Associations Between Air Pollution and Emergency Department Visits for Ischemic Stroke, Respiratory and Cardiovascular Diseases, in Izmir

Murat Ozsarac; Hatice Uluer; Nese Oray; Selahattin Kıyan; Murat Ersel; Aslihan Yuruktumen

Murat Ozsarac¹, Hatice Uluer², Nese Oray³, Selahattin Kıyan¹, Murat Ersel¹, Aslihan Yuruktumen¹

¹Departments Of Emergency Medicine Ege University Hospital, Izmir
²Departments Of Bioistatistic And Medical Informatics, Ege University Hospital, Izmir
³Department Of Emergency Medicine, Dokuz Eylul University Hospital, Izmir

Keywords: Air pollution, emergency department visit; ischemic stroke; respiratory and cardiovascular diseases

Abstract

Objectives: Some recent studies have shown that increased levels of particulate air pollutants are positively associated with cardiovascular morbidity and mortality, asthma, stroke and deep vein thrombosis. We aim to determine the association between levels of ambient particulate air pollutants and Emergency Department (ED) visits for ishemic stroke, cardiovascular and pulmonary disease in winter months.
Methods: This is a dual-center retrospective study. We identified adults patients who had been presented to emergency department with cardiovascular and pulmonary disease between October 1, 2008 and March 31, 2009. The air pollutants that were analyzed for this study included PM10, carbon monoxide (CO) and sulfur dioxide (SO2). For 6 months, air pollution data for downtown Izmir were obtained from the National Air Quality Monitoring system. Multiple linear regression was used to estimate for the effects of particulate air pollution factors and Rho Spearman test for the correlations between ED visits.
Results: There were 3070 cardiovascular and pulmonary disease of ED visits. We found no association between outdoor measures of CO, SO2, PM10 and COPD, heart failure and ischemic stroke visits. Significant correlations were found between ED visits for asthma and the mean ambient concentrations of CO (p=0.024, R2=%70) measurements and PM10 (p=0.024, R2=%70). Statistically significant associations were observed between pulmonary embolus and PM10 (p=0.016, R2=%55) with multiple linear regression. And statistically significant associations were observed between angina/myocardial infarction and CO (p=0.001) and SO2 (p=0.005) with bivariate correlation.
Conclusions: An increase in ambient levels of CO is associated with an increase in the number of ED visits for MI and asthma. PM10 were strongly associated with pulmonary embolus and asthma visits during the warm season.