School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
South African Medical Research Council, Pretoria, South Africa.
Environ Sci Pollut Res Int. 2020 May;27(14):16677-16685. doi: 10.1007/s11356-020-07938-7. Epub 2020 Mar 4.
Climate change and air pollution are two independent risk factors to cardiovascular diseases (CVD). Few studies investigated their interaction and potential effect modification of one another in developing countries. Individual level CVD hospital admission (ICD10: I00-I99) data for 1 January 2011 to 31 October 2016 were obtained from seven private hospitals in Cape Town. NO, SO, PM, temperature and relative humidity data were obtained from the South African Weather Services and the City of Cape Town. A case-crossover epidemiological study design and conditional logistic regression model were applied. Various cut-off values were applied to classify cold and warm days. In total, 54,818 CVD hospital admissions were included in the study. In general, on warm and cold days the 15-64 years old group was more at risk for CVD hospitalization with increasing air pollution levels compared to all ages combined or the ≥ 65 years old group. Females appeared to be more at risk than males with increasing PM levels. In contrast, males were more vulnerable to the effects of NO and SO than females. The study showed the modification effect of temperature on air pollution associated with CVD hospital admissions. The consideration of such interaction will help in policy making and public health interventions dealing with climate change-related health risks.
气候变化和空气污染是心血管疾病（CVD）的两个独立风险因素。很少有研究调查它们在发展中国家的相互作用和潜在的影响修饰。从开普敦的 7 家私立医院获取了 2011 年 1 月 1 日至 2016 年 10 月 31 日的心血管疾病住院（ICD10：I00-I99）的个体水平数据。NO、SO、PM、温度和相对湿度数据来自南非气象局和开普敦市。采用病例交叉流行病学研究设计和条件逻辑回归模型。应用各种截断值对冷暖和温暖的日子进行分类。在这项研究中，共有 54818 例 CVD 住院治疗。总的来说，与所有年龄组或≥65 岁组相比，在温暖和寒冷的日子里，15-64 岁年龄组的人随着空气污染水平的升高，患 CVD 住院的风险更高。与 PM 水平的增加相比，女性似乎比男性更容易受到影响。相比之下，男性比女性更容易受到 NO 和 SO 的影响。该研究表明，温度对与 CVD 住院相关的空气污染的修饰作用。考虑到这种相互作用将有助于制定政策和公共卫生干预措施，以应对与气候变化相关的健康风险。
