Ambient nitrogen dioxide is associated with emergency hospital visits for atrial fibrillation: a population-based case-crossover study in Reykjavik, Iceland.

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Published in:Environmental Health
Main Authors: Halldorsdottir, Solveig, Finnbjornsdottir, Ragnhildur Gudrun, Elvarsson, Bjarki Thor, Gudmundsson, Gunnar, Rafnsson, Vilhjalmur
Other Authors: 1University of Iceland, Centre of Public Health Science, Reykjavik, Iceland. 2Environment Agency of Iceland, Reykjavik, Iceland. 3Marine and Freshwater Research Institute, Reykjavik, Iceland. 4Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 5Department of Respiratory Medicine & Sleep, Landspitali University Hospital, Reykjavik, Iceland. 6University of Iceland, Department of Preventive Medicine, Reykjavik, Iceland. vilraf@hi.is.
Format: Article in Journal/Newspaper
Language:English
Published: BioMed Central 2022
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Online Access:http://hdl.handle.net/2336/622106
https://doi.org/10.1186/s12940-021-00817-9
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Summary:To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Download Background: In Iceland air quality is generally good; however, previous studies indicate that there is an association between air pollution in Reykjavik and adverse health effects as measured by dispensing of medications, mortality, and increase in health care utilisation. The aim was to study the association between traffic-related ambient air pollution in the Reykjavik capital area and emergency hospital visits for heart diseases and particularly atrial fibrillation and flutter (AF). Methods: A multivariate time-stratified case-crossover design was used to study the association. Cases were those patients aged 18 years or older living in the Reykjavik capital area during the study period, 2006-2017, who made emergency visits to Landspitali University Hospital for heart diseases. In this population-based study, the primary discharge diagnoses were registered according to International Classification of Diseases, 10th edition (ICD-10). The pollutants studied were NO2, PM10, PM2.5, and SO2, with adjustment for H2S, temperature, and relative humidity. The 24-h mean of pollutants was used with lag 0 to lag 4. Results: During the study period 9536 cases of AF were identified. The 24-h mean NO2 was 20.7 μg/m3. Each 10 μg/m3 increase in NO2 was associated with increased risk of heart diseases (ICD-10: I20-I25, I44-I50), odds ratio (OR) 1.023 (95% CI 1.012-1.034) at lag 0. Each 10 μg/m3 increase in NO2 was associated with an increased risk of AF (ICD-10: I48) on the same day, OR 1.030 (95% CI: 1.011-1.049). Females were at higher risk for AF, OR 1.051 (95% CI 1.019-1.083) at lag 0, and OR 1.050 (95% CI 1.019-1.083) at lag 1. Females aged younger than 71 years had even higher risk for AF, OR 1.077 (95% CI: 1.025-1.131) at lag 0. Significant associations were found for other pollutants and emergency hospital visits, but they were weaker and did ...