The short-term effects and burden of particle air pollution on hospitalization for coronary heart disease: a time-stratified case-crossover study in Sichuan, China

Abstract

Background Coronary heart disease (CHD), the leading cause of death globally, might be developed or exacerbated by air pollution, resulting high burden to patients. To date, limited studies have estimated the relations between short-term exposure to air pollution and CHD disease burden in China, with inconsistent results. Hence, we aimed to estimate the short-term impact and burden of ambient PM pollutants on hospitalizations of CHD and specific CHD. Methods PM10 and PM2.5 were measured at 82 monitoring stations in 9 cities in Sichuan Province, China during 2017-2018. Based on the time-stratified case-crossover design, the effects of short-term exposure to particle matter (PM) pollution on coronary heart disease (CHD) hospital admissions were estimated. Meanwhile, the linked burden of CHD owing to ambient PM pollution were estimated. Results A total of 104,779 CHD records were derived from 153 hospitals from these 9 cities. There were significant effects of PM pollution on hospital admissions (HAs) for CHD and specific CHD in Sichuan Province. A 10 μg/m3 increase of PM10 and PM2.5 was linked with a 0.46% (95% CI: 0.08, 0.84%), and 0.57% (95% CI: 0.05, 1.09%) increments in HAs for CHD at lag7, respectively. The health effects of air pollutants were comparable modified by age, season and gender, showing old (≥ 65 years) and in cold season being more vulnerable to the effects of ambient air pollution, while gender-specific effects is positive but not conclusive. Involving the WHO’s air quality guidelines as the reference, 1784 and 2847 total cases of HAs for CHD could be attributable to PM10 and PM2.5, separately. The total medical cost that could be attributable to exceeding PM10 and PM2.5 were 42.04 and 67.25 million CNY from 2017 to 2018, respectively. Conclusions This study suggested that the short-term exposure to air pollutants were associated with increased HAs for CHD in Sichuan Province, which could be implications for local environment improvement and policy reference.

Health and economic impacts of ambient air pollution on hospital admissions for overall and specific cardiovascular diseases in Panzhihua, Southwestern China

“…When it comes to economic losses, previous studies have measured the economic costs of CVDs from air pollution (including PM 2.5 and PM 10 ) [27,29,30] and found that air pollutants entailed a heavy economic burden for CVDs hospitalization to society, which was consistent with our findings. Meanwhile, for the first time, our study provided straightforward information for assessing the economic burden of diseases caused by SO 2 exposure by estimating economic costs regarding hospitalization expenses attributable to exceeding SO 2 exposure.…”

“…Moreover, relatively few studies have estimated the attributable risk of HAs for CVDs due to PM 2.5 , PM 10 , and SO 2 exposure [27][28][29][30] and the economic costs of CVDs due to PM 2.5 and PM 10 exposure [27,29,30] in mainland China, as well as the economic costs of CVDs due to SO 2 exposure. Compared with measurements such as relative risk, attributable risk measures (such as attributable fraction (AF) and attributable number (AN)) and economic cost were more suitable and intuitive for researchers and policymakers to evaluate the threat of air pollutants to health.…”

Risk and economic cost of hospitalization due to atrial fibrillation caused by air pollution: a multi-city time series analysis

“…Previous studies showed that air pollution has a lag effect on health [26,27]. To fully study the lag pattern of the correlation between AF and various air pollutants, a lag structure was constructed from the day of admission (lag0) to 7 days before admission (lag7) to evaluate the 1-day lag effect.…”

Association between air pollution exposure and coronary heart disease hospitalization in a humid sub-tropical region of China: A time-series study

“…Even within the same country, differences in climate type and geographical location may also lead to differences in the role of atmospheric pollutants. Regardless of these, previous studies carried out in China have mainly reported on the association between PM and hospitalization of CHD (16)(17)(18), ignoring research on other pollutants. Therefore, in the present study, we carried out a time-series analysis to explore the relationship between air pollutants and CHD hospitalization in Hefei, and to identify the possible vulnerable sub-populations and meteorological factors.…”