Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States.
Center for Air and Aquatic Resources Engineering and Sciences, Clarkson University, Potsdam, NY, United States.
Front Public Health. 2024 Aug 1;12:1369698. doi: 10.3389/fpubh.2024.1369698. eCollection 2024.
Previous work reported increased rates of cardiovascular hospitalizations associated with increased source-specific PM concentrations in New York State, despite decreased PM concentrations. We also found increased rates of ST elevation myocardial infarction (STEMI) associated with short-term increases in concentrations of ultrafine particles and other traffic-related pollutants in the 2014-2016 period, but not during 2017-2019 in Rochester. Changes in PM composition and sources resulting from air quality policies (e.g., Tier 3 light-duty vehicles) may explain the differences. Thus, this study aimed to estimate whether rates of STEMI were associated with organic carbon and source-specific PM concentrations.
Using STEMI patients treated at the University of Rochester Medical Center, compositional and source-apportioned PM concentrations measured in Rochester, a time-stratified case-crossover design, and conditional logistic regression models, we estimated the rate of STEMI associated with increases in mean primary organic carbon (POC), secondary organic carbon (SOC), and source-specific PM concentrations on lag days 0, 0-3, and 0-6 during 2014-2019.
The associations of an increased rate of STEMI with interquartile range (IQR) increases in spark-ignition emissions (GAS) and diesel (DIE) concentrations in the previous few days were not found from 2014 to 2019. However, IQR increases in GAS concentrations were associated with an increased rate of STEMI on the same day in the 2014-2016 period (Rate ratio [RR] = 1.69; 95% CI = 0.98, 2.94; 1.73 μg/m). In addition, each IQR increase in mean SOC concentration in the previous 6 days was associated with an increased rate of STEMI, despite imprecision (RR = 1.14; 95% CI = 0.89, 1.45; 0.42 μg/m).
Increased SOC concentrations may be associated with increased rates of STEMI, while there seems to be a declining trend in adverse effects of GAS on triggering of STEMI. These changes could be attributed to changes in PM composition and sources following the Tier 3 vehicle introduction.
尽管 PM 浓度有所降低，但之前的研究报告显示，纽约州与特定来源的 PM 浓度增加相关的心血管住院率有所上升。我们还发现，在 2014-2016 年期间，与短期增加超细颗粒和其他交通相关污染物浓度相关的 ST 段抬高型心肌梗死（STEMI）发生率也有所增加，但在 2017-2019 年罗切斯特却没有。空气质量政策（例如，三级轻型车辆）导致的 PM 成分和来源的变化可能解释了这些差异。因此，本研究旨在评估 STEMI 发生率是否与有机碳和特定来源的 PM 浓度有关。
使用罗切斯特大学医学中心治疗的 STEMI 患者，测量罗切斯特的成分和来源分配的 PM 浓度，采用时间分层病例交叉设计和条件逻辑回归模型，我们估计了在 2014-2019 年期间，滞后 0、0-3 和 0-6 天内，平均初级有机碳（POC）、二次有机碳（SOC）和特定来源 PM 浓度增加与 STEMI 发生率增加之间的关系。
在 2014 年至 2019 年期间，我们没有发现前几天火花点火排放（GAS）和柴油（DIE）浓度的 IQR 增加与 STEMI 发生率增加之间存在关联。然而，在 2014-2016 年期间，GAS 浓度的 IQR 增加与当天 STEMI 发生率增加有关（比率比 [RR] = 1.69；95%CI = 0.98, 2.94；1.73μg/m）。此外，尽管存在不精确性，但在之前 6 天内，平均 SOC 浓度的每个 IQR 增加都与 STEMI 发生率增加有关（RR = 1.14；95%CI = 0.89, 1.45；0.42μg/m）。
SOC 浓度的增加可能与 STEMI 发生率的增加有关，而 GAS 对 STEMI 触发的不良影响似乎呈下降趋势。这些变化可能归因于 Tier 3 车辆引入后 PM 成分和来源的变化。
