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Rural-urban differences in associations between air pollution and cardiovascular hospital admissions in Guangxi, southwest China

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Abstract

Epidemiological studies found that exposure to air pollution increases cardiovascular hospitalizations. However, studies on rural-urban differences in associations between hospitalizations for cardiovascular diseases and air pollution are limited. The generalized linear model (GLM) was applied to investigate the associations between cardiovascular hospitalizations and air pollution (SO2, NO2, PM2.5, PM10, CO, and O3) in Guangxi, southwest China, in 2015 (January 1–December 31). The relative risk of pollutants (SO2, NO2) on cardiovascular hospital admissions was significantly different between urban and rural areas. The effect of SO2 on cardiovascular hospitalizations was higher in urban areas than in rural areas at lag0 to lag3 and cumulative lag01 to lag03. In urban areas, there were positive associations between NO2 and cardiovascular hospitalizations at lag0, lag1 and cumulative lag01, lag02. In contrast, the effect of NO2 on cardiovascular hospitalizations was not significant in rural areas. Urban residents were more sensitive than rural residents to SO2 and NO2. Subgroup analyses showed statistically significant differences between rural and urban areas in the association between SO2 and NO2 and cardiovascular hospitalizations for males. For age groups, people aged ≥ 65 years appeared to be more vulnerable to SO2 and NO2 in urban areas. The effects of PM2.5 PM10, CO, and O3 on cardiovascular hospitalizations were consistently negative for all groups. Our findings indicated that there were rural-urban differences in associations between cardiovascular hospitalizations and air pollutants. In rural areas, the risk of cardiovascular hospitalizations was mainly influenced by SO2. Therefore, we expect to pay attention to protecting people from air pollution, particularly for those aged ≥ 65 years in urban areas.

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Data availability

Air pollution data were collected from the China National Environmental Monitoring Center (http://106.37.208.233:20035/). Meteorological data were acquired from the National Weather Sharing Website (http://data.cma.cn). The datasets of cardiovascular hospitalizations are not publicly available due to confidentiality requirements, but they are available from corresponding authors upon reasonable request.

Abbreviations

GLM:

generalized linear model

RR:

relative risk

SO2 :

sulfur dioxide

NO2 :

nitrogen dioxide

PM2.5 :

particulate matter < 2.5 μm

PM10 :

particulate matter < 10 μm

CO:

carbon oxide

O3 :

ozone

GDP:

gross domestic product

ICD:

International Classification of Diseases

TEM:

mean temperature

PRS:

surface pressure

RHU:

2-m relative humidity

PRE:

precipitation

WIN:

10-m wind speed

SD:

standard deviation

Min:

minimum

Max:

maximum

IDW:

inverse distance weighted

CI:

confidence interval

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Acknowledgements

All of the authors thank the Major Application Project of Guangdong Science and Technology Department for providing the data of cardiovascular diseases.

Funding

The work was supported by the Major Application Project of Guangdong Science and Technology Department [grant number: 2015B010131016].

Author information

Authors and Affiliations

  1. College of Geography and Environmental Science, Henan University, Kaifeng, 475004, Henan, China

    Guangli Zhang, Shiyan Zhai, Genxin Song, Hongquan Song, Yunfeng Kong, Rui Ma & Xinxin He

  2. Department of Community Health Sciences, Cumming School of Medicine, University of Calgary AQ2, Calgary, Canada

    Xiaoxiao Liu

  3. Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education, Henan University, Kaifeng, 475004, Henan, China

    Shiyan Zhai, Hongquan Song & Yunfeng Kong

  4. The Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China

    Lizhong Liang

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  1. Guangli Zhang
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Contributions

GZ: Methodology, data curation, writing—original draft, and writing—review and editing. SZ: Conceptualization, methodology, and writing—review and editing. XL: Methodology and writing—review and editing. GS: Writing—review and editing. HS: Writing—review and editing. LL: Funding acquisition. YK: Methodology and conceptualization. RM: Data curation. XH: Data curation.

Corresponding author

Correspondence to Shiyan Zhai.

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Biomedical Research Ethics Sub-Committee of Henan University approved the research protocol (Prot. Number: HUSOM2020-292).

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All of the authors approved the manuscript for publication.

Competing interests

The authors declare no competing interests.

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Zhang, G., Liu, X., Zhai, S. et al. Rural-urban differences in associations between air pollution and cardiovascular hospital admissions in Guangxi, southwest China. Environ Sci Pollut Res 29, 40711–40723 (2022). https://doi.org/10.1007/s11356-021-18196-6

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