The Effect of Exposure to Ambient Air Pollutants on Cardiovascular Mortality in Arak, Iran


Mostafa Vahedian ORCID 1 , Omid Garkaz ORCID 2 , Narges Khanjani ORCID 3 , * , Moghaddameh Mirzaee ORCID 4 , Ali Koolivand ORCID 5

1 Clinical Research Development Center, Qom University of Medical Sciences, Qom, IR Iran

2 School of Public Health, Shahroud University of Medical Sciences, Shahroud, IR Iran

3 Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, IR Iran

4 Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran

5 Department of Environmental Health Engineering٫ Faculty of Health٫ Arak University of Medical Sciences٫ Arak, IR Iran

How to Cite: Vahedian M , Garkaz O, Khanjani N , Mirzaee M , Koolivand A . The Effect of Exposure to Ambient Air Pollutants on Cardiovascular Mortality in Arak, Iran, Int Cardio Res J. 2020 ; 14(4):e104746.


International Cardiovascular Research Journal: 14 (4); e104746
Published Online: December 15, 2020
Article Type: Research Article
Received: May 08, 2020
Accepted: October 10, 2020


Background: Air pollution is one of the most critical environmental problems around
the world.
Objectives: This study aimed to estimate cardiovascular mortality related to NO2,
PM10, SO2, and O3 concentrations in Arak in 2014.
Methods: This ecological study was performed on 599634 participants. Data about air
pollutant concentrations, including NO2, PM10, SO2, and O3, in the urban population
of Arak in 2014 were obtained from Arak Environment Department. Cardiovascular
mortality related to air pollutant exposure was estimated using Baseline Incidences (BI)
and Relative Risks (RR) based on the World Health Organization (WHO) databases and
time-series and case-crossover studies about the association between air pollutants and
health outcomes and using the AirQ2.2.3 software.
Results: The results showed that the annual average concentrations of PM10, NO2,
O3, and SO2 were 69, 38, 57, and 53 μg/m3, respectively during the study period. In
addition, the number of excess cases for cardiovascular mortality in the central RR was
138, 100, 55, and 16 for PM10, SO2, O3, and NO2, respectively. The cumulative number
of cardiovascular mortality due to exposure to NO2 (RR = 1.00, 1.002, and 1.004) was
16, while this measure was 55 for cardiovascular mortality due to O3 (RR = 1.00, 1.004,
and 1.006).
Conclusions: This study showed that PM10 and SO2 had the highest adverse health
effects in relation to cardiovascular mortality in Arak. This necessitates important and
vital measures and planning by national and international officials.



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