Czernych Radosław, Badyda Artur Jerzy, Kozera Grzegorz, Zagożdżon Paweł
Department of Hygiene and Epidemiology, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland.
Department of Informatics and Environment Quality Research, Faculty of Building Services, Hydro- and Environmental Engineering, Warsaw University of Technology, 00-653 Warsaw, Poland.
J Clin Med. 2023 Mar 13;12(6):2206. doi: 10.3390/jcm12062206.
(1) Background: More than 1.8 million people in the European Union die every year as a result of CVD, accounting for 36% of all deaths with a large proportion being premature (before the age of 65). There are more than 300 different risk factors of CVD, known and air pollution is one of them. The aim of this study was to investigate whether daily cardiovascular mortality was associated with air pollutants and meteorological conditions in an urban environment with a low level of air pollution. (2) Methods: Data on daily incidence of strokes and myocardial infarctions in the city of Gdansk were obtained from the National Health Fund (NHF) and covered the period from 1 January 2014 to 31 December 2018. Data on the level of pollution, i.e., SO, NO, NO, NOx, CO, PM10, PM2.5, CO, O and meteorological conditions came from the foundation: Agency of Regional Air Quality Monitoring in the Gdańsk metropolitan area (ARMAG). Using these data, we calculated mean values with standard deviation (SD) and derived the minimum and maximum values and interquartile range (IQR). Time series regression with Poisson distribution was used in statistical analysis. (4) Results: Stroke incidence is significantly affected by an increase in concentrations of NO, NO and NOx with RRs equal to 1.019 (95%CI: 1.001-1.036), 1.036 (95%CI: 1.008-1.064) and 1.017 (95%CI: 1.000-1.034) for every increase in IQR by 14.12, 14.62 and 22.62 μg/m, respectively. Similarly, myocardial infarction incidence is significantly affected by an increase in concentrations of NO, NO and NOx with RRs equal to 1.030 (95%CI: 1.011-1.048), 1.053 (95%CI: 1.024-1.082) and 1.027 (95%CI: 1.010-1.045) for every increase in IQR by 14.12, 14.62 and 22.62 μg/m, respectively. Both PM10 and PM2.5 were positively associated with myocardial infarction incidence. (5) Conclusions: In this time-series cross-sectional study, we found strong evidence that support the hypothesis that transient elevations in ambient PM2.5, PM10, NO, SO and CO are associated with higher relative risk of ischemic stroke and myocardial infarction incidents.
（1）背景：欧盟每年有超过180万人死于心血管疾病（CVD），占所有死亡人数的36%，其中很大一部分为过早死亡（65岁之前）。已知心血管疾病有300多种不同的风险因素，空气污染是其中之一。本研究的目的是调查在空气污染水平较低的城市环境中，每日心血管疾病死亡率是否与空气污染物和气象条件相关。（2）方法：格但斯克市中风和心肌梗死的每日发病数据来自国家卫生基金（NHF），涵盖2014年1月1日至2018年12月31日期间。污染水平数据，即二氧化硫（SO）、一氧化氮（NO）、二氧化氮（NO₂）、氮氧化物（NOₓ）、一氧化碳（CO）、可吸入颗粒物（PM10）、细颗粒物（PM2.5）、臭氧（O₃）以及气象条件数据来自格但斯克大都市区区域空气质量监测机构（ARMAG）。利用这些数据，我们计算了平均值及标准差（SD），并得出最小值、最大值和四分位间距（IQR）。统计分析采用泊松分布的时间序列回归。（4）结果：中风发病率受一氧化氮、二氧化氮和氮氧化物浓度升高的显著影响，每IQR分别增加14.12、14.62和22.62μg/m³时，相对风险（RR）分别为1.019（95%置信区间：1.001 - 1.036）、1.036（95%置信区间：1.008 - 1.064）和1.017（95%置信区间：1.000 - 1.034）。同样，心肌梗死发病率受一氧化氮、二氧化氮和氮氧化物浓度升高的显著影响，每IQR分别增加14.12、14.62和22.62μg/m³时，RR分别为1.030（95%置信区间：1.011 - 1.048）、1.053（95%置信区间：1.024 - 1.082）和1.027（95%置信区间：1.010 - 1.045）。PM10和PM2.5均与心肌梗死发病率呈正相关。（5）结论：在这项时间序列横断面研究中，我们发现有力证据支持以下假设：环境中PM2.5、PM10、NO、SO₂和CO的短暂升高与缺血性中风和心肌梗死事件的较高相对风险相关。
