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Spatial variation of heart failure and air pollution in Warwickshire, UK : an investigation of small scale variation at the ward-level
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Bennett, Oscar, Kandala, Ngianga-Bakwin, Ji, Chen, Linnane, John and Clarke, Aileen (2014) Spatial variation of heart failure and air pollution in Warwickshire, UK : an investigation of small scale variation at the ward-level. BMJ Open, Volume 4 (Number 12). Article number e006028. doi:10.1136/bmjopen-2014-006028 ISSN 2044-6055.
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Official URL: http://dx.doi.org/10.1136/bmjopen-2014-006028
Abstract
Objectives To map using geospatial modelling techniques the morbidity and mortality caused by heart failure within Warwickshire to characterise and quantify any influence of air pollution on these risks.
Design Cross-sectional.
Setting Warwickshire, UK.
Participants Data from all of the 105 current Warwickshire County wards were collected on hospital admissions and deaths due to heart failure.
Results In multivariate analyses, the presence of higher mono-nitrogen oxide (NOx) in a ward (3.35:1.89, 4.99), benzene (Ben) (31.9:8.36, 55.85) and index of multiple deprivation (IMD; 0.02: 0.01, 0.03), were consistently associated with a higher risk of heart failure morbidity. Particulate matter (Pm; −12.93: −20.41, −6.54) was negatively associated with the risk of heart failure morbidity. No association was found between sulfur dioxide (SO2) and heart failure morbidity. The risk of heart failure mortality was higher in wards with a higher NOx (4.30: 1.68, 7.37) and wards with more inhabitants 50+ years old (1.60: 0.47, 2.92). Pm was negatively associated (−14.69: −23.46, −6.50) with heart failure mortality. SO2, Ben and IMD scores were not associated with heart failure mortality. There was a prominent variation in heart failure morbidity and mortality risk across wards, the highest risk being in the regions around Nuneaton and Bedworth.
Conclusions This study showed distinct spatial patterns in heart failure morbidity and mortality, suggesting the potential role of environmental factors beyond individual-level risk factors. Air pollution levels should therefore be taken into account when considering the wider determinants of public health and the impact that changes in air pollution might have on the health of a population.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RA Public aspects of medicine | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Heart failure -- England -- Warwickshire, Heart failure -- Environmental aspects, Air -- Pollution -- Health aspects, Hospital wards | ||||||||
| Journal or Publication Title: | BMJ Open | ||||||||
| Publisher: | BMJ | ||||||||
| ISSN: | 2044-6055 | ||||||||
| Official Date: | 2 December 2014 | ||||||||
| Dates: |
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| Volume: | Volume 4 | ||||||||
| Number: | Number 12 | ||||||||
| Article Number: | Article number e006028 | ||||||||
| DOI: | 10.1136/bmjopen-2014-006028 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||
| Date of first compliant deposit: | 28 December 2015 | ||||||||
| Date of first compliant Open Access: | 28 December 2015 | ||||||||
| Funder: | National Institute for Health Research (Great Britain) (NIHR) |
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