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Environ Int. 2017 Sep;106:257-266. doi: 10.1016/j.envint.2017.06.001. Epub 2017 Jul 11.

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

Author information

1
Department of Family Medicine and Urgent Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, J1H 5N4, QC, Canada; Research Center of the Centre hospitalier universitaire de Sherbrooke - Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, J1H 5N4, QC, Canada. Electronic address: Alain.Vanasse@USherbrooke.ca.
2
Research Center of the Centre hospitalier universitaire de Québec - Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, QC, Canada; Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, G1V 0A6, QC, Canada. Electronic address: denis.talbot@fmed.ulaval.ca.
3
The Eau Terre Environnement Research Center, Institut national de la recherche scientifique, 490 Rue de la Couronne, Québec, G1K 9A9, QC, Canada. Electronic address: fateh.chebana@ete.inrs.ca.
4
Research Center of the Centre hospitalier universitaire de Québec - Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, QC, Canada; The Eau Terre Environnement Research Center, Institut national de la recherche scientifique, 490 Rue de la Couronne, Québec, G1K 9A9, QC, Canada. Electronic address: diane.belanger@ete.inrs.ca.
5
Institut national de santé publique du Québec, 945 Avenue Wolfe, Québec, G1V 5B3, QC, Canada; Faculty of Pharmacy, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, G1V 0A6, QC, Canada. Electronic address: claudia.blais@inspq.qc.ca.
6
Institut national de santé publique du Québec, 945 Avenue Wolfe, Québec, G1V 5B3, QC, Canada. Electronic address: Philippe.Gamache@inspq.qc.ca.
7
The Eau Terre Environnement Research Center, Institut national de la recherche scientifique, 490 Rue de la Couronne, Québec, G1K 9A9, QC, Canada. Electronic address: Jean-Xavier.Giroux@ete.inrs.ca.
8
Department of Family Medicine and Urgent Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, J1H 5N4, QC, Canada. Electronic address: Roxanne.Dault2@USherbrooke.ca.
9
Research Center of the Centre hospitalier universitaire de Québec - Université Laval, 1050 Chemin Sainte-Foy, Québec, G1S 4L8, QC, Canada; Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, G1V 0A6, QC, Canada; The Eau Terre Environnement Research Center, Institut national de la recherche scientifique, 490 Rue de la Couronne, Québec, G1K 9A9, QC, Canada; Institut national de santé publique du Québec, 945 Avenue Wolfe, Québec, G1V 5B3, QC, Canada; Faculty of Pharmacy, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Québec, G1V 0A6, QC, Canada. Electronic address: pierre.gosselin@inspq.qc.ca.

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 7days before the event. An increase in atmospheric pressure in the previous 7days 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.

KEYWORDS:

Canada; Climate changes; Elderly; Fine particulate matter; Heart failure; Lag effect

PMID:
28709636
DOI:
10.1016/j.envint.2017.06.001
[Indexed for MEDLINE]

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