Population susceptibility differences and effects of air pollution on cardiovascular mortality: epidemiological evidence from a time-series study
- 62 Downloads
There is insufficient evidence on the relationship between air pollution and mortality from cardiovascular disease (CVD) in northeast China. Here, we explored the short-term effects of air pollution on CVD mortality and preliminarily investigated differences in population susceptibility to air pollution in Shenyang, China. CVD mortality, air pollution, and meteorological data during 2013–2016 were obtained. Time-series analysis was applied to evaluate the association between air pollution and daily CVD mortality with different lag structures. In the single-pollutant model, each 10 μg/m3 increase in PM2.5, PM10, SO2, NO2, and O3 concentrations and 1 mg/m3 increase in CO concentrations at lag0 (same day) was significantly associated with an increase of 0.40% (95% confidence interval, 0.22–0.59%), 0.26% (0.12–0.40%), 0.43% (0.16–0.70%), 0.90% (0.14–1.67%), 0.76% (0.21–1.32%), and 3.33% (0.97–5.75%), respectively, in overall CVD mortality. Susceptibility to air pollutants was higher among females, elderly people, and ischemic heart disease patients. Furthermore, air pollution effects on CVD mortality were 2–8 times greater during the non-heating period. In conclusion, the air pollutants PM2.5, PM10, SO2, NO2, O3, and CO showed significant positive effects on CVD mortality in Shenyang, China. These findings highlight the adverse effects of air pollution and suggest the need for personal protective equipment and reduction of air pollution sources.
KeywordsAir pollution Cardiovascular mortality Time-series analysis Susceptibility differences
We wish to thank the China National Environmental Monitoring Center and the Mission China air quality–monitoring program of the USA for publicly sharing the air pollution data, as well as the Chinese Meteorological Data Sharing Service System for providing meteorology data.
This study was supported by the National Key Research and Development Program of China (No. 2016YFC1302500).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- Baccini M, Biggeri A, Accetta G, Lagazio C, Lerxtundi A, Schwartz J (2006) Comparison of alternative modelling techniques in estimating short-term effect of air pollution with application to the Italian meta-analysis data (MISA Study). Epidemiol Prev 30:279–288Google Scholar
- Chen W, Gao R, Liu L, Zhu M, Wang W, Wang Y (2018b) Summary of Chinese cardiovascular disease report of 2017. Chinese Circulation Journal:1–8Google Scholar
- Crouse DL, Peters PA, Hystad P et al (2015) Ambient PM2.5, O(3), and NO(2) exposures and associations with mortality over 16 years of follow-up in the Canadian Census Health and Environment Cohort (CanCHEC). Environ Health Perspect 123:1180–1186. https://doi.org/10.1289/ehp.1409276 CrossRefGoogle Scholar
- Du Y, Xu X, Chu M, Guo Y, Wang J (2016) Air particulate matter and cardiovascular disease: the epidemiological, biomedical and clinical evidence. J Thorac Dis 8:E8–E19Google Scholar
- Gao J, Wang K, Wang Y et al (2018) Temporal-spatial characteristics and source apportionment of PM2.5 as well as its associated chemical species in the Beijing-Tianjin-Hebei region of China Environmental pollution (Barking, Essex: 1987) 233:714–724.Google Scholar
- Huang W, Wang L, Li J, Liu M, Xu H, Liu S, Chen J, Zhang Y, Morishita M, Bard RL, Harkema JR, Rajagopalan S, Brook RD (2018) Short-term blood pressure responses to ambient fine particulate matter exposures at the extremes of global air pollution concentrations. Am J Hypertens 31:590–599CrossRefGoogle Scholar
- Kabacoff RI (2016) R in action: data analysis and graphics with R. Post & Telecom PressGoogle Scholar
- Liang RM, Yin P, Wang LJ, Li YC, Liu JM, Liu YN, You JL, Qi JL, Zhou MG (2017) Acute effect of fine particulate matters on daily cardiovascular disease mortality in seven cities of China. Zhonghua Liu Xing Bing Xue Za Zh 38:283–289Google Scholar
- Nations U. World Population Ageing Report, 2015. [cited 2018 July 18th]; Available from: http://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2015_Report.pdf.Google Scholar
- Park YM, Park KS, Kim H et al (2018) Characterizing isotopic compositions of TC-C, NO3(-)-N, and NH4(+)-N in PM2.5 in South Korea: impact of China’s winter heating. Environmental pollution (Barking, Essex: 1987) 233:735–744.Google Scholar
- Pei X, Wan B (1998) Environmental problems in the process of urbanization and the countermeasures of urbanization regulation in Shenyang. Geo-Informations:57–63Google Scholar
- Peng RD, Dominici F, Louis TA (2005) Model choice in time series studies of air pollution and mortality. J Royal Stat Soc:179–203Google Scholar
- Qian X (2016) Ambient air pollution associated with cardiovascular mortality in Ningbo city, 2011–2014: a time-series analysis master. Soochow University, ChinaGoogle Scholar
- Sciences CRAE (2012) Ambient air quality standards. China Environmental PressGoogle Scholar
- Sun Z (2010) Cardiovascular responses to cold exposure. Front Biosci (Elite Ed) (2):495–503Google Scholar
- Vahedian M, Khanjani N, Mirzaee M, Koolivand A (2017) Ambient air pollution and daily hospital admissions for cardiovascular diseases in Arak, Iran. ARYA Atheroscler 13:117–134Google Scholar
- Wei Y, Wang L (2016) The assessment of factors affecting the air quality in Shenyang. Geomatics and Spatial Information Technology:24–27+34Google Scholar
- WHO.Air quality guidelines - global update 2005. (2014) . Public Health & Environment.Google Scholar
- WHO.Ambient air pollution: health impacts2018.. [cited July 18th]; Available from: http://who.int/airpollution/ambient/health-impacts/en/.
- WHO.Cardiovascular disease: World Heart Day 2017 2018. [cited July 18th]; Available from: http://www.who.int/cardiovascular_diseases/en/.
- WHO.Global Urban Ambient Air Pollution Database (update 2016).2018. [cited July 18th]; Available from: http://www.who.int/phe/health_topics/outdoorair/databases/cities/en/.
- Xu A, Mu Z, Jiang B, Wang W, Yu H, Zhang L, Li J (2017) Acute effects of particulate air pollution on ischemic heart disease hospitalizations in Shanghai, China. Int J Environ Res Public Health 14Google Scholar
- Yang K, Zheng Y, Guo X, Zhang Z (2017) Environmental hygiene. People’s Medical Publishing House (PMPH), p 2017Google Scholar
- Zhang X, Cai F, Wang S, Hu B, Li K, Luo L (2006) Characteristics of air pollution in Shenyang City, China. China Environ Sci:650–652Google Scholar
- Zhao X, Sun Z, Ruan Y, Yan J, Mukherjee B, Yang F, Duan F, Sun L, Liang R, Lian H, Zhang S, Fang Q, Gu D, Brook JR, Sun Q, Brook RD, Rajagopalan S, Fan Z (2014) Personal black carbon exposure influences ambulatory blood pressure: air pollution and cardiometabolic disease (AIRCMD-China) study. Hypertension (Dallas, Tex: 1979) 63: 871–877.Google Scholar
- Zhao L, Liang H, Chen F, Chen Z, Guan W, Li J (2017) Association between air pollution and cardiovascular mortality in China: a systematic review and meta-analysis. Oncotarget 8:66438–66466,448.Google Scholar