Abstract
BackgroundMany studies have reported the impact of air pollution on cardiovascular disease (CVD), but few of these studies were conducted in severe haze-fog areas. The present study focuses on the impact of different air pollutant concentrations on daily CVD outpatient visits in a severe haze-fog city.MethodsData regarding daily air pollutants and outpatient visits for CVD in 2013 were collected, and the association between six pollutants and CVD outpatient visits was explored using the least squares mean (LSmeans) and logistic regression. Adjustments were made for days of the week, months, air temperature and relative humidity.ResultsThe daily CVD outpatient visits for particulate matter (PM10 and PM2.5), sulphur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) in the 90th-quantile group were increased by 30.01, 29.42, 17.68, 14.98, 29.34%, and − 19.87%, respectively, compared to those in the <10th-quantile group. Odds ratios (ORs) and 95% confidence intervals (CIs) for the increase in daily CVD outpatient visits in PM10 300- and 500-μg/m3, PM2.5 100- and 300-μg/m3 and CO 3-mg/m3 groups were 2.538 (1.070–6.020), 7.781 (1.681–36.024), 3.298 (1.559–6.976), 8.72 (1.523–49.934), and 5.808 (1.016–33.217), respectively, and their corresponding attributable risk percentages (AR%) were 60.6, 87.15, 69.68, 88.53 and 82.78%, respectively. The strongest associations for PM10, PM2.5 and CO were found only in lag 0 and lag 1. The ORs for the increase in CVD outpatient visits per increase in different units of the six pollutants were also analysed.ConclusionsAll five air pollutants except O3 were positively associated with the increase in daily CVD outpatient visits in lag 0. The high concentrations of PM10, PM2.5 and CO heightened not only the percentage but also the risk of increased daily CVD outpatient visits. PM10, PM2.5 and CO may be the main factors of CVD outpatient visits.
Highlights
Many studies have reported the impact of air pollution on cardiovascular disease (CVD), but few of these studies were conducted in severe haze-fog areas
We considered the results of preliminary analysis in our data on the one hand; on the other hand, referencing the results of other similar studies, days of the week, months, daily air temperature and relative humidity were identified as confounding factors
CVD outpatient visits increased by approximately 30% in the 90th-quantile group (PM10 ≥ 535 μg/m3, PM2.5 ≥ 304 μg/m3, carbon monoxide (CO) ≥ 4.3 mg/m3), which was consistent with the television reports when severe haze-fog occurred
Summary
Many studies have reported the impact of air pollution on cardiovascular disease (CVD), but few of these studies were conducted in severe haze-fog areas. The present study focuses on the impact of different air pollutant concentrations on daily CVD outpatient visits in a severe haze-fog city. Many epidemiological studies have revealed that primary ambient air pollutants, including PM2·5, PM10, NO2, SO2, O3 and CO, increase the risk of hospital admission and mortality for CVD [1,2,3,4,5,6,7,8,9]. Except for O3, was strongly associated with acute cardiovascular events such as myocardial infarction, heart failure and arrhythmia [10, 11]. More high-quality studies are urgently needed to establish the effect of air pollution on heart failure outcomes in developing countries [10]
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