Antithrombotic medication and endovascular interventions associated with short-term exposure to particulate air pollution: A nationwide case-crossover study.
Environ Pollut
; 266(Pt 1): 115130, 2020 Nov.
Article
em En
| MEDLINE
| ID: mdl-32652373
ABSTRACT
Short-term exposure to air pollution has pro-thrombotic effects and triggers thrombo-embolic events such as myocardial infarction or stroke in adults. This study evaluates the association between short-term variation in air pollution and treatments for acute thrombo-embolic events among the whole Belgian population. In a bidirectional time-stratified case-crossover design, we included 227,861 events treated with endovascular intervention and 74,942 with antithrombotic enzymes that were reimbursed by the Belgian Social Security between January 1st, 2009 and December 31st, 2013. We compared the concentrations of particulate matter (PM) air pollution (PM10 and PM2.5), as estimated at the municipality level on the day of the event (lag 0) and two days earlier (lag 1 and lag 2) with those of control days from the same month, matched by temperature and accounting for day of the week (weekend vs week days). We applied conditional logistic regression models to obtain odds ratios (OR) and their 95% CI for an increase of 10 µg/m3 (PM10) or 5 µg/m3 (PM2.5) in pollutant concentrations over three lag days (lag 0, 1 and 2). We observed significant associations of PM10 and PM2.5 with treatment of acute thrombo-embolic events at the three lags. The strongest associations were observed for air pollution concentrations on the day of the event (lag0). Increases of 10 µg/m3 PM10 and 5 µg/m3 PM2.5 on lag0 increased the odds of events treated with endovascular intervention by 2.7% (95%CI2.3%-3.2%) and 1.3% (95%CI1%-1.5%), respectively, and they increased the odds of events treated with antithrombotic enzymes by 1.9% (95%CI1.1-2.7%) and 1.2% (95%CI0.7%-1.6%), respectively. The associations were generally stronger during autumn months and among children. Our nationwide study confirms that acute exposure to outdoor air pollutants such as PM10 or PM2.5 increase the use of medication and interventions to treat thrombo-embolic events.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Poluentes Atmosféricos
/
Poluição do Ar
Tipo de estudo:
Clinical_trials
/
Risk_factors_studies
Limite:
Adult
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Child
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Humans
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article