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Association Between Air Pollution and Coronary Heart Disease Hospitalizations in Lanzhou City, 2013–2020: a Time Series Analysis

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Abstract

Coronary heart disease (CHD) is one of the most serious public health problems. However, few studies have focused on the effects of exposure to particulate matter and gaseous air pollutants on CHD. This study aimed to explore the relationship between air pollutants and the number of hospitalized patients with CHD in Lanzhou, and we collected daily data on the number of hospitalized patients with CHD, daily air pollutants, and meteorological factors from 2013 to 2020. A distributed lag nonlinear model (DLNM) combined with a quasi-Poisson regression model was applied to evaluate the relationship between air pollutants and the number of hospitalized patients with CHD. The results indicated that the hysteresis effect of all pollutants except O38h reached its maximum at lag3, and the relative risk of coronary heart disease admission was 1.0014 (95%CI: 1.0004, 1.0023), 1.0003 (95%CI: 1.0000, 1.0006), 1.0020 (95%CI: 1.0004, 1.0035), and 1.0053 (95%CI: 1.0026, 1.0080) when PM2.5, PM10, NO2, and SO2 concentrations were increased by 10 μg/m3, respectively. Each 1 mg/m3 increase in CO concentration was associated with a relative risk of coronary heart disease; hospitalization risk was 1.1076 (95%CI: 1.0530, 1.1650). We observed a relative risk of 0.9991 (95%CI: 0.9986, 0.9999) for each 10 μg/m3 increase in O38h for coronary heart disease admission at lag1. Women and elderly were more susceptible to the impact of air pollution, and the impact was greater during cold seasons. Our results indicate that air pollution increased the risk of hospitalization for CHD in a short term. The research findings can provide strategic insights into the impact of current and future air pollution on CHD.

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Data Availability

Air pollution data for this study are available at the China Environmental Monitoring General Station http://www.cnemc.cn/. Meteorological data can be accessed at http://data.cma.cn, which is managed by the National Meteorological Information Centre of China. Clinical hospital admission data are not available to the public. All analyses in this study were performed using R version 4.2.1 software, and licensing and other information are available at https://www.r-project.org. The package used to construct the distributed lag nonlinear model (DLNM) is publicly available at https://cran.r-project.

Abbreviations

CHD:

Coronary heart disease

DLNM:

Distributed lag non-linear models

RR:

Relative risk

SD:

Standard deviation

IQR:

Inter quartile range

Q-AIC:

Quasi Akaike information criterion

CI:

Confidence intervals

WHO:

World Health Organization

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Funding

Supported by the Fundamental Research Funds for the Central Universities (lzujbky-2020-9).

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Authors and Affiliations

  1. School of Public Health, Lanzhou University, Lanzhou, 730000, People’s Republic of China

    Miaoxin Liu, Jingze Yu, Anning Zhu, Jianglong Ling, Rentong Chen, Yaoyi Zhang & Ye Ruan

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  1. Miaoxin Liu
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  2. Jingze Yu
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  3. Anning Zhu
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  4. Jianglong Ling
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  5. Rentong Chen
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  6. Yaoyi Zhang
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  7. Ye Ruan
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Correspondence to Ye Ruan.

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Liu, M., Yu, J., Zhu, A. et al. Association Between Air Pollution and Coronary Heart Disease Hospitalizations in Lanzhou City, 2013–2020: a Time Series Analysis. J Urban Health 100, 1246–1257 (2023). https://doi.org/10.1007/s11524-023-00797-w

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