Effects Of Air Pollutants And Meteorological Factors On Daily Hospitalization Of Coronary Heart Disease In Ganzhou

Objective:To explore the influence of air pollutants and meteorological factors on the daily hospitalization of coronary heart disease in Ganzhou,and analyze the sensitivity of different populations to the disease,so as to provide scientific basis for local precise prevention of coronary heart disease.Methods:Daily air quality monitoring data(including PM_2.5,PM₁₀,PM_C,SO₂,NO₂,CO and O₃),meteorological monitoring data（including maximum temperature,minimum temperature,average temperature,relative humidity,and average pressure）,and daily hospitalization data（including hospitalization number,name,gender and age,etc.）of coronary heart disease in Ganzhou from January 1,2019 to December 31,2021 were collected.By using the generalized additive model and the distributed lag nonlinear model,and using the natural spline function to control the confounding factors such as the time and seasonal variation trend and the"day of the week effect",the single-day lag effect（lag1-lag7）and the cumulative lag effect（lag01-lag07）were analyzed.The effects of air pollutants and meteorological factors on the number of daily inpatients with coronary heart disease in Ganzhou were quantitatively analyzed to determine the strongest response period.At the same time,subgroup analysis was conducted according to different genders and different ages to identify the susceptible population.Results:1.Air pollutants,meteorological factors and the number of patients with coronary heart disease in GanzhouFrom January 1,2019 to December 31,2021,the average concentrations（standard deviation）of PM_2.5,PM₁₀,PM_C,SO₂,CO,NO₂and O₃in Ganzhou were25.97（13.23）μg/m³,46.42（22.91）μg/m³,20.45（11.49）μg/m³,11.02（4.99）μg/m³,1.07（0.42）mg/m³,19.53（11.63）μg/m³,88.19（37.53）μg/m³,respectively,and the variation of atmospheric pollutant concentration has certain seasonal and periodic fluctuations;The average value（standard deviation）of five meteorological factors（average temperature,maximum temperature,minimum temperature,relative humidity and average air pressure）in the same period is 21.34（8.01）℃,25.18（8.29）℃,17.50（7.81）℃,72.54（12.20）%,748.78（5.92）mm Hg,respectively;During the study period,33653 people were hospitalized for coronary heart disease in Ganzhou,including 21821 males and 11832 females,with a sex ratio of 1.84:1,and the average daily number of inpatients was 31.The results of Spearman correlation analysis showed that there is strong correlation between the particles（|r|>0.6）,and there is strong correlation between three kinds of particles with NO₂（|r|>0.6）,there is strong correlation between O₃and DTR,RH（|r|>0.6）,T_mhas strong correlations with P_m（|r|>0.6）.DTR has strong correlations with RH（|r|>0.6）.2.The relationship between air pollutants,meteorological factors and coronary heart disease hospitalization in GanzhouGAM model was used to analyze the impact of seven air pollutants on daily hospitalization of coronary heart disease.The results showed that PM_2.5,PM₁₀,PM_C,NO₂were related to the increase of daily hospitalization of coronary heart disease.The best single day lag time of PM_2.5and PM₁₀is lag1.The daily hospitalization of coronary heart disease increases by 2.60%and 1.69%for every 10μg/m³increase in concentration.The best single day lag time of PM_Cand NO₂is lag0.The daily hospitalization of coronary heart disease increases by 3.01%and 4.29%for every 10μg/m³increase in concentration;The best cumulative lag time of PM₁₀and PM_Cis lag01,and the daily hospitalizations of coronary heart disease increase by 2.10%and3.77%with every increase of 10μg/m³of concentration;the best cumulative lag time of PM_2.5is lag02,and the daily hospitalizations of coronary heart disease increase by3.14%with every increase of 10μg/m³of concentration.The best cumulative lag time of NO₂is lag07,and the daily hospitalizations of coronary heart disease increased by 6.33%with every increase of 10μg/m³of concentration.Different gender and age have different effects on hospitalization of coronary heart disease.Subgroup analysis of gender found that the cumulative lag effect of PM_2.5,PM₁₀,PM_Cand NO₂was statistically significant for different genders（P<0.05）,and females were more sensitive to exposure to PM_2.5,PM₁₀,PM_C,NO₂and SO₂.By subgroup analysis of age,it was found that the cumulative lag effect of PM_2.5,PM₁₀,PM_Cand NO₂was statistically significant in relation to different ages（P<0.05）,and the elderly≥65years old were more sensitive.In the dual-pollutant model test,the results fluctuated after adjusting for other pollutants,but still had statistical significance（P<0.05）.The DLNM model was used to analyze the influence of meteorological factors on daily hospitalization of coronary heart disease.The results showed that the influence of meteorological factors on daily hospitalization of coronary heart disease was nonlinear correlation,however,no meteorological factors were found to increase the risk of hospitalization for coronary heart disease in Ganzhou.We also assessed the potential effects of sex and age,and found no dangerous effects.Conclusion:1.From 2019 to 2021,all air pollutants and meteorological factors in Ganzhou showed periodic changes.2.The number of inpatients with coronary heart disease in Ganzhou showed an increasing trend year by year,and there was a certain fluctuation.3.During the whole lag period,the exposure-response relationship between air pollutants and meteorological factors and hospitalization of coronary heart disease in Ganzhou basically showed a non-linear correlation.4.Short-term exposure to PM_2.5,PM₁₀,PM_Cand NO₂is associated with an increase in the number of hospitalizations for coronary heart disease,the women and the elderly are more sensitive to short-term exposure to air pollutants.5.There is no correlation has been found between meteorological factors and the number of inpatients with coronary heart disease in Ganzhou.