Wang Wenli, Chen Yang, Li Ruoyu, Yang Linsheng, Jiang Yu, Xiang Jianjun, Wu Jing, Li Jing, Liu Baoying, Lin Huaying, Wu Chuancheng
Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, China.
The Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China.
Front Public Health. 2025 Jul 29;13:1629857. doi: 10.3389/fpubh.2025.1629857. eCollection 2025.
Atmospheric oxidative pollutants, air temperature, and heatwave events pose potential threats to public health. However, the combined effects of these factors on the risk of mortality from circulatory disease remain insufficiently studied. This study aims to evaluate the synergistic effects of ozone (O₃), oxidant (O), and nitrogen dioxide (NO₂) with temperature and heat waves, and to explore their impact on circulatory disease mortality, providing evidence to support public health interventions.
Based on the mortality, meteorological, and environmental protection data of residents in Fuzhou City from January 1, 2016, to December 31, 2022, we employed a generalized additive model (GAM) and a distributed lag nonlinear model (DLNM) to assess the effects of atmospheric oxidative pollutants interacting with temperature and heat waves on the risk of death from circulatory diseases, where temperature includes the daily maximum temperature and diurnal temperature range (DTR). A bivariate three-dimensional model was used to visualize their synergistic effects, and stratified analyses were conducted to compare differences between heat wave and non-heat wave periods.
O, O, and NO exhibit synergistic effects with ambient temperature, and their combined exposure significantly increases the mortality risk of circulatory system diseases, myocardial infarction, and stroke, with some health effects showing a "nonlinear exposure-response relationship with an inverted U-shaped pattern." Under heatwave conditions, the synergistic effect between NO and high temperatures is markedly enhanced, leading to a greater increase in mortality risk compared to O and O, and demonstrating both a same-day lag and a cumulative effect. After introducing other pollutants into the dual-pollution model, NO still shows a strong independent health effect on major causes of death during heatwaves, with the most pronounced risk elevation observed for stroke.
Atmospheric oxidative pollutants interact with high temperatures, diurnal temperature range, and heatwaves, significantly increasing the risk of mortality. It is essential to integrate air pollution and meteorological factors to strengthen health protection during high-risk periods.
大气氧化性污染物、气温和热浪事件对公众健康构成潜在威胁。然而，这些因素对循环系统疾病死亡风险的综合影响仍研究不足。本研究旨在评估臭氧（O₃）、氧化剂（O）和二氧化氮（NO₂）与温度和热浪的协同效应，并探讨它们对循环系统疾病死亡率的影响，为公共卫生干预措施提供依据。
基于福州市2016年1月1日至2022年12月31日居民的死亡率、气象和环境保护数据，我们采用广义相加模型（GAM）和分布滞后非线性模型（DLNM）来评估大气氧化性污染物与温度和热浪相互作用对循环系统疾病死亡风险的影响，其中温度包括日最高气温和日较差（DTR）。使用双变量三维模型来可视化它们的协同效应，并进行分层分析以比较热浪期和非热浪期之间的差异。
O、O和NO与环境温度呈现协同效应，它们的联合暴露显著增加循环系统疾病、心肌梗死和中风的死亡风险，一些健康效应呈现“倒U形非线性暴露-反应关系”。在热浪条件下，NO与高温之间的协同效应显著增强，导致死亡风险的增加幅度大于O和O，并表现出当日滞后和累积效应。在双污染模型中引入其他污染物后，NO在热浪期间对主要死因仍显示出强烈的独立健康效应，中风的风险升高最为明显。
大气氧化性污染物与高温、日较差和热浪相互作用，显著增加死亡风险。整合空气污染和气象因素对于在高危时期加强健康保护至关重要。
