Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China.
Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
Environ Pollut. 2021 Nov 1;288:117806. doi: 10.1016/j.envpol.2021.117806. Epub 2021 Jul 16.
Although short-term exposure to air pollution can trigger sudden heart attacks, evidence is scarce regarding the relationship between sub-daily changes in air pollution level and the risk of acute myocardial infarction (AMI). Here we assessed the intraday effect of air pollution on AMI risk and potential effect modification by pre-existing cardiac risk factors. Hourly data on emergency department visits (EDVs) for AMI and air pollutants in Brisbane, Australia during 2013-2015 were acquired from pertinent government departments. A time-stratified case-crossover analysis was adopted to examine relationships of AMI risk with hourly changes in particulate matters (aerodynamic diameter ≤ 2.5 μm (PM) and ≤10 μm (PM)) and gaseous pollutants (ozone and nitrogen dioxide) after adjusting for potential confounders. We also conducted stratified analyses according to age, gender, disease history, season, and day/night time exposure. Excess risk of AMI per 10 μg/m increase in air pollutant concentration was reported at four time windows: within 1, 2-6, 7-12, and 13-24 h. Both single- and multi-pollutant models found an elevated risk of AMI within 2-6 h after exposure to PM (excessive risk: 12.34%, 95% confidence interval (CI): 1.44%-24.42% in single-pollutant model) and PM within 1 h (excessive risk: 5.21%, 95% CI: 0.26%-10.40% in single-pollutant model). We did not find modification effect by age, gender, season or day/night time, except that PM had a greater effect on EDVs for AMI during night-time than daytime. Our findings suggest that AMI risk could increase within hours after exposure to particulate matters.
尽管短期接触空气污染会引发突发性心脏病发作，但关于亚日变化的空气污染水平与急性心肌梗死（AMI）风险之间的关系，证据还很有限。在这里，我们评估了空气污染对 AMI 风险的日内影响以及预先存在的心脏危险因素的潜在影响修饰作用。从相关政府部门获取了澳大利亚布里斯班 2013-2015 年期间急诊部门（EDV）因 AMI 和空气污染物就诊的每小时数据。采用时间分层病例交叉分析来检查 AMI 风险与大气颗粒物（空气动力学直径≤2.5μm（PM）和≤10μm（PM））和气态污染物（臭氧和二氧化氮）每小时变化之间的关系，在调整了潜在混杂因素后。我们还根据年龄、性别、疾病史、季节和白天/夜间暴露情况进行了分层分析。报告了每增加 10μg/m 的空气污染物浓度，AMI 的超额风险在四个时间窗口：1 小时内、2-6 小时内、7-12 小时内和 13-24 小时内。单污染物和多污染物模型均发现，暴露于 PM 后 2-6 小时内 AMI 的风险升高（单污染物模型中的过量风险：12.34%，95%置信区间（CI）：1.44%-24.42%）和暴露于 PM 后 1 小时内（单污染物模型中的过量风险：5.21%，95%CI：0.26%-10.40%）。除了 PM 对夜间 EDV 对 AMI 的影响大于白天外，我们没有发现年龄、性别、季节或白天/夜间的修饰作用。我们的研究结果表明，暴露于颗粒物后数小时内 AMI 风险可能会增加。
