Short-term effects of individual exposure to PM2.5 on hospital admissions for myocardial infarction and stroke: a population-based case-crossover study in Guangzhou, China

• Published in: Environmental science and pollution research international 2023-07, Vol.30 (32), p.78802-78810
• Main Authors: Jin, Jie-Qi, Lin, Guo-Zhen, Wu, Shuang-Ying, Zheng, Mu-Rui, Liu, Hui, Liu, Xiang-Yi, Yan, Min-Qian, Chen, Zhao-Yue, Ou, Chun-Quan
• Format: Article
• Language: English
• Subjects: Aquatic Pollution; Atmospheric Protection/Air Quality Control/Air Pollution; Cardiovascular diseases; Cerebral infarction; Cold season; Confidence intervals; Disease control; Earth and Environmental Science; Ecotoxicology; Environment; Environmental Chemistry; Environmental Health; Environmental science; Exposure; Heart attacks; Hemorrhage; Hospitalization; Ischemia; Myocardial infarction; Particulate matter; Population studies; Population-based studies; Regression models; Research Article; Sex differences; Statistical analysis; Stroke; Trends; Waste Water Technology; Water Management; Water Pollution Control
• ISSN: 1614-7499; 0944-1344; 1614-7499
• DOI: 10.1007/s11356-023-28058-y

Some studies have investigated the effects of PM 2.5 on cardiovascular diseases based on the population–average exposure data from several monitoring stations. No one has explored the short-term effect of PM 2.5 on cardiovascular hospitalizations using individual-level exposure data. We assessed the short-term effects of individual exposure to PM 2.5 on hospitalizations for myocardial infarction (MI) and stroke in Guangzhou, China, during 2014–2019. The population-based data on cardio-cerebrovascular events were provided by Guangzhou Center for Disease Control and Prevention. Average annual percent changes (AAPCs) were used to describe trends in the hospitalization rates of MI and stroke. The conditional logistic regression model with a time-stratified case-crossover design was applied to estimate the effects of satellite-retrieved PM 2.5 with 1-km resolution as individual-level exposure. Furthermore, we performed stratified analyses by demographic characteristics and season. There were 28,346 cases of MI, 188,611, and 36,850 cases of ischemic stroke (IS) and hemorrhagic stroke (HS), respectively, with an annual average hospitalization rate of 37.2, 247, and 48.4 per 100,000 people. Over the six-year study period, significant increasing trends in the hospitalization rates were observed with AAPCs of 12.3% (95% confidence interval [CI]: 7.24%, 17.6%), 13.1% (95% CI: 9.54%, 16.7%), and 9.57% (95% CI: 6.27%, 13.0%) for MI, IS, and HS, respectively. A 10 μg/m 3 increase in PM 2.5 was associated with an increase of 1.15% (95% CI: 0.308%, 1.99%) in MI hospitalization and 1.29% (95% CI: 0.882%, 1.70%) in IS hospitalization. A PM 2.5 -associated reduction of 1.17% (95% CI: 0.298%, 2.03%) was found for HS hospitalization. The impact of PM 2.5 was greater in males than in females for MI hospitalization, and greater effects were observed in the elderly (≥ 65 years) and in cold seasons for IS hospitalization. Our study added important evidence on the adverse effect of PM 2.5 based on satellite-retrieved individual-level exposure data.