Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China.
Life Science Research Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China.
Environ Sci Pollut Res Int. 2023 Aug;30(40):93242-93254. doi: 10.1007/s11356-023-28456-2. Epub 2023 Jul 28.
Epidemiological studies in recent years have identified an association between exposure to air pollutants and acute myocardial infarction (AMI); however, the association between short-term ozone (O) exposure and AMI hospitalization remains unclear, particularly in developing countries. Therefore, this study collected information on 24,489 AMI patients, including daily air pollutant and meteorological data in Henan, China, between 2016 and 2021. A distributed lagged nonlinear model combined with a Poisson regression model was used to estimate the nonlinear lagged effect of O on AMI hospitalizations. We also quantified the effects of O on the number of AMI hospitalizations, hospitalization days, and hospitalization costs. The results showed that single- and dual-pollution models of O at lag0, lag1, and lag (01-07) were risk factors for AMI hospitalizations, with the most significant effect at lag03 (RR = 1.132, 95% CI:1.083-1.182). Further studies showed that males, younger people (15-64 years), warm seasons, and long sunshine duration were more susceptible to O. Hospitalizations attributable to O during the study period accounted for 11.66% of the total hospitalizations, corresponding to 2856 patients, 33,492 hospital days, and 90 million RMB. Maintaining O at 10-130 µg/m can prevent hundreds of AMI hospitalizations and save millions of RMB per year in Henan, China. In conclusion, we found that short-term exposure to O was significantly associated with an increased risk of hospitalization for AMI in Henan, China, and that further reductions in ambient O levels may have substantial health and economic benefits for patients and local healthcare facilities.
近年来的流行病学研究表明，暴露于空气污染物与急性心肌梗死（AMI）之间存在关联；然而，短期臭氧（O）暴露与 AMI 住院之间的关联仍不清楚，尤其是在发展中国家。因此，本研究收集了 2016 年至 2021 年期间中国河南省 24489 例 AMI 患者的信息，包括每日空气污染物和气象数据。采用分布式滞后非线性模型结合泊松回归模型，估计 O 对 AMI 住院的非线性滞后效应。我们还量化了 O 对 AMI 住院人数、住院天数和住院费用的影响。结果表明，O 在 lag0、lag1 和 lag（01-07）的单污染和双污染模型是 AMI 住院的危险因素，在 lag03 时影响最大（RR=1.132，95%CI：1.083-1.182）。进一步的研究表明，男性、年轻人（15-64 岁）、温暖季节和长日照时间更容易受到 O 的影响。研究期间归因于 O 的住院治疗占总住院治疗的 11.66%，相当于 2856 例患者、33492 天住院和 9000 万元人民币。维持 O 在 10-130µg/m 范围内可以预防河南省数百例 AMI 住院治疗，并每年节省数百万人民币。总之，我们发现短期暴露于 O 与中国河南省 AMI 住院风险增加显著相关，进一步降低环境 O 水平可能会为患者和当地医疗机构带来巨大的健康和经济效益。
