Multi-City Analysis of the Acute Effect of Polish Smog on Cause-Specific Mortality (EP-PARTICLES Study)

Abstract

Polish smog is a specific type of air pollution present in Eastern Poland, which may cause particularly adverse cardiovascular effects. It is characterized primarily by high concentrations of particulate matter (PM) and different favorable conditions of formation. Our study aimed to assess whether PM and nitrogen dioxide (NO2) have a short-term impact on mortality due to acute coronary syndrome (ACS) and ischemic stroke (IS). The study covered the years 2016–2020, a total of 6 million person-years from five main cities in Eastern Poland. To evaluate the association between air pollution and cause-specific mortality, a case-crossover study design with conditional logistic regression was used at days with LAG from 0 to 2. We recorded 87,990 all-cause deaths, including 9688 and 3776 deaths due to ACS and IS, respectively. A 10 μg/m3 increase in air pollutants was associated with an increase in mortality due to ACS (PM2.5 OR = 1.029, 95%CI 1.011–1.047, p = 0.002; PM10 OR = 1.015, 95%CI 1–1.029, p = 0.049) on LAG 0. On LAG 1 we recorded an increase in both IS (PM2.5 OR = 1.03, 95%CI 1.001–1.058, p = 0.04) and ACS (PM2.5 OR = 1.028, 95%CI 1.01–1.047, p = 0.003; PM10 OR = 1.026, 95%CI 1.011–1.041, p = 0.001; NO2 OR = 1.036, 95%CI 1.003–1.07, p = 0.04). There was a strong association between air pollution and cause-specific mortality in women (ACS: PM2.5 OR = 1.032, 95%CI 1.006–1.058, p = 0.01; PM10 OR = 1.028, 95%CI 1.008–1.05, p = 0.01) and elderly (ACS: PM2.5 OR = 1.03, 95%CI 1.01–1.05, p = 0.003; PM10 OR = 1.027, 95% CI 1.011–1.043, p < 0.001 and IS: PM2.5 OR = 1.037, 95%CI 1.007–1.069, p = 0.01; PM10 OR = 1.025, 95%CI 1.001–1.05, p = 0.04). The negative influence of PMs was observed on mortality due to ACS and IS. NO2 was associated with only ACS-related mortality. The most vulnerable subgroups were women and the elderly.

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

“…In summary, this work, similar to our previous studies, 2 , 3 , 7 , S6 highlights the significance of air pollution as a crucial factor for public health. It underscores the necessity for ongoing efforts for more precise monitoring of air quality, even in areas commonly perceived as free from air pollution.…”

“…To avoid the co-linearity effect, we separately modelled each air pollutant. Based on our previous experience, 2 , 3 , 7 , S6 we also conducted separate analyses for different lag: simple lags of 0–6 days (lag 0 to lag 6), 0–1 days moving average (lag 0–1), 0–6 days moving average (lag 0–6), and 0–30 days moving average (lag 0–30).…”

“…Well-established MI risk factors encompass arterial hypertension, diabetes, obesity, chronic kidney disease, hyperlipidaemia, and smoking, but in recent decades, air pollution and its impact on human health has been the focus of numerous studies, demonstrating the harmful impact of this environmental risk factor in the case of ACS. 2 , 3 …”

Sex-Related Differences in the Prevalence of Classical, Non-Classical Risk Factors and Management of the Chronic Coronary Syndrome

“…Liver disease [27] * Environmental factors and Pollution [28,29] * Atrial fibrillation [30,31] * Non-analyzed in the study.…”

Physicochemical Assessment of the Road Vehicle Traffic Pollution Impact on the Urban Environment

“…These PMs combined with dangerous organic compounds may affect environmental aspects, such as climate change, the greenhouse effect, thinning of the ozone layer due to their toxic effect on the plants and tree leaves, which further affects the oxygen balance in the local atmosphere [12,13]. Mammals are also very exposed to the risk due to contaminated PM penetration into the respiratory system causing respiratory diseases, such as asthma and silicosis [14,15], pulmonary cancer [16,17], and cardiovascular diseases [18,19], which induce long-time illness until death. Nitrogen and sulfur oxide emissions into the atmosphere facilitate acid rain formations that might affect PM sources (e.g., street dust) composition increasing their hazardous potential [20].…”