Individual Effect Modifiers of Dust Exposure Effect on Cardiovascular Morbidity

Abstract

BackgroundHigh concentrations of particulate matter (PM) air pollution have been associated with death and hospital admissions due to cardiovascular morbidity. However, it is not clear a) whether high levels of non-anthropogenic PM from dust storms constitute a health risk; and b) whether these health risks are exacerbated in a particular demographic.MethodsThis study comprised all patients above 18 years old admitted to Soroka University Medical Center (1000 bed tertiary hospital, Be’er- Sheva, Israel, 2001–2010) with a primary diagnosis of acute coronary syndrome (ACS). Data on meteorological parameters and PM10 (particulate matter <10 μm in aerodiameter) were obtained from monitoring stations in the city of Be'er-Sheva. Data were analyzed using a case crossover analysis to examine the effect of dust exposure on hospitalization due to ACS and the interaction with co-morbidities and demographic factors.ResultsThere were 16,734 hospitalizations due to ACS during the study period. The estimated odds of hospitalization due to ACS was significantly associated with PM10 during non dust storm days at the same day of the exposure (lag0); OR = 1.014 (95%CI 1.001–1.027) for a 10 μg/m3 increase, while a delayed response (lag1) was found during the dust storm days; OR = 1.007 (95%CI 1.002–1.012). The effect size for the dust exposure association was larger for older (above the age of 65), female or Bedouin patients.ConclusionsExposure to non-anthropogenic PM is associated with cardiovascular morbidity. Health risk associated dust exposure is gender and age specific with older women and Bedouin patients being the most vulnerable groups.

The Association between Dust Storms and Daily Non-Accidental Mortality in the United States, 1993–2005

“…A series of papers focusing on the population of Beer-Shiva, a city in southern Israel, estimated significant associations of dust storms and dust storm–related PM 10 with hospitalizations for COPD (chronic obstructive pulmonary disease) exacerbations (Vodonos et al 2014) and acute coronary syndrome (Vodonos et al 2015). Similarly, studies of dust storms in Kuwait estimated associations with increased asthma and respiratory hospital admissions (Thalib and Al-Taiar 2012).…”

“…There has also been growing interest in the health impacts of airborne Saharan dust in southern Europe (Alessandrini et al 2013; Karanasiou et al 2012; Middleton et al 2008; Neophytou et al 2013; Samoli et al 2011; Tobías et al 2011; Zauli Sajani et al 2011) as the health impacts of coarse particles (e.g., Perez et al 2009) have come to be recognized. Additionally, there has been notable work on dust storms in other dust-affected parts of the world including Australia (Merrifield et al 2013), Israel (Vodonos et al 2014, 2015), Kuwait (Al-Taiar and Thalib 2014; Thalib and Al-Taiar 2012), and the Caribbean (Gyan et al 2005). The positive associations found in many of these works suggest a need to revisit North American dust storms.…”

Article Commentary: The Cold Dusty Harmattan: A Season of Anguish for Cardiologists and Patients

“…There is usually a lag period, which has been shown in some studies to be a minimum of 15 days 27. In some cases, it could be less, as short as one to three days 30. Normally, the status of the patient in the pathogenetic process of the disease would determine how soon after exposure to dust pollution the disease would manifest.…”

Exposure Assessment of Indoor PM Levels During Extreme Dust Episodes

“…In terms of human health, viable health risk assessments must incorporate information about particulate matter (PM) and its chemical and biological properties [2]. Such exposure can have significant impacts on human health in these areas [3][4][5][6][7]. PM exposure data for epidemiological studies are derived from environmental monitoring of outdoor ambient levels that have been scrutinized intensely by regulatory agencies and health assessment panels.…”