Environmental factors predict risk of death

Besides high blood pressure, diabetes and smoking, environmental factors such as air pollution are highly predictive of the risk of death, especially heart attack and stroke, according to a new study. .

Led by researchers from NYU Grossman School of Medicine and Icahn School of Medicine at Mount Sinai, the study showed that exposure to above-average levels of outdoor air pollution increased the risk of death. by 20% and the risk of death from cardiovascular disease by 17%.

The use of wood or kerosene stoves, poorly ventilated by a chimney, to cook food or heat the house also increases the overall risk of death (by 23% and 9%) and the risk of cardiovascular death (by 36% and 19%). Living far from specialized medical clinics and near busy roads also increases the risk of death.

Publication in the journal PLOS ONE online June 24, the findings come from personal and environmental health data collected from 50,045 mostly poor rural villagers living in the northeastern region of Golestan in Iran. All of the study participants were over the age of 40 and agreed to have their health monitored during annual visits with researchers dating back to 2004.

The researchers say their latest investigation not only identifies the environmental factors that pose the greatest risk to heart and overall health, but also adds much-needed scientific evidence from people living in low- and middle-income countries. Traditional research on environmental risk factors, the researchers note, has favored urban populations in high-income countries with much greater access to modern health care services.

Compared to those with easier access to specialist medical services, those who live farther from clinics with catheterization labs capable of unblocking clogged arteries, for example, had a 1% increased risk of death every 10 kilometers. (6.2 miles) away. In Gulistan, most people live more than 80 kilometers from these modern facilities.

The study results also showed that the third of study participants who lived within 500 meters (1,640 feet) of a major road had a 13% increased risk of death.

“Our study highlights the role that the key environmental factors of indoor/outdoor air pollution, access to modern health services and proximity to noisy and polluted roads play in all causes of death and death. cardiovascular disease in particular,” said study lead author and cardiologist Rajesh Vedanthan, MD, MPH.

“Our findings help broaden the disease risk profile beyond age and traditional personal risk factors,” says Vedanthan, associate professor in the Department of Population Health and Department of Medicine at NYU Langone Health. .

“These results illustrate a new opportunity for health policymakers to reduce the burden of disease in their communities by mitigating the impact of environmental risk factors like air pollution on cardiovascular health,” says the author. study principal Michael Hadley, MD, a cardiology researcher and incoming assistant professor of medicine at Mount Sinai.

In contrast, the study showed that other environmental factors included in the analysis – low neighborhood income levels, increasing population density and too much exposure to nighttime light – were not independent predictors of risk of death, despite previous research in predominantly urban settings suggesting otherwise.

For the survey, the researchers analyzed data collected up to December 2018. They then created a predictive model on the overall risk of death and the risk of death from cardiovascular disease.

The research team plans to continue its analysis and hopes to apply the predictive model to other countries in an effort to refine its predictive ability. They say their new tool could serve as a guide to assess the effectiveness of environmental, lifestyle and personal health changes in reducing death rates around the world.

According to the World Health Organization, a quarter of all deaths worldwide are now attributable to environmental factors, including poor air and water quality, lack of sanitation and exposure to toxic chemicals.

Funding for the study was provided by US National Institutes of Health grant R21HL140474.