The association between air pollution and the occurrence of atrial fibrillation (EP-PARTICLES study)

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Science Centre Poland NCN (UMO-2021/41/B/NZ7/03716). Background Atrial fibrillation (AF) is the most common arrhythmia and environmental conditions are one of its risk factors. The "Polish smog" that occurs in Eastern Poland - due to its composition and the conditions in which it is formed - is characterized by extremely adverse health effects. Aim To assess the relationship between Polish smog and the occurrence of AF episodes. Material and methods The study area included voivodeship cities of Eastern Poland. Data on hospitalizations for 2016-2020 were obtained from regional departments of the National Health Fund. In the statistical analysis, a case-crossover study (CCO) method was used. Results During the analyzed period, a total of 40,471 hospitalizations for AF were recorded, including 18,139 emergency ones. The main pollutant affecting the occurrence of AF episodes was NO2 – a 10 μg/m3 increase in NO2 concentrations (OR=1.047, 95% CI 1.026-1.068; P<0.001) resulted in an increase in emergency hospitalizations for AF. The effect of NO2 on AF was greater in the cold season than in the warm season (ORcold=1.562 95%CI 1.222-1.997, P<0.001 vs ORwarm=1.055 95%CI 1.018-1.093, P<0.001; P<0.001). No age and sex differences in the influence of NO2 were observed. However, when it comes to the lag effect, the impact of NO2 was significantly greater among men than women on lag1 ORman=1.036 95%CI 1.007-1.066, P=0.01 vs ORwomen=0.978 95%CI 0.951-1.006, P=0.12; P<0.001). Conclusions Variations in air pollution levels, especially NO2, can increase the risk of acute AF incidents. We associate the more pronounced adverse health effects noted during the heating season with the particularly toxic effects of Polish smog.