Environmental Science and Pollution Research

, Volume 26, Issue 16, pp 15943–15952 | Cite as

Population susceptibility differences and effects of air pollution on cardiovascular mortality: epidemiological evidence from a time-series study

  • Mengyao Liu
  • Xiaoxia Xue
  • Baosen Zhou
  • Yawei Zhang
  • Baijun Sun
  • Jianping Chen
  • Xuelian LiEmail author
Research Article


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.


Air 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.

Supplementary material

11356_2019_4960_MOESM1_ESM.xlsx (19 kb)
ESM 1 (XLSX 18 kb)
11356_2019_4960_MOESM2_ESM.docx (564 kb)
ESM 2 (DOCX 564 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Epidemiology, School of Public HealthChina Medical UniversityShenyangPeople’s Republic of China
  2. 2.Science Experiment CenterChina Medical UniversityShenyangPeople’s Republic of China
  3. 3.Department of Environmental Health Sciences, Yale Cancer CenterYale School of Public HealthNew HavenUSA
  4. 4.Shenyang Center for Disease Control and PreventionShenyangPeople’s Republic of China

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