Impact of Ambient PM<sub>10</sub> and SO<sub>2 </sub>Levels on Intensive Care Unit Admissions Due to Cardiopulmonary Diseases in a Tertiary Care Hospital


Creative Commons License

Yavuz M. Y., DÖNGELLİ H., Yavuz M., ŞAHİN A., Gunes M., Guldogan I. K., ...Daha Fazla

ARCHIVES OF IRANIAN MEDICINE, cilt.28, sa.9, ss.514-521, 2025 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 28 Sayı: 9
  • Basım Tarihi: 2025
  • Doi Numarası: 10.34172/aim.34530
  • Dergi Adı: ARCHIVES OF IRANIAN MEDICINE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, Index Islamicus, MEDLINE
  • Sayfa Sayıları: ss.514-521
  • Anahtar Kelimeler: Air pollution, Intensive care unit, In-hospital mortality, Particulate matter, Sulfur dioxide
  • Dokuz Eylül Üniversitesi Adresli: Hayır

Özet

Background: Ambient air pollution, especially particulate matter (PM10) and sulfur dioxide (SO2), has been implicated in exacerbating cardiopulmonary diseases. While emergency department visits have been widely studied, the impact of pollution on intensive care unit (ICU) admissions and mortality is less understood. This retrospective observational study aimed to evaluate the association between monthly air pollutant levels and ICU admissions for cardiopulmonary conditions, as well as in-hospital mortality. Methods: We retrospectively analyzed 6,112 ICU admissions in a tertiary hospital from January 2012 to November 2019. Using defined inclusion criteria, 227 pulmonary and 344 cardiovascular ICU admissions were selected. Monthly PM10 and SO2 levels were obtained from official air monitoring stations. A one-month lag model was applied for cardiovascular admissions. Multivariate models were used to assess associations, and results were reported with 95% confidence intervals (CIs). Results: Higher PM10 levels were significantly associated with pulmonary ICU admissions (beta=0.017; 95% CI: 0.003-0.031; P=0.020) and with cardiovascular admissions using a one-month lag structure (beta=0.018; 95% CI: 0.005-0.030; P=0.006). SO2 showed no significant associations. No significant relationship was observed between air pollution and in-hospital mortality. Chronic kidney disease (HR=1.309; 95% CI: 1.031-1.663; P=0.027) and higher Simplified Acute Physiology Score (SAPS) scores (HR=1.012; 95% CI: 1.006-1.017; P<0.001) were independent mortality predictors. Conclusion: This study indicates that long-term exposure to PM10 significantly affects ICU hospitalization rates for both pulmonary and cardiac conditions, particularly reflecting delayed effects in cardiovascular admissions, without a corresponding impact on in-hospital mortality.