Risk of Cardiovascular Hospital Admission After Exposure to Fine Particulate Pollution

Zhang, Yi; Ma, Runmei; Ban, Jie; Lü, Feng; Guo, Moning; Zhong, Yiren; Jiang, Ning; Chen, Chen; Li, Tiantian; Shi, Xiaoming

doi:10.1016/j.jacc.2021.06.043

Cited by 37 publications

(32 citation statements)

References 29 publications

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“…Second, the use of data from a city-level registry system minimised selection bias. The system combined the validated Beijing HDIS, as mentioned above, and VRMS which has been widely used in many large-scale studies and other similar research exploring factors associated with OHCD 18 33 34. The VRMS in Beijing was established to cover the whole city population in 1975, and is the highest quality in China.…”

Section: Discussionmentioning

confidence: 99%

Overall and gender-specific associations between marital status and out-of-hospital coronary death during acute coronary events: a cross-sectional study based on data linkage in Beijing, China

Deng

Long

Guo³

et al. 2022

BMJ Open

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ObjectivesTo assess overall and gender-specific associations between marital status and out-of-hospital coronary death (OHCD) compared with patients surviving to hospital admission.DesignA cross-sectional study based on linkage of administrative health databases.SettingBeijing, China.ParticipantsFrom 2007 to 2019, 378 883 patients with acute coronary event were identified in the Beijing Monitoring System for Cardiovascular Diseases, a validated city-wide registration system based on individual linkage of vital registration and hospital discharge data.Outcome measuresOHCD was defined as coronary death occurring before admission. Multilevel modified Poisson regression models were used to calculate the prevalence ratios (PR) and 95% CIs.ResultsAmong 378 883 acute coronary events, OHCD accounted for 33.8%, with a higher proportion in women compared with men (41.5% vs 28.7%, p<0.001). Not being married was associated with a higher proportion of OHCD in both genders, with a stronger association in women (PR 2.18, 95% CI 2.10 to 2.26) than in men (PR 1.97, 95% CI 1.91 to 2.02; p for interaction <0.001). The associations of OHCD with never being married (PR 1.98, 95% CI 1.88 to 2.08) and being divorced (PR 2.54, 95% CI 2.42 to 2.67) were stronger in men than in women (never married: PR 0.98, 95% CI 0.82 to 1.16; divorced: PR 1.47, 95% CI 1.34 to 1.61) (p for interaction <0.001 for both). Being widowed was associated with a higher proportion of OHCD in both genders, with a stronger association in women (PR 2.26, 95% CI 2.17 to 2.35) compared with men (PR 1.89, 95% CI 1.84 to 1.95) (p for interaction <0.001).ConclusionsNot being married was independently associated with a higher proportion of OHCD and the associations differed by gender. Our study may aid the development of gender-specific public health interventions in high-risk populations characterised by marital status to reduce OHCD burden.

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Section: Discussionmentioning

confidence: 99%

Overall and gender-specific associations between marital status and out-of-hospital coronary death during acute coronary events: a cross-sectional study based on data linkage in Beijing, China

Deng

Long

Guo³

et al. 2022

BMJ Open

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“…First, data analysis in most previous geographic studies has focused either on AMI hospital admissions or mortality, which may lead to underestimation of the total AMI burden [ 37 , 38 , 39 ]. We obtained data on AMI incidence that covered both hospitalized AMI cases and out-of-hospital deaths from the BCDSS [ 12 , 14 ], thus providing more accurate depictions of spatiotemporal patterns for the AMI burden. In addition, by borrowing statistical strength across space (neighboring townships), our Bayesian model produced more robust estimates of AMI incidence at the small area level [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…AMI cases were identified through the BCDSS, which links routinely collected records in the Beijing Hospital Discharge Information System (HDIS) and the Beijing Vital Registration Monitoring System (VRMS) using personal identification information prior to this study [ 11 ] ( Figure S2 ). The HDIS of the Beijing Municipal Health Commission Information Center covers admissions to all secondary and tertiary level hospitals in Beijing, with the exception of first-level hospitals which directly provide comprehensive medical, prevention, rehabilitation, and health care services to communities [ 12 ]. AMI admissions were identified from the Beijing HDIS based on principal discharge diagnoses with codes I21–I22 of the International Classification of Diseases, Tenth Revision (ICD-10) [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

Trends and Inequalities in the Incidence of Acute Myocardial Infarction among Beijing Townships, 2007–2018

Chang

Deng

Guo

et al. 2021

IJERPH

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Acute myocardial infarction (AMI) poses a serious disease burden in China, but studies on small-area characteristics of AMI incidence are lacking. We therefore examined temporal trends and geographic variations in AMI incidence at the township level in Beijing. In this cross-sectional analysis, 259,830 AMI events during 2007–2018 from the Beijing Cardiovascular Disease Surveillance System were included. We estimated AMI incidence for 307 consistent townships during consecutive 3-year periods with a Bayesian spatial model. From 2007 to 2018, the median AMI incidence in townships increased from 216.3 to 231.6 per 100,000, with a greater relative increase in young and middle-aged males (35–49 years: 54.2%; 50–64 years: 33.2%). The most pronounced increases in the relative inequalities was observed among young residents (2.1 to 2.8 for males and 2.8 to 3.4 for females). Townships with high rates and larger relative increases were primarily located in Beijing’s northeastern and southwestern peri-urban areas. However, large increases among young and middle-aged males were observed throughout peri-urban areas. AMI incidence and their changes over time varied substantially at the township level in Beijing, especially among young adults. Targeted mitigation strategies are required for high-risk populations and areas to reduce health disparities across Beijing.

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“…Another time-stratified case-crossover study observed that persistent heavily or extremely heavily PM 2.5 -polluted weather was associated with increased risk of cardiovascular disease hospitalization among Beijing residents. The odds ratios (ORs) associated with extremely heavy PM pollution events (PM concentration ≥150 μg/m 3 for 3 days or more) were 1.085, 1.112, 1.068, 1.071, and 1.060 for total cardiovascular disease, angina, myocardial infarction, ischemic stroke, and heart failure, respectively ( 22 ). The study also showed that the higher the concentration and the longer the duration of heavy pollution events, the greater the impact was on hospitalizations for various cardiovascular diseases ( 22 ).…”

Section: Introductionmentioning

confidence: 99%

“…The odds ratios (ORs) associated with extremely heavy PM pollution events (PM concentration ≥150 μg/m 3 for 3 days or more) were 1.085, 1.112, 1.068, 1.071, and 1.060 for total cardiovascular disease, angina, myocardial infarction, ischemic stroke, and heart failure, respectively ( 22 ). The study also showed that the higher the concentration and the longer the duration of heavy pollution events, the greater the impact was on hospitalizations for various cardiovascular diseases ( 22 ). Among them, the risks of angina pectoris and ischemic stroke were more pronounced.…”

Section: Introductionmentioning

confidence: 99%

Recommendations of Controlling and Preventing Acute Health Risks of Fine Particulate Matter Pollution — China, 2021

Force¹,

Shi²,

Duan³

2022

China CDC Weekly

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The task force has comprehensively reviewed efforts for air pollution prevention and control, the acute health effects of fine particles (PM 2.5 ), and the health benefits of air pollution prevention and control in China. It has been found that the overall prevention and control of ambient PM 2.5 pollution in China has made remarkable progress in recent years. However, it still remains at a relatively high level. Short-term exposure to ambient PM 2.5 significantly increases the mortality and morbidity risk of Chinese residents, resulting in changes to levels of relevant biological markers. Prolonged PM 2.5 heavily polluted weather greatly increases the risk of cardiovascular disease morbidity and mortality. Among chemical composition of PM 2.5 , carbon-containing components, some inorganic salts, and heavy metals are linked with the health impacts. The health risks of PM 2.5 pollution are higher for children, the elderly, and patients with cardiovascular or respiratory diseases than for the general population because the former groups are vulnerable subpopulations. The implementation of air pollution prevention and control policies has significantly improved human health. The implementation of personal protective equipment can significantly reduce the health damage caused by short-term exposure to ambient PM 2.5 pollution. Based on scientific evidence of PM 2.5 pollution and acute health risks in China, the following three recommendations are proposed. 1) The policy recommendations for the prevention and control of ambient PM 2.5 pollution include the following: to continuously strengthen the widespread use and efficient development of clean energy; to further promote industrial upgrading; to focus on the control of transportation pollution; to keep improving the modernization system of air pollution control; to formulate and refine relevant standards for air quality gradually; and to estimate the effects and health benefits after the implementation of clean air actions, and relevant policies. 2) Prevention of ambient PM 2.5 pollution and protection of public health recommendations include the following: to strengthen the release of air pollution monitoring and relevant information; to strengthen awareness of air pollution hazards; to clarify the guidance and recommendations for protecting population health from air pollution; and to strengthen the health protection of population vulnerable to ambient air pollution. 3) Recommendations for research on health risks of air pollution include the following: to strengthen research on air pollutant monitoring technology and monitoring system based on the promotion of accurate exposure assessment; to systematically carry out full-spectrum identification and correlation studies of air pollutants and health effects; to conduct studies on key...

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Risk of Cardiovascular Hospital Admission After Exposure to Fine Particulate Pollution

Cited by 37 publications

References 29 publications

Overall and gender-specific associations between marital status and out-of-hospital coronary death during acute coronary events: a cross-sectional study based on data linkage in Beijing, China

Overall and gender-specific associations between marital status and out-of-hospital coronary death during acute coronary events: a cross-sectional study based on data linkage in Beijing, China

Trends and Inequalities in the Incidence of Acute Myocardial Infarction among Beijing Townships, 2007–2018

Recommendations of Controlling and Preventing Acute Health Risks of Fine Particulate Matter Pollution — China, 2021

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