Department of Epidemiology and Biostatistics, School of Public Health, Shandong University, 44, Wenhuaxi Street, Jinan 250012, China.
Health and Family Planning Information Center of Shandong Province, 75, Yuhan Street, Jinan 250014, China.
Int J Environ Res Public Health. 2020 Jan 31;17(3):879. doi: 10.3390/ijerph17030879.
There has been an increasing number of clinical and epidemiologic research projects providing supporting evidence that short-term exposure to ambient air pollution contributes to the exacerbation of cardiovascular disease. However, few studies consider measurement error and spatial effects in the estimate of underlying air pollution levels, and less is known about the influence of baseline air pollution levels on cardiovascular disease. We used hospital admissions data for cardiovascular diseases (CVD) collected from an inland, heavily polluted city and a coastal city in Shandong Province, China. Bayesian spatio-temporal models were applied to obtain the underlying pollution level in each city, then generalized additive models were adopted to assess the health effects. The total cardiovascular disease hospitalizations were significantly increased in the inland city by 0.401% (0.029, 0.775), 0.316% (0.086, 0.547), 0.903% (0.252, 1.559), and 2.647% (1.607, 3.697) per 10 μg/m increase in PM, PM, SO, and NO respectively. The total cardiovascular diseases hospitalizations were increased by 6.568% (3.636, 9.584) per 10μg/m increase in the level of NO. Although the air pollution overall had a more significant adverse impact on cardiovascular disease hospital admissions in the heavily polluted inland city, the short-term increases in air pollution levels in the less polluted coastal areas led to excessive exacerbations of cardiovascular disease.
越来越多的临床和流行病学研究项目提供了支持证据，表明短期暴露于环境空气污染会加重心血管疾病。然而，很少有研究考虑到基础空气污染水平估计中的测量误差和空间效应，也很少有人了解基础空气污染水平对心血管疾病的影响。我们使用了来自中国内陆污染严重的城市和山东省沿海城市的心血管疾病（CVD）住院数据。我们应用贝叶斯时空模型获得每个城市的基础污染水平，然后采用广义加性模型评估健康影响。在污染严重的内陆城市，PM、PM、SO 和 NO 每增加 10μg/m，心血管疾病总住院率分别显著增加 0.401%（0.029，0.775）、0.316%（0.086，0.547）、0.903%（0.252，1.559）和 2.647%（1.607，3.697）。NO 水平每增加 10μg/m，心血管疾病总住院率增加 6.568%（3.636，9.584）。尽管整体空气污染对污染严重的内陆城市的心血管疾病住院率有更显著的不利影响，但污染较轻的沿海地区空气污染水平的短期增加导致了心血管疾病的过度恶化。
