Ozone pollution and hospital admissions for cardiovascular events

Author:

Jiang Yunxing123,Huang Jing4,Li Guoxing4,Wang Wanzhou4,Wang Kai123,Wang Jinxi5,Wei Chen5,Li Yinxiang6,Deng Furong4,Baccarelli Andrea A7,Guo Xinbiao4,Wu Shaowei123ORCID

Affiliation:

1. Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center , 76 Yanta West Road, Yanta District, Xi'an, Shaanxi 710061 , China

2. Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health , Xi'an, Shaanxi 710061 , China

3. Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province , Xi'an, Shaanxi 710061 , China

4. Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University , 38 Xueyuan Road, Haidian District, Beijing 100191 , China

5. Yunyi Health Technology Co. Ltd. , Tianfu Street, Daxing District, Beijing 102629 , China

6. Medical Apparatus and Instrument Commitee, China-Europe Association for Technical and Economic Cooperation , No.17 Houshayu section, Shunyi District, Beijing 101318 , China

7. Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University , 722 West 168th Street, New York, NY 10032 , USA

Abstract

Abstract Aims The available literature on morbidity risk of cardiovascular diseases associated with ambient ozone pollution is still limited. This study examined the potential acute effects of exposure to ambient ozone pollution on hospital admissions of cardiovascular events in China. Methods and results A two-stage multi-city time-series study approach was used to explore the associations of exposure to ambient ozone with daily hospital admissions (n = 6 444 441) for cardiovascular events in 70 Chinese cities of prefecture-level or above during 2015–17. A 10 μg/m3 increment in 2-day average daily 8 h maximum ozone concentrations was associated with admission risk increases of 0.46% [95% confidence interval (CI): 0.28%, 0.64%] in coronary heart disease, 0.45% (95% CI: 0.13%, 0.77%) in angina pectoris, 0.75% (95% CI: 0.38%, 1.13%) in acute myocardial infarction (AMI), 0.70% (95% CI: 0.41%, 1.00%) in acute coronary syndrome, 0.50% (95% CI: 0.24%, 0.77%) in heart failure, 0.40% (95% CI: 0.23%, 0.58%) in stroke and 0.41% (95% CI: 0.22%, 0.60%) in ischemic stroke, respectively. The excess admission risks for these cardiovascular events associated with high ozone pollution days (with 2-day average 8-h maximum concentrations ≥100 µg/m3 vs. < 70 µg/m3) ranged from 3.38% (95% CI: 1.73%, 5.06%) for stroke to 6.52% (95% CI: 2.92%, 10.24%) for AMI. Conclusion Ambient ozone was associated with increased hospital admission risk for cardiovascular events. Greater admission risks for cardiovascular events were observed under high ozone pollution days. These results provide evidence for the harmful cardiovascular effects of ambient ozone and call for special attention on the control of high ozone pollution.

Funder

National Natural Science Foundation of China

National Key Research and Development Program of China

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

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