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Barchielli, Alessandro*; Balzi, Daniela*; Nuvolone, Daniela†; Grechi, Daniele‡; Scala, Danila‡; “Urban air quality and health ARPAT Working Group
*Epidemiology Unit 10, Firenze, Italy; †Epidemiology Unit, Regional Agency for Public Health of Tuscany, Firenze, Italy; and ‡ARPAT Regional agency for environmental protection of Tuscany, Firenze, Italy.
Several studies have reported significant associations between outdoor air pollution and health outcome, such as deaths and hospital admissions for respiratory and cardiovascular diseases. RisCAT study (Cardiovascular RISks and Air pollution in Tuscany) aimed to evaluate the relationship between the incidence of acute myocardial infarction (AMI) and air pollution levels in urban areas in Tuscany.
Data on AMI events, air pollution and meteorological variables were collected for the period 2002–2004. We included both hospitalised AMI events and coronary deaths without hospital admissions. We selected air quality monitoring stations classified as background urban sites and we calculated daily mean concentrations for main pollutants. We identified six homogeneous areas (covering 43% of the total population in Tuscany), according to the values recorded at the monitoring sites. A bi-directional case cross-over design was performed to evaluate the short term effects of air pollutants on AMI events at different time lags. A conditional logistic regression analysis was carried out in each area and the pooled association was estimated in a random-effect meta-analysis.
We identified 14.000 AMI events in the 6 areas (73.1% in hospital and 26.9% coronary deaths without admission). 58% of events occurred in subjects over 74 years of age. We observed a general increase of health risk, especially for elder people. For subjects over 74 years for all events we observed an OR = 1.03 (lag 0–3 95% CI 1.003–1.067) for 10 μg/m3 increase in ozone, in summer months; an OR = 1.02 (lag 0–1 95% CI 1.001–1.035) for 10 μg/m3 increase in PM10. Significant associations were reported for coronary deaths without admission, but not for AMI events occurred in hospital.
Our study confirmed the negative effects of outdoor air pollution on cardiovascular health. Elder people have higher risks of disease, mainly during the hot season.
© 2009 Lippincott Williams & Wilkins, Inc.
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