Study On The Relationship Between Air Pollution And Cardiovascular Disease Mortality Risk In Wuhai City

Objective The main purpose of this study is to analyze the impact of air pollutants on the risk of death from cardiovascular disease,quantitatively analyze the lagged effect of various pollutants on the risk of death from cardiovascular disease,and identify the categories of high-exposure pollutants.The association was stratified by season,sex,age and specific disease causing death to identify vulnerable groups and focus on prevention and treatment.Methods The cardiovascular disease death information,air pollution and meteorological monitoring data of Wuhai residents from 2015 to 2019 were collected.The generalized additive model was established and meteorological factors were included.The spline function adopted cubic regression spline and the connecting function was Poisson distribution.Finally,the optimal model was determined by generalized cross validation.The characteristic transformation of the independent variables of air pollutants was carried out,and a cross basis was established to form a new independent variable.The new independent variables were put into the generalized additive model,and the distributed lag nonlinear model was fitted to analyze the effects of air pollutants at the latitudes of expose-response and expose-lag.The effects of air pollutants on each subgroup were calculated by stratification of death groups by sex,age,heating and non-heating season and specific cause of death.Major air pollutants affecting cardiovascular mortality were selected and their interactions were analyzed.Results 1.Basic characteristic analysis of cardiovascular disease deaths,air pollutants and meteorological factors 1.1 A total of 5,441 people died of cardiovascular diseases in Wuhai from 2015 to 2019,with an average of 2.98 people dying every day.According to the comparison of death number and mortality rate,male was higher than female,heating season was more than non-heating season,and 71.79% of people aged 65 or older died.Acute myocardial infarction,sequelae of cerebral infarction and hypertensive encephalopathy ranked the top three cardiovascular diseases in terms of death ratio.1.2 The average daily concentrations of Fine Particulate Matter(PM2.5),Respirable Particulate Matter(PM10),Sulphur Dioxide(SO2),Nitrogen Dioxide(NO2),Ozone(O3)and Carbon Monoxide(CO)were 41.94μg/m3,105.02μg/m3,46.71μg/m3,28.47μg/m3,99.76μg/m3 and 0.97mg/m3,respectively.According to the second-class concentration limit of “Ambient Air Quality Standard”(GB3095-2012)formulated in China,the exceedance rate of particulate matter is high.The exceeding rates of PM2.5and PM10 reached 9.26% and 15.99%.2.Correlation analysis between air pollutants and meteorological factors: There was a strong positive correlation between PM2.5 and PM10,SO2 and NO2,CO and NO2(The correlation coefficients are all greater than 0.8),and a negative correlation between O3 and other pollutants except SO2(Absolute value of correlation coefficient is less than0.25).3.Effects of air pollutants on total cardiovascular mortality PM2.5 concentration at Lag0,Lag5,Lag6,Lag01,Lag05,Lag06 and Lag07 days had a significant effect on the mortality of cardiovascular diseases,the effect was the largest at Lag06 days.When PM2.5 concentration increased by 10μg/m3,the risk of death of cardiovascular diseases increased to 1.036 times(95%CI: 1.007-1.065).CO had a greater impact on cardiovascular mortality at Lag05 and Lag06 days,its concentration increased by 0.1mg/m3,the RR values were 1.015(95%CI : 1.001-1.028)and 1.017(95%CI :1.003-1.033).On the basis of the single pollutant model,the effects of other pollutants were adjusted respectively,and the two-pollutant model was fitted with stable results.4.Stratified analysis 4.1 PM2.5,SO2 and CO were associated with higher risk of death from cardiovascular disease in women.A 10μg/m3 increase in PM2.5 was associated with a 1.023-fold(95%CI: 1.002-1.044)and a 1.013-fold(95%CI: 1.002-1.044)increase in the risk of cardiovascular death at Lag0 and Lag5 days.The effect sizes of SO2 increased by 10 μg/m3 and CO increased by 0.1 mg/m3 were 1.007 at Lag5 day.For men,only PM2.5 had a statistically significant effect,with RR of 1.013(95%CI:1.002-1.025),1.04(95%CI: 1.004-1.077)and 1.046(95%CI:1.007-1.086)on Lag6,Lag06 and Lag07 days.4.2 In the older age group(≧65 years),PM2.5,PM10 and CO were risk factors for cardiovascular death.When the pollutant concentration increased by 10μg/m3,the RR value of PM2.5 on Lag06 day was the largest,which was 1.032(95%CI: 1.000-1.066),and the RR value of PM10 on Lag01 day was 1.007(95%CI: 1.000-1.014).When CO increased by 0.1 mg/m3,the RR value of Lag5 day increased to 1.004(95%CI :1.000-1.009).In the younger age group(<65 years),O3 was a protective factor for cardiovascular death,and the RR values for Lag06 and Lag07 days were less than 1.4.3 In the heating season(October to March of the following year),PM2.5,NO2 and CO are risk factors for cardiovascular disease death.When the pollutant concentration increased by 10 μg/m3,the RR value of PM2.5 was significant on Lag5,Lag01,Lag05,and Lag06 days.The RR value of Lag06 day was the largest,which was 1.043(95%CI: 1.009-1.079);the RR value of NO2 on Lag06 day was 1.062(95%CI:1.000-1.127).The RR values of Lag5 and Lag6,Lag01,Lag05,Lag06 and Lag07 were significantly increased when CO increased by 0.1 mg/m3,with a maximum of1.023(95%CI:1.005-1.042)on Lag06 day.During the non-heating season(April to September),only increased PM10 concentrations significantly increased the risk of death from cardiovascular disease,with RR values of 1.005(95%CI: 1.001-1.010)and 1.007(95%CI: 1.001-1.013)on Lag5 and Lag6 days.4.4 Air pollutants had the greatest impact on death from acute myocardial infarction,and PM2.5,PM10 and CO were all risk factors for death from acute myocardial infarction.The risk of death from acute myocardial infarction was increased by 1.028(95%CI: 1.004-1.052)and 1.019(95%CI: 1.003-1.035)times when PM2.5 and PM10 concentration increased by 10 μg/m3.Increased CO by 0.1mg/m3 was associated with a 1.012-fold increased risk of death from acute myocardial infarction(95%CI:1.003-1.022).The mortality of sequelae of cerebral infarction was mainly affected by PM10,and the RR of Lag6 increased to 1.010(95%CI: 1.000-1.020)when the concentration of PM10 increased by 10μg/m3.All air pollutants were not statistically significant for death from hypertensive encephalopathy.5.Interaction of air pollutants To explore the interaction between PM2.5 and CO,the main air pollutants that affected death from cardiovascular disease.The interaction diagram showed when the CO concentration was low,the total effect of the two pollutants on cardiovascular deaths increased with the increase of the PM2.5concentration.At higher concentration of PM2.5,the effect on cardiovascular deaths decreased with increasing CO concentrations.However,the interaction terms of the two pollutants in the model were not statistically significant.Conclusions PM2.5 and CO were the main air pollutants affecting the death rate of cardiovascular diseases,and had significant effects on the total cardiovascular death rate and stratified analysis.There were many types of air pollutants that affect female cardiovascular mortality,including PM2.5,SO2 and CO.Cardiovascular mortality in men was only affected by PM2.5 exposure.Older people aged ≧ 65 years were vulnerable to air pollutants.The harm caused by air pollutants in heating season was much greater than that in non-heating season season.Acute myocardial infarction was most likely to be affected by air pollutants.