Related Experiment Video
Updated: Aug 6, 2026

Aggravation of Myocardial Ischemia upon Particulate Matter Exposure in Atherosclerosis Animal Model
Published on: December 10, 2021
Nationwide and regional evidence on PM2.5-mortality in a tropical climate: Risks persist below standard and under
Phichet Khunthong1, Panuwat Vittayapraparat2, Sitthichok Puangthongthub1
1Industrial Toxicology and Risk Assessment Graduate Program, Department of Environmental Science, Faculty of Science, Chulalongkorn University, Bangkok, Thailand.
Background:
Thailand has recorded daily PM2.5 up to 414 µg/m³ , nationwide, and region-specific evidence on short-term associations with cardiorespiratory mortality remains limited under tropical climate extremes, diverse climate regions, or below standard levels. Prior studies emphasized temperate settings. This nationwide tropical study assessed region-specific risks and effect modifiers.
Method:
We analyzed 4.3 million hourly pollutant and meteorological data (2014-2022) from 87 stations, aggregated to daily exposures for 6584 sub-districts. Cardiovascular (259,463) and respiratory (153,170) deaths were examined using a time-stratified case-crossover with logistic regression to estimate adjusted odds ratios (AORs: 95% CIs) per 10 µg/m³ PM2.5.
Results:
PM2.5 correlated with O3 in the north and with NO2 in Bangkok, p < 0.001. Cardiovascular was significant at lag01 with AOR of 1.016 (95% CI: 1.009-1.022) nationwide, higher in Bangkok, northeast, and north, and elevated in females 1.022 (95% CI: 1.011-1.032); elderly 1.017 (95% CI: 1.008-1.025); winter 1.023 (95% CI: 1.012-1.033); and vein diseases 1.153 (95% CI: 1.028-1.294). Respiratory was significant at lag02, 1.022 (95% CI: 1.013-1.031), highest in east, central, Bangkok, and north, and stronger in females 1.034 (95% CI: 1.019-1.048); elderly 1.025 (95% CI: 1.014-1.036); winter 1.031 (95% CI: 1.017-1.046); and lung diseases 1.134 (95% CI: 1.064-1.208). Risks persisted under Thailand's PM2.5 standard, cardiovascular 1.016 (95% CI: 1.001-1.030) and respiratory 1.031 (95% CI: 1.010-1.051); extreme cold 1.055 (95% CI: 1.030-1.082) and 1.055 (95% CI: 1.022-1.090); and extreme dry 1.014 (95% CI: 1.003-1.026) and 1.017 (95% CI: 1.002-1.033). Sensitivity, temperature, and COVID-19 analyses confirmed robustness.
Conclusion:
This nationwide tropical study identified regional variation and subgroup-specific short-term associations between PM2.5 exposure and cardiovascular and respiratory mortality. offering evidence that may inform and guide region-specific abatement, strengthen standards, and inform protective health policies.
Related Concept Videos
What is Climate?
Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
Global Climate Change
Pneumothorax II: Pathophysiology
Asthma III: Clinical Manifestations
