Spatial Epidemiological Study On The Association Of Atmospheric Aerosol With The Acute Attacks Of Cardio-Cerebral-Vascular Diseases In Hangzhou City

Objective:The aims of the study were to explore whether or not the acute attacks of cardio-cerebral-vascular diseases were associated with time,geographical factors,and atmospheric aerosol,to investigate the space-time distribution of atmospheric aerosol and its related factors in Hangzhou city,to describe the space-time clusters of the acute attacks of cardio-cerebral-vascular diseases among the monitored population in Hangzhou city,and to study the associations of atmospheric aerosol with the acute attacks of cardio- cerebral-vascular diseases.Methods:The temporal pattern of atmospheric aerosol was examined using autocorrelation analysis and Kringing interpolation methods of spatial statistics.The autoregressive-moving average model was used to analyze the related factors of atmospheric aerosol.The spatial distribution of cardio-cerebral-vascular diseases was evaluated by Kringing interpolation method of spatial statistics.The clusters of cardio-cerebral-vascular diseases were examined using the retrospective space-time permutation model.The association of atmospheric aerosol with the attacks of cardio-cerebral-vascular diseases was analyzed using cross-correlation analysis and time series Poisson regression analysis.The autocorrelation analysis and Kringing interpolation of spatial statistics analyses were conducted using DPS version 9.50.The analysis of the retrospective space-time permutation models was performed using SaTscan version 7.0.3.The other statistical analyses were carried out using SPSS version 16.0 program for Windows.A two-tailedαvalue equal to 0.05 served as the threshold for statistical significance.Results:To certain extent,the temporal pattern of atmospheric aerosol optical depth(AOD) in Hangzhou city presented the periodicity.There were positive correlations between AODs in 0 day,lag 96^th,383^rd,479^th,766^th,1149^th and 1532^nd day.It indicated global spatial clustering.However,there were negative correlations between AODs in 0 day, lag 191^st,287^th,574^th,957^th,1340^th and 1723^rd day.AOD in resident region was higher than that in non-resident region,and there was difference in AOD for various monthes.AOD in the first day was positively related with AOD in lag 1^st day(7=39.531, P<0.001).AOD was related with relative humidity(7=3.700,P<0.001),SO₂(t=-3.064, P=0.002),NO₂(t=2.148,P=0.032),and NO₂ in lag 1^st day(t=-2.769,P=0.006).But the statistical significant associations of AOD with temperature and cloud mask were not observed.There was statistically significance on the geographical cluster of attacks of cardio-cerebral-vascular diseases among the monitored population from October 20, 1998 to November 25,2005 in Lvzhu town,Xukou town,Xintong township,Xindeng town,Changkou town,Wanshi town,Lushan neighbourhood,Yongchang town, Dongzhou neighbourhood,Huangshan township,Chunjian township,Huyuan township, Changan town,Longmen town and Dongqiao town in Fuyang city(SMR=0.05, P=0.001),from December 1,2000 to December 22,2004 in Daciyan town,Xinanjiang town,Yangxi neighbourhood,Genglou neighbourhood,Lianhua town and Shouchang town in Jiande city(SMR=0.01,P=0.001),from June 15,1995 to November 18,2005 in Fuchun neighbourhood,Yushan township in Fuyang city(SMR=0.05,P=0.001),from January 15,2002 to July 17,2004 in Dayang town,Tongjia township in Jiande city and Dayuan town in Fuyang city(SMR=3A3,P=0.001),from January 1,1997 to May 17, 2004 in Gaoqiao town,Lingqiao town in Fuyang city(SMR=2.77,P=0.001),from December 21,2001 to December 28,2004 in Shiqiao neighbourhood,Dongxin neighbourhood,Wenhui neighbourhood,Chaoming neighbourhood in Hangzhou city (SMR=0.17,P=0.001),and from February 2,2002 to December 13,2004 in Datong town in Fuyang city(SMR=2.52,P=0.001).There was statistically significance on the geographical cluster of attacks of coronary heart disease(CHD) among the monitored population from July 15,2004 to December 11,2005 in Lvzhu town,Xintong township,Xindeng town,Changkou town, Wanshi town,Lushan neighbourhood,Yongchang town,Huanshan township,Chunjian township,Huyuan township,Changan town,Dongqiao town,Fuchun neighbourhood, Shangguan township,lingqiao town,Dongzhou neighbourhood,Changlv town,Gaoqiao town,Shouxiang town,Lishan town,Yushan township,Dayuan town in Fuyang city and Qiantan town,Yangcunqiao town,Sandu town,Xiaya town,Meicheng town, Yangxi neighbourhood,Lianhua town,Dayang town in Jiande city(SMR=0.42, P=0.001),from January 5,2002 to January 25,2005 in Shiqiao neighbourhood, Dongxin neighbourhood,Wenhui neighbourhood and Chaoming neighbourhood in Hangzhou city(SMR=0.00,P=0.001),from July 4,2004 to January 2,2006 in Ziyang neighbourhood,Chengzhan neighbourhood,Xiaoying neighbourhood,Hubin neighbourhood,Wangjiang neighbourhood,Tianshui neighbourhood,Zhaohui neighbourhood,Wulin neighbourhood,Changqing neighbourhood and Qingbo neighbourhood in Hangzhou city(SMR=1.44,P=0.006).There was statistically significance on the geographical cluster of attacks of stroke among the monitored population from July 28,2002 to Noveber 30,2005 in Xindeng town,Yongchang town,Chunjian township,Wanshi town,Lushan neighbourhood, Changkou town,Xinyi township,Fuchun neighbourhood,Huanshan township,and Dongzhou neighbourhood in Fuyang city(SMR=0.00,P=0.001),form August 15, 2002 to January 25,2004 in Datong in Jiande city(SMR=4.19,P=0.002),there was random on the geographical cluster of attacks of stroke among the monitored population from March 31,2005 to September 10,2005 in Qingbo neighbourhood,Wulin neighbourhood,Tianshui neighbourhood and Zhaohui neighbourhood in Hangzhou city (SMR=5.26,P=0.591),from April 14,2006 to April 28,2006 in Fuchun neighbourhood in Fuyang city(SMR=23.00,P=0.722),from January 11,2005 to Februray 12,2005 in Sandu town and Yangxi neighbourhood in Jiande city(SMR=22.08,P=0.754).There was statistically significance on the geographical cluster of attacks of cardiogenic sudden death among the monitored population from June 20,2005 to December 20,2006 in Datong town,Shouchang town,Xiaya town,Qiantan town in Jiande city and in Changkou town in Fuyang city(SMR=0.07,P=0.001),there was random on the geographical cluster of attacks of cardiogenic sudden death among the monitored population from August 26,2002 to December 20,2004 in Changqing neighbourhood,Xiaoying neighbourhood,Hubin neighbourhood,Tianshui neighbourhood,Wenhui neighbourhood,Qingbo neighbourhood,Ziyang neighbourhood,Wangjiang neighbourhood,Zhaohui neighbourhood,Nanxing neighbourhood and Shiqiao neighbourhood in Hangzhou city(SMR=0.00,P=0.072), from December 20,2004 to April 29,2005 in Shouxiang town in Fuyang city (SMR=10.78,P=0.394),from January 19,2006 to January 19,2006 in Wanshi town in Fuyang city(SMR=48.50,P=0.512),from October 18,2005 to November 18,2005 in Gaoqiao town and Lingqiao town in Fuyang city(SMR=32.33,P=0.890).There was statistically significance on the geographical cluster of attacks of intracerebral hemorrhage among the monitored population from November 20,2000 to September 8,2005 in Lvzhu town,Xukou town,Xintong town,Xindeng town, Changkou town,Wanshi town,Lushan neighbourhood,Yongchang town,Huanshan township,Chunjian township,Huyuan township,Changan town,Longmen town and Dongqiao town in Fuyang city(SMR=0.03,P=0.001),from December 1,2000 to December 20,2004 in Daciyan town,Xinanjiang town,Genglou neighbourhood, Lianhua town,and Shouchang town in Jiande city(SMR=0.01,P=0.001),from February 16,2002 to September 28,2004 in Dayang town,Dayuan town and Tongjia township in Jiande city(SMR=2.66,P=0.0.01),from September 11,1999 to April 12,2004 in Changqing neighbourhood,Tianshui neighbourhood,Zhaohui neighbourhood,Wulin neighbourhood,Xiaoying neighbourhood,Chaoming neighbourhood,Qingbo neighbourhood,Hubin neighbourhood,Chengzhan neighbourhood,Wenhui neighbourhood,Dongxin neighbourhood,Ziyang neighbourhood,Wangjiang neighbourhood,Shiqiao neighbourhood in Hangzhou city and Fuchun neighbourhood and Yushan township in Fuyang city(SMR=0.37,P=0.001),from December 6,2005 to February 8,2007 in Gaoqiao town and Lingqiao town in Fuyang city(SMR=0.31, P=0.001),from August 1,2001 to December 19,2005 in Dongzhou in Fuyang city(SMR=0.03,P=0.001).There was statistically significance on the geographical cluster of attacks of cerebral thrombosis among the monitored population from May 10,2001 to Deccember 28,2005 in Longmen town,Huanshan township,Shangguan township,Changan town, Changkou town,Lushan neighbourhood,Huyuan township,Xintong township,Changlv town,Liangqiao town,Lishan town,Gaoqiao town,Dongzhou neighbourhood,Yushan township,Chunjian township,Xindeng town,Lvzhu town,Yongchang town,Shouxiang town,Xukou town,Wanshi town,Dongqiao town in Fuyang city,in Nanxing neighbourhood,Ziyang neighbourhood and Wangjiang neighbourhood in Hangzhou city and Shouchang town in Jiande city(SMR=0.44,P=0.001),from January 12,2002 to november 14,2003 in Qiantan town in Jiande city(SMR=12.73,P=0.001),from March 25,2004 to January 28,2005 in Changqing neighbourhood,Tianshui neighbourhood, Zhaohui neighbourhood,Wulin neighbourhood,Xiaoying neighbourhood in Hangzhou city(SMR=2.67,P=0.010),There was random on the geographical cluster of attacks of cerebral thrombosis among the monitored population from January 15,2007 to January 18,2007 in Dongxin neighbourhood in Hangzhou city(SMR=84.09,P=0.191).There was statistically significance on the geographical cluster of attacks of cerebral embolism among the monitored population from June 15,1995 to November 30,2005 in Lvzhu town,Xukou town,Xintong township,Xindeng town,Changkou town,Wanshi town,Lushan neighbourhood,Yongchang town,Huanshan township, Chunjian township,Huyuan township,Changan town,Longmen town and Dongqiao town in Fuyang city(SMR=0.01,P=0.001),from november 7,1997 to January 13,2005 in Daciyan town,Xinanjiang town,Genglou neighbourhood,Lianhua town and Shouchang town in Jiande city(SMR=0.00,P=0.001),from June 15,1995 to December 5,2005 in Fuchun neighbourhood and Yushan township in Fuyang city (SMR=0.03,P=0.001),from September 21,2002 to February 14,2005 in Chengzhan neighbourhood,Xiaoying neighbourhood,Changqing neighbourhood and Ziyang neighbourhood in Hangzhou city(SMR=2.02,P=0.001).The attacks of cardio-cerebral-vascular diseases were related to the day of a week [attacks on Sunday as control,its on Thursday(t=2.933,P=0.003) and Saturday (t=3.015,P=0.003)],and to the average AOD(t= 2.962,P=0.003).The attacks of coronary heart disease were associated with cloud mask(t=2.860,P =0.004),the daily average concentration of PM₁₀(t=2.388,P=0.017) and type of aerosol(t=2.690, P=0.008).The attacks of cardiogenic sudden death were related to the day of a week [attacks on Sunday as control,its on Saturday(t=2.918,P =0.004) and Friday(t=3.746, P <0.001)],to cloud mask(t=2.680,P=0.008).The attacks of stroke were associated with cloud mask(t=2.088,P=0.037).The attacks of intracerebral hemorrhage were related to AOD(t=2.117,P=0.035).The attacks of cerebral thrombosis were related to the day of a week[attacks on Sunday as control,its on Monday(t=3.176,P=0.002), Tuesday(t=2.133,P=0.033) and Saturday 0=2.600,P 0.009)].The attacks of cerebral emblolism were associated with the day of a week[attacks on Sunday as control,its on Saturday(t=2.600,P=0.009)].Conclusions:To certain extent,the space-time distribution of AOD in Hangzhou city appeared positive autocorrelation,which is obvious characteristic of spatial-time.The results supported the hypothesis that AOD associates with the environmental and meteorological factors.The attacks of cardio-cerebral-vascular disease presented space-time cluster.The attacks of cardio-cerebral-vascular disease and intra-cerebral hemorrhage were positively related to AOD.