Abstract
BackgroundAir pollution and cardiovascular disease are increasing problems in China. However, the short-term association between fine particulate matter (PM2.5) and cardiovascular disease (CVD) is not well documented. The purpose of this study is to estimate the short-term effects of PM2.5 on CVD admissions in Beijing, China.MethodsIn total, 460,938 electronic hospitalization summary reports for CVD between 2013 and 2017 were obtained. A generalized additive model using a quasi-Poisson distribution was used to investigate the association between exposure to PM2.5 and hospitalizations for total and cause-specific CVD, including coronary heart disease (CHD), atrial fibrillation (AF), and heart failure (HF) after controlling for the season, the day of the week, public holidays, and weather conditions. A stratified analysis was also conducted for age (18–64 and ≥ 65 years), sex and season.ResultsFor every 10 μg/m3 increase in the PM2.5 concentration from the previous day to the current (lag 0–1) there was a significant increase in total CVD admissions (0.30, 95% CI: 0.20, 0.39%), with a strong association for older adults (aged ≥65 years), CHD (0.34, 95% CI: 0.22 to 0.45%) and AF (0.29, 95% CI, 0.03 to 0.55%). However, the observed increased risk was not statistically significant for HF hospitalizations. The associations in the single-pollutant models were robust to the inclusion of other pollutants in a two-pollutant model. No differences were found after stratification by sex and season.ConclusionsExposure to PM2.5 increased the risk of hospitalizations from CVD, especially for CHD, and appeared to have more influence in the elderly. Precautions and protective measures and efforts to reduce exposure to PM2.5 should be strengthened, especially for the elderly.
Highlights
Despite considerable progress in the reduction of air pollution and its corresponding impact on health, air pollution studies have attracted more attention [1]
In total, 460,938 hospital admissions from cardiovascular disease (CVD) were reported during the 5-year study period in Beijing, including 378,090 coronary heart disease (CHD), 24,455 atrial fibrillation (AF) and 58,393 heart failure (HF) admissions
A 10 μg/m3 increase from the previous day to the current day in the single-pollutant model was associated with significant increases in hospital admissions for CVD (0.30, 95% CI: 0.20, 0.39%), CHD (0.34, 95% CI: 0.22, 0.45%), and AF (0.29, 95% CI: 0.03, 0.55%)
Summary
Despite considerable progress in the reduction of air pollution and its corresponding impact on health, air pollution studies have attracted more attention [1]. Several studies associate an increase in CVD morbidity and mortality with PM2.5 air pollution [7,8,9]. The use of hospital admissions is a more sensitive indicator than mortality [14] and has great public health importance, adverse short-term effects of PM2.5 on cause-specific CVD hospital admissions are not well documented in large cities such as Beijing. We estimate the daily effect of PM2.5 on admissions for CVD and its subtypes (coronary heart disease: CHD, heart failure: HF, and atrial fibrillation: AF) in Beijing using a single-pollutant model, a two-pollutant model, and several subgroup analyses. The purpose of this study is to estimate the short-term effects of PM2.5 on CVD admissions in Beijing, China
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