Impact of the Lubrizol factory fire in Rouen on coronary events: A retrospective study from the France PCI registry

Central illustration. Impact of the Lubrizol factory fire in Rouen on coronary events: a retrospective study from the France Percutaneous Coronary Intervention (France PCI) registry. ACS: acute coronary syndrome; CI: confidence interval. ▪ 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. To assess the impact of the Lubrizol factory fire on the incidence of coronary artery events. 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. 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. 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. Le 26 septembre 2019, un incendie industriel s’est déclaré dans l’usine Lubrizol à Rouen (France), exposant la population à l’inhalation de nombreux agents toxiques volatils secondaires à la combustion. Évaluer son impact sur l’incidence des événements coronariens aigus. Toutes les coronarographies réalisées à Rouen (zone exposée) et au Havre (zone non exposée) de janvier 2019 à décembre 2019 ont été extraites du registre prospectif France PCI. Pour étudier l’impact de