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With polluted air more cardiac arrests: the Italian study

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The more polluted the air, the greater the risk of cardiac arrest. This is what emerged from a research carried out in Italy, in which seven common pollutants were studied. As the concentration of these increases, it turns out, cardiac risk increases. It is a correlation, and research also highlights that if incorporated into predictive models, it could improve planning and management of the health system.

Air pollution had previously been accused of being a potential trigger for the disease, but the correlation with specific pollutants remained unanswered for a long time due to the high amount of variables involved.

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The data of four Lombard provinces are under examination

The doctor’s office Francesca Gentile, of the Fondazione Irccs Policlinico San Matteo di Pavia, presented at the ESC Congress, examined the associations between short-term exposure to particulate matter and gaseous pollutants with the incidence of out-of-hospital cardiac arrest phenomena, analyzing data from four provinces Lombardy (Cremona, Mantua, Pavia and Lodi), which between metropolitan and rural areas have over 1.5 million inhabitants.

Cardiac arrests in 2019 in the Lombardy regional register and the daily concentrations of particulate matter (PM10, PM2.5), nitrogen dioxide, carbon monoxide, benzene, sulfur dioxide and ozone by the regional agency for environmental protection (Arpa). The average daily incidence of cardiac arrest and the average daily concentration of pollutants were then calculated.

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In 2019, the total number of cardiac arrests in the area was 1,582 episodes, with an average daily incidence of 0.3 cases per 100,000 inhabitants. It was found that the concentrations of the pollutants examined were significantly higher, except for ozone, on days with an above average incidence of cardiac arrest, compared to days when the incidence was below average.

The “dose – response” relationship

The study therefore demonstrated a ‘dose-response’ relationship for all pollutants tested: an increase in concentration is in fact associated with a greater probability of cardiac arrest. An inverse relationship for temperature was also found, with the likelihood of cardiac arrest increasing as temperature decreases.

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“The observed relationships between the concentrations of individual pollutants and the likelihood of cardiac arrest could be used in the future to predict the incidence of this life-threatening condition in specific geographic areas,” Gentile explained. “We hope that the monitoring of air pollutants will improve the efficiency of the health service, with the use in forecasting models for the management of ambulances and alarm systems. In addition to being a threat to the ecosystem, there are always more evidence that polluted air should be considered a contributing factor to cardiovascular disease, “he concluded.

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