Association between short-term exposure to sulfur dioxide and carbon monoxide and ischemic heart disease and non-accidental death in Changsha city, China

Abstract

Background To investigate the effects of short-term exposure to sulfur dioxide (SO2) and carbon monoxide (CO) in the central and southern China areas on ischemic heart disease (IHD) and non-accidental deaths. Method We investigated the associations between short-term exposure to SO2 and CO in a city in south-central China and IHD and non-accidental death using a time-series design and generalized additive models with up to a 5-day lag adjusting for day of the week, temperature, air pressure, wind speed, and relative humidity. The relative risks of IHD and non-accidental death per 10-unit increase in SO2 and CO were derived from zero to five days in single-pollutant models. Results Between 2016 and 2018, a total of 10,507 IHD and 44,070 non-accidental deaths were identified. The largest significant relative risk for IHD death was lag 02 for both SO2 (1.080; 95% confidence interval: 1.075–1.084) and CO (5.297; 95% confidence interval: 5.177–5.418) in single-pollutants models. A significant association was shown at all lag multiple-day moving averages. Two-pollutant models identified an association between SO2 and mortality when adjusting for CO. In stratified analyses, SO2 exhibited a stronger association with death during the cold season, while CO exhibited a stronger association with mortality from IHD during the warm season. The risk of death was more robust in the elderly for both pollutants, but was greater in men for CO and in women for SO2. Conclusions Overall, we found an association between short-term exposure to low-level SO2 and CO and the risk of IHD and non-accidental death.

Ambient carbon monoxide and cardiovascular-related hospital admissions: A time-series analysis

“…Although Liu et al (2018) , Li et al (2018) , Bell et al (2009) , and Motessadi Zarandi et al (2022) adjusted other pollutants by only two pollutant models and did not use multiple-pollutant models, the same as our findings, their results were robust to controlling for other pollutants. Unlike our study, the result of Xu et al (2021) did not remain robust when adjusted for SO 2 .…”

“…In the current study, in a time-series framework, we investigated the association between the ambient CO and hospitalizations for CVDs, using Poisson’s regression or negative binomial regression models and applying the data extracted from the CAPACITY study for patients aged 18 years or more. The mean concentration of CO in our study was 4.5 ± 2.3 mg/m 3 , which was a little higher than the recommended standard of 4 mg/m 3 ( Evangelopoulos et al, 2020 ) and higher than that in other studies such as Vahedian et al (2017) and Xu et al (2021) .…”

“…First, considering the suggestions of other studies such as Li et al (2018 ) and Xu et al (2021) , single pollutant models were derived from 0 to 5 lag days, and multiple-day moving averages of lags including lag0–1, lag2–5, and lag0–5. For instance, lag0–1 stands for the average concentrations of CO in lag0 and lag1.…”

Acute Effects of Air Pollution on Ischemic Heart Disease Hospitalizations: A Population-Based Time-Series Study in Wuhan, China, 2017–2018

“…On the contrary, females were more sensitive to NO 2 and SO 2 in our study, which is in line with several previous studies [ 14 , 30 , 41 , 42 ]. A study conducted in southern China showed that the risk of IHD death from short-term exposure to SO 2 was greater in women than in men [ 20 ]. A recent study in Canada reported that females were at higher risks of IHD hospitalization from NO 2 exposure than males [ 43 ].…”

“…However, some of these studies were limited to a particular district or a hospital [ 19 ] in Wuhan, and the populations of these studies may not represent the entire population. In addition, recent large-scale studies that focused solely on the health hazards of particulate matter (PM 2.5 and PM 10 ) [ 5 ], and the relationship of ambient NO 2 and SO 2 with the risk of IHD hospitalization have not been adequately investigated in China [ 20 ]. Therefore, a study on the association between air pollutants (both particulate matter and gaseous pollutants) and IHD hospitalization based on the entire population of Wuhan is needed to better understand the actual impact of ambient air pollution problems in central China.…”