nitrogen-dioxide and Myocardial-Ischemia

To determine whether long term exposure to outdoor nitrogen dioxide (NO2) is associated with all-cause or cause-specific mortality.. MEDLINE, Embase, CENTRAL, Global Health and Toxline databases were searched using terms developed by a librarian. Screening, data extraction and risk of bias assessment were completed independently by two reviewers. Conflicts were resolved through consensus and/or involvement of a third reviewer. Pooling of results across studies was conducted using random effects models, heterogeneity among included studies was assessed using Cochran's Q and I2 measures, and sources of heterogeneity were evaluated using meta-regression. Sensitivity of pooled estimates to individual studies was examined and publication bias was evaluated using Funnel plots, Begg's and Egger's tests, and trim and fill.. Seventy-nine studies based on 47 cohorts, plus one set of pooled analyses of multiple European cohorts, met inclusion criteria. There was a consistently high degree of heterogeneity. After excluding studies with probably high or high risk of bias in the confounding domain (n = 12), pooled hazard ratios (HR) indicated that long term exposure to NO2 was significantly associated with mortality from all/ natural causes (pooled HR 1.047, 95% confidence interval (CI), 1.023-1.072 per 10 ppb), cardiovascular disease (pooled HR 1.058, 95%CI 1.026-1.091), lung cancer (pooled HR 1.083, 95%CI 1.041-1.126), respiratory disease (pooled HR 1.062, 95%CI1.035-1.089), and ischemic heart disease (pooled HR 1.111, 95%CI 1.079-1.144). Pooled estimates based on multi-pollutant models were consistently smaller than those from single pollutant models and mostly non-significant.. For all causes of death other than cerebrovascular disease, the overall quality of the evidence is moderate, and the strength of evidence is limited, while for cerebrovascular disease, overall quality is low and strength of evidence is inadequate. Important uncertainties remain, including potential confounding by co-pollutants or other concomitant exposures, and limited supporting mechanistic evidence. (PROSPERO registration number CRD42018084497).

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; Environmental Exposure; Humans; Lung Neoplasms; Myocardial Ischemia; Nitrogen Dioxide; Respiratory Tract Diseases

Nitrogen dioxide (NO. MEDLINE, Embase, CENTRAL, Global Health and Toxline databases were searched using terms developed by a librarian. Screening, data extraction and risk of bias assessment were completed independently by two reviewers. Conflicts between reviewers were resolved through consensus and/or involvement of a third reviewer. Pooling of results across studies was conducted using random effects models, heterogeneity among included studies was assessed using Cochran's Q and I. Thirty-eight case-crossover studies and 48 time-series studies were included in our analysis. NO. We concluded that there is a likely causal relationship between short term NO

Topics: Air Pollutants; Cross-Over Studies; Environmental Exposure; Humans; Linear Models; Morbidity; Myocardial Ischemia; Nitrogen Dioxide; Time Factors

Studying the impact of local meteorological conditions and air pollution on cardiovascular disease is crucial for reducing the burden of cardiovascular disease. However, there have been few studies on the acute effects of various air pollutants on stable ischemic heart disease (SIHD), and the effects of these factors are not well defined and require further investigation. We performed a time-series study aimed at exploring the association between short-term exposure to various air pollutants and emergency department (ED) visits for SIHD during 2013-2020 in Baoshan District Renhe Hospital of Shanghai, China. The associations between air pollution (NO

Topics: Air Pollutants; Air Pollution; Cardiovascular Diseases; China; Emergency Service, Hospital; Environmental Pollutants; Female; Humans; Myocardial Ischemia; Nitrogen Dioxide; Particulate Matter

Particulate matter (PM) and NO2 induce pathophysiological changes which contribute to an increased incidence of acute cardiovascular (CV) and respiratory (Rp) events.. To analyze the relationship between air quality and the frequency of admissions to the emergency department (ED) due to the CV diseases and Rp causes.. The study analyzed the reasons for admissions to the ED during the cold periods from January 2017 to January 2020. These data were combined with the average daily concentrations of NO2, PM2.5 and PM10, and the individual air quality indexes (IAQIs) for these pollutants.. Our analyses have shown that 3468 (11.4%) and 1053 (3.46%) of all 30,419 analyzed patients were admitted to the ED for CV and Rp reasons, respectively. Cardiovascular patients were significantly more often admitted to the ED when the IAQI for NO2 was worse than very good, and the IAQI for PM2.5 or PM10 was worse than good. In such periods, diagnoses such as ischemic heart disease (IHD) or syncope were statistically more common and the risk of admission of a patient with a diagnosis such as IHD, heart failure (HF), syncope, stroke, or transient ischemic attack (TIA) was increased. Registered deaths occurred significantly more often among patients admitted on days with moderate or worse than moderate air quality determined in relation to PM10 in comparison to days with very good or good air quality (0.35% and 0.23%, respectively, p = 0.04).. Air quality significantly affects the admissions to the ED for CV and Rp reasons and has an impact on mortality.

Topics: Air Pollution; Cardiovascular Diseases; Emergency Service, Hospital; Environmental Pollutants; Hospitals; Humans; Myocardial Ischemia; Nitrogen Dioxide; Particulate Matter; Syncope

Greener residential surroundings are associated with beneficial health outcomes, whereas higher air pollution exposure is linked with elevated risks of chronic diseases. To date, limited studies have explored the interaction between residential greenness and air pollution on the risk of ischemic heart disease (IHD). We performed a prospective cohort study that included 29,141 adult participants recruited from Yinzhou District, Ningbo, China. Normalized Difference Vegetation Index (NDVI) around each participant's residence was calculated to measure residential greenness exposure. Land-use regression models were conducted to estimate long-term individual exposure to air pollutants, including nitrogen dioxide (NO

Topics: Adult; Air Pollutants; Air Pollution; China; Environmental Exposure; Humans; Myocardial Ischemia; Nitrogen Dioxide; Particulate Matter; Prospective Studies

The aim: To determine changes in endothelial dysfunction and immunological response in patients with rheumatoid arthritis with and without coronary heart disease.. Materials and methods: The study involved 151 patients with RA and coronary heart disease. The ED was assessed by examining the NO system in RA for determination of the content in the blood of the product of NO synthase - the final metabolites of NO2- and NO3- and the level of VEGF and CD28 in the serum.. Results: The results of the study of the levels of metabolites NO2- and NO3- in the first and second groups showed their increased content. Analysis of the content of VEGF in the blood for patients with different durations of the disease showed that the concentration of the studied protein grows larger with increasing duration of the disease. The maximum of sCD28 concentration was found in middle-aged patients, and the minimum (the difference was significant) - in the elderly.. Conclusions: As the duration of the disease increases, the content of VEGF in the blood of patients increases, which, at the same time, did not show age dependence on RA and did not change further with concomitant coronary heart disease. Detected concentrations of sCD28 are higher in patients with less prolonged RA, and begin to decrease with increasing duration of the disease.

Topics: Aged; Arthritis, Rheumatoid; CD28 Antigens; Coronary Disease; Humans; Immunity; Middle Aged; Myocardial Ischemia; Nitrogen Dioxide; Vascular Endothelial Growth Factor A

In recent years, ambient air has been severely contaminated by particulate matters (PMs) and some gas pollutants (nitrogen dioxide (NO

Topics: Air Pollutants; Air Pollution; Cerebrovascular Disorders; China; Environmental Exposure; Humans; Lung Neoplasms; Meteorological Concepts; Mortality; Myocardial Ischemia; Nitrogen Dioxide; Particulate Matter; Public Health; Pulmonary Disease, Chronic Obstructive; Respiratory Tract Infections; Seasons; Sulfur Dioxide

Few studies have used spatially resolved ambient particulate matter with an aerodynamic diameter of <10 μm (PM10) to examine the impact of PM10 on ischemic heart disease (IHD) mortality in China. The aim of our study is to evaluate the short-term effects of PM10 concentrations on IHD mortality by means of spatiotemporal analysis approach.. We collected daily data on air pollution, weather conditions and IHD mortality in Beijing, China during 2008 and 2009. Ordinary kriging (OK) was used to interpolate daily PM10 concentrations at the centroid of 287 township-level areas based on 27 monitoring sites covering the whole city. A generalized additive mixed model was used to estimate quantitatively the impact of spatially resolved PM10 on the IHD mortality. The co-effects of the seasons, gender and age were studied in a stratified analysis. Generalized additive model was used to evaluate the effects of averaged PM10 concentration as well.. The averaged spatially resolved PM10 concentration at 287 township-level areas was 120.3 ± 78.1 μg/m3. Ambient PM10 concentration was associated with IHD mortality in spatiotemporal analysis and the strongest effects were identified for the 2-day average. A 10 μg/m3 increase in PM10 was associated with an increase of 0.33% (95% confidence intervals: 0.13%, 0.52%) in daily IHD mortality. The effect estimates using spatially resolved PM10 were larger than that using averaged PM10. The seasonal stratification analysis showed that PM10 had the statistically stronger effects on IHD mortality in summer than that in the other seasons. Males and older people demonstrated the larger response to PM10 exposure.. Our results suggest that short-term exposure to particulate air pollution is associated with increased IHD mortality. Spatial variation should be considered for assessing the impacts of particulate air pollution on mortality.

Topics: Aged; Air Pollutants; Air Pollution; China; Cities; Female; Humans; Humidity; Male; Myocardial Ischemia; Nitrogen Dioxide; Particulate Matter; Seasons; Spatio-Temporal Analysis; Sulfur Dioxide; Temperature

Increasing evidence links air pollution to the risk of cardiovascular disease. This study investigated the association between ischemic heart disease (IHD) prevalence and exposure to traffic-related air pollution (nitrogen dioxide [NO₂], fine particulate matter [PM₂.₅], and ozone [O₃]) in a population of susceptible subjects in Toronto. Local (NO₂) exposures were modeled using land use regression based on extensive field monitoring. Regional exposures (PM₂.₅, O₃) were modeled as confounders using inverse distance weighted interpolation based on government monitoring data. The study sample consisted of 2360 patients referred during 1992 to 1999 to a pulmonary clinic at the Toronto Western Hospital in Toronto, Ontario, Canada, to diagnose or manage a respiratory complaint. IHD status was determined by clinical database linkages (ICD-9-CM 412-414). The association between IHD and air pollutants was assessed with a modified Poisson regression resulting in relative risk estimates. Confounding was controlled with individual and neighborhood-level covariates. After adjusting for multiple covariates, NO₂ was significantly associated with increased IHD risk, relative risk (RR) = 1.33 (95% confidence interval [CI]: 1.2, 1.47). Subjects living near major roads and highways had a trend toward an elevated risk of IHD, RR = 1.08 (95% CI: 0.99, 1.18). Regional PM₂.₅ and O₃ were not associated with risk of IHD.

Topics: Aged; Air Pollution; Cohort Studies; Cross-Sectional Studies; Environmental Monitoring; Epidemiological Monitoring; Female; Humans; Inhalation Exposure; Male; Middle Aged; Models, Theoretical; Myocardial Ischemia; Nitrogen Dioxide; Ontario; Oxidants, Photochemical; Ozone; Particulate Matter; Poisson Distribution; Prevalence; Regression Analysis; Risk

Relatively little research exists focusing on the impact of air pollution on hospital admissions in Asia compared to the extensive work conducted in the USA and Europe. The issue is of particular importance because of the frequency, intensity and health effects of Asian sandstorms. This work investigates the relation between cause-specific hospital admissions and sandstorms and air pollution in Taipei, Taiwan's capital.. Time-series analyses of asthma, pneumonia, ischaemic heart disease and cerebrovascular disease hospital admissions were performed for Taipei. An eight-year time period (1995-2002) was considered for various indicators of sandstorms and the pollutants NO(2), CO, ozone, SO(2), PM(10), and PM(2.5). Pollution effects based on single-day lags of 0, 1, 2 and 3 days were explored, along with the average of the same day and previous three days (L03).. The risk of ischaemic heart disease admissions was associated with several sandstorm metrics, including indicators of high PM(10) levels in the Taipei area, indicators of high PM(10) at a monitor designed to measure background pollution, the PM coarse fraction, and the ratio of PM(10) to PM(2.5). However, the lag structure of effect was not consistent across sandstorm indicators. Hospital admissions for this disease were 16-21% higher on sandstorm days compared to other days. This cause was also associated with transportation-related pollutants, NO(2), CO and PM(2.5). Asthma admissions rose 4.48% (95% CI 0.71% to 8.38%) per 28 mug/m(3) increase in L03 PM(10) levels and 7.60% (95% CI 2.87% to 12.54%) per 10 ppb increase in L03 ozone. Cerebrovascular disease admissions were associated with PM(10) and CO, both at lag 3 days. SO(2) exhibited no relation with admissions.. Risk of hospital admissions in Taipei may be increased by air pollution and sandstorms. Additional research is needed to clarify the lag structure and magnitude of such effects.

Topics: Air Pollutants; Air Pollution; Asthma; Carbon Monoxide; Cerebrovascular Disorders; Environmental Exposure; Environmental Monitoring; Fourier Analysis; Hospitalization; Humans; Myocardial Ischemia; Nitrogen Dioxide; Ozone; Particle Size; Particulate Matter; Pneumonia; Silicon Dioxide; Sulfur Dioxide; Taiwan; Urban Health; Weather

We examined the associations between emergency department (ED) visits for ischemic heart disease (IHD) and short-term elevations in ambient air pollutants (CO and NO(2)).. A hierarchical clusters design was used to study ED visits (n = 4979) for ischemic heart disease (ICD-9: 410-414) that occurred at a Montreal hospital between 1997 and 2002. The generalized linear mixed models technique was applied to create Poisson models for the clustered counts of ED visits for IHD. The analysis was done by gender for two age categories, all patients and patients aged over 64 years.. The results are presented as an excess risk increase associated with the interquartile range (IQR) of daily average of the pollutant concentration. The results for NO(2) (IQR = 9.5 ppb) were 5.9% (95% CI: 2.1-9.9) for all patients and 6.2% (95% CI: 1.2-11.4) for males; for patients aged over 64: 7.1% (95% CI: 2.5-11.9) for all patients, 9.1% (95% CI: 2.8-15.7) for males, and 6.5% (95% CI: 0.7-12.7) for females (for exposure lagged by 1-day). The results for CO (IQR = 0.2 ppm): 5.4% (95% CI: 2.3-8.5) for all patients, and 7.5% (95% CI: 3.6-11.6) for males. For patients aged over 64 years, 4.9% (95% CI: 1.3-8.7) for all patients, and 7.5% (95% CI: 2.6-12.6) for males. The results show the associations for the same day exposures.. The short-term effects of nitrogen dioxide and carbon monoxide are associated significantly with daily ED visits for ischemic heart disease. For NO(2) the associations are stronger for patients aged over 64 years. As indicated by our results, it is likely that vehicular traffic, a producer of NO(2) and CO, contributes to an increased number of ED visits for IHD.

Topics: Adult; Age Distribution; Aged; Aged, 80 and over; Air Pollutants; Air Pollution; Carbon Monoxide; Cluster Analysis; Emergency Service, Hospital; Female; Humans; Linear Models; Male; Middle Aged; Myocardial Ischemia; Nitrogen Dioxide; Quebec; Risk Factors; Sex Distribution

Out-of-hospital coronary heart disease death is a major public health problem, but the association with air pollution is not well understood.. We evaluated the association between daily ambient air pollution levels (particle number concentration [PNC]--a proxy for ultrafine particles [diameter < 0.1 microm], mass of particles with diameter less than 10 microm [PM10]; CO, NO2, and O3) and the occurrence of fatal, nonhospitalized coronary events.. Subjects were 5,144 out-of-hospital fatalities (410-414, International Classification of Diseases-9; 1998-2000) who had been residents of Rome. Hospitalizations during the 3 yr before death were considered to identify comorbidities (e.g., diabetes, hypertension, heart failure, dysrhythmia, chronic obstructive pulmonary disease). Statistical analyses were performed using a case-crossover design.. The association with out-of-hospital coronary deaths was statistically significant for PNC, PM10, and CO. Air pollution on the day of death had the strongest effect (e.g., 7.6% increase [95% confidence interval, 2.0-13.6%]) for an interquartile range of PNC, 27,790 particles/cm3. The 65-74- and 75+-yr age groups were at higher risk than the 35-64-yr age group, and there was a suggestion of effect modification for people with hypertension and chronic obstructive pulmonary disease.. Air pollutants originating from combustion processes, including ultrafine particles, are related to fatal, nonhospitalized coronary events. The effect is stronger among people over 65 years of age, but is not limited to a group with a specific comorbidity.

Topics: Aged; Air Pollutants; Air Pollution; Carbon Monoxide; Case-Control Studies; Cross-Over Studies; Female; Humans; Male; Middle Aged; Myocardial Ischemia; Nitrogen Dioxide; Ozone; Particle Size; Rome; Sulfur Dioxide

We examined whether ischemic heart disease (IHD) hospital admissions were associated with air pollutants in those with and without secondary diagnoses of arrhythmia (ARR) or congestive heart failure (CHF). We assessed the occurrence of increased vulnerability among persons with these conditions to daily variations in ozone, carbon monoxide, nitrogen dioxide, or particulate matter less than or equal to 10 micro m in aerodynamic diameter (PM10). The study population consisted of members of a large health maintenance organization residing in the South Coast Air Basin of California from 1988 to 1995. After adjustment for day of week, study year, and smoothing splines for day of study, temperature, and relative humidity, CO and NO2 were both associated with admissions with the greatest effects for CO. A 1-ppm increase in 8-hr average CO was associated with a 3.60% [95% confidence interval (CI), 1.62-5.63%] increase in same-day IHD admissions in persons with a secondary diagnosis of CHF, a 2.99% (95% CI, 1.80-4.19%) increase in persons with a secondary diagnosis of ARR, and a 1.62% (95% CI, 0.65-2.59%) increase in IHD admissions in persons without either secondary diagnosis. Air pollution was most strongly associated with myocardial infarction hospital admissions. The vulnerability of the secondary CHF subgroup may be due to a greater prevalence of myocardial infarction primary diagnoses and not the modifying effect of CHF. This study suggests that people with IHD and accompanying CHF and/or ARR constitute a sensitive subgroup in relation to the effects of criteria ambient air pollutants associated with motor vehicle combustion.

Topics: Aged; Air Pollutants; Arrhythmias, Cardiac; Carbon Monoxide; Epidemiologic Studies; Female; Heart Failure; Humans; Incidence; Male; Middle Aged; Myocardial Ischemia; Nitrogen Dioxide; Oxidants, Photochemical; Ozone; Particle Size; Patient Admission; Risk Factors; Vehicle Emissions

This article describes a Poisson regression model for time trends of mortality to detect the long-term effects of common levels of air pollution on lung cancer, in which the adjustment for cigarette smoking is not always necessary. The main hypothesis to be tested in the model is that if the long-term and common-level air pollution had an effect on lung cancer, the death rate from lung cancer could be expected to increase gradually at a higher rate in the region with relatively high levels of air pollution than in the region with low levels, and that this trend would not be expected for other control diseases in which cigarette smoking is a risk factor. Using this approach, we analyzed the trend of mortality in females aged 40 to 79, from lung cancer and two control diseases, ischemic heart disease and cerebrovascular disease, based on vital statistics in 23 wards of the Tokyo metropolitan area for 1972 to 1988. Ward-specific mean levels per day of SO2 and NO2 from 1974 through 1976 estimated by Makino (1978) were used as the ward-specific exposure measure of air pollution. No data on tobacco consumption in each ward is available. Our analysis supported the existence of long-term effects of air pollution on lung cancer.

Topics: Adult; Aged; Air Pollutants; Air Pollution; Cerebrovascular Disorders; Cohort Studies; Environmental Exposure; Female; Humans; Lung Neoplasms; Middle Aged; Myocardial Ischemia; Nitrogen Dioxide; Poisson Distribution; Regression Analysis; Risk Factors; Smoking; Sulfur Dioxide; Tokyo; Vital Statistics