Environmental pollution and myocardial hospitalisations in five Slovenian communities

Environmental pollution represents an increasingly acknowledged determinant of cardiovascular disease. In the present analysis, we assessed the association between community-level exposure to particulate matter of aerodynamic diameter no greater than 2.5 µm (PM2.5) and daily hospitalisations for acute myocardial infarction in five Slovenian communities using a time-series design. Hospital admissions due to myocardial infarction at five Slovenian communities over 1-30 days from exposure to PM2.5 (collected from publicly available Slovenian Environment Agency reports) were analysed for the 2015-2021 period using lag nonlinear time-series modelling. Effect estimates were calculated as incidence rate ratios with 95% confidence intervals (95%CI) for PM2.5 exposure at lags 0–7 and for 3-, 7- and 30-day moving averages using generalized additive mixed models with a quasi-Poisson distribution. Models were adjusted for serial correlation (AR1 error structure), meteorological variables (temperature, humidity, pressure), seasonality and weekends/public holidays, and random effects for community. Between 2015 and 2021, 2,687 myocardial infarction hospitalisations occurred in the five observed communities. PM2.5 concentrations at lags 3 and 7 days and for 30-day moving average were associated with a 1.0015 (95%CI 1.0001-1.0029, p=0.040), 1.0019 (95%CI 1.0006-1.0033) and 1.0048 (95%CI 1.0008-1.0087, p=0.019) incident rate ratio increase in hospital admissions for myocardial infarction, respectively (Figure 1). The exposure to PM2.5 is associated with a lagged increase in the short-term risk of hospital admission due to myocardial infarction.