Title : Air pollution and atrial fibrillation: A regional epidemiological study in Western Macedonia, Greece
Abstract:
Air pollution is a major environmental determinant of cardiovascular morbidity and mortality worldwide. Fine particulate matter (PM10), nitrogen oxides (NO, NO?, NOx), and sulfur dioxide (SO?) have been consistently associated with increased hospital admissions for cardiovascular and respiratory diseases. Atrial fibrillation (AF) represents the most common sustained cardiac arrhythmia and is strongly linked with environmental triggers, including air pollution. This study investigates the association between short-term exposure to major air pollutants and hospital admissions related to cardiac arrhythmias, with an emphasis on atrial fibrillation, in Western Macedonia, Greece. Daily air pollution data (PM10, SO?, NO, NO?, NOx) and hospital admission records were analyzed for the regions of Kozani, Ptolemaida, Florina, and Grevena over the period 2011–2021. Descriptive statistical analysis assessed the temporal trends of pollutants, while Spearman correlation analysis examined the association between three-day average pollutant concentrations and hospital admissions. Regional comparisons of pollution levels and hospitalization rates were also performed. PM10 levels demonstrated a clear declining trend after 2014, particularly in 2021, while NO? and NOx exhibited significant interannual variability. Statistically significant positive correlations were identified between NO? and hospitalizations in Kozani (Rho = 0.115, p = 0.045) and between SO? and hospitalizations in Ptolemaida (Rho = 0.122, p = 0.034). In Florina, PM10 showed a statistically significant positive association with admissions (Rho = 0.138, p = 0.017). Furthermore, increased pollutant exposure in Ptolemaida was associated with a higher probability of arrhythmia episodes, including atrial fibrillation. Significant regional differences in hospitalization rates were also observed, with Grevena presenting consistently lower admissions. The findings indicate that short-term exposure to specific air pollutants, particularly NO?, SO?, and PM10, is associated with increased hospital admissions for cardiac arrhythmias, including atrial fibrillation. These results highlight the critical need for targeted air quality interventions and continuous monitoring in industrial and urban areas of Western Macedonia.
