Health and Environnement

Assessing the impact of short term outdoor air pollution exposure on cardiac dyspnea: a case study in the “Région Sud”, south of France

Project participants: Prof. Charles Bouveyron (Chair Inria on Data Science, UCA), Prof. Pierre Gibelin (CHU Nice), Dr. Didier Giolito (CHU Nice), Prof. Jacques Levraut (CHU Nice), Eric Monch (DRC CHU Nice), Prof. Charles Maria (ATMOsud), Christine Pintaric (DRC CHU Nice), Dominique Robin (ATMOsud).

Project description: A growing body of evidence shows that air pollution is a significant threat to health worldwide. Air pollution is composed of particulate matter (PM) and gaseous pollutants, such as nitrogen dioxide (NO2) and ozone (O3). The length of exposure to air pollution has diverse effects on health. Although the relationship between short-term exposure to air pollution and several cardiovascular pathologies is widely established, its link with cardiac dyspnea is still to be explored.

In this study, we aim to fill this gap using the Région Sud (Provence-Alpes-Côte d’Azur) as a model. We focused on the 2013-2018 period over which we collected 43,404 events of cardiac dyspnea. We collected pollutants (NO2, PM10 and O3) and climate (temperature and pressure) measurements on a daily basis, and we set up a reproducible statistical framework to analyze these data.

Briefly, we first divided the Région Sud into 366 areas in order to match the environmental and health data with the minimal resolution. To identify areas with a similar distribution of the number of dyspnea events over time, we applied a multivariate time-series clustering technique (fun-HDDC). Then, we employed a distributed lag non-linear model (DLNM) to show the relationship between short-term exposure to outdoor air pollution and the incidence of cardiac dyspnea events. Finally, we developed a user-friendly web application called HEART (Health, Environment in PACA Region Tool) to present all the results.

This study showed that each pollutant has a specific effect on cardiac dyspnea: the number of days between exposure to a pollutant and cardiac dyspnea depends on the type of pollutant and the area studied. Overall, we established a model to predict the pollutant threshold levels that may trigger new dyspnea events and can be generalized to other areas.


F. Simões, C. Bouveyron, D. Piga, et al. Cardiac dyspnea risk zones in the South of France identified by geo-pollution trends study, in Scientific Reports 12, 1900 (2022).

C. Bouveyron, J. Jacques, A. Schmutz, F. Simões and S. Bottini, Co-Clustering of Multivariate Functional Data for the Analysis of Air Pollution in the South of France, in The Annals of Applied Statistics, in press, 2021