Association Between Long-term Exposure to Ambient Air Pollution and Hospitalization With Aortic Aneurysm or Aortic Dissection
Presented During:
Thursday, April 25, 2024: 5:38PM - 7:00PM
Sheraton Times Square
Posted Room Name:
Central Park
Abstract No:
P0063
Submission Type:
Abstract Submission
Authors:
Kanhua Yin (1), Yaguang Wei (2), Joel Schwartz (2)
Institutions:
(1) Department of Surgery, University of Missouri-Kansas City, Kansas City, MO, (2) Harvard T.H. Chan School of Public Health, Boston, MA
Submitting Author:
Kanhua Yin
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Department of Surgery, University of Missouri-Kansas City
Department of Surgery, University of Missouri-Kansas City
Co-Author(s):
Yaguang Wei
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Harvard T.H. Chan School of Public Health
Harvard T.H. Chan School of Public Health
Joel Schwartz
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Harvard T.H. Chan School of Public Health
Harvard T.H. Chan School of Public Health
Presenting Author:
Kanhua Yin
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Department of Surgery, Washington University School of Medicine
Department of Surgery, Washington University School of Medicine
Abstract:
Objective: The environmental contributions to the development of aortic aneurysms or aortic dissection are poorly understood, though emerging evidence suggests a correlation between air pollution and increased risks of various cardiovascular diseases. This study utilized a validated population-level air pollution exposure model and a national clinical database to assess the associations between long-term exposures to fine particulate matter (PM2.5), ozone, and nitrogen dioxide (NO2) - key air pollutants regulated by the US Environmental Protection Agency - and hospitalizations related to aortic aneurysms or dissections.
Methods: Annual concentration levels of PM2.5, warm-season ozone, and NO2 at 1 km2 grid cells were estimated based on three machine-learning models combined with geographically weighted regressions. Predictors encompassed satellite data, land use, meteorological, and ancillary variables. Data were aggregated from 1 km2 grid cells to ZIP codes to match the spatial resolution of hospitalization records. Hospitalization records for residents of 14 U.S. states (2000-2016) were obtained from the State Inpatient Databases (SIDs). ICD-9 (441) and ICD-10 (I-71) codes were used to identify aortic aneurysm and aortic dissection-related hospitalizations. Hospitalization rates were calculated at the ZIP code level. A multivariable linear regression model was built to estimate associations between annual air pollutant levels and hospitalization rates, adjusting for patient demographics, neighborhood-level covariates, and seasonal temperatures during summer and winter. Penalized cubic splines with up to nine degrees of freedom were used for all three pollutants to estimate nonlinear exposure-response relationships.
Results: Analysis included 338, 381 hospitalizations related to aortic aneurysm or dissection (mean age 70.8 years, 71.8% male, and 70.0% Caucasian). Average annual PM2.5, warm-season ozone, and NO2 levels were 9.2 µg/m3, 44.7 parts per billion (ppb), and 17.1 ppb, respectively. All three pollutants were associated with increased hospitalization rates, with the effects of PM2.5 and NO2 being statistically significant. PM2.5 displayed a more pronounced effect, demonstrating that each unit increase in annual exposure correlated with 16.7 additional hospitalizations (95% confidence interval: 10.5, 22.9, p < 0.001) per ten million person-years, followed by NO2, which exhibited 1.85 additional hospitalizations (95% confidence interval: 0.03-3.7, p < 0.05) per ten million person-years. A clear exposure-effect relationship was observed for PM2.5 and NO2 (Figure 1).
Conclusions: Long-term exposures to PM2.5 and NO2 are independently associated with an elevated risk of hospitalization related to aortic aneurysm or aortic dissection, with PM2.5 being a more deleterious pollutant. This study underscores the potential role of air pollution in the development or progression of aortic aneurysm/dissection.
Methods: Annual concentration levels of PM2.5, warm-season ozone, and NO2 at 1 km2 grid cells were estimated based on three machine-learning models combined with geographically weighted regressions. Predictors encompassed satellite data, land use, meteorological, and ancillary variables. Data were aggregated from 1 km2 grid cells to ZIP codes to match the spatial resolution of hospitalization records. Hospitalization records for residents of 14 U.S. states (2000-2016) were obtained from the State Inpatient Databases (SIDs). ICD-9 (441) and ICD-10 (I-71) codes were used to identify aortic aneurysm and aortic dissection-related hospitalizations. Hospitalization rates were calculated at the ZIP code level. A multivariable linear regression model was built to estimate associations between annual air pollutant levels and hospitalization rates, adjusting for patient demographics, neighborhood-level covariates, and seasonal temperatures during summer and winter. Penalized cubic splines with up to nine degrees of freedom were used for all three pollutants to estimate nonlinear exposure-response relationships.
Results: Analysis included 338, 381 hospitalizations related to aortic aneurysm or dissection (mean age 70.8 years, 71.8% male, and 70.0% Caucasian). Average annual PM2.5, warm-season ozone, and NO2 levels were 9.2 µg/m3, 44.7 parts per billion (ppb), and 17.1 ppb, respectively. All three pollutants were associated with increased hospitalization rates, with the effects of PM2.5 and NO2 being statistically significant. PM2.5 displayed a more pronounced effect, demonstrating that each unit increase in annual exposure correlated with 16.7 additional hospitalizations (95% confidence interval: 10.5, 22.9, p < 0.001) per ten million person-years, followed by NO2, which exhibited 1.85 additional hospitalizations (95% confidence interval: 0.03-3.7, p < 0.05) per ten million person-years. A clear exposure-effect relationship was observed for PM2.5 and NO2 (Figure 1).
Conclusions: Long-term exposures to PM2.5 and NO2 are independently associated with an elevated risk of hospitalization related to aortic aneurysm or aortic dissection, with PM2.5 being a more deleterious pollutant. This study underscores the potential role of air pollution in the development or progression of aortic aneurysm/dissection.
Aortic Symposium:
Aortic Surgery Forum (Basic Aortic Research, Venue for Residents, Fellows, Junior Attendings)
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