title: The Influence of Nitrogen Dioxide on Arrhythmias in Spain and Its Relationship with Atmospheric Circulation.
abstract: Epidemiological studies suggest that increased ambient NO2concentrations are associated with cardiovascular disease. However, none of them have examined the association between ambient air pollution and cardiac arrhythmias in the general population in Spain. This paper assesses the short-term association between the aforementioned air pollutant and hospital admissions for arrhythmia in nine different regions of Spain during a 6-year period (2005-2010), and the possible season-specific effects of the compound on this pathology, by performing a time-series analysis based on Poisson regression models. The results show statistically significant positive relationship increases between arrhythmia admissions and increments in NO2concentration during the whole year, most notably in wintertime. Moreover, while trying to establish a threshold for NO2concentration above which the incidence of arrhythmia episodes increases significantly, this study reveals that hospital admissions increased linearly in response to an increase in as we move to higher NO2concentration levels. Finally, an analysis of NO2concentrations and their relationship with atmospheric circulation is performed, showing higher values of NO2under anticyclonic conditions during winter that could be used for implementing pollution level alert protocols depending on forecast circulation patterns.
authors.affiliation: Unit of Legal Medicine, Department of Physiology and Pharmacology, University of Cantabria, Av Cardenal Herrera Oria s/n, 39011, Santander, Spain. ana.santurtun@unican.es.
authors.forename: Ana
authors.initials: A
authors.lastname: Santurtún
authors.affiliation: Instituto Pirenaico de Ecología, Consejo Superior de Investigaciones Científicas (IPE-CSIC), 50059, Saragossa, Spain.
authors.forename: Arturo
authors.initials: A
authors.lastname: Sanchez-Lorenzo
authors.affiliation: Independent IT Consultant, 39009, Santander, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Villar
authors.affiliation: Department of Internal Medicine, Hospital U.M. Valdecilla, IDIVAL, University of Cantabria, 39011, Santander, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: Riancho
authors.affiliation: Unit of Legal Medicine, Department of Physiology and Pharmacology, University of Cantabria, Av Cardenal Herrera Oria s/n, 39011, Santander, Spain.
authors.forename: María T
authors.initials: MT
authors.lastname: Zarrabeitia
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D004784:Environmental Monitoring / Q000379:methods; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D019570:Inhalation Exposure / Q000009:adverse effects*; D016014:Linear Models; D009585:Nitrogen Dioxide / Q000009:adverse effects*; D016012:Poisson Distribution; D018570:Risk Assessment; D012307:Risk Factors; D012621:Seasons; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
chemical_list: D000393:Air Pollutants; D009585:Nitrogen Dioxide
keywords: Air pollution; Arrhythmia; Atmospheric circulation; Nitrogen dioxide; Spain