Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
Ecotoxicol Environ Saf. 2022 Nov;246:114149. doi: 10.1016/j.ecoenv.2022.114149. Epub 2022 Oct 10.
Previous studies showed different risk effects on exposure of fine particulate matter (PM) mass for cardiovascular disease (CVD) globally, which is likely due to different constituents of PM. This study aimed to investigate the association between short-term exposure of PM constituents and hospital admissions of CVD. Daily counts of city-specific hospital admissions for CVD in 18 cities in China between 2014 and 2017 were extracted from the national Urban Employee Basic Medical Insurance database and the Beijing Municipal Commission of Health and Family Planning Information Center database. Directly measured PM constituents, including ions and polycyclic aromatic hydrocarbons, were collected by the Chinese Environmental Public Health Tracking system. We used the time-stratified case-crossover design to estimate the association between PM constituents and hospital admissions of CVD. Concentrations of ions accounted for the majority of the detected constituents. Excess risk (ER) of average ions concentrations for CVD was highest as 2.30% (95% CI: 1.62-2.99%) for NH, whose major sources are residential and agricultural emissions. This was followed by 1.85% (1.30-2.41%) for NO (generally from vehicles), 0.95% (0.28-1.63%) for SO (often from fossil fuel burning) respectively. The association for ions were generally consistent with ischemic heart disease (IHD) and ischemic stroke, e.g., NH was associated with IHD (2.50%; 1.52-3.48%) and ischemic stroke (1.77%; 0.65-2.9%). For polycyclic aromatic hydrocarbons (PAHs), mainly from coal and vehicle-related oil combustion, the constituents were all associated with ischemic stroke but not for IHD. The ER for ischemic stroke was highest at 1.69% (0.99-2.39%) for indeno (123-cd) pyrene. Thus, in terms of the subtypes of CVD, the risks of hospital admissions varied with exposure to different PM constituents. Exposed to NH had the highest risk to IHD and ischemic stroke, whereas PAHs were predominately associated with ischemic stroke only.
先前的研究表明，全球范围内，细颗粒物（PM）质量暴露对心血管疾病（CVD）的风险影响不同，这可能是由于 PM 的不同成分造成的。本研究旨在探讨 PM 成分短期暴露与 CVD 住院的关系。从国家城镇职工基本医疗保险数据库和北京市卫生和计划生育信息中心数据库中提取了 2014 年至 2017 年中国 18 个城市 CVD 特定医院的每日住院人数。中国环境公共卫生跟踪系统收集了直接测量的 PM 成分，包括离子和多环芳烃。我们采用时间分层病例交叉设计来估计 PM 成分与 CVD 住院的关系。离子浓度占检测到的成分的大部分。NH 的平均离子浓度对 CVD 的超额风险（ER）最高，为 2.30%（95%CI：1.62-2.99%），其主要来源是住宅和农业排放。其次是 NO（一般来自车辆）的 1.85%（1.30-2.41%），SO（通常来自化石燃料燃烧）的 0.95%（0.28-1.63%）。离子的关联通常与缺血性心脏病（IHD）和缺血性中风一致，例如，NH 与 IHD（2.50%；1.52-3.48%）和缺血性中风（1.77%；0.65-2.9%）相关。对于多环芳烃（PAHs），主要来自煤和与车辆相关的油燃烧，这些成分都与缺血性中风有关，但与 IHD 无关。缺血性中风的 ER 最高，为 1.69%（0.99-2.39%），苯并[a]芘。因此，就 CVD 的亚型而言，住院风险因暴露于不同的 PM 成分而有所不同。暴露于 NH 的人患 IHD 和缺血性中风的风险最高，而 PAHs 主要与缺血性中风有关。
