Short-Term Effects of “Polish Smog” on Cardiovascular Mortality in the Green Lungs of Poland: A Case-Crossover Study with 4,500,000 Person-Years (PL-PARTICLES Study)

Abstract

Previous studies conducted in highly polluted areas have reported associations between air pollution and daily mortality. The Green Lungs of Poland are characterized by unique natural features and a moderate pollution level. We aimed to assess the short-term impact of air pollution on cardiovascular (CVD)-, acute coronary syndrome (ACS)-, and cerebrovascular-related (CbVD) mortality. An analysis with 4,500,000 person-years and a time-stratified case-crossover design was performed. The interquartile range increase in the PM2.5 (OR 1.036, 95% CI 1.016–1.056, p < 0.001) and PM10 concentration (OR 1.034, 95% CI 1.015–1.053, p < 0.001) was associated with increased CVD mortality on lag 0, and this effect persisted on the following days. The effects of PMs were expressed more in association with ACS-related mortality (PM2.5-OR = 1.045, 95% CI 1.012–1.080, p = 0.01; PM10-OR = 1.044, 95% CI 1.010–1.078, p = 0.01) and CbVD mortality (PM10-OR = 1.099, 95% CI 1.019–1.343, p = 0.02). We also noted a higher CVD mortality OR in the cold season for PM10 in cities with area-source domination: Białystok (p = 0.001) and Suwałki (p = 0.047). The short-term impact of PMs on cardiovascular mortality is also observed in moderately polluted areas. This adverse health effect was more apparent in CbVD- and ACS-related mortality, and in the cold season. Further research focusing on the adverse health effects of “Polish smog” is sorely needed.