A new study conducted by the Politecnico di Milano in Lombardy has revealed alarming findings about the link between air pollution and cardiac arrest risk.
The study, published in the journal Global Challenges, shows that exposure to high levels of air pollution significantly increases the likelihood of experiencing a cardiac arrest, especially on days when pollution levels are at their highest.
The researchers analyzed over 37,000 cases of out-of-hospital cardiac arrest in Lombardy, a region in northern Italy, between 2016 and 2019. They looked at daily concentrations of various pollutants, including particulate matter (PM₂.₅, PM₁₀), nitrogen dioxide (NO₂), ozone (O₃), and carbon monoxide (CO), using data from the European Copernicus program.
Advanced statistical models were then applied to identify any potential links between pollution spikes and an increase in cardiac events.
The results of the study were striking. The most significant association was found with nitrogen dioxide (NO₂), a major air pollutant commonly produced by traffic and industrial activities.
For every 10 micrograms per cubic meter increase in NO₂ levels, the risk of cardiac arrest rose by 7% over the next 96 hours. Particulate matter (PM₂.₅ and PM₁₀) also showed a correlation, with a 3% and 2.5% increased risk of cardiac arrest, respectively, on the day of exposure.
While the effect was stronger in urban areas, it was also observed in rural towns, highlighting the widespread impact of air pollution. The risk was particularly higher during warmer months, suggesting that heat may interact with pollutants to further increase the danger to cardiovascular health.
What’s more concerning is that these effects were seen even at levels of pollution that fall within legal limits, indicating that no level of exposure is truly safe.
Dr. Amruta Umakant Mahakalkar, a researcher at the Department of Electronics, Information and Bioengineering at Politecnico di Milano, and the first author of the study, emphasized the significance of these findings.
“We observed a strong association with nitrogen dioxide. Indeed, for every 10 micrograms per cubic meter increase, the risk of cardiac arrest rises by 7% over the next 96 hours,” she explained. “Even particulate matter PM₂.₅ and PM₁₀ present a 3% and 2.5% increase in the risk rate, respectively, on the same day of exposure.”
The study’s findings are a wake-up call for local health systems. Dr. Enrico Caiani, a professor at Politecnico di Milano and co-author of the study, pointed out that emergency services should be prepared for potential surges in cardiac arrest cases during periods of high pollution.
“The link between air quality and out-of-hospital cardiac arrest is a wake-up call for local health systems,” he said.
These results reinforce the growing concern about air pollution as a major public health issue. According to the World Health Organization, air pollution is the second leading environmental risk factor for non-communicable diseases, contributing to millions of deaths worldwide each year.
Lombardy, one of the most industrialized and densely populated regions in Europe, is particularly vulnerable to smog episodes, especially in winter when heating systems increase pollution and atmospheric dispersion is poor.
The research also offers valuable insights for improving health systems. By integrating environmental data into health forecasting systems, institutions could better anticipate increases in emergency calls related to pollution events, allowing for more efficient resource planning and management.
The findings come as the new CLIMA-CARE project is launched, continuing this line of research. The project will use satellite data to examine how environmental conditions impact public health and emergency medical services in Lombardy. It aims to create climate projections to better understand and address the health impacts of air pollution and climate change.
“The project will give us the opportunity to address the impact of climate change on a population-wide scale,” said Lorenzo Gianquintieri, a researcher at Politecnico di Milano. “Consistently with the One-Health vision, which combines human, environmental and animal health, we promote a preventive adaptation approach based on scientific evidence.”
This study is a reminder of how air pollution can affect not just long-term health, but also immediate risks to life, particularly during high pollution periods. It emphasizes the importance of considering environmental factors in public health planning and calls for stronger action to reduce pollution levels and protect the heart health of residents.
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