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Adverse impacts of air pollution on human health have been well documented in Spain; however, very few have been conducted in the Spanish region of Castilla-La Mancha (CLM). CLM is an extensive region with a low population density, little industrial production, and moderate air pollution level. The aim of the study was to assess the relationship between the risk of hospital admission for cardiovascular disease (CVD) and exposure to PM 2.5 , PM 10 , and NO 2  in CLM during 2006–2015. Daily air pollution concentration, temperature, and relative humidity were monitored from the air quality monitoring stations in CLM. A time-series analysis with generalized linear model was used to examine the effects of air pollution on hospital admissions by controlling for long-term trend and other potential confounders. The effect modifications by sex and age (15–64; ≥ 65 years) were examined. Lagging exposure concept was used to analyze a possible latency period in cumulative exposure-pollution analyses. Relative risks (RR) of CVD admissions at the same day (lag 0) and to 7 days after exposure (lag 7) were calculated. Relative risks of CVD admissions (for an increase of 10 µg m −3  in concentration of air pollutant) were calculated. The elderly group (≥ 65 years) were the most susceptible group to the effect of air pollution, whereas the estimated effect by sex was significantly different depending on the age group. The potential utility of these results may help for syndromic surveillance during future similar air pollutant concentrations, where an increase in the use of health services among the vulnerable groups could be unexpected by the emergency department.

Effects of air pollution on daily hospital admissions for cardiovascular diseases in Castilla-La Mancha, Spain: a region with moderate air quality