Abstract
BackgroundAmbient air pollution has been associated with increased cardiovascular morbidity and mortality. In Reykjavik, Iceland, air pollutant concentrations exceed official health limits several times every year. The aim was to study the association of concentrations of NO2, O3, PM10, and H2S in the Reykjavik capital area with the dispensing of anti-angina pectoris medication, glyceryl trinitrate to the inhabitants.MethodsData on daily dispensing of glyceryl trinitrate, were retrieved from the Icelandic Medicines Registry. Data on hourly concentrations of NO2, O3, PM10, and H2S were obtained from the Environment Agency of Iceland. A case-crossover design was used, based on the dispensing of glyceryl trinitrate to 5,246 individuals (≥18 years) between 2005 and 2009.ResultsFor every 10 μg/m3 increase of NO2 and O3 3-day mean concentrations, the odds ratio (OR) for daily dispensing of glyceryl trinitrates was 1.136 (95% confidence intervals (CI) 1.069-1.207) and 1.094 (95% CI 1.029-1.163) at lag 0, and OR was 1.096 (95% CI 1.029-1.168) and 1.094 (95% CI 1.028-1.166) at lag 1, respectively.ConclusionsThese findings suggest that NO2 and O3 ambient air concentrations may adversely affect cardiovascular health, as measured by the dispensing of glyceryl trinitrates for angina pectoris. Further, the findings suggest that data on the dispensing of medication may be a valuable health indicator when studying the effect of air pollution on cardiovascular morbidity.
Highlights
Ambient air pollution has been associated with increased cardiovascular morbidity and mortality
The inter-correlation was strongest between 24-hour mean concentration levels of Nitrogen dioxide (NO2) and O3 where there was a negative correlation of -0.62 (Table 1), while the strongest positive correlation of 0.41 was between the 3-day means of NO2 and Hydrogen sulfide (H2S)
In this study we found that exposure to urban air pollution was associated with the dispensing of glyceryl trinitrates (ATC code: C01DA02) among adults living in the Reykjavik area
Summary
Ambient air pollution has been associated with increased cardiovascular morbidity and mortality. In previous studies an increased risk of cardiovascular morbidity and mortality has been found in association with exposure to air pollution [1,2,3]. In these studies different outcome measures were used such as hospital admission [4], emergency department visits [5], or deaths [6,7] due to cardiovascular diseases. The aims were to evaluate the association of changes in ambient air concentrations of NO2, O3, PM10, and H2S with dispensing of the sublingual medication glyceryl trinitrate used against attacks of angina pectoris
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