The associations of multiple pollutants and cardiovascular disease (CVD) morbidity, and the spatial variations of these associations have not been nationally studied in Sweden. The main aim of this study was, thus, to spatially analyze the associations between ambient air pollution (black carbon, carbon monoxide, particulate matter (both <10 µm and <2.5 µm in diameter) and Sulfur oxides considered) and CVD admissions while controlling for neighborhood deprivation across Sweden from 2005 to 2010. Annual emission estimates across Sweden along with admission records for coronary heart disease, ischemic stroke, atherosclerotic and aortic disease were obtained and aggregated at Small Areas for Market Statistics level. Global associations were analyzed using global Poisson regression and spatially autoregressive Poisson regression models. Spatial non-stationarity of the associations was analyzed using Geographically Weighted Poisson Regression. Generally, weak but significant associations were observed between most of the air pollutants and CVD admissions. These associations were non-homogeneous, with more variability in the southern parts of Sweden. Our study demonstrates significant spatially varying associations between ambient air pollution and CVD admissions across Sweden and provides an empirical basis for developing healthcare policies and intervention strategies with more emphasis on local impacts of ambient air pollution on CVD outcomes in Sweden.

中文翻译：

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瑞典各地环境空气污染和心血管疾病 (CVD) 住院的空间分析


多种污染物与心血管疾病 (CVD) 发病率之间的关联以及这些关联的空间变化尚未在瑞典进行全国性研究。因此，本研究的主要目的是从空间上分析环境空气污染（黑碳、一氧化碳、颗粒物（直径为 <10 µm 和 <2.5 µm）和硫氧化物）与 CVD 入院之间的关联同时控制 2005 年至 2010 年瑞典各地的邻里贫困。瑞典各地的年度排放量估计值以及冠心病、缺血性中风、动脉粥样硬化和主动脉疾病的入院记录均在小区域市场统计级别获得和汇总。使用全局泊松回归和空间自回归泊松回归模型分析全局关联。使用地理加权泊松回归分析关联的空间非平稳性。一般来说，大多数空气污染物与 CVD 入院率之间观察到微弱但显着的关联。这些关联是非同质的，瑞典南部地区的变异性更大。我们的研究表明，瑞典各地环境空气污染与心血管疾病入院率之间存在显着的空间差异关联，并为制定医疗保健政策和干预策略提供了实证基础，重点关注环境空气污染对瑞典心血管疾病结果的局部影响。