Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
Department of Preventive Medicine, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
Int J Biometeorol. 2019 Oct;63(10):1437-1447. doi: 10.1007/s00484-019-01766-2. Epub 2019 Aug 5.
China is among the countries with the worst air quality throughout the world. As PM was not included in the national air quality monitoring network before January 2013 in China, no study has investigated the associations of ambient PM and O with cardiovascular mortality in Hefei, China. In this time-series analysis, Poisson regression in generalized additive model was adopted to assess the associations between the air pollutants and cardiovascular mortality during the 2013-2015 in Hefei, China. The findings showed that the daily average level of PM and O was 77.8 μg/m and 60.1 μg/m in the study period, respectively. PM and O exposure tended to increase cardiovascular mortality, but the associations were statistically insignificant. Further stratified analyses by seasons showed that with every 10 μg/m increase of PM in the cold season (October-March), the risk of cardiovascular death increased by 0.22% (95% CI 0.05%, 0.39%); while every 10 μg/m increase of O in the warm season (April-September), the risk of cardiovascular death increased by 1.29% (95% CI 0.26%, 2.33%) on Lag0. Interestingly, stratified analysis by gender showed that the associations of PM, but not O exposure, could significantly increase cardiovascular mortality in females, but not males. The findings of this study especially underscored the adverse associations of PM and O exposure with females in specific seasons. More studies are needed to verify our findings and further investigate the underlying mechanisms. Graphical Abstract.
中国是世界上空气质量最差的国家之一。由于 2013 年 1 月之前，在中国的国家空气质量监测网络中没有包括 PM2.5，因此，没有研究调查环境 PM2.5 和 O3 与中国合肥心血管死亡率之间的关联。在这项时间序列分析中，采用广义相加模型中的泊松回归来评估 2013-2015 年期间中国合肥空气污染与心血管死亡率之间的关系。研究结果表明，研究期间，PM2.5 和 O3 的日平均水平分别为 77.8μg/m3 和 60.1μg/m3。PM2.5 和 O3 暴露与心血管死亡率升高呈正相关趋势，但统计学上无显著性差异。按季节进一步分层分析表明，在寒冷季节（10 月至 3 月），PM2.5 每增加 10μg/m3，心血管死亡风险增加 0.22%（95%CI 0.05%，0.39%）；而在温暖季节（4 月至 9 月），O3 每增加 10μg/m3，心血管死亡风险增加 1.29%（95%CI 0.26%，2.33%）。有趣的是，按性别分层分析表明，PM2.5 暴露与心血管死亡率的相关性在女性中显著，但在男性中不显著。本研究的结果特别强调了 PM2.5 和 O3 暴露与女性在特定季节的不良关联。需要进一步的研究来验证我们的发现，并进一步探讨潜在的机制。
