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Study on the association between ambient air pollution and daily cardiovascular death in Hefei, China
Jixiang Xu1, Wenfeng Geng1, Xiya Geng1
1Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230000, Anhui, China.
Insights
Air pollution significantly increases daily cardiovascular deaths in Hefei, China. Vulnerable groups include females, the elderly, and those with cerebrovascular disease, highlighting the need for air quality interventions.
Area of Science:
- Environmental Health
- Epidemiology
- Public Health
Background:
- Cardiovascular disease (CVD) is a major public health concern in China.
- Previous studies show inconsistent links between air pollution and CVD mortality.
- Understanding local impacts is crucial for targeted interventions.
Purpose of the Study:
- To investigate the association between daily air pollutant concentrations and daily cardiovascular deaths in Hefei, China.
- To quantify the risk of CVD mortality associated with specific air pollutants.
- To identify vulnerable subgroups within the population.
Main Methods:
- Time-series study design utilizing a distributed lag nonlinear model (DLNM).
- Analysis of daily cardiovascular deaths, air pollutant data (PM10, SO2, NO2, PM2.5, CO, O3), and meteorological factors from 2007-2016.
- Single and two-pollutant models were fitted, with subgroup analyses by gender, age, and disease type.
Main Results:
- An IQR increase in PM10, SO2, NO2, PM2.5, CO, and O3 was associated with increased CVD mortality risks of 4.34%, 5.79%, 4.47%, 3.14%, 3.11%, and 8.17% respectively.
- Lag effects varied by pollutant, with significant associations observed across different lag periods (0-6 days).
- Females, individuals aged 65 and above, and deaths from cerebrovascular disease showed higher vulnerability.
Conclusions:
- Air pollution is a significant risk factor for daily cardiovascular deaths in Hefei.
- Specific pollutants like SO2 and O3 pose substantial risks.
- Findings support the implementation of air quality management strategies to mitigate CVD mortality.
Abstract:
Cardiovascular disease has always been the most serious public health problem in China. Although many studies have found that the risk of death caused by cardiovascular disease is related to air pollutants, the existing results are still inconsistent. The aim of this study was to investigate the effects of air pollutants on the risk of daily cardiovascular deaths in Hefei, China. Daily data on cardiovascular deaths, daily air pollutants, and meteorological factors from 2007 to 2016 were collected in this study. A time-series study design using a distributed lag nonlinear model was employed to evaluate the association between air pollutants and cardiovascular deaths. First, a single air pollutant model was established based on the minimum value of Akaike information criterion (AIC), and the single day lag effects and multi-day lag effects were discussed separately. Then, two-pollutant models were fitted. Subgroup analyses were conducted by gender (male and female), age (< 65 age and ≥ 65 age), and disease type (ischemic heart disease and cerebral vascular disease). There were 34,500 cases of cardiovascular deaths during the period 2007-2016, and the average concentrations of air pollutants (PM10, SO2, NO2, PM2.5, CO, O3) were 106.11, 20.34, 30.49, 72.59, 958.7, and 67.88 μg/m3, respectively. An increase of interquartile range (IQR) in PM10, SO2, NO2, PM2.5, CO, and O3 were associated with an increase of 4.34% (95%CI 1.54~7.23%) at lag 0-6, 5.79% (95%CI 2.43~9.27%) at lag 0-5, 4.47% (95%CI 1.64~7.37%) at lag 0-5, 3.14% (95%CI 0.03~6.36%) at lag 0-4, 3.11% (95%CI 0.21~6.10%) at lag 0-3, and 8.17% (95%CI 1.89~14.84%) at lag 0-5 in cardiovascular deaths, respectively. Females, older group (≥ 65 years) and deaths from cerebral vascular disease were more vulnerable to air pollution than males, younger individuals (< 65 years) and deaths from ischemic heart disease. Our results suggest that air pollution increased the risk of cardiovascular deaths in Hefei. These findings can provide evidence for effective air quality interventions in Hefei.
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