 1.033–1.162) on lag 2, and OR 1.118 (95%CI 1.031–1.212) on lag 0–2. Significant associations were shown between exposure to PM10 on lag 2 and on lag 0–2 and increased risk of cardiac arrest in the age, gender, and season strata. Females and those 71 years and older were at higher risk for cardiac arrest, OR 1.193 (95%CI 1.059–1.344), and OR 1.186 (95%CI 1.066–1.320) on lag 2, per 10 µg/m3 increase in PM10, respectively. Significant associations were sporadically found for NO2 and SO2 and emergency hospital visits for cardiac arrest, but these associations were weaker and did not show a discernable pattern. Conclusions A new endpoint was used for the first time in this study: cardiac arrest (ICD-10 code I46). Short-term increase in PM10 concentrations was associated with cardiac arrest. The effect seemed higher among the elderly and females. Future ecological studies of this type and their related discussions should perhaps concentrate more on precisely defined endpoints.