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Effects of Asian dust-derived particulate matter on ST-elevation myocardial infarction: retrospective, time series study

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Authors
Lee, Suji; Lee, Whanhee; Lee, Eunil; Jeong, Myung Ho; Rha, Seung-Woon; Kim, Chong-Jin; Chae, Shung Chull; Kim, Hyo-Soo; Gwon, Hyeon-Cheol; Kim, Ho
Issue Date
2021-01-07
Publisher
BMC
Citation
BMC Public Health. 2021 Jan 07;21(1):68
Keywords
Particulate matterMyocardial infarctionAsian dustAir pollutionHealth effect
Abstract
Background
Dust storms affect human health by impairing visibility and promoting interactions with microscopic organisms, such as bacteria and fungi. Although ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI) differ mechanistically, few studies have investigated the incidence of cardiovascular diseases according to infarction type; these studies have yielded inconsistent findings. This study aimed to examine whether PM size (< 2.5 μm (PM2.5) and < 10 μm (PM10)) modifies the effect of Asian dust on acute myocardial infarction (AMI), with separate analyses for STEMI and NSTEMI.

Methods
MI-related data from 9934 emergency visits were collected from the Korea AMI Registry from 2005 to 2017. Asian dust events were defined as days with visibility of ≤10 km. Generalized linear models were used to analyze data with natural cubic splines. To examine potential modifiers, analyses were stratified by age, smoking status, and body mass index (BMI).

Results
No significant associations were observed between Asian dust and AMI. By adjusting for different lag structures, a significant effect was exclusively observed in STEMI. For moving average lags, the largest value at lag 5 (relative risk [RR] 1.083; 95% confidence interval [CI], 1.007–1.166) for single and lags 0–7 (RR 1.067; 95% CI: 1.002–1.136) was observed for PM2.5; for PM10, the largest significant effect was observed at lag 4 (RR 1.075; 95% CI: 1.010–1.144) for single and lags 0–7 (RR 1.067; 95% CI: 1.002–1.136). RRs were significantly higher in < 65-year-olds than in ≥65-year-olds. Additionally, RRs between the BMI < 25 and BMI ≥ 25 groups were not different; statistically significant effects were observed for concentration at lags 0–5 (RR: 1.073; 95% CI: 1.002–1.150) and lags 0–6 (RR: 1.071; 95% CI: 1.001–1.146) in the BMI < 25 group. A negative exposure-response association was observed between daily average visibility-adjusted PM and STEMI and daily average visibility-adjusted PM in < 65-year-olds.

Conclusions
Reducing PM2.5 and PM10 emissions, particularly during the days of Asian dust, may be crucial and reduce STEMI and AMI incidence among < 65-year-olds. These results indicate that the Asian dust alarm system needs revision to protect vulnerable populations.
ISSN
1471-2458
Language
English
URI
http://hdl.handle.net/10371/173372
DOI
https://doi.org/10.1186/s12889-020-10067-y
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Graduate School of Public Health (보건대학원)Dept. of Public Health (보건학과)Journal Papers (저널논문_보건학과)
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