Short-term PM2.5 exposure and acute incidence of myocardial infarction a time-stratified case-crossover study in China

Abstract

Background Myocardial infarction (MI) and ambient fine particulate matter (PM2.5) pollution are two global public health concerns. Evidence investigating the association between PM2.5 and acute incidence of MI in developing countries is limited. Methods A multicenter study based on a time-stratified case-crossover design including 36,679 cases from MI incidence registry data and PM2.5 site monitoring data was conducted. Results With a 10 μg/m3 increase in PM2.5 concentration, there was an increase of 0.98% (0.40%, 1.57%) in acute incidence risk of MI on day lag02. The corresponding values for males and individuals aged over 74 years were 1.58% (95% CI: 0.82%, 2.35%) and 1.19% (95% CI: 0.35%, 2.05%) respectively, indicating higher risks than other groups. The non-linear concentration-response curve indicated a steeper slope under daily PM2.5 below 50μg/m3 and the marginal avoided premature morbidity attributed to per 10μg/m3 reduction became larger under the current air quality standard.Conclusion This study is the first multicenter study to examine the association between the acute incidence of MI and short-term exposure to PM2.5 in China. We provide solid evidence that PM2.5 is a risk factor for accelerating MI incidence. A susceptible population was identified. The robust findings from this study may suggest the necessity for a continuous reduction of PM2.5 concentration from the perspectives of public health.