open access publication

Article, 2024

Effect of air pollution exposure on risk of acute coronary syndromes in Poland: a nationwide population-based study (EP-PARTICLES study)

The Lancet Regional Health - Europe, ISSN 2666-7762, Volume 41, Page 100910, 10.1016/j.lanepe.2024.100910

Contributors

Kuźma, Łukasz 0000-0002-4156-5695 [1] Dąbrowski, Emil Julian 0000-0001-7598-1913 (Corresponding author) [1] Kurasz, Anna 0000-0003-0526-3339 [1] Swieczkowski, Michał 0000-0002-7381-6604 [1] Jemielita, Piotr [1] Kowalewski, Mariusz 0000-0002-5478-3245 [2] [3] [4] [5] Wańha, Wojciech M 0000-0003-1220-9496 [5] [6] Kralisz, Paweł [1] Tomaszuk-Kazberuk, Anna [1] Bachorzewska-Gajewska, Hanna 0000-0002-0233-6996 [1] Dobrzycki, Sławomir J [1] Lip, Gregory Yoke Hong [1] [7] [8]

Affiliations

  1. [1] Medical University of Białystok
    2. [NORA names: Poland; Europe, EU; OECD];
  2. [2] Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, 1 Via Tricomi, Palermo 90127, Italy
    3. [NORA names: Italy; Europe, EU; OECD];
  3. [3] Maastricht University Medical Centre
    4. [NORA names: Netherlands; Europe, EU; OECD];
  4. [4] Ministry of Interior and Administration
    5. [NORA names: Poland; Europe, EU; OECD];
  5. [5] Collegium Medicum in Bydgoszcz
    6. [NORA names: Poland; Europe, EU; OECD];

Abstract

Background: Air pollution (AP) is linked up to 20% of cardiovascular deaths. The aim of this nationwide study was to investigate subpopulations vulnerable to AP for non-ST- (NSTEMI) and ST-elevation myocardial infarction (STEMI) incidence. Methods: We analysed short- (lags up to seven days) and mid-term (0-30 days moving average) influence of particulate matter (PM2.5), sulphur dioxide (SO2), nitrogen dioxide (NO2) and benzo(a)pyrene (BaP) on hospitalizations due NSTEMI and STEMI in 2011-2020. Data on AP concentrations were derived using GEM-AQ model. Study included residents of five voivodeships in eastern Poland, inhabited by over 8,000,000 individuals. Findings: Higher NO2 and PM2.5 concentrations increased mid-term risk of NSTEMI in patients aged < 65 years by 1.3-5.7%. Increased SO2 and PM2.5 concentration triggered STEMI in the short- (SO2, PM2.5) and mid-term (PM2.5) amongst those aged ≥ 65 years. In the short- and mid-term, women were more susceptible to PM2.5 and BaP influence resulting in increased STEMI incidence. In rural regions, STEMI risk was triggered by SO2, PM2.5 and BaP. Income-based stratification showed disproportions regarding influence of BaP concentrations on NSTEMI incidence based on gross domestic product (up to 1.4%). Interpretation: There are significant disparities in the influence of air pollution depending on the demographic and socio-economic factors. AP exposure is associated with the threat of a higher risks of NSTEMI and STEMI, especially to younger people, women, residents of rural areas and those with lower income. Funding: National Science Center and Medical University of Bialystok, Poland.

Keywords

AP concentrations, AP exposure, BaP, BaP concentrations, BaP., Bialystok, EPS particles, GEM-AQ, GEM-AQ model, Higher NO<sub>2</sub> an, Medical University of Bialystok, NSTEMI, National, Non-ST, Poland, ST-elevation myocardial infarction, STEMI incidence, University of Bialystok, Voivodeship, acute coronary syndrome, air, air pollution, air pollution exposure, area, benzo(a)pyrene, cardiovascular death, concentration, coronary syndrome, data, death, dioxide, disparities, disproportion, domestic product, eastern Poland, effect, effects of air pollution exposure, exposure, factors, gross domestic product, hospital, incidence, income, increased SO<sub>2</sub> fa, individuals, infarction, influence, influence of air pollution, influence of particulate matter, low-income, matter, mid-term, model, myocardial infarction, nationwide population-based study, nitrogen, nitrogen dioxide, particulate matter, patients, people, pollution, pollution exposure, population-based study, production, region, residents, residents of rural areas, risk, risk of acute coronary syndrome, rural areas, rural regions, short-, socio-economic factors, stratification, study, sulfur dioxide, syndrome, threat, women, years, young people

Funders

  • National Institute for Health and Care Research
  • National Science Center
  • European Commission

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