title: Individual Effect Modifiers of Dust Exposure Effect on Cardiovascular Morbidity.
abstract: BACKGROUND
  High concentrations of particulate matter (PM) air pollution have been associated with death and hospital admissions due to cardiovascular morbidity. However, it is not clear a) whether high levels of non-anthropogenic PM from dust storms constitute a health risk; and b) whether these health risks are exacerbated in a particular demographic.
  
  
  METHODS
  This study comprised all patients above 18 years old admitted to Soroka University Medical Center (1000 bed tertiary hospital, Be'er-Sheva, Israel, 2001-2010) with a primary diagnosis of acute coronary syndrome (ACS). Data on meteorological parameters and PM10 (particulate matter <10 μm in aerodiameter) were obtained from monitoring stations in the city of Be'er-Sheva. Data were analyzed using a case crossover analysis to examine the effect of dust exposure on hospitalization due to ACS and the interaction with co-morbidities and demographic factors.
  
  
  RESULTS
  There were 16,734 hospitalizations due to ACS during the study period. The estimated odds of hospitalization due to ACS was significantly associated with PM10 during non dust storm days at the same day of the exposure (lag0); OR = 1.014 (95%CI 1.001-1.027) for a 10 μg/m3 increase, while a delayed response (lag1) was found during the dust storm days; OR = 1.007 (95%CI 1.002-1.012). The effect size for the dust exposure association was larger for older (above the age of 65), female or Bedouin patients.
  
  
  CONCLUSIONS
  Exposure to non-anthropogenic PM is associated with cardiovascular morbidity. Health risk associated dust exposure is gender and age specific with older women and Bedouin patients being the most vulnerable groups.
authors.affiliation: Department of Public Health, Ben-Gurion University of the Negev, Be'er-Sheva, Israel; Clinical Research Center, Soroka University Medical Center, Be'er-Sheva, Israel.
authors.forename: Alina
authors.initials: A
authors.lastname: Vodonos
authors.affiliation: Department of Public Health, Ben-Gurion University of the Negev, Be'er-Sheva, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Friger
authors.affiliation: Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Be'er-Sheva, Israel.
authors.forename: Itzhak
authors.initials: I
authors.lastname: Katra
authors.affiliation: Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Be'er-Sheva, Israel.
authors.forename: Helena
authors.initials: H
authors.lastname: Krasnov
authors.affiliation: Intensive Cardiac Care Unit, Department of Cardiology, Soroka University Medical Center, Be'er-Sheva, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Zahger
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Joel
authors.initials: J
authors.lastname: Schwartz
authors.affiliation: Clinical Research Center, Soroka University Medical Center, Be'er-Sheva, Israel.
authors.forename: Victor
authors.initials: V
authors.lastname: Novack
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology*; D000367:Age Factors; D000368:Aged; D000393:Air Pollutants / Q000009:adverse effects*; D000397:Air Pollution / Q000009:adverse effects*; D004391:Dust; D005260:Female; D006760:Hospitalization; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D052638:Particulate Matter / Q000009:adverse effects*; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D000393:Air Pollutants; D004391:Dust; D052638:Particulate Matter