Medical University of Plovdiv Faculty of Public Health, Department of Hygiene, Plovdiv, Bulgaria.
Graz University of Technology, Institute of Highway Engineering and Transport Planning, Graz, Austria.
Arh Hig Rada Toksikol. 2023 Apr 4;74(1):48-60. doi: 10.2478/aiht-2023-74-3704. Print 2023 Mar 1.
Bulgaria has a very high incidence of cardiometabolic diseases and air pollution-related mortality rate. This study investigated the relationship between daily air pollution levels and hospital admissions for ischaemic heart diseases (IHD), cerebral infarction (CI), and type 2 diabetes mellitus (T2DM) in Sofia, Bulgaria. We obtained daily data on hospitals admissions and daily average air pollution levels from 2009 to 2018. Pollutants of interest were particulate matter (PM and PM), nitrogen dioxide (NO), sulphur dioxide (SO), ozone (O), and carbon monoxide (CO). Negative binomial regressions were fitted to study the effects of air pollution on hospital admission over the course of seven days prior to that event, accounting for autocorrelations and time trend in the data, day of the week, temperature, and relative humidity. Our findings confirm that higher air pollution levels generally increase the risk of hospital admissions for IHD and CI. For T2DM the association is less clear. Admissions often lagged several days behind and were more common in specific demographic subgroups or when pollution crossed a particular threshold. However, we did not expect to find the risk of hospital admissions increased in warmer rather than colder months of the year. Our findings are to be taken with reservation but do provide an idea about how air pollution could trigger acute episodes of related cardiovascular diseases, and our model may serve to investigate similar associations across the country.
保加利亚患有心脏代谢疾病和与空气污染有关的死亡率非常高。本研究调查了保加利亚索非亚市每日空气污染水平与缺血性心脏病（IHD）、脑梗死（CI）和 2 型糖尿病（T2DM）住院之间的关系。我们获得了 2009 年至 2018 年期间医院住院和每日平均空气污染水平的每日数据。感兴趣的污染物是颗粒物（PM 和 PM）、二氧化氮（NO）、二氧化硫（SO）、臭氧（O）和一氧化碳（CO）。负二项式回归用于研究在该事件发生前七天内空气污染对医院入院的影响，同时考虑了数据中的自相关和时间趋势、星期几、温度和相对湿度。我们的研究结果证实，较高的空气污染水平通常会增加 IHD 和 CI 住院的风险。对于 T2DM，关联不太明确。住院通常会滞后几天，并且在特定的人口统计学亚组中或当污染超过特定阈值时更为常见。然而，我们预计在一年中较温暖而不是较寒冷的月份，医院入院的风险不会增加。我们的研究结果需要谨慎对待，但确实提供了有关空气污染如何引发相关心血管疾病急性发作的思路，并且我们的模型可以用于调查全国范围内的类似关联。
