Emergency Hospital Admissions for Cardiovascular Causes Attributable to Air Pollution and Extreme Temperatures in Spain: Influence of Economic and Demographic Factors in a Nationwide Study.

IF 4.1 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
J A López-Bueno, J Díaz, M Iriso, R Ruiz-Páez, M A Navas-Martín, C Linares
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Abstract

Using generalised linear models (GLMs) with a Poisson link, this study analysed the short-term effect of NO2, ozone, PM10 and PM2.5 on the daily number of emergency hospital admissions due to cardiovascular disease (CVD), acute cerebrovascular disease, acute myocardial infarction (AMI) and ischaemic heart disease (IHD). The impact of the minimum daily temperature in cold waves and maximum daily temperature in heat waves was likewise analysed. Specific dose-response functions were calculated for each province and cause of admission considered. We used random effects mixed models to analyse the relationship between the percentage of admissions in each province and the following provincial variables: income level; number of inhabitants; population percentage aged 65 years and over and percentage of women. Our results indicated that in Spain there were 10,167 (95%CI: 3.679, 16.554) emergency CVD-related annual admissions attributable to the variables considered, which accounted for 7.7% of total annual CVD-related admissions in Spain and broke down as follows: 6.9% attributable to air pollution in general, and NO2 and O3 in particular, and 0.8% attributable to extreme temperatures, especially during cold waves. A similar pattern could be observed for the specific causes. With respect to the percentage of CVD-related admissions attributable to air pollution, higher income level was a protective element and age over 65 years was a risk factor for the percentage of the population concerned. Air pollution is a risk factor for short-term emergency hospital admissions due to CVD in Spain, with the effect NO2 and O3 being especially noteworthy, in terms of all CVD-related causes and the specific causes considered. The impact of extreme temperatures is of a lower order of magnitude than that of air pollution, and the effect of the maximum daily temperature in heat waves on CVD is extremely small.

西班牙因空气污染和极端温度导致的心血管疾病急诊入院:一项全国性研究中经济和人口因素的影响
本研究使用广义线性模型(GLMs)与泊松联系,分析了NO2、臭氧、PM10和PM2.5对每日因心血管疾病(CVD)、急性脑血管疾病、急性心肌梗死(AMI)和缺血性心脏病(IHD)而急诊住院人数的短期影响。对寒潮日最低气温和热浪日最高气温的影响也进行了分析。计算了每个省的具体剂量-反应函数,并考虑了入院原因。我们使用随机效应混合模型来分析各省的录取率与以下各省变量之间的关系:收入水平;居民人数;65岁及以上人口比例和妇女比例。我们的研究结果表明,在西班牙,由于所考虑的变量,每年有10,167例(95%CI: 3.679, 16.554)与心血管疾病相关的急诊入院,占西班牙心血管疾病相关的年度总入院人数的7.7%,分解如下:6.9%归因于一般的空气污染,特别是NO2和O3, 0.8%归因于极端温度,特别是寒潮期间。对于特定的原因,可以观察到类似的模式。关于因空气污染而入院的心血管病患者的百分比,较高的收入水平是一个保护因素,65岁以上的年龄是有关人口百分比的一个危险因素。在西班牙,空气污染是因心血管疾病而短期急诊住院的一个危险因素,就所有心血管疾病相关原因和所考虑的具体原因而言,NO2和O3的影响尤其值得注意。极端温度对CVD的影响低于空气污染的影响,且热浪中日最高温度对CVD的影响极小。
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来源期刊
Journal of Urban Health-Bulletin of the New York Academy of Medicine
Journal of Urban Health-Bulletin of the New York Academy of Medicine 医学-公共卫生、环境卫生与职业卫生
CiteScore
9.10
自引率
3.00%
发文量
105
审稿时长
6-12 weeks
期刊介绍: The Journal of Urban Health is the premier and authoritative source of rigorous analyses to advance the health and well-being of people in cities. The Journal provides a platform for interdisciplinary exploration of the evidence base for the broader determinants of health and health inequities needed to strengthen policies, programs, and governance for urban health. The Journal publishes original data, case studies, commentaries, book reviews, executive summaries of selected reports, and proceedings from important global meetings. It welcomes submissions presenting new analytic methods, including systems science approaches to urban problem solving. Finally, the Journal provides a forum linking scholars, practitioners, civil society, and policy makers from the multiple sectors that can influence the health of urban populations.
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