Air Pollution and Myocardial Infarction in Rome

D’Ippoliti, Daniela; Forastiére, Francesco; Ancona, Carla; Agabiti, Nera; Fusco, Danilo; Michelozzi, Paola; Perucci, Carlo A.

doi:10.1097/01.ede.0000082046.22919.72

Cited by 191 publications

(116 citation statements)

References 41 publications

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“…Two additional single-city case-crossover studies of air pollution and MI had inconsistent results. A study from Rome, Italy, reported increased risk of MI associated with PM pollution, especially during warm periods, 261 but a study from King County, WA, observed no PM-MI associations. 262 In a much larger case-crossover study using data from 21 U.S. cities with Ͼ300,000 MI events, a 20-g/m 3 increase in PM 10 ambient concentration was associated with a 1.3% (95% CI, 0.6%-2%) increased risk of MI.…”

Section: Short-term Exposure and Cardiovascularmentioning

confidence: 98%

Health Effects of Fine Particulate Air Pollution: Lines that Connect

Pope

Dockery²

2006

Journal of the Air & Waste Management Association

5,591

3,159

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Efforts to understand and mitigate the health effects of particulate matter (PM) air pollution have a rich and interesting history. This review focuses on six substantial lines of research that have been pursued since 1997 that have helped elucidate our understanding about the effects of PM on human health. There has been substantial progress in the evaluation of PM health effects at different time-scales of exposure and in the exploration of the shape of the concentration-response function. There has also been emerging evidence of PM-related cardiovascular health effects and growing knowledge regarding interconnected general pathophysiological pathways that link PM exposure with cardiopulmonary morbidity and mortality. Despite important gaps in scientific knowledge and continued reasons for some skepticism, a comprehensive evaluation of the research findings provides persuasive evidence that exposure to fine particulate air pollution has adverse effects on cardiopulmonary health. Although much of this research has been motivated by environmental public health policy, these results have important scientific, medical, and public health implications that are broader than debates over legally mandated air quality standards.

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Section: Short-term Exposure and Cardiovascularmentioning

confidence: 98%

Health Effects of Fine Particulate Air Pollution: Lines that Connect

Pope

Dockery²

2006

Journal of the Air & Waste Management Association

5,591

3,159

View full text Add to dashboard Cite

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“…Several air pollutants, including particulate matter (PM), carbon monoxide (CO), nitrogen oxides (NO x ), sulfur dioxide (SO 2 ) and ozone (O 3 ) have been associated with increased hospitalization and mortality as a result of cardiovascular disease and stroke [1][2][3][4][5][6][7][8][9]. The underlying mechanisms linking air pollutants and increased cardiovascular risk remain unclear, although prior studies have associated exposure to air pollution with activation of inflammatory pathways, production of reactive oxygen species, endothelial injury and dysfunction, arterial vasoconstriction and alterations in blood coagulation factors [2,[10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Effects of exposure to air pollution on blood coagulation

Baccarelli

Zanobetti²,

Martinelli

et al. 2007

Journal of Thrombosis and Haemostasis

197

130

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Summary. Background: Consistent evidence has indicated that air pollution increases the risk of cardiovascular diseases. The underlying mechanisms linking air pollutants to increased cardiovascular risk are unclear. Objectives: We investigated the association between the pollution levels and changes in such global coagulation tests as the prothrombin time (PT) and the activated partial thromboplastin time (APTT) in 1218 normal subjects from the Lombardia Region, Italy. Plasma fibrinogen and naturally occurring anticoagulant proteins were also evaluated. Methods: Hourly concentrations of particulate (PM 10 ) and gaseous pollutants (CO, NO 2 , SO 2 , and O 3 ) were obtained from 53 monitoring sites covering the study area. Generalized additive models were applied to compute standardized regression coefficients controlled for age, gender, body mass index, smoking, alcohol, hormone use, temperature, day of the year, and long-term trends. Results: The PT became shorter with higher ambient air concentrations at the time of the study of PM 10 (coefficient ¼ )0.06; P < 0.05), CO (coefficient ¼ )0.11; P < 0.001) and NO 2 (coefficient ¼ )0.06; P < 0.05). In the 30 days before blood sampling, the PT was also negatively associated with the average PM 10 (coefficient ¼ )0.08; P < 0.05) and NO 2 (coefficient ¼ )0.08; P < 0.05). No association was found between the APTT and air pollutant levels. In addition, no consistent relations with air pollution were found for fibrinogen, antithrombin, protein C and protein S. Conclusions: This investigation shows that air pollution is associated with changes in the global coagulation function, suggesting a tendency towards hypercoagulability after short-term exposure to air pollution. Whether these changes contribute to trigger cardiovascular events remains to be established.

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“…Evidence suggests that increased PM concentrations mainly affect the cardiovascular and respiratory systems (Peters et al, 1997a(Peters et al, , 1999Gold et al, 2000;Ibald-Mulli et al, 2001;Brook et al, 2002;Devlin et al, 2003;Schulz et al, 2005) and are especially associated with increased cardiovascular hospital admissions (Schwartz, 1999;Zanobetti et al, 2000;Le Tertre et al, 2002;D'Ippoliti et al, 2003;von Klot et al, 2005;Dominici et al, 2006) or increased cardiovascular mortality (Clancy et al, 2002;Forastiere et al, 2005;Zeka et al, 2005;Ostro et al, 2006). The physical or chemical particle properties (e.g.…”

Section: Introductionmentioning

confidence: 99%

Daily mortality and particulate matter in different size classes in Erfurt, Germany

Stölzel

Breitner

Cyrys

et al. 2006

J Expo Sci Environ Epidemiol

213

109

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The link between elevated concentrations of ambient particulate matter (PM) and increased mortality has been investigated in numerous studies. Here we analyzed the role of different particle size fractions with respect to total and cardio-respiratory mortality in Erfurt, Germany, between 1995 and 2001. Number concentrations (NC) of PM were measured using an aerosol spectrometer consisting of a Differential Mobility Particle Sizer and a Laser Aerosol Spectrometer to characterize particles between 0.01 and 0.5 and between 0.1 and 2.5 mm, respectively. We derived daily means of particle NC for ultrafine (0.01-0.1 mm) and for fine particles (0.01-2.5 mm). Assuming spherical particles of a constant density, we estimated the mass concentrations (MC) of particles in these size ranges. Concurrently, data on daily total and cardio-respiratory death counts were obtained from local health authorities. The data were analyzed using Poisson Generalized Additive Models adjusting for trend, seasonality, influenza epidemics, day of the week, and meteorology using smooth functions or indicator variables. We found statistically significant associations between elevated ultrafine particle (UFP; diameter: 0.01-0.1 mm) NC and total as well as cardio-respiratory mortality, each with a 4 days lag. The relative mortality risk (RR) for a 9748 cm À3 increase in UFP NC was RR ¼ 1.029 and its 95% confidence interval (CI) ¼ 1.003-1.055 for total mortality. For cardio-respiratory mortality we found: RR ¼ 1.031, 95% CI: 1.003-1.060. No association between fine particle MC and mortality was found. This study shows that UFP, representing fresh combustion particles, may be an important component of urban air pollution associated with health effects.

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Air Pollution and Myocardial Infarction in Rome

Abstract: The results suggest that air pollution increases the risk of myocardial infarction, especially during the warm season. There was a tendency for a stronger effect among the elderly and people with heart conduction disturbances.

Cited by 191 publications

References 41 publications

Health Effects of Fine Particulate Air Pollution: Lines that Connect

Health Effects of Fine Particulate Air Pollution: Lines that Connect

Effects of exposure to air pollution on blood coagulation

Daily mortality and particulate matter in different size classes in Erfurt, Germany

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