Short-term effects of extreme air pollutant concentrations on coronary heart disease hospitalization in Henan province: a time-stratified case-crossover study.
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引用次数: 0
Abstract
Introduction: Coronary heart disease (CHD) is a leading cause of cardiovascular mortality, with air pollution serving as a significant risk factor. Henan Province, characterized by both a high incidence of CHD and severe air pollution, faces substantial health and economic challenges. However, limited research has explored the relationship between air pollution and CHD in this region.
Methods: This study employs a case-crossover design combined with a distributed lag non-linear model (DLNM) to examine the short-term effects of extreme concentrations of air pollutants (PM₂.₅, PM₁₀, NO₂, SO₂, CO, and O₃) on CHD hospitalizations in Henan. Data on 133,294 confirmed CHD patients from seven large hospitals across five cities (2016-2021) were collected, with patients' addresses linked to nearby air quality monitoring stations to assess exposure to air pollutants and meteorological factors. The time-stratified case-crossover design and DLNM were used to calculate relative risks (RRs) for pollutant exposure on CHD hospitalizations, and subgroup analyses were conducted to identify sensitive groups.
Results: Significant increases in CHD hospitalizations were associated with extremely high concentrations of NO₂, SO₂, and PM₁₀, with maximum RRs of 1.768 for NO₂, 2.821 for SO₂, and 1.728 for PM₁₀ on the 7th cumulative day, while high O₃ levels showed a protective effect. Younger individuals (≤64y) and males were more sensitive to these effects, and high CO concentrations only increase the risk of CHD incidence in the younger (≤64y) subgroup. Synergistic interactions were observed between certain pollutants, such as CO and NO₂/SO₂/PM₁₀, suggesting that the negative impact of CO on CHD is amplified in a multi-pollutant environment due to interactions with other pollutants.
Discussion: These findings highlight the significant public health impact of air pollution on CHD in Henan Province.
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