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Association Between Air Pollution and Monday Peak Mortality From Acute Myocardial Infarction

Ruben Lévy1, Laurent Lévy2, Joan Ballester3

  • 1Department of Rehabilitation and Geriatrics, Medical School of the University of Geneva, Geneva, Switzerland; Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Thônex, Switzerland.

JACC. Advances
|December 17, 2025
PubMed
Abstract

Insights

The Monday peak in acute myocardial infarction (AMI) mortality is not linked to air pollution levels. This study found no association between daily air pollutant variations and increased AMI deaths on Mondays.

Area of Science:

  • Environmental Health
  • Cardiovascular Epidemiology
  • Time-Series Analysis

Background:

  • Acute myocardial infarction (AMI) mortality shows a weekly pattern, peaking on Mondays.
  • The influence of air pollution on this Monday excess in AMI deaths remains uninvestigated.

Purpose of the Study:

  • To determine if daily fluctuations in major air pollutants modify the risk of AMI mortality on Mondays.
  • Investigating the link between air quality and the observed Monday peak in cardiac mortality.

Main Methods:

  • A time-series analysis of 260,320 AMI deaths in Spain (2004-2018).
  • Assessed daily levels of PM2.5, PM10, nitrogen dioxide, and ozone.
  • Employed regression models and multilevel meta-analysis to examine weekly AMI mortality patterns and air pollution associations.

Main Results:

  • AMI mortality peaked on Mondays (+3.7%).
  • Particulate air pollution (PM2.5, PM10) exhibited weekly patterns, with lower weekend levels.
  • No significant association was found between air pollutant levels or changes and the Monday excess in AMI mortality.

Conclusions:

  • The excess AMI mortality on Mondays in Spain is not attributable to concurrent variations in major air pollutants.
  • Findings suggest other factors contribute to the Monday peak in acute myocardial infarction deaths.
Keywords:
Monday peakSpainacute myocardial infarctionair pollutionmortality

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