Abstract
Cardiovascular disease (CVD) has been the leading cause of death in China. Identifying the relationship between particulate matter (PM) and CVD in China is a significant challenge. In this study, daily CVD emergency room visit, environmental monitoring, and weather data from January 1, 2017, to December 31, 2018, in Lanzhou were collected. Generalized additive models (GAMs) were constructed to estimate the short-term effects of daily PM2.5, PMC, and PM10 concentrations on CVD emergency room visits with different lag structures after controlling for the influence of meteorological elements and gaseous pollutants. Stratified analyses were conducted according to age (≥ 65 years and < 65 years), sex (male and female), cold season (from November to April), and warm season (from May to October). The results showed that each 10 μg/m3 increase in PM2.5 was associated with a 1.93% (95% CI 0.12–3.78%) increase in CVD emergency room visits at lag03, and no single lag model was statistically significant. The excess relative risks (ERRs) of PM10 and PMC were not statistically significant at any lag pattern. The exposure-response curves demonstrated a nonlinear upward trend for these three PM pollutants. When adjusting for other gaseous pollutants, such as NO2, SO2, CO, and O3, in the two-pollutant models, the associations between PM10 and PMC and CVD emergency room visits did not change compared with the single-pollutant models. The ERRs of PM2.5 were 1.67% (95% CI 0.03–3.34%) at lag02 after adjustment for NO2 and 1.65% (95% CI 0.02–3.30%) at lag02 after adjustment for SO2. The ERRs of PM2.5 were still statistically significant at lag03 when we adjusted for any one of the gaseous pollutants. Susceptibility to PM2.5 was increased in people aged < 65 years, in males, and in the warm season. The findings are very important for local governments to develop environmental policies and strategies to reduce ambient PM2.5 levels.
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Abbreviations
- CVD:
-
cardiovascular diseases
- PM:
-
particulate matter
- RR:
-
relative risk
- CI:
-
confidence interval
- NAAQS:
-
National Ambient Air Quality Standards
- ICD-10:
-
International Classification of Diseases 10th revision
- GAM:
-
generalized additive model
- GCV:
-
generalized cross-validation
- DOW:
-
day of the week
- ERR:
-
excess relative risk
References
Amiri P et al (2019) Smoking habits and incidence of cardiovascular diseases in men and women: findings of a 12 year follow up among an urban Eastern-Mediterranean population. BMC Public Health 19:1042. https://doi.org/10.1186/s12889-019-7390-0
Chai G, He H, Sha Y, Zhai G, Zong S (2019) Effect of PM2.5 on daily outpatient visits for respiratory diseases in Lanzhou, China. Sci Total Environ 649:1563–1572. https://doi.org/10.1016/j.scitotenv.2018.08.384
Cicoira M (2018) Ambient air pollution as a new risk factor for cardiovascular diseases: time to take action. Eur J Prev Cardiol 25:816–817. https://doi.org/10.1177/2047487318770827
Garrett P, Casimiro E (2011) Short-term effect of fine particulate matter (PM(2).(5)) and ozone on daily mortality in Lisbon, Portugal. Environ Sci Pollut Res Int 18:1585–1592. https://doi.org/10.1007/s11356-011-0519-z
Ge E et al (2018) Differential effects of size-specific particulate matter on emergency department visits for respiratory and cardiovascular diseases in Guangzhou, China. Environ Pollut 243:336–345. https://doi.org/10.1016/j.envpol.2018.08.068
Guo Y, Jia Y, Pan X, Liu L, Wichmann HE (2009) The association between fine particulate air pollution and hospital emergency room visits for cardiovascular diseases in Beijing, China. Sci Total Environ 407:4826–4830. https://doi.org/10.1016/j.scitotenv.2009.05.022
Guo Y, Barnett AG, Zhang Y, Tong S, Yu W, Pan X (2010) The short-term effect of air pollution on cardiovascular mortality in Tianjin, China: comparison of time series and case-crossover analyses. Sci Total Environ 409:300–306. https://doi.org/10.1016/j.scitotenv.2010.10.013
Guo P, Feng W, Zheng M, Lv J, Wang L, Liu J, Zhang Y, Luo G, Zhang Y, Deng C, Shi T, Liu P, Zhang L (2018) Short-term associations of ambient air pollution and cause-specific emergency department visits in Guangzhou, China. Sci Total Environ 613-614:306–313. https://doi.org/10.1016/j.scitotenv.2017.09.102
Hu H et al (2016) Fine particulate matter induces vascular endothelial activation via IL-6 dependent JAK1/STAT3 signaling pathway. Toxicol Res 5:946–953. https://doi.org/10.1039/c5tx00351b
Hwang SH, Lee JY, Yi SM, Kim H (2017) Associations of particulate matter and its components with emergency room visits for cardiovascular and respiratory diseases. PLoS One 12:e0183224. https://doi.org/10.1371/journal.pone.0183224
Ito T, Suzuki T, Tamura K, Nezu T, Honda K, Kobayashi T (2008) Examination of mRNA expression in rat hearts and lungs for analysis of effects of exposure to concentrated ambient particles on cardiovascular function. Toxicology 243:271–283. https://doi.org/10.1016/j.tox.2007.10.013
Kan H, London SJ, Chen G, Zhang Y, Song G, Zhao N, Jiang L, Chen B (2008) Season, sex, age, and education as modifiers of the effects of outdoor air pollution on daily mortality in Shanghai, China: The Public Health and Air Pollution in Asia (PAPA) Study. Environ Health Perspect 116:1183–1188. https://doi.org/10.1289/ehp.10851
Khan R, Konishi S, Ng CFS, Umezaki M, Kabir AF, Tasmin S, Watanabe C (2019) Association between short-term exposure to fine particulate matter and daily emergency room visits at a cardiovascular hospital in Dhaka, Bangladesh. Sci Total Environ 646:1030–1036. https://doi.org/10.1016/j.scitotenv.2018.07.288
Li Z, Bai Y, Guo X, Zheng L, Sun Y, Roselle AM (2016) Alcohol consumption and cardiovascular diseases in rural China. Int J Cardiol 215:257–262. https://doi.org/10.1016/j.ijcard.2016.04.095
Lin KC, Tsao HM, Chen CH, Chou P (2004) Hypertension was the major risk factor leading to development of cardiovascular diseases among men with hyperuricemia. J Rheumatol 31:1152–1158
Lin H et al (2016) Particle size and chemical constituents of ambient particulate pollution associated with cardiovascular mortality in Guangzhou, China. Environ Pollut 208:758–766. https://doi.org/10.1016/j.envpol.2015.10.056
Liu C et al (2019) Ambient particulate air pollution and daily mortality in 652 cities. N Engl J Med 381:705–715. https://doi.org/10.1056/NEJMoa1817364
Luca AC, Iordache C (2013) Obesity—a risk factor for cardiovascular diseases. Rev Med Chir Soc Med Nat Iasi 117:65–71
Ma Y, Xiao B, Liu C, Zhao Y, Zheng X (2016) Association between ambient air pollution and emergency room visits for respiratory diseases in spring dust storm season in Lanzhou, China. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph13060613
Ma Y, Zhang H, Zhao Y, Zhou J, Yang S, Zheng X, Wang S (2017a) Short-term effects of air pollution on daily hospital admissions for cardiovascular diseases in western China. Environ Sci Pollut Res Int 24:14071–14079. https://doi.org/10.1007/s11356-017-8971-z
Ma Y, Zhao Y, Yang S, Zhou J, Xin J, Wang S, Yang D (2017b) Short-term effects of ambient air pollution on emergency room admissions due to cardiovascular causes in Beijing, China. Environ Pollut 1987 230:974–980. https://doi.org/10.1016/j.envpol.2017.06.104
Metzger KB et al (2004) Ambient air pollution and cardiovascular emergency department visits. Epidemiology 15:46–56. https://doi.org/10.1097/01.Ede.0000101748.28283.97
Nasser Z, Salameh P, Nasser W, Abou Abbas L, Elias E, Leveque A (2015) Outdoor particulate matter (PM) and associated cardiovascular diseases in the Middle East. Int J Occup Med Environ Health 28:641–661. https://doi.org/10.13075/ijomeh.1896.00186
Pei Y et al (2016) Effects of fine particulate matter (PM2.5) on systemic oxidative stress and cardiac function in ApoE(−/−) mice. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph13050484
Pun VC et al (2014) Short-term associations of cause-specific emergency hospitalizations and particulate matter chemical components in Hong Kong. Am J Epidemiol 179:1086–1095. https://doi.org/10.1093/aje/kwu026
Qiu H, Yu IT, Tian L, Wang X, Tse LA, Tam W, Wong TW (2012) Effects of coarse particulate matter on emergency hospital admissions for respiratory diseases: a time-series analysis in Hong Kong. Environ Health Perspect 120:572–576. https://doi.org/10.1289/ehp.1104002
Rodopoulou S, Samoli E, Chalbot MG, Kavouras IG (2015) Air pollution and cardiovascular and respiratory emergency visits in Central Arkansas: a time-series analysis. Sci Total Environ 536:872–879. https://doi.org/10.1016/j.scitotenv.2015.06.056
Simkhovich BZ, Kleinman MT, Kloner RA (2008) Air pollution and cardiovascular injury epidemiology, toxicology, and mechanisms. J Am Coll Cardiol 52:719–726. https://doi.org/10.1016/j.jacc.2008.05.029
Slaughter JC, Kim E, Sheppard L, Sullivan JH, Larson TV, Claiborn C (2005) Association between particulate matter and emergency room visits, hospital admissions and mortality in Spokane, Washington. J Expo Anal Environ Epidemiol 15:153–159. https://doi.org/10.1038/sj.jea.7500382
Su C, Breitner S, Schneider A, Liu L, Franck U, Peters A, Pan X (2016) Short-term effects of fine particulate air pollution on cardiovascular hospital emergency room visits: a time-series study in Beijing, China. Int Arch Occup Environ Health 89:641–657. https://doi.org/10.1007/s00420-015-1102-6
Valdes A, Zanobetti A, Halonen JI, Cifuentes L, Morata D, Schwartz J (2012) Elemental concentrations of ambient particles and cause specific mortality in Santiago, Chile: a time series study. Environ Health 11:82. https://doi.org/10.1186/1476-069x-11-82
Valdez R, Greenlund KJ, Khoury MJ, Yoon PW (2007) Is family history a useful tool for detecting children at risk for diabetes and cardiovascular diseases? A public health perspective. Pediatrics 120(Suppl 2):S78–S86. https://doi.org/10.1542/peds.2007-1010G
Vidale S, Campana C (2018) Ambient air pollution and cardiovascular diseases: from bench to bedside. Eur J Prev Cardiol 25:818–825. https://doi.org/10.1177/2047487318766638
Vonesh EF, Chinchilli VM, Pu K (1996) Goodness-of-fit in generalized nonlinear mixed-effects models. Biometrics 52:572–587
Wu T, Ma Y, Wu X, Bai M, Peng Y, Cai W, Wang Y, Zhao J, Zhang Z (2019) Association between particulate matter air pollution and cardiovascular disease mortality in Lanzhou, China. Environ Sci Pollut Res Int 26:15262–15272. https://doi.org/10.1007/s11356-019-04742-w
Xi B, Liu F, Hao Y, Dong H, Mi J (2014) The growing burden of cardiovascular diseases in China. Int J Cardiol 174:736–737. https://doi.org/10.1016/j.ijcard.2014.04.098
Xie J, He M, Zhu W (2014) Acute effects of outdoor air pollution on emergency department visits due to five clinical subtypes of coronary heart diseases in Shanghai, China. J Epidemiol 24:452–459. https://doi.org/10.2188/jea.je20140044
Xu Q et al (2017) Acute exposure to fine particulate matter and cardiovascular hospital emergency room visits in Beijing, China. Environ Pollut 220:317–327. https://doi.org/10.1016/j.envpol.2016.09.065
Ye X, Peng L, Kan H, Wang W, Geng F, Mu Z, Zhou J, Yang D (2016) Acute effects of particulate air pollution on the incidence of coronary heart disease in Shanghai, China. PLoS One 11:e0151119. https://doi.org/10.1371/journal.pone.0151119
Zhang Y, Li M, Bravo MA, Jin L, Nori-Sarma A, Xu Y, Guan D, Wang C, Chen M, Wang X, Tao W, Qiu W, Zhang Y, Bell ML (2014) Air quality in Lanzhou, a major industrial city in china: characteristics of air pollution and review of existing evidence from air pollution and health studies. Water Air Soil Pollut. https://doi.org/10.1007/s11270-014-2187-3
Zhang Y et al (2015) Association between ambient air pollution and hospital emergency admissions for respiratory and cardiovascular diseases in Beijing: a time series study. Biomed Environ Sci 28:352–363. https://doi.org/10.3967/bes2015.049
Zheng S, Wang M, Wang S, Tao Y, Shang K (2013) Short-term effects of gaseous pollutants and particulate matter on daily hospital admissions for cardio-cerebrovascular disease in Lanzhou: evidence from a heavily polluted city in China. Int J Environ Res Public Health 10:462–477. https://doi.org/10.3390/ijerph10020462
Zhou J, Ito K, Lall R, Lippmann M, Thurston G (2011) Time-series analysis of mortality effects of fine particulate matter components in Detroit and Seattle. Environ Health Perspect 119:461–466. https://doi.org/10.1289/ehp.1002613
Acknowledgments
We thank Lanzhou Environmental Protection Bureau and Lanzhou Meteorological Administration for providing environmental monitoring data and meteorological data.
Funding
This study was supported by the Gansu Province Health Industry Scientific Research Program Project (grant number: GSWSKY-2015-39).
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Chen, R., Gao, Q., Sun, J. et al. Short-term effects of particulate matter exposure on emergency room visits for cardiovascular disease in Lanzhou, China: a time series analysis. Environ Sci Pollut Res 27, 9327–9335 (2020). https://doi.org/10.1007/s11356-020-07606-w
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DOI: https://doi.org/10.1007/s11356-020-07606-w