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

Suji Lee, Whanhee Lee, Eun Il Lee, Myung Ho Jeong, Seung Woon Rha, Chong Jin Kim, Shung Chull Chae, Hyo Soo Kim, Hyeon Cheol Gwon, Ho Kim

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Article number68
JournalBMC Public Health
Volume21
Issue number1
DOIs
Publication statusPublished - 2021 Dec
Externally publishedYes

Keywords

  • Air pollution
  • Asian dust
  • Health effect
  • Myocardial infarction
  • Particulate matter

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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