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Ambient carbon monoxide and the risk of cardiovascular disease emergency room visits: a time-series study in Lanzhou, China

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Abstract

Until now, the epidemiological evidence on the association between short-term exposure to ambient carbon monoxide (CO) and cardiovascular diseases (CVDs) is relatively lacking and controversial. This study aims to examine the relationship between ambient CO and daily emergency room visits (ERVs) for total and cause-specific CVD in Lanzhou, China. A distributed lag nonlinear model was used to examine the association. For every 1 mg/m3 increase in the CO concentration, the relative risks of daily ERVs were 1.041 (95% CI: 1.017, 1.065) for total CVD, 1.065 (95% CI: 1.018, 1.114) for ischemic heart disease (IHD), 1.083 (95% CI: 1.020, 1.149) for heart rhythm disturbances (HRD), 1.062 (95% CI: 1.011, 1.115) for heart failure (HF), and 1.057 (95% CI: 1.017, 1.098) for cerebrovascular diseases (CD). For the two different gender subgroups, the short-term impact of CO on total CVD, IHD, and CD was relatively stronger for the females than for the males, while the opposite was true for HRD and HF. In the age subgroup analyses, the effect of ambient CO on total CVD and IHD appeared to be greater for the age ≥ 65 years group, while the opposite was true for HRD, HF, and CD. The associations for all disease categories were stronger in cold seasons than in warm seasons. We also observed a nearly linear correlation between CO and CVD ERVs. In conclusion, the study showed that exposure to ambient CO may increase the risks of ERVs for total and cause-specific CVD. Besides, CO-ERVs associations may vary by gender and age.

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Abbreviations

CVD:

Cardiovascular diseases

CO:

Carbon monoxide

IHD:

Ischemic heart disease

HRD:

Heart rhythm disturbances

HF:

Heart failure

CD:

Cerebrovascular diseases

ERV:

Emergency room visit

DLNM:

Distributed lag nonlinear models

RR:

Relative risk

Q-AIC:

Quasi-Akaike information criterion

CI:

Confidence intervals

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Acknowledgements

The authors acknowledge the dedication and cooperation of all the participants in this study.

Funding

This study was supported by the National Natural Science Foundation of China (72264002), and the Fundamental Research Funds for the Central Universities, Lanzhou University, China (lzujbky-2022–44).

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Authors and Affiliations

  1. School of Public Health, Lanzhou University, Lanzhou, 730000, People’s Republic of China

    Jianhua You, Yaocong Liu & Jiyuan Dong

  2. Gansu Provincial Hospital, Lanzhou, 730050, People’s Republic of China

    Jiancheng Wang

  3. Department of Gerontal Respiratory Medicine, The First Hospital of Lanzhou University, Lanzhou, 730000, China

    Hairong Bao

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  1. Jianhua You
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Contributions

JCW and HRB contributed to the conception or design of the work. JHY, YCL and JYD were major contributors in writing the manuscript.

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Correspondence to Jiyuan Dong.

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You, J., Liu, Y., Dong, J. et al. Ambient carbon monoxide and the risk of cardiovascular disease emergency room visits: a time-series study in Lanzhou, China. Environ Geochem Health 45, 7621–7636 (2023). https://doi.org/10.1007/s10653-023-01653-1

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