Effects of climate and fine particulate matter on hospitalizations and deaths for heart failure in elderly: A population-based cohort study. (September 2017)

• Record Type: Journal Article
• Authors: Vanasse, Alain; Talbot, Denis; Chebana, Fateh; Bélanger, Diane; Blais, Claudia; Gamache, Philippe; Giroux, Jean-Xavier; Dault, Roxanne; Gosselin, Pierre
• Is Part Of: Environment international. Volume 106(2017)
• Page Start: 257
• Page End: 266
• Publication Date: 2017-09
• Subjects: AIC Akaike information criterion -- BIC Bayesian information criterion -- CAs Census agglomerations -- CHDs Coronary heart diseases -- CMAs Census metropolitan areas -- CNS Central nervous system -- CSDs Census subdivisions -- CTs Census tracts -- CVDs Cardiovascular diseases -- DAs Dissemination areas -- GEE Generalized estimating equation -- HF Heart failure -- ICD International classification of diseases -- INSPQ Institut national de santé publique du Québec -- km Kilometer -- kPa Kilopascal -- NAPS National Air Pollution Surveillance -- ORNL DAAC Oak Ridge National Laboratory Distributed Active Archive Center -- PM2.5 Fine particulate matter -- QICDSS Quebec Integrated Chronic Disease Surveillance System; Heart failure -- Elderly -- Climate changes -- Fine particulate matter -- Lag effect -- Canada; Environmental protection -- Periodicals; Environmental health -- Periodicals; Environmental monitoring -- Periodicals; Environmental Monitoring -- Periodicals; Environnement -- Protection -- Périodiques; Hygiène du milieu -- Périodiques; Environnement -- Surveillance -- Périodiques; Environmental health; Environmental monitoring; Environmental protection; Periodicals; 333.705
• DOI: 10.1016/j.envint.2017.06.001
• Languages: English
• ISSNs: 0160-4120

Abstract

Abstract: Background: There are limited data on the effects of climate and air pollutant exposure on heart failure (HF) within taking into account individual and contextual variables. Objectives: We measured the lag effects of temperature, relative humidity, atmospheric pressure and fine particulate matter (PM2.5 ) on hospitalizations and deaths for HF in elderly diagnosed with this disease on a 10-year period in the province of Quebec, Canada. Methods: Our population-based cohort study included 112, 793 elderly diagnosed with HF between 2001 and 2011. Time dependent Cox regression models approximated with pooled logistic regressions were used to evaluate the 3- and 7-day lag effects of daily temperature, relative humidity, atmospheric pressure and PM2.5 exposure on HF morbidity and mortality controlling for several individual and contextual covariates. Results: Overall, 18, 309 elderly were hospitalized and 4297 died for the main cause of HF. We observed an increased risk of hospitalizations and deaths for HF with a decrease in the average temperature of the 3 and 7 days before the event. An increase in atmospheric pressure in the previous 7 days was also associated with a higher risk of having a HF negative outcome, but no effect was observed in the 3-day lag model. No association was found with relative humidity and with PM2.5 regardless of the lag period. Conclusions: Lag effects of temperature and other meteorological parameters on HF events were limited but present. Nonetheless, preventive measures should be issued for elderly diagnosed with HF considering the burden and the expensive costs associated with the management of this disease.