Cardiac arrhythmia emergency room visits and environmental air pollution in São Paulo, Brazil

Pulmonary Division of Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Journal of epidemiology and community health (Impact Factor: 3.5). 04/2008; 62(3):267-72. DOI: 10.1136/jech.2006.058123
Source: PubMed


Air-pollution exposure has been associated with increased cardiovascular hospital admissions and mortality in time-series studies. We evaluated the relation between air pollutants and emergency room (ER) visits because of cardiac arrhythmia in a cardiology hospital.
In a time-series study, we evaluated the association between the emergency room visits as a result of cardiac arrhythmia and daily variations in SO(2), CO, NO(2), O(3) and PM(10), from January 1998 to August 1999. The cases of arrhythmia were modelled using generalised linear Poisson regression models, controlling for seasonality (short-term and long-term trend), and weather.
Interquartile range increases in CO (1.5 ppm), NO(2) (49,5 microg/m(3)) and PM(10) (22.2 microg/m(3)) on the concurrent day were associated with increases of 12.3% (95% CI: 7.6% to 17.2%), 10.4% (95% CI: 5.2% to 15.9%) and 6.7% (95% CI: 1.2% to 12.4%) in arrhythmia ER visits, respectively. PM(10), CO and NO(2) effects were dose-dependent and gaseous pollutants had thresholds. Only CO effect resisted estimates in models with more than one pollutant.
Our results showed that air pollutant effects on arrhythmia are predominantly acute starting at concentrations below air quality standards, and the association with CO and NO(2) suggests a relevant role for pollution caused by cars.

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    • "In a recent long-term follow-up from the Normative Aging Study, short-term exposure to combustion-derived PM air pollution (measured as black carbon) was associated with an increased risk of ventricular ectopy (Zanobetti et al. 2014). There is an association between air pollution exposure and the risk of hospitalization due to cardiac dysrhythmia (Colais et al. 2012; Santos et al. 2008; Tsai et al. 2009) and out-of-hospital cardiac arrest (Rosenthal et al. 2013), although this may be confounded by the strong association between exposure and the triggering of myocardial infarction (Nawrot et al. 2011) or decompensation of patients with cardiac failure (Atkinson et al. 2013; Shah et al. 2013). "
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    ABSTRACT: Epidemiological studies have demonstrated that air pollution exposure is associated with increases in cardiovascular morbidity and mortality. Exposure to air pollutants can influence cardiac autonomic tone and reduce heart rate variability, and may increase the risk of cardiac arrhythmias, particularly in susceptible patient groups. To investigate the incidence of cardiac arrhythmias during and after controlled exposure to air pollutants in healthy volunteers and patients with coronary heart disease. We analysed data from 13 double-blind randomized crossover studies including 282 subjects (140 healthy volunteers and 142 patients with stable coronary heart disease) from whom continuous electrocardiograms were available. The incidence of cardiac arrhythmias was recorded for each exposure and study population. There were no increases in any cardiac arrhythmia during or following exposure to dilute diesel exhaust, wood smoke, ozone, concentrated ambient particles, engineered carbon nanoparticles or high ambient levels of air pollution in either healthy volunteers or patients with coronary heart disease. Acute controlled exposure to air pollutants did not increase the short-term risk of arrhythmia in participants. Research employing these techniques remains crucial in identifying the important pathophysiological pathways involved in the adverse effects of air pollution, and is vital to inform environmental and public health policy decisions.
    Environmental Health Perspectives 03/2014; 122(7). DOI:10.1289/ehp.1307337 · 7.98 Impact Factor
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    • "The preponderance of findings indicates that short-term exposure to PM can trigger CVD-related mortality and nonfatal events (Brook et al., 2010). The existing evidence provides powerful support for the effect of PM on ischemic heart disease, moderate support (yet growing) for the effect of PM on heart failure (Pope et al., 2008) and ischemic cerebrovascular stroke (Kettunen et al., 2007), and modest or mixed support for the effect of PM on peripheral vascular and cardiac heart conduction system disorders (arrhythmia/arrest) (Santos et al., 2008). This topic studies the effects of air PM on the cardiovascular mortality and hospitalization (Bell et al., 2008, 2009), and mostly adopts the longitudinal and cross-over studies. "
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    ABSTRACT: Abstract In recent years, many epidemiological and toxicological studies have investigated the adverse effects of air particulate matter (PM) on the cardiovascular system. However, it is difficult for the researchers to have a timely and effective overall command of the latest characteristics and popular topics in such a wide field. Different from the previous reviews, in which the research characteristics and trends are empirically concluded by experts, we try to have a comprehensive evaluation of the above topics for the first time by bibliometric analysis, a quantitative tool in information exploration. This study aims to introduce the bibliometric method into the field of PM and cardiovascular system. The articles were selected by searching PubMed/MEDLINE (from 2007 to 2012) using Medical Subject Headings (MeSH) terms "particulate matter" and "cardiovascular system". A total of 935 eligible articles and 1895 MeSH terms were retrieved and processed by the software Thomson Data Analyzer (TDA). The bibliographic information and the MeSH terms of these articles were classified and analyzed to summarize the research characteristics. The top 200 high-frequency MeSH terms (the cumulative frequency percentage was 74.2%) were clustered for popular-topic conclusion. We summarized the characteristics of published articles, of researcher collaborations and of the contents. Ten clusters of MeSH terms are presented. Six popular topics are concluded and elaborated for reference. Our study presents an overview of the characteristics and popular topics in the field of PM and cardiovascular system in the past five years by bibliometric tools, which may provide a new perspective for future researchers.
    Inhalation Toxicology 03/2013; 25(4):211-218. DOI:10.3109/08958378.2013.775196 · 2.26 Impact Factor
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    • "H. Lin et al. / Atmospheric Environment xxx (2012) 1e6 4 Please cite this article in press as: Lin, H., et al., Gaseous air pollution and acute myocardial infarction mortality in Hong Kong: A time-stratified case-crossover study, Atmospheric Environment (2012), A number of clinical studies have supported the hypothesis that NO 2 pollution might adversely affect cardiovascular health by increasing blood coagulability (Peters et al., 1997; Bigert et al., 2003), and some epidemiological studies have also suggested that elevated exposure to ambient NO 2 could increase the occurrence of cardiovascular diseases (Santos et al., 2008). Studies on the biological mechanism suggested that increased NO 2 was associated with increased plasma fibrinogen, ventricular arrhythmia and ventricular tachycardia (Schwartz, 2001). "
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    ABSTRACT: Acute myocardial infarction (AMI) is a common disease with serious consequences in mortality and morbidity. An association between gaseous air pollution and AMI has been suggested, but the epidemiological evidence is still limited. For the study period 1998 to 2010, daily counts of AMI deaths were collected, as well as daily air pollution data including concentrations of particulates (PM 10), nitrogen dioxide (NO 2), sulfur dioxide (SO 2), ozone (O 3) and carbon monoxide (CO) were also obtained. The associations between gaseous ...
    Atmospheric Environment (1967) 09/2012; 76. DOI:10.1016/j.atmosenv.2012.08.043
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