Climate Change Research Centre, University of New South Wales, Sydney, NSW 2052, Australia.
ARC Centre of Excellence for Climate Extremes, University of New South Wales, Sydney, NSW 2052, Australia.
Int J Environ Res Public Health. 2019 Sep 5;16(18):3270. doi: 10.3390/ijerph16183270.
Little is known about the potential interactive effects of heat waves and ambient particulate matter on cardiovascular morbidity. A time-stratified case-crossover design was used to examine whether particulate matter (PM) modifies the association between heat waves and emergency hospital admissions for six cardiovascular diseases in Greater Sydney, Australia during the warm season for 2001-2013. We estimated and compared the effect of heat waves on high- and low-level PM days at lag-lag, adjusting for dew-point temperature, ambient ozone, ambient nitrogen dioxide, and public holidays. We also investigated the susceptibility of both younger (0-64 years) and older populations (65 years and above), and tested the sensitivity of three heat wave definitions. Stronger heat wave effects were observed on high- compared to low-level PM days for emergency hospital admissions for cardiac arrest for all ages combined, 0-64 years and 65 years and above; conduction disorders for 0-64 years; and hypertensive diseases for all ages combined and 0-64 years. Overall, we found some evidence to suggest that PM may modify the association between heat waves and hospital admissions for certain cardiovascular diseases, although our findings largely differed across disease, age group, lag, and heat wave definition.
关于热浪和环境颗粒物对心血管发病率的潜在交互影响知之甚少。本研究采用时间分层病例交叉设计，考察了颗粒物（PM）是否会改变澳大利亚大悉尼地区温暖季节（2001-2013 年）六种心血管疾病因热浪而急诊入院的关联。我们在滞后-滞后模型中估计并比较了热浪对高和低水平 PM 日的影响，同时调整了露点温度、环境臭氧、环境二氧化氮和公共假期。我们还研究了年轻（0-64 岁）和老年（65 岁及以上）人群的敏感性，并测试了三种热浪定义的敏感性。对于所有年龄段、0-64 岁和 65 岁及以上人群的心脏骤停急诊入院、0-64 岁人群的传导障碍以及所有年龄段和 0-64 岁人群的高血压疾病，高水平 PM 日的热浪效应强于低水平 PM 日。总体而言，我们发现一些证据表明，PM 可能会改变热浪与某些心血管疾病住院之间的关联，但我们的发现在疾病、年龄组、滞后和热浪定义方面存在较大差异。
