背景:2019年9月26日,鲁昂(法国)的路博润工厂发生工业火灾,使人们吸入许多挥发性有毒物质,其次燃烧。
目的:评估路博润工厂火灾对冠状动脉事件发生率的影响。
方法:2019年5月至2019年12月在鲁昂(暴露)和勒阿弗尔(未暴露)进行的所有冠状动脉造影均取自前瞻性法国经皮冠状动脉介入治疗(法国PCI)注册表。为了研究火灾对冠状动脉事件的影响,在鲁昂进行了中断的时间序列分析,在自回归移动平均(ARMA)(1,1)模型中调整勒阿弗尔,精度为1周。主要结果是急性冠脉综合征的发病率,次要结局是ST段抬高型心肌梗死的发生率.
结果:暴露区(鲁昂)每周急性冠状动脉综合征的平均数从火灾前的37.5±9.4增加到火灾后的43.2±6.2,对于每周+5.5(95%置信区间-0.7至11.8;P=0.09)事件的估计效果。在暴露于烟羽的城市(鲁昂小组),急性冠状动脉综合征的平均数量从火灾前的7.3±2.8增加到火灾后的8.7±3.6,对于每周+1.0(95%置信区间-2.0至4.0;P=0.51)事件的估计效果。仅考虑ST段抬高心肌梗死或所有冠状动脉事件时,结果相似。
结论:我们的研究未发现路博润工厂火灾对急性冠脉综合征的发病率有显著影响。需要进一步的研究来调查工业事故对空气污染和冠状动脉事件的影响。
BACKGROUND: On 26 September 2019, an industrial fire occurred in the Lubrizol factory in Rouen (France), exposing the population to the inhalation of many volatile toxic agents secondary to combustion.
OBJECTIVE: To assess the impact of the Lubrizol factory fire on the incidence of coronary artery events.
METHODS: All coronary angiograms performed in Rouen (exposed) and Le Havre (unexposed) from May 2019 to December 2019 were extracted from the prospective France Percutaneous Coronary Intervention (France PCI) registry. To
study the impact of the fire on coronary events, an interrupted time series analysis was performed in Rouen, with adjustment on Le Havre in an autoregressive moving average (ARMA)(1,1) model with the precision of 1 week. The primary outcome was the incidence of acute coronary syndrome, and the secondary outcome was the incidence of ST-segment elevation myocardial infarction.
RESULTS: The mean number of acute coronary syndromes per week in the exposed zone (Rouen) increased non-significantly from 37.5±9.4 before the fire to 43.2±6.2 after the fire, for an estimated effect of +5.5 (95% confidence interval -0.7 to 11.8; P=0.09) events per week. In municipalities exposed to the plume of smoke (subgroup of Rouen), the mean number of acute coronary syndromes increased non-significantly from 7.3±2.8 before the fire to 8.7±3.6 after the fire, for an estimated effect of +1.0 (95% confidence interval -2.0 to 4.0; P=0.51) events per week. The results were similar when taking into account only ST-segment elevation myocardial infarctions or all coronary events.
CONCLUSIONS: Our
study did not find a significant effect of the Lubrizol factory fire on the incidence of acute coronary syndrome. Further studies are needed to investigate the impact of industrial accidents on air pollution and coronary events.