Impact of meteorological parameters and air pollution on emergency department visits for cardiovascular diseases in the city of Zagreb, Croatia

Abstract

The aim of this study was to investigate whether nitrogen dioxide (NO2), ozone (O3), and certain meteorological conditions had an impact on cardiovascular disease (CVD)-related emergency department (ED) visits in the metropolitan area of Zagreb. This retrospective, ecological study included 20,228 patients with a cardiovascular disease as their primary diagnosis who were examined in the EDs of two Croatian University Hospitals, Sisters of Charity and Holy Spirit, in the study period July 2008-June 2010. The median of daily CVD-related ED visits during the study period was 28 and was the highest during winter. A significant negative correlation was found between CVD-related emergency visits and air temperature measured no more than three days prior to the visit, and the highest negative correlation coefficient was measured two days earlier (R=0.266, p≤0.001). The number of CVD-related emergency visits significantly correlated with the average NO2 concentration on the same day (R=0.191, p<0.001). The results of multiple stepwise regression analysis showed that the number of CVD-related emergency visits depended on air temperature, and NO2 and O3 concentrations. The higher the air temperatures, the lower the number of daily CVD-related emergency visits (p<0.001). An increase in NO2 concentrations (p=0.005) and a decrease in O3 concentrations of two days earlier (p=0.006) led to an increase in CVD-related ED visits. In conclusion, the decrease in O3 concentrations and the increase in NO2, even if below the legally binding thresholds, could be associated with an increase in CVD-related emergency visits and a similar effect was observed with lower temperature measured no more than three days prior to the visit.

Time series analysis of the admission to the emergency department due to respiratory and cardiovascular diseases between 2010 and 2014 in Kırklareli, Turkey

“…However, if the exposure is decreased, IHD, arrhythmia and related diseases hospitalization costs could be diminished [25]. Our research, in which the monthly changes of CVD has a conjuncture structure, similar findings are obtained in the study by Pintaric et al [5] which was conducted in Croatia. Because there is a difference in higher estimations of admissions during winter and spring, our results may be due to increased air-pollutant concentration in Turkey.…”

“…Epidemiological studies have shown the association between air pollution and climate change and health effects over the past decade. Many of these studies examined the effects of air pollution and climate change on daily mortality, emergency department visits, and hospital admissions for particularly cardiovascular and respiratory diseases in many parts of the world [1][2][3][4][5][6]. These studies provide evidence for the negative effects of urban air pollution on health and a better understanding of biological mechanisms; and in addition to creating an important field of research, they have allowed decision-makers to understand the effects of pollutants and the benefits that can be achieved by control measures [6][7][8].…”

High Temperatures and Cardiovascular-Related Morbidity: A Scoping Review

“…Of the remaining 17 studies, the majority utilized either a case-crossover design with conditional logistic regression [ 26 , 27 , 28 ], time series analysis utilizing Poisson regression [ 29 , 30 , 31 , 32 , 33 , 34 ], distributed lag nonlinear models [ 35 ], or generalized additive models [ 36 ]. Poisson regression and generalized linear regression [ 37 , 38 ], multiple stepwise regression analysis [ 39 ], canonical correlation analysis [ 40 ], and t -test [ 41 , 42 ] were also conducted. Detailed descriptions of the included studies can be found in Table 1 .…”

“…The five systematic reviews included studies from North America, Europe, Asia, and Australia. Single studies were conducted in the United States [ 26 , 27 , 28 , 29 , 33 , 40 , 41 ], Canada [ 34 , 35 , 36 , 37 ], Southern Europe [ 31 , 38 , 39 ], Northern Europe [ 30 , 32 ], and Eastern Europe [ 42 ].…”

Correlation between Concentration of Air Pollutants and Occurrence of Cardiac Arrhythmias in a Region with Humid Continental Climate

“…Nitrogen dioxide is a primary pollutant and strong respiratory irritant mainly from outdoor sources including motor vehicles and fossilfuel power plants, whereas the most important indoor sources are gas heaters, stoves and tobacco smoke 28 . Th e number of patients admitted to ED correlates with the concentration of NO 2 and PM 10 particles 8,10,24,[29][30][31] , which have strong infl uence on cardiovascular morbidity and mortality. In this study, the number of patients with arrhythmias was in positive correlation with the concentration of NO 2 and PM 10 particles on the day of ED admission.…”