6 The objective of the present study was, therefore, to look for any relationship between levels of air pollution and the morbidity and mortality associated with heart failure within Warwickshire in the past few years (2005–2013 for morbidity, 2007–2012 for mortality). We examined a range of traditional air pollutants for an ecological association with heart failure morbidity and mortality
DOT1L at the county level. Furthermore, the present analysis attempted to highlight spatial patterns in heart failure morbidity and mortality risk within the county, after multiple adjustments for proximate, county-level factors. The geographic locations of wards within the county can be considered as proxy measures of many other unmeasured factors such as availability and access to health services, individual health-seeking behaviour, preventive ward policy and general ward factors. Such estimates might illustrate how much can be learned by detailed exploratory analyses as well as how these data can be used to strategically inform policy aiming at the prevention and management
of serious conditions such as heart failure in these settings. The evidence from published literature for the link between air pollution and health problems Studies have shown an effect on the health of populations caused by long-term exposure as well as short-term ‘spikes’ in local air pollution levels.5 A relevant systematic review and meta-analysis has been published recently in The Lancet.2 It pooled
the results of studies that have been conducted worldwide looking at the temporal relationship between the levels of a number of different air pollutants with local heart failure hospital admission rates and mortality rates. This showed a clear link between short-term rises in all types of air pollution (except ozone) and rises in hospital admissions and mortality due to heart failure. This study did not look at any potential effects from long-term exposure to air pollution. However, it did provide strong evidence that air pollution can ‘exacerbate’ heart failure, increasing the likelihood that a patient with existing heart failure will become sufficiently unwell to require hospital admission, or even die. The ESCAPE study3 published recently in the Lancet Oncology, pooling the results of 17 cohort studies from around Europe, looked at Anacetrapib the ambient levels of air pollution in an area (Pm and NOx) and the incidence of lung cancers in the inhabitants of that area during many years of follow-up (mean 12.8 years). This was intended to look at the risk associated with long-term exposure to air pollution. A statistically significant correlation was found between the levels of particulate matter air pollution and the local incidence of lung cancer diagnoses. Pm with a diameter of less than 10 μm had a HR of 1.22 (95% CI 1.03 to 1.45) per (10 μg/m3).