Short-term effects of ambient air pollution and cardiovascular events in Shiraz, Iran, 2009 to 2015

Air pollution and dust storms are associated with increased cardiovascular hospital admissions. The aim of this study was to investigate the association between short-term exposure to ambient air pollutants and CVD (cardiovascular disease) events in a long-term observational period. The study included the events of cardiovascular diseases (namely coronary artery disease, ischemic heart disease, myocardial infarction, and pneumo thrombo embolism) within the population of Shiraz, from March 21, 2009 to March 20, 2015. Also, each patient's demographics were recorded. Main meteorological variables and five ambient pollutants (CO, O-3, SO2, NO2, and PM10) were recorded. Statistical analysis was performed using linear regression (GLM) and a generalized additive model (GAM) estimating Poisson distribution and adjusted for the main risk factors and ambient meteorological variables. A mild prevalence (51.5%) of coronary artery disease (CAD) was registered in 6425 events. In GLM analysis, we observed an association among the pollutants with the coronary artery disease hospital admissions which was in the order of CO, NO2, and PM10. The highest association of each pollutant with hospital admission was observed as PM10 at lag 4 (RR=1.08; 95% CI 1.02, 1.14 and p<0.05), NO2 at lag 0 (RR=1.22; 95% CI 1.00, 1.48), and CO at lag 0 (RR=1.52 95% CI=(1.16, 1.99)). However, on dusty days, there were significantly higher numbers of referrals of cardiovascular patients (mean=7.54 +/- 4.44 and p=0.002,) than on non-dusty days. According to these data, dust storms and some types of pollutants in the air are responsible for more admissions to hospitals for cardiovascular problems.