Effects of Fine Particulate Matter on Daily Mortality for Specific Heart Diseases in Japan

Ueda, Kayo; Nitta, Hiroshi; Ono, Masaji

doi:10.1253/circj.cj-08-1149

Cited by 44 publications

(17 citation statements)

References 42 publications

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“…Among the studies examining the association between air pollutants and cardiovascular mortality in Japan [15,16,17,18,19,20], a recent study has demonstrated that long-term exposure to traffic-related air pollution, indexed by NO 2 concentration, increases the risk of cardiopulmonary mortality [19]. In our study, we observed the higher levels of NO 2 to be associated with higher risk of cardiovascular acute fatality.…”

Section: Discussionsupporting

confidence: 64%

“…The differences in urban-rural distribution in pollutants could be the reason for the inconclusiveness of our findings. Furthermore, it has been suggested that there is a degree of heterogeneity in the effect of pollutant on mortality even within the same country [34,35] and regional heterogeneity was reported in the estimated effect of fine particulate matter on cardiac disease mortality in Japan [16]. It is therefore possible that there is regional heterogeneity in the effect of ambient pollutants on cardiovascular acute case-fatality.…”

Section: Discussionmentioning

confidence: 99%

“…Although a few studies in Japan had been conducted on the effect of air pollutants on CVD, these studies have predominantly reported on CVD deaths [14,15,16,17,18,19,20] rather than acute case-fatality. Using data from an entire community population covering a disease registration system, we examined the acute case-fatality of stroke and AMI in relation to exposure to ambient pollutant levels to enumerate the effect of air pollutant levels on the acute outcome of cardiovascular events.…”

Section: Introductionmentioning

confidence: 99%

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Ambient Air Pollutants and Acute Case-Fatality of Cerebro-Cardiovascular Events: Takashima Stroke and AMI Registry, Japan (1988–2004)

Turin

Kita²,

Rumana³

et al. 2012

Cerebrovasc Dis

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Background: Apart from the conventional risk factors, cerebro-cardiovascular disease (CVD) are also reported to be associated with air pollution, thus lowering the level of exposure might contribute in prevention activities to reduce the associated adverse outcomes. Though few studies conducted in Japan have reported on the CVD mortality but none have explored the effect of air pollutant exposure on the acute case-fatality of CVD. We investigated the effects of air pollution exposure on acute case-fatality of stroke and acute myocardial infarction (AMI) in a setting where pollutant levels are rather low. Methods: We leveraged the data from the Takashima Stroke and AMI Registry, which covers a population of approximately 55,000 in Takashima County located in central Japan. The study period of 6,210 days (16 years, leap years also taken into account) were divided into quartiles of daily average pollutant concentration; suspended particulate matter (SPM), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), and photochemical oxidants (Ox). The stroke and AMI events were categorized to corresponding quartiles based on the pollution levels of the onset day. To study the effects of air pollutants, we estimated the fatality rate ratio across quartiles of the pollutants where the lowest quartile served as the reference. Results: There were 307 (men: 153 and women: 154) fatal stroke cases within 28 days of onset among the 2,038 first ever stroke during 1988–2004. In the same period, there were 142 (men: 94 and women: 54) fatal AMI cases within 28 days of onset among the 429 first ever AMI events. The mean of the measured pollutant levels were as follows: SPM 26.9 µg/m³, SO₂ 3.9 ppb, NO₂ 16.0 ppb, and Ox 28.4 ppb. Among the pollutants, higher levels of NO₂ showed increased fatality risk. In multi-pollutant model, the highest quartile of NO₂ was associated with 60% higher stroke case-fatality risk in comparison to lowest quartile of NO₂. In the fully adjusted model the fatality-rate ratio was 1.65 (95% CI 1.06–2.57). This association was more prominent among stroke subtype of cerebral infarction. Other pollutant levels did not show any association with stroke or AMI case-fatality. Conclusion: We observed association between NO₂ levels, an index of traffic related air pollution, with the acute case-fatality of stroke, especially cerebral infarction in our study population. Further studies are needed in different regions to determine the association between ambient air pollutants and acute cardiovascular fatalities.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ambient Air Pollutants and Acute Case-Fatality of Cerebro-Cardiovascular Events: Takashima Stroke and AMI Registry, Japan (1988–2004)

Turin

Kita²,

Rumana³

et al. 2012

Cerebrovasc Dis

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“…PM2.5, which can penetrate deep into the lung, 9 has frequently been the focus of air pollution and health studies. 10, 11 Smaller still are the ultrafine particles (PM0.1), with an aerodynamic diameter <0.1 μm, that can penetrate into alveoli and the systemic circulation. 9 In a dust storm, the predominant fraction tends to consist of coarse particles, 12 or the coarse fraction of PM10 (expressed as PM10-2.5).…”

mentioning

confidence: 99%

Effect of Dust Storm Events on Daily Emergency Admissions for Cardiovascular Diseases

Tam

Wong

2012

Circ J

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Background: Dust storm is a meteorological phenomenon and dust particles have been suspected as harmful to heart and lungs. The aim of this study was to investigate the association between coarse particles and emergency hospital admissions for cardiovascular diseases (CVD) in Hong Kong. Methods and Results:Data on mean daily emergency admissions for CVD to major hospitals in Hong Kong, concentrations of air pollutants and meteorological variables from January 1998 to December 2002 were obtained from several government departments. We identified 5 dust storm days during the study period. Independent t-tests were used to compare the mean daily number of admissions on dust storm and non-dust storm days. Case-crossover analysis, using the Poisson regression, was used to examine the effects of coarse particles' concentration on emergency hospital admissions for CVD. A marginally significant increase in emergency hospital admissions for ischemic heart disease (IHD) was found with RR=1.04 (95% confidence interval: 1.00, 1.08) per 10 μg/m 3 increase in the concentration of coarse particles. Conclusions:This study demonstrated a marginally significant increase in emergency hospital admissions for IHD on the day of dust storm events in Hong Kong, when the levels of coarse particles were very high. Further studies are required to assess the role of coarse particles on cardiac health. (Circ J 2012; 76: 655 - 660)

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“…These studies were predominantly based on North American and European populations. Although a few authors in Japan have evaluated the short-term effect of air pollutants on CVD, these reports were predominantly concerned with deaths, rather than the incidence of CVD [7][8][9][10] . Stroke and AMI are common causes of morbidity and mortality in Japan and represent a great health risk in the middle-aged and elderly [11,12] .…”

mentioning

confidence: 99%

Short-Term Exposure to Air Pollution and Incidence of Stroke and Acute Myocardial Infarction in a Japanese Population

Turin¹,

Kita²,

Rumana³

et al. 2012

Neuroepidemiology

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Background: Exposure to high levels of air pollution can increase the risk of cardiovascular events. However, there is no clear information in Japan on the effect of pollution on the incidence of stroke and acute myocardial infarction (AMI). Therefore, we investigated the effects of air pollution on the incidence of stroke and AMI in a setting where pollutant levels are rather low. Methods: Data were obtained from the Takashima Stroke and AMI Registry, which covers a population of approximately 55,000 in Takashima County in central Japan. We applied a time-stratified, bidirectional, case-crossover design to estimate the effects of air pollutants, which included suspended particulate matter (SPM), sulfur dioxide (SO₂), nitrogen dioxide (NO₂) and photochemical oxidants (Ox). We used the distributed lag model to estimate the effect of pollutant exposure 0-3 days before the day of event onset and controlled for meteorological covariates in all of the models. Results: There were 2,038 first-ever strokes (1,083 men, 955 women) and 429 first-ever AMI cases (281 men, 148 women) during 1988-2004. The mean pollutant levels were as follows: SPM 26.9 µg/m³; SO₂ 3.9 ppb; NO₂ 16.0 ppb, and Ox 28.4 ppb. In single-pollutant and two-pollutant models, SO₂ was associated with the risk of cerebral hemorrhage. Other stroke subtypes and AMI were not associated with air pollutant levels. Conclusions: We observed an association between SO₂ and hemorrhagic stroke; however, we found inconclusive evidence for a short-term effect of air pollution on the incidence of other stroke types and AMI.

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Effects of Fine Particulate Matter on Daily Mortality for Specific Heart Diseases in Japan

Cited by 44 publications

References 42 publications

Ambient Air Pollutants and Acute Case-Fatality of Cerebro-Cardiovascular Events: Takashima Stroke and AMI Registry, Japan (1988–2004)

Ambient Air Pollutants and Acute Case-Fatality of Cerebro-Cardiovascular Events: Takashima Stroke and AMI Registry, Japan (1988–2004)

Effect of Dust Storm Events on Daily Emergency Admissions for Cardiovascular Diseases

Short-Term Exposure to Air Pollution and Incidence of Stroke and Acute Myocardial Infarction in a Japanese Population

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