The effect of secondary inorganic aerosols, soot and the geographical origin of air mass on acute myocardial infarction hospitalisations in Gothenburg, Sweden during 1985–2010: a case-crossover study

Abstract

BackgroundThe relative importance of different sources of air pollution for cardiovascular disease is unclear. The aims were to compare the associations between acute myocardial infarction (AMI) hospitalisations in Gothenburg, Sweden and 1) the long-range transported (LRT) particle fraction, 2) the remaining particle fraction, 3) geographical air mass origin, and 4) influence of local dispersion during 1985–2010.MethodsA case-crossover design was applied using lag0 (the exposure the same day as hospitalisation), lag1 (exposure one day prior hospitalisation) and 2-day cumulative average exposure (CA2) (mean of lag0 and lag1). The LRT fractions included PMion (sum of sulphate, nitrate and ammonium) and soot measured at a rural site. The difference between urban PM10 (particulate matter with an aerodynamic diameter smaller than 10 μm) and rural PMion was a proxy for locally generated PM10 (PMrest). The daily geographical origin of air mass was estimated as well as days with limited or effective local dispersion. The entire year was considered, as well as warm and cold periods, and different time periods.ResultsIn total 28 215 AMI hospitalisations occurred during 26 years. PM10, PMion, PMrest and soot did not influence AMI for the entire year. In the cold period, the association was somewhat stronger for PMrest than for urban PM10; the strongest associations were observed during 1990–2000 between AMI and CA2 of PMrest (6.6% per inter-quartile range (IQR), 95% confidence interval 2.1 to 11.4%) and PM10 (4.1%, 95% CI 0.2% − 8.2%). Regarding the geographical air mass origins there were few associations. Days with limited local dispersion showed an association with AMI in the cold period of 2001–2010 (6.7%, 95% CI 0.0% − 13.0%).ConclusionsIn the cold period, locally generated PM and days with limited local dispersion affected AMI hospitalisations, indicating importance of local emissions from e.g. traffic.

Short-term exposure to particulate air pollution and risk of myocardial infarction: a systematic review and meta-analysis

“…Even though a growing number of studies have demonstrated the association between transient elevations in PM 10 , PM 2.5 , and risk of MI (Hoffmann et al 2009;Turin et al 2012;Jalaludin and Cowie 2014;Talbott et al 2014;Wichmann et al 2014;Xie et al 2014), the results of many time-series studies and case-crossover studies in recent years had conflicting results compared with a recent meta-analysis (Mustafic et al 2012). To our knowledge, the systematic review and meta-analysis have been published in February 2012, which only have searched relevant literatures up to 2011, comprehensively clarifying the relationship between main air pollution (SO 2 , NO 2 , NO, O 3 , PM 10 , PM 2.5 ) and risk of MI, and observing an evidence of publication bias in PM 2.5 exposure, but not PM 10 .…”

“…After obtaining and reading full texts of the remaining articles, 34 studies were excluded: 4 had not sufficient data, 4 were the same or overlapping dataset, 12 were long-term exposure analysis, 5 were reviews or meta-analysis, 7 did not explore the effect of PM2.5 or PM10, and 2 were reported in nonEnglish language. Then, reviewing of reference lists of all the identified articles, related published reviews, metaanalysis, and excluding studies with the same or overlapping dataset in the same region, finally, 31 studies were included (Medina et al 1997;Hoek et al 2000;Linn et al 2000;Mann et al 2002;Sharovsky et al 2004;Peters et al 2005;Sullivan et al 2005;Zanobetti and Schwartz 2005;Barnett et al 2006;Cendon et al 2006;Lanki et al 2006;Pope et al 2006;Zanobetti and Schwartz 2006;Cheng et al 2009;Stieb et al 2009;Ueda et al 2009;Zanobetti and Schwartz 2009;Belleudi et al 2010;Hsieh et al 2010;Mate et al 2010;Rich et al 2010;Nuvolone et al 2011;von Klot et al 2011;Chang et al 2013;Rosenthal et al 2013;Wichmann et al 2013;Bard et al 2014;Milojevic et al 2014;Talbott et al 2014;Wichmann et al 2014;Xie et al 2014). The study screening process is presented briefly in Fig.…”

“…It is well established that risk factors for MI include hypertension, diabetes, obesity, tobacco use, high cholesterol levels, physical inactivity, and psychosocial factors (Castelli 1984;Yusuf et al 2004). And, a large body of studies has associated shortterm exposure to daily average levels of air pollution and risk of MI (Hoffmann et al 2009;Turin et al 2012;Jalaludin and Cowie 2014;Talbott et al 2014;Wichmann et al 2014;Xie et al 2014). In particular, airborne particulate matter (PM) not only is an extremely complex air pollutant but also is a large harmful risk factors to human health.…”

Long-range transport clusters and positive matrix factorization source apportionment for investigating transboundary PM2.5in Gothenburg, Sweden

“…Days with local limited dispersion were much more common when the air masses originated from E-Eur, UK-NorthS-DK or N-Atlantic (>60% of the days) during 1985-2010. 29 On days with limited local dispersion the contributions from combustion and resuspension were found to be signicantly higher (p ¼ 0.02 and p < 0.0001, respectively), while the marine inuence was reduced (p < 0.0001). Low wind speed limits the amount of sea spray from the ocean, while the local emissions from combustion and resuspension would not be dispersed and transported away as effectively and thus increase the contribution to the PM 2.5 concentrations from these sources.…”

Evaluation of a meta-analysis of air quality and heart attacks, a case study

“…We show that the results from the base papers can be viewed as a two-component mixture, some base papers indicate positive effects, where as other appear without effect. The fact that recent large studies indicate no air quality-MI effect (e.g., Tsai et al 2012, Milojevic et al 2014, Talbott et al 2014, Wichmann et al 2014, Wang et al 2015b, Young et al 2017) support that these negative studies are correct and positive studies are consistent with so-called p-hacking. recently analyzed the reliability of 14 observational epidemiology base studies about particulate matter−MI effects that were combined in a MA published in The Lancet (Nawrot et al 2011).…”