College of Geography and Environmental Science, Henan University, Henan, 475004, Kaifeng, China.
Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education, Henan University, Kaifeng, 475004, Henan, China.
Environ Sci Pollut Res Int. 2022 Feb;29(7):9841-9851. doi: 10.1007/s11356-021-16334-8. Epub 2021 Sep 10.
Previous studies demonstrated that short-term exposure to gaseous pollutants (nitrogen dioxide (NO), sulfur dioxide (SO), and ozone (O)) had a greater adverse effect on cardiovascular disease. However, little evidence exists regarding the synergy between gaseous pollutants and cardiovascular disease (CVD). Therefore, we aimed to estimate the effect of individual gaseous pollutants on hospital admissions for CVD and to explore the possible synergistic effects between gaseous pollutants. Daily hospitalization counts for CVD were collected from January 1, 2014, to December 31, 2015. We also collected daily time series on gaseous pollutants from the Environment of the People's Republic of China, including NO, SO, and O. We used distributed lag nonlinear models (DLNMs) to assess the association of individual gaseous pollutants on CVD hospitalization, after controlling for seasonality, day of the week, public holidays, and weather variables. Then, we explored the variability across age and sex groups. In addition, we analyzed the synergistic effects between gaseous pollutants on CVD. Extremely low NO and SO increase the risk of CVD in all subgroup at lag 7 days. The greatest effect of high concentration of SO was observed in male and the elderly (≥ 65 years) at lag 3 days. Greater effects of high concentration of O were more pronounced in the young (< 65 years) and female at lag 3 days, while the effect of low concentration of O was greater in male and the young (< 65 years) at lag 0 day. We found a synergistic effect between NO and SO for CVD, as well as between SO and O. The synergistic effects of NO and SO on CVD were stronger in the elderly (≥ 65) and female. The female was sensitive to synergistic effects of SO-O and NO-O. Interestingly, we found that there was a risk of CVD in the susceptible population even for gaseous pollutant concentrations below the National Environmental Quality Standard. The synergy between NO and SO was significantly associated with cardiovascular disease hospitalization in the elderly (≥ 65). This study provides evidence for the synergistic effect of gaseous pollutants on hospital admissions for cardiovascular disease.
先前的研究表明，短期暴露于气态污染物（二氧化氮（NO）、二氧化硫（SO）和臭氧（O））对心血管疾病的不良影响更大。然而，关于气态污染物与心血管疾病（CVD）之间的协同作用，证据甚少。因此，我们旨在估计单个气态污染物对心血管疾病住院的影响，并探讨气态污染物之间可能存在的协同作用。我们从 2014 年 1 月 1 日至 2015 年 12 月 31 日收集了心血管疾病的每日住院人数。我们还从中华人民共和国环境中收集了每日气态污染物的时间序列，包括 NO、SO 和 O。我们使用分布滞后非线性模型（DLNMs）来评估单个气态污染物对 CVD 住院的关联，同时控制了季节性、星期几、节假日和天气变量。然后，我们在不同年龄和性别组之间进行了探索。此外，我们分析了气态污染物对 CVD 的协同作用。极低的 NO 和 SO 在滞后 7 天内增加了所有亚组的 CVD 风险。在滞后 3 天，高浓度 SO 的最大影响发生在男性和老年人（≥65 岁）。在滞后 3 天，高浓度 O 的更大影响在年轻人（<65 岁）和女性中更为明显，而低浓度 O 的影响在男性和年轻人（<65 岁）中在滞后 0 天更大。我们发现 NO 和 SO 之间以及 SO 和 O 之间对 CVD 存在协同作用。NO 和 SO 对 CVD 的协同作用在老年人（≥65 岁）和女性中更强。女性对 SO-O 和 NO-O 的协同作用敏感。有趣的是，我们发现即使气态污染物浓度低于国家环境质量标准，易感人群也存在患心血管疾病的风险。NO 和 SO 之间的协同作用与老年人（≥65 岁）心血管疾病住院显著相关。本研究为气态污染物对心血管疾病住院的协同作用提供了证据。
