Abstract
Most of studies relating ambient nitrogen dioxide (NO2) exposure to hospital admissions for cardiovascular diseases (CVDs) were conducted among urban population. Whether and to what extent these results could be generalizable to rural population remains unknown. We addressed this question using data from the New Rural Cooperative Medical Scheme (NRCMS) in Fuyang, Anhui, China. Daily hospital admissions for total CVDs, ischaemic heart disease, heart failure, heart rhythm disturbances, ischaemic stroke, and haemorrhagic stroke in rural regions of Fuyang, China, were extracted from NRCMS between January 2015 and June 2017. A two-stage time-series analysis method was used to assess the associations between NO2 and CVD hospital admissions and the disease burden fractions attributable to NO2. In our study period, the average number (standard deviation) of hospital admissions per day were 488.2 (117.1) for total CVDs, 179.8 (45.6) for ischaemic heart disease, 7.0 (3.3) for heart rhythm disturbances, 13.2 (7.2) for heart failure, 267.9 (67.7) for ischaemic stroke, and 20.2 (6.4) for haemorrhagic stroke. The 10-μg/m3 increase of NO2 was related to an elevated risk of 1.9% (RR: 1.019, 95% CI: 1.005 to 1.032) for hospital admissions of total CVDs at lag0–2 days, 2.1% (1.021, 1.006 to 1.036) for ischaemic heart disease, and 2.1% (1.021, 1.006 to 1.035) for ischaemic stroke, respectively, while no significant association was observed between NO2 and hospital admissions for heart rhythm disturbances, heart failure, and haemorrhagic stroke. The attributable fractions of total CVDs, ischaemic heart disease, and ischaemic stroke to NO2 were 6.52% (1.87 to 10.94%), 7.31% (2.19 to 12.17%), and 7.12% (2.14 to 11.85%), respectively. Our findings suggest that CVD burdens in rural population are also partly attributed to short-term exposure to NO2. More studies across rural regions are required to replicate our findings.
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The datasets analysed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
We would like to thank all the subjects who participated in this research.
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This study was funded by the Key Scientific Research Fund of Anhui Provincial Education Department (grant number KJ2017A189) and Grants for Scientific Research of BSKY from Anhui Medical University (grant number Xj201525).
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Conceptualization: Teng-Fei Dong, Lin-Sheng Yang; methodology: Teng-Fei Dong, Ling-Li Liu, Yuan Wang, Xiang-Long Meng; data curation: Zhen-Qiu Zha, Liang Sun, Huai-Biao Li, Lin-Sheng Yang; formal analysis: Teng-Fei Dong, Xing-Yang Li, Hong-Li Wang, Huan-Huan Nie; writing — original draft preparation: Teng-Fei Dong, Zhen-Qiu Zha, Liang Sun, Ling-Li Liu; writing — review and editing: Teng-Fei Dong, Lin-Sheng Yang; supervision: Teng-Fei Dong, Lin-Sheng Yang; validation: Zhen-Qiu Zha, Liang Sun, Ling-Li Liu.
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Dong, TF., Zha, ZQ., Sun, L. et al. Ambient nitrogen dioxide and cardiovascular diseases in rural regions: a time-series analyses using data from the new rural cooperative medical scheme in Fuyang, East China. Environ Sci Pollut Res 30, 51412–51421 (2023). https://doi.org/10.1007/s11356-023-25922-9
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DOI: https://doi.org/10.1007/s11356-023-25922-9