Particulate matter and ozone might trigger deaths from chronic ischemic heart disease

Abstract

Aims: To study the association between short-term exposure to air pollutants and mortality of Chronic Ischemic Heart Disease (CIHD).

Methods: Using a case-crossover design, we investigated 148,443 CIHD deaths from 2015 to 2020 in Jiangsu Province, China. Exposure to six ambient pollutants, including PM₁₀, PM_2.5, NO₂, CO, SO₂, and O_3, was assessed by extracting daily concentrations from validated 10 km × 10 km pollutant grids at each subject's residential address. A conditional logistic regression approach was used to explore the exposure-response relationship with adjustment for temperature and relative humidity. We calculated the Population Attributable Fractions (PAFs) and the attributable deaths number of CIHD.

Results: An increase of 10 μg/m³ in PM₁₀ and PM_2.5 exposure was associated with a 1.16% (95% CI: 0.85-1.48%) and 1.80% (1.36-2.24%) increase in CIHD mortality, respectively. A threshold value of 123 µg/m³ was identified for the association between O₃ exposure and CIHD mortality. Controlling for PM_2.5, each increase of 10 µg/m³ in O₃ (>threshold) was statistically significantly associated with a 0.94% (0.19-1.71%) increase in CIHD mortality, however there was no association between NO₂, SO₂, CO exposure and CIHD mortality. Reducing PM_2.5, PM₁₀ and O₃ to the WHO air quality guidelines would prevent 6.16% (95% CI: 4.70-7.58%), 4.30% (3.18-5.43%) and 1.29% (0.48-4.20%) of CIHD deaths, respectively. During the warm season, mortality and PAFs of CIHD associated with PM_2.5, PM₁₀, and O₃ were significantly higher.

Conclusions: Short-term exposure to ambient PM_2.5, PM_10, and O₃ might trigger deaths from CIHD. These findings indicate that the premature deaths of CIHD patients can be alleviated by reducing exposure to polluted air.

Keywords: Air pollution; Case-crossover design; Chronic ischemic heart disease; Mortality.