Abstract

Background:
Air pollution exposure is associated with hospital admissions and emergency room visits forcardiopulmonary disease and stroke. Iceland's capital area, Reykjavik, has generally low air pollution levels, but trafficand natural sources contribute to pollution levels. The objective of this study was to investigate temporal associations between emergency hospital visits and air pollutants ozone (O3), nitrogen dioxide (NO2), andparticulate matter (PM10) in the Icelandic capital area.
Methods:
We constructed a time series of the daily number of adults who visited the emergency room, or wereacutely admitted for stroke or cardiorespiratory causes to Landspitali University Hospital 1 January 2003 –31 December 2009 from the hospital in-patient register. We used generalized additive models assuming Poisson distribution, to analyze the daily emergency hospital visits as a function of the pollutant levels, and adjusted formeteorological variables, day of week, and time trend with splines.
Results:
Daily emergency hospital visits increased 3.9% (95% confidence interval (CI) 1.7-6.1%) per interquartile (IQR)change in average O3 the same and two previous days. For females, the increase was 7.8% (95% CI 3.6-12.1) for elderly(70+), the increase was 3.9% (95% CI 0.6-7.3%) per IQR increase of NO2. There were no associations with PM10.
Conclusions:
We found an increase in daily emergency hospital visits associated with O3, indicating that low-levelexposure may trigger cardiopulmonary events or stroke.

Keywords:
Air pollution, Stroke, Cardiopulmonary, Cardiac, Cardiovascular, Hospital admissions, Emergency room visits

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