Wang Wenhan, Ming Xiaoyan, Chen Lu, Chen Yingdong, Yang Zhongcheng, Hu Chi, Zhang Qiuju
The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, China.
School of Public Health, Harbin Medical University, 157 Baojian Road, Harbin, 150081, China.
Environ Health. 2025 Sep 24;24(1):63. doi: 10.1186/s12940-025-01219-x.
Rapid industrialization has exacerbated ambient air pollution in Yichang, China, posing cardiovascular health risks. This study evaluates the short-term impact of ambient air pollutants on cardiovascular disease (CVD) outpatient visits and assesses the effectiveness of environmental policies implemented post-2018.
We analyzed 510,831 CVD outpatient records alongside daily concentrations of PM, PM, SO, NO, CO, and O from five monitoring stations. Generalized additive Poisson regression with distributed lag non-linear models (DLNM) quantified associations between ambient air pollutant exposure (per interquartile range (IQR) increase) and daily visits, adjusting for meteorological factors, time trends, and COVID-19. Effects pre- and post-2018 policy implementation (targeting riverside chemical industry relocation) were compared.
Short-term exposure to NO₂ (lag05, RR = 1.253, 95% CI: 1.192-1.317), SO₂ (lag0, RR = 1.053, 95% CI: 1.011-1.096), and CO (lag01, RR = 1.063, 95% CI: 1.016-1.111) was significantly associated with increased cardiovascular disease outpatient visits. Concentrations of five major ambient air pollutants (excluding O₃) showed significant reductions after 2018 (P < 0.001). The associations of SO₂, CO, and PM₁₀ with CVD visits were attenuated after 2018. NO₂ effects were stronger in colder seasons and remained robust in two-pollutant models. No statistically significant associations were observed for PM₂.₅, PM₁₀, and O₃.
Short-term exposure to NO₂, SO₂, and CO demonstrated statistically significant positive associations with cardiovascular disease outpatient visits. Environmental policies reduced ambient air pollutant levels and attenuated health impacts, supporting continued air quality interventions.
快速工业化加剧了中国宜昌市的环境空气污染，对心血管健康构成风险。本研究评估环境空气污染物对心血管疾病（CVD）门诊就诊的短期影响，并评估2018年后实施的环境政策的有效性。
我们分析了510,831份心血管疾病门诊记录以及来自五个监测站的PM、PM、SO、NO、CO和O的每日浓度。采用具有分布滞后非线性模型（DLNM）的广义相加泊松回归来量化环境空气污染物暴露（每增加一个四分位数间距（IQR））与每日就诊之间的关联，并对气象因素、时间趋势和新冠疫情进行了调整。比较了2018年政策实施前后（针对沿江化工产业搬迁）的影响。
短期暴露于二氧化氮（滞后05，RR = 1.253，95%置信区间：1.192 - 1.317）、二氧化硫（滞后0，RR = 1.053，95%置信区间：1.011 - 1.096）和一氧化碳（滞后01，RR = 1.063，95%置信区间：1.016 - 1.111）与心血管疾病门诊就诊增加显著相关。2018年后，五种主要环境空气污染物（不包括臭氧）的浓度显著降低（P < 0.001）。2018年后，二氧化硫、一氧化碳和可吸入颗粒物与心血管疾病就诊的关联减弱。二氧化氮在较冷季节的影响更强，在双污染物模型中仍然显著。未观察到细颗粒物、可吸入颗粒物和臭氧有统计学显著关联。
短期暴露于二氧化氮、二氧化硫和一氧化碳与心血管疾病门诊就诊呈统计学显著正相关。环境政策降低了环境空气污染物水平并减弱了健康影响，支持持续的空气质量干预措施。
