Risk of Cardiovascular Hospital Admission After Exposure to Fine Particulate Pollution

Yi Zhang; Runmei Ma; Jie Ban; Feng Lu; Moning Guo; Yu Zhong; Ning Jiang; Chen Chen; Tiantian Li; Xiaoming Shi

doi:10.1016/j.jacc.2021.06.043

Risk of Cardiovascular Hospital Admission After Exposure to Fine Particulate Pollution

J Am Coll Cardiol. 2021 Sep 7;78(10):1015-1024. doi: 10.1016/j.jacc.2021.06.043.

Authors

Yi Zhang¹, Runmei Ma¹, Jie Ban¹, Feng Lu², Moning Guo², Yu Zhong¹, Ning Jiang¹, Chen Chen¹, Tiantian Li³, Xiaoming Shi⁴

Affiliations

¹ China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
² Beijing Municipal Health Commission Information Center, Beijing, China.
³ China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China. Electronic address: litiantian@nieh.chinacdc.cn.
⁴ China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China. Electronic address: shixm@chinacdc.cn.

PMID: 34474733
DOI: 10.1016/j.jacc.2021.06.043

Abstract

Background: Heavy fine particulate matter with an aerodynamic diameter ≤2.5 μm (PM_2.5) pollution events continue to occur frequently in developing countries.

Objectives: The authors conducted a case-crossover study aimed at exploring the association between heavy PM_2.5 pollution events and hospital admission for cardiovascular diseases.

Methods: Hospital admissions for cardiovascular diseases were observed by Beijing Municipal Commission of Health and Family Planning Information Center from 2013 to 2017. Air pollution data were collected from the Beijing Municipal Environmental Monitoring Center. Distinct definitions were used to identify heavy and extremely heavy fine particulate pollution events. A conditional logistic regression model was used. The hospital admission burdens for cardiovascular disease were also estimated.

Results: A total of 2,202,244 hospital admissions for cardiovascular diseases and 222 days of extremely heavy PM_2.5 pollution events (PM_2.5 concentration ≥150 μg/m³) were observed. The ORs associated with extremely heavy PM_2.5 pollution events lasting for 3 days or more for total cardiovascular disease, angina, myocardial infarction, ischemic stroke, and heart failure were 1.085 (95% CI: 1.077-1.093), 1.112 (95% CI: 1.095-1.130), 1.068 (95% CI: 1.037-1.100), 1.071 (95% CI: 1.053-1.090), and 1.060 (95% CI: 1.021-1.101), respectively. The numbers and days of cardiovascular disease hospital admission annually related to extremely heavy PM_2.5 pollution events lasting for 1 day or more were 3,311 (95% CI: 2,969-3,655) and 37,020 (95% CI: 33,196-40,866), respectively.

Conclusions: Heavy and extremely heavy PM_2.5 pollution events resulted in substantial increased hospital admission risk for cardiovascular disease. With higher PM_2.5 concentration and longer duration of heavy PM_2.5 pollution events, a greater risk of cardiovascular hospital admission was observed.

Keywords: cardiovascular disease; fine particulate matter; heavy pollution event; hospital admission.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Air Pollution / adverse effects*
Air Pollution / statistics & numerical data
Beijing / epidemiology
Cardiovascular Diseases / epidemiology*
Cardiovascular Diseases / etiology
Case-Control Studies
Female
Humans
Male
Middle Aged
Particulate Matter / adverse effects*
Patient Admission / statistics & numerical data*
Risk Factors

Substances

Particulate Matter