Department of Environment Health, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China.
Nanjing Meteorological Bureau of Jiangsu Province, Nanjing 210019, China.
Environ Sci Technol. 2024 Nov 19;58(46):20378-20388. doi: 10.1021/acs.est.4c05899. Epub 2024 Nov 7.
Global warming and elevated ozone (O) levels are gradually gaining widespread attention, and exposure to which may cause many physiological changes associated with cardiovascular events such as hypertension, cardiomyocyte apoptosis, etc. In addition, ischemic heart disease (IHD) is the leading cause of death worldwide. However, the contributions of temperature and O, independently or in combination, to IHD mortality are not well understood. This study employs a two-stage analytical protocol (generalized additive model followed by meta-analysis) to explore the respective associations of temperature and O with IHD mortality, and determine their possible mediation and interaction effects. Our results suggest that increases of 10 μg/m in O and 1 °C in temperature at lag01 day are associated with increased IHD mortality risks of 0.789% and 0.686%, respectively. O can mediate the relationship between temperature and IHD mortality, with a pooled estimate of 0.140%, while temperature can mediate the association between O and IHD mortality, with a pooled estimate of 0.162%. The additive and multiplicative interaction effects of O and temperature were significantly associated with IHD mortality. The study findings demonstrate that higher temperature and O concentrations can increase human IHD mortality risk through interaction and mediation effects, providing a scientific basis for the synergistic management of temperature and O or associated interventions.
全球变暖与臭氧（O）水平升高逐渐受到广泛关注，接触这些物质可能会引起许多与心血管事件相关的生理变化，如高血压、心肌细胞凋亡等。此外，缺血性心脏病（IHD）是全球范围内主要的死亡原因。然而，温度和 O 单独或联合作用对 IHD 死亡率的影响尚不清楚。本研究采用两阶段分析方案（广义加性模型后进行荟萃分析），探讨温度和 O 与 IHD 死亡率的相关性，并确定其可能的中介和交互作用。研究结果表明，O 浓度每增加 10μg/m，滞后 01 天的温度每升高 1°C，IHD 死亡率的风险分别增加 0.789%和 0.686%。O 可以介导温度与 IHD 死亡率之间的关系，综合估计值为 0.140%，而温度可以介导 O 与 IHD 死亡率之间的关系，综合估计值为 0.162%。O 和温度的相加和相乘交互作用与 IHD 死亡率显著相关。研究结果表明，较高的温度和 O 浓度可通过相互作用和中介效应增加人类 IHD 死亡率风险，为协同管理温度和 O 或相关干预措施提供了科学依据。
