PM2.5-associated risk for cardiovascular hospital admission and related economic burdens in Beijing, China

Abstract

BackgroundThe study of ambient air particulate matter (PM2.5)-associated health and economic burdens of cardiovascular disease are crucial for air pollution control and disease prevention strategies. Quantified evidence remains inadequate. ObjectivesThis study aimed to estimate the PM2.5 associated risk in cardiovascular hospital admission as well as attributable health burdens and economic costs. MethodsA total of 2,202,244 hospital admission records of cardiovascular disease and six common clinical subtypes in Beijing were included. A time-stratified case-crossover design was applied to estimate the associations and the concentration-response curve. Then, the annual average additional hospital admissions, days of hospital stay, and hospital expenditures were evaluated from 2013 to 2017 and compared between 2017 and 2013. ResultsThe results showed that each 10 μg/m3 increase in previous-day PM2.5 concentration was associated with a risk increase of 0.44% (95%CI: 0.40%, 0.47%) for cardiovascular disease, 0.66% (95%CI: 0.58%, 0.73%) for angina pectoris, 0.53% (95%CI: 0.39%, 0.66%) for chronic ischemic heart disease, 0.48% (95%CI: 0.34%, 0.63%) for myocardial infarction, 0.44% (95%CI: 0.29%, 0.60%) for hypertensive heart disease and 0.40% (95%CI: 0.27%, 0.52%) for ischemic stroke. There were 1938 PM2.5 attributed additional hospital admissions, resulting in 21,668 additional days in hospital, along with 5527.12 and 1947.04 ten-thousand of additional total hospital cost and self-afforded cost, respectively. Compared with 2013, the above-mentioned four burdens decreased by 18.17%, 28.80%, 18.90% and 13.72% in 2017, respectively. ConclusionPM2.5 exposure was significantly associated with substantial burdens of cardiovascular hospital admission and economic expenditures. The results highlight the necessity of continuous PM2.5 control from the perspective of healthy and sustainable city development in urban China.