Spatio-temporal correlation between admissions for ruptured abdominal aortic aneurysms and levels of atmospheric pollution in Italy

Aims: The aim of our study was to determine a correlation between rates and number of patients admitted with ruptured abdominal aortic aneurysms (rAAA) in Italian regions with different levels of atmospheric pollution. Methods: We analyzed a possible correlation between the number and rate (ruptured versus not ruptured) of patients with rAAA admitted in eight Italian regions with different levels of atmospheric pollution. Results: Number and rates of patients with rAAA were statistically correlated with levels of air pollution and low air temperature (RR = 1.90, 95% CI: 1.42, 2.1.0) (p<0.01). Even if low temperatures amplified the correlation between admissions for rAAA and PMs exposure, also during Summer and Spring there were sudden increases of the number of admissions for rAAA patients in periods with higher air pollution. The regions with high levels of atmospheric pollution had higher rates of admissions of patients with rAAA in comparison with regions with low level of air pollution. However, there was no difference between regions with low and very low level of atmospheric pollution. Mean age, sex distribution, exposure to established risk factors were similar for the population of the eight analyzed Italian regions. Conclusions: The findings of this study highlight the potential to reduce AAA related mortality and burden by addressing the negative effects of exposure to high levels of atmospheric pollution. The possibility of a dose-dependent effect of atmospheric pollution on the cardiovascular system opens research initiatives and discussions about when and how to modulate interventions to reduce atmospheric pollutants.