Cardiovascular Health

This study (Kranc et al., 2021), led by Hannan Kranc, examined whether short-term exposure to air pollution can trigger out-of-hospital cardiac arrest. Using nationwide data, higher levels of nitrogen dioxide and fine particulate matter were linked to increased risk in the hours before an event. Overall, the findings suggest that acute air pollution exposure may increase cardiac arrest risk independently of weather conditions.

This nationwide study (Kranc et al, 2021), led by Hannan Kranc, examined the association between weather conditions and out-of-hospital cardiac arrest. Based on over 12,000 cases, it found that both high and low temperatures were linked to increased risk, especially during summer and winter, respectively. Low humidity was also associated with higher risk. Overall, the findings indicate that extreme weather conditions can contribute to cardiac arrest risk.

This study (Yitshak-Sade et al, 2017) led by Maayan Yitshak-Sade, assessed whether adding air pollution and neighbourhood greenness improves prediction of cardiovascular disease beyond traditional risk factors. In a cohort of 23,110 individuals, 12% developed CVD. Coarse particulate matter was associated with higher risk of stroke and myocardial infarction, while greenness showed a protective association with myocardial infarction. However, adding these environmental factors to prediction models led to only a minimal improvement in performance (c-statistic increase of ~0.1–0.2%).

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and a major risk factor for ischemic stroke. We aimed to evaluate the effect of air pollution on the new AF onset requiring (Yitshak Sade et al, 2015a). A case-crossover analysis was performed on a population of patients hospitalized between 2006-2010 with first time occurrence of atrial fibrillation. AF onset was associated with an interquartile range elevation of carbon monoxide concentrations during the winter season (odds ratio (OR) 1.15, p = 0.040) and sulfur dioxide concentrations during the fall season (OR 1.21, p = 0.028). An interquartile range elevation in nitric dioxide concentration was associated with AF onset only among patients younger than 65 years of age (OR 1.08, p = 0.025). Patients with diabetes mellitus or chronic obstructive pulmonary disorder had higher susceptibility for carbon monoxide-associated AF development.

In the study led by Alina Vodonos (Vodonos et al, 2017), we examined the association between particulate matter (PM) exposure and ischemic stroke incidence. Using a case-crossover design, we stratified analyses by personal characteristics and residential proximity to major roads. Increases in PM10 and PM2.5 on the day of the event were associated with higher stroke risk among individuals under 55 years (OR 1.11 and 1.10, respectively). Stronger associations were observed among those living within 75 meters of a main road (OR 1.22 and 1.26, respectively).

This study (Yitshak Sade et al, 2015b), led by Maayan Yitshak-Sade, examined the association between ambient temperature changes and ischemic stroke risk. Using a time-stratified case-crossover design, it included all IS admissions to Soroka University Medical Center (2012–2014) and assessed exposure windows of 6–96 hours before symptom onset. Increases in temperature were associated with higher stroke risk during summer (OR 3.10, 95% CI 1.45–6.61) and autumn (OR 1.86, 95% CI 1.15–2.99), while in winter they were linked to lower risk (OR 0.68, 95% CI 0.48–0.97). Men showed greater sensitivity to temperature fluctuations (OR 1.35, 95% CI 1.01–1.80) than women (OR 0.96, 95% CI 0.68–1.36).

This study (Vodonos et al, 2015), led by Alina Vodonos, examined whether exposure to non-anthropogenic particulate matter from dust storms is associated with acute coronary syndrome (ACS) and whether effects differ across population groups. Using a case-crossover design, the analysis included all adults admitted to Soroka Hospital with a primary diagnosis of ACS. Higher PM10 levels on non-dust storm days were associated with increased odds of hospitalization on the same day (OR 1.014 per 10 μg/m³, 95% CI 1.001–1.027). Stronger effects were observed among older individuals (≥65), women, and Bedouin patients.