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1254276 
Journal Article 
Even low levels of ambient air pollutants are associated with increased emergency department visits for hypertension 
Szyszkowicz, M; Rowe, BH; Brook, RD 
2012 
Yes 
Canadian Journal of Cardiology
ISSN: 0828-282X
EISSN: 1916-7075 
28 
360-366 
English 
is supplemented by 3520327 - Supplementary materials
BACKGROUND: Numerous studies have reported associations between air pollution and cardiovascular diseases. While several studies illustrate that exposures to air pollutants can elevate blood pressure, few have evaluated the clinical relevance of this relationship. Hence, we aimed to explore the associations between daily concentrations of several air pollutants and emergency department visits for hypertension.

METHODS: Odds ratios (ORs) for emergency department visits for hypertension in Edmonton, Canada, from April 1992 to March 2002 were associated with pollutant levels (CO, NO(2), SO(2), O(3), and particulate matter [PM] < 10 microns [PM(10)] and < 2.5 microns [PM(2.5)] in aerodynamic diameter, respectively) by means of a case-crossover technique with time-stratified strategy to define controls. The analysis was performed for all (N = 5365), male (N = 2069), and female (N = 3296) patients and for six air pollutants lagged by 0 to 9 days. ORs and their 95% confidence intervals (CIs) were reported for an increase in an interquartile range (IQR) for each pollutant.

RESULTS: We observed associations for all patients and levels of NO(2) (IQR = 12.8 parts per billion; OR, 1.06; 95% CI, 1.00-1.12), SO(2) (IQR = 2.3 parts per billion; OR, 1.04; 95% CI, 1.00-1.08), and PM(10) (IQR = 15.0 μg/m(3); OR, 1.06; 95% CI, 1.01-1.11) for lag day 3, as well as for PM(10) (IQR = 15.0 μg/m(3); OR, 1.06; 95% CI, 1.01-1.11) and PM(2.5) (IQR = 6.2 μg/m(3); OR, 1.07; 95% CI, 1.01-1.11) for lag day 6.

CONCLUSIONS: These findings support the contention that ambient pollution can produce clinically meaningful increases in blood pressure. 
• ISA-CO (2010 Final Project Page)
     Health Effects
• ISA-NOx
     Considered
          Health Effects
     Cited
          1st Draft
               Epidemiology
          2nd Draft
          Final
          Final Cited
• ISA-PM (2009 Final Project Page)
• ISA-PM (current)
     Peer Input Draft
          Chapter 6
     1st Draft
          Chapter 6
     Final ISA
          Chapter 6
• ISA-SOx
     Health Effects
     Considered
     Chapter Review
          Health Effects
     Cited in First ERD Nov2015
     Cited Second ERD Dec2016
     Cited in Final ISA Dec2017
          Chapter 5 – Health
• PM Provisional Assessment (2012 Project Page)
     Cited
     Epidemiological Studies
          U.S.-Canada
          Cardio (hospital/emergency)