Unconventional Natural Gas Development and Hospitalization for Heart Failure in Pennsylvania
| Autor: | Brian S. Schwartz, Erin D. Michos, Jonathan Pollak, John W. McEvoy, Tara McAlexander, Jessie P. Buckley, Karen Bandeen-Roche |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Natural Gas 030204 cardiovascular system & hematology Article 03 medical and health sciences 0302 clinical medicine Older patients Internal medicine medicine Humans Petroleum Pollution 030212 general & internal medicine Aged Aged 80 and over Heart Failure Ejection fraction Hydraulic Fracking business.industry Mean age Environmental Exposure Odds ratio Middle Aged Pennsylvania medicine.disease Confidence interval Hospitalization Quartile Control selection Case-Control Studies Heart failure Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | J Am Coll Cardiol |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2020.10.023 |
| Popis: | Background Growing literature linking unconventional natural gas development (UNGD) to adverse health has implicated air pollution and stress pathways. Persons with heart failure (HF) are susceptible to these stressors. Objectives This study sought to evaluate associations between UNGD activity and hospitalization among HF patients, stratified by both ejection fraction (EF) status (reduced [HFrEF], preserved [HFpEF], not classifiable) and HF severity. Methods We evaluated the odds of hospitalization among patients with HF seen at Geisinger from 2008 to 2015 using electronic health records. We assigned metrics of UNGD activity by phase (pad preparation, drilling, stimulation, and production) 30 days before hospitalization or a frequency-matched control selection date. We assigned phenotype status using a validated algorithm. Results We identified 9,054 patients with HF with 5,839 hospitalizations (mean age 71.1 ± 12.7 years; 47.7% female). Comparing 4th to 1st quartiles, adjusted odds ratios (95% confidence interval) for hospitalization were 1.70 (1.35 to 2.13), 0.97 (0.75 to 1.27), 1.80 (1.35 to 2.40), and 1.62 (1.07 to 2.45) for pad preparation, drilling, stimulation, and production metrics, respectively. We did not find effect modification by HFrEF or HFpEF status. Associations of most UNGD metrics with hospitalization were stronger among those with more severe HF at baseline. Conclusions Three of 4 phases of UNGD activity were associated with hospitalization for HF in a large sample of patients with HF in an area of active UNGD, with similar findings by HFrEF versus HFpEF status. Older patients with HF seem particularly vulnerable to adverse health impacts from UNGD activity. |
| Databáze: | OpenAIRE |
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