The impact of acute exposure to desert dust on bospitalizations due to acute coronary syndrome. Gender effect

摘要

Background: Recent studies show an association between urban air pollution and cardiovascular diseases, but the understanding of impact of acute exposure to particulate matter (PM) originating from dust storms in an arid urban environment is limited. Trends of desertification and climate change pose a significant health problem increasingly exposing world population to desert dust storms. The Negev area (Israel) situated within one of the largest dust belt offers an opportunity to investigate the effect of desert dust on the human health. Aims: To assess the impact of acute exposure to PM dust particles on frequency of acute coronary syndrome (ACS) hospital admissions. Methods and statistical analysis: Patients admitted to Soroka University Medical Center during 2001-2010 with a primary diagnosis of ACS. Data on temperature, relative humidity and daily concentration of PM10, and co-pollutants (NO2, SO2, O3, and CO) were obtained. Oust storm days were defined by PM10 greater than two standard deviations above the background values. We performed time series analysis using GLM and GAM models, to assess the ACS incidence rate ratio (IRR) controlled for meteorological, seasonal factors and other pollutants. Results: We identified 17,024 admissions of 10,802 patients with the primary diagnosis of ACS. 68.4% were male and average age was 66±13.3 years, 30.2% had diabetes, 59% dyslipidemia and 50.1% hypertension. A short-term increase in hospital admission rates was found during the dust storm days in female patients (IRR=1.16 95%CI 1.06-1.25, p＜0.01) but not in male patients (IRR=0.96 95%CI 0.91-1.02, p=0.19). This difference between the genders remained significant in sub-analysis of patients older than 70 years. Conclusions appears that health risk associated with the non-anthropogenic PM10 exposure is gender specific. Further investigation is needed to understand the role of these natural events, particularly among the vulnerable population groups.