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Assessing the short-term effects of PM2.5 and O3 on cardiovascular mortality using high-resolution exposure: a time-stratified case cross-over study in Southwestern China

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Abstract

Air pollution is a major risk factor of cardiovascular disease (CVD). To date, limited studies have estimated the effects of ambient air pollution on CVD mortality using high-resolution exposure assessment, which might fail to capture the spatial variation in exposure and introduce bias in results. Besides, the three-year action plan (TYAP, 2018–2020) was released; thus, the constitution and health effect of air pollutants may have changed. In this study, we estimated the short-term effect exposed to particulate matters with parameter less than 2.5 µm (PM2.5) and ozone (O3) with 0.05° × 0.05° resolution on CVD mortality and measured the influence of TYAP in the associations. We used random forest models with spatial weight matrices to attain high-resolution pollutant concentrations and conditional Poisson regression to assess the relationship between air pollution and cardiovascular mortality. With an increase of 10 µg/m3 in PM2.5 and O3 during 2018–2021 in the Sichuan Basin (SCB), CVD mortality increased 1.0134 (95% CI 1.0102, 1.0166) and 1.0083 (95% CI 1.0060, 1.0107), respectively, using high-resolution air pollutant concentration, comparing to 1.0070 (95% CI 1.0052, 1.0087) and 1.0057 (95% CI 1.0037, 1.0078) using data from air quality monitoring stations (AQMs). After TYAP, the relative risk (RR) due to PM2.5 rose up to 1.0149 (95% CI 1.0054, 1.0243), and the RR due to O3 rose up to 1.0089 (95% CI 1.0030, 1.0148) in Sichuan Province. We found significantly positive association of cardiovascular mortality and air pollution in Sichuan Province. And using high-resolution exposure would be more accurate to estimate the effect of air pollution on CVD. After TYAP, the cardiovascular mortality risk estimation due to PM2.5 decreased in elderly in SCB, and the risk due to O3 increased in Sichuan Province.

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Data availability

Data will be made available on request.

Abbreviations

PM2.5 :

Particulate matters with diameter less than 2.5 µm

O3 :

Ozone

AQMs:

Air quality monitoring stations

CVD:

Cardiovascular disease

TYAP:

Three-year action plan

SCB:

Sichuan Basin

DDW:

Data-driven weighting

IDW:

Inverse-distance weighting

RF:

Random forest model

SAR:

Spatial autocorrelation

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Funding

This work was supported by the National Natural Science Foundation of China (Grant Nos. 81803332, 81872713, and 82373689) and the Sichuan Science & Technology Program (Grant Nos. 2021YFS0181 and 24NSFJQ0205).

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Author notes

  1. **nyue Tian and **g Zeng contributed equally to this work.

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China

    **nyue Tian, Xuelin Li, Sheng Li, Tao Zhang, Fei Yin & Yue Ma

  2. Department of Chronic Disease Surveillance, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China

    **g Zeng & Ying Deng

  3. Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China

    Yue Ma

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  1. **nyue Tian
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Contributions

XT: conceptualization, methodology, software, formal analysis, writing—original draft, writing—review and editing. JZ: formal analysis, data curation, validation, writing—review and editing. XL: formal analysis, writing—review and editing. SL: software, writing—review and editing. TZ: writing—review and editing. YD: writing—review and editing. FY: writing—review and editing. YM: conceptualization, methodology, project administration, funding acquisition, writing—review and editing. XT and JZ contributed equally to this work.

Corresponding author

Correspondence to Yue Ma.

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Highlights

1. We found a significantly positive association between cardiovascular mortality and air pollution in Sichuan Province.

2. Using high-resolution exposure would be more accurate to estimate the effect of air pollution on CVD.

3. After TYAP, the cardiovascular mortality risk estimation due to PM2.5 decreased in elderly in SCB, and the risk estimate due to O3 increased in Sichuan Province.

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Tian, X., Zeng, J., Li, X. et al. Assessing the short-term effects of PM2.5 and O3 on cardiovascular mortality using high-resolution exposure: a time-stratified case cross-over study in Southwestern China. Environ Sci Pollut Res 31, 3775–3785 (2024). https://doi.org/10.1007/s11356-023-31276-z

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