Effects of air pollution on daily hospital admissions for cardiovascular diseases in Castilla-La Mancha, Spain: a region with moderate air quality

Abstract

Adverse impacts of air pollution on human health have been well documented in Spain; however, very few have been conducted in the Spanish region of Castilla-La Mancha (CLM). CLM is an extensive region with a low population density, little industrial production, and moderate air pollution level. The aim of the study was to assess the relationship between the risk of hospital admission for cardiovascular disease (CVD) and exposure to PM2.5, PM10, and NO2 in CLM during 2006–2015. Daily air pollution concentration, temperature, and relative humidity were monitored from the air quality monitoring stations in CLM. A time-series analysis with generalized linear model was used to examine the effects of air pollution on hospital admissions by controlling for long-term trend and other potential confounders. The effect modifications by sex and age (15–64; ≥ 65 years) were examined. Lagging exposure concept was used to analyze a possible latency period in cumulative exposure-pollution analyses. Relative risks (RR) of CVD admissions at the same day (lag 0) and to 7 days after exposure (lag 7) were calculated. Relative risks of CVD admissions (for an increase of 10 µg m−3 in concentration of air pollutant) were calculated. The elderly group (≥ 65 years) were the most susceptible group to the effect of air pollution, whereas the estimated effect by sex was significantly different depending on the age group. The potential utility of these results may help for syndromic surveillance during future similar air pollutant concentrations, where an increase in the use of health services among the vulnerable groups could be unexpected by the emergency department.

Assessment of indoor air quality and risk of COVID-19 infection in Spanish secondary school and university classrooms

“…NO 2 is linked to negative health effects even at levels within ambient air quality standards European Directive 2008/50/EC or WHO guidelines [ 93 ]. Indoor NO 2 , especially in urban areas, is normally influenced by on-road traffic and industries [ 94 , 95 ].…”

Short-term effects of air pollution on hospital admissions for cardiovascular diseases and diabetes mellitus in Sofia, Bulgaria (2009–2018)

“…Although most studies confirm a correlation between hospitalisation for cardiovascular diseases and short-term peaks in air pollution, this finding is not universally true and studies vary in that respect ( 26 ). Some report that the risk increases on the same day (lag0 ( 23 ) and many other report a delay of several days ( 10 – 13 ).…”

“…Demographic stratification also did not reveal a clear-cut pattern, as the hospitalisation increased in both older and younger individuals for different combinations of a pollutant, outcome, and lag. Other authors suggest that the elderly are more susceptible to the effects of air pollution ( 23 ). However, recent WHO reviews on short-term effects of different air pollutants on hospital admissions, emergency room visits, and mortality reported much higher diversity for this population group ( 29 – 31 ).…”

“…As the main outcomes we used the total daily number of hospital admissions per diagnosis. Then, to identify potential gender and age-related differences, we stratified the number of cases as follows: men <65 years, men ≥65 years, women <65 years, and women ≥65 years, in line with earlier studies ( 23 ). We used only the publicly available patient data, and the study was therefore not subject to an approval by a bioethics committee.…”

Ambient carbon monoxide and cardiovascular-related hospital admissions: A time-series analysis

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