Analysis of Short-Term Effects of Air Pollution on Cardiovascular Disease Using Bayesian Spatio-temporal Models.

Yi Liu,Fuzhong Xue,Xiubin Sun,Yannong Gou,Jingjie Sun,Dandan Zhang

doi:10.3390/ijerph17030879

Abstract

There has been an increasing number of clinical and epidemiologic research projects providing supporting evidence that short-term exposure to ambient air pollution contributes to the exacerbation of cardiovascular disease. However, few studies consider measurement error and spatial effects in the estimate of underlying air pollution levels, and less is known about the influence of baseline air pollution levels on cardiovascular disease. We used hospital admissions data for cardiovascular diseases (CVD) collected from an inland, heavily polluted city and a coastal city in Shandong Province, China. Bayesian spatio-temporal models were applied to obtain the underlying pollution level in each city, then generalized additive models were adopted to assess the health effects. The total cardiovascular disease hospitalizations were significantly increased in the inland city by 0.401% (0.029, 0.775), 0.316% (0.086, 0.547), 0.903% (0.252, 1.559), and 2.647% (1.607, 3.697) per 10 μg/m3 increase in PM2.5, PM10, SO2, and NO2, respectively. The total cardiovascular diseases hospitalizations were increased by 6.568% (3.636, 9.584) per 10μg/m3 increase in the level of NO2. Although the air pollution overall had a more significant adverse impact on cardiovascular disease hospital admissions in the heavily polluted inland city, the short-term increases in air pollution levels in the less polluted coastal areas led to excessive exacerbations of cardiovascular disease.

Highlights

Cardiovascular diseases (CVD) cause 17.7 million deaths every year (31% of all global deaths), and are the most common cause of death and disability around the world [1,2,3,4,5]
We proposed a Bayesian spatio-temporal model to accurately estimate the underlying air pollution level in the study regions, assessed the short-term effect of air pollutants, including PM2.5, PM10, SO2, and NO2, on the exacerbation of CVD by analyzing the data of hospital admissions collected from all the tertiary-level and secondary-level hospitals in Jinan and Weihai, both in Shandong Province
We found that the associations between air pollution and CVD hospitalizations were spatially heterogeneous, and that air pollution contributed, overall, more prominent adverse health effects in the inland city

Summary

Introduction

Cardiovascular diseases (CVD) cause 17.7 million deaths every year (31% of all global deaths), and are the most common cause of death and disability around the world [1,2,3,4,5]. Many studies across the world have shown that ambient air pollution contributes to the increase of mortality, morbidity, and hospitalizations of CVD [6,7,8,9,10,11,12,13]. Researchers have previously conducted a series of analyses on the effect of ambient air pollution on CVD in China [20,21,22,23,24,25,26,27]; few studies have considered measurement error and spatial effects in the estimate of the underlying air pollution levels. The most commonly used approach is to average the measurements over spatial locations, and to use the resulting

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Conclusion