Acute effects of fine particulate matter (PM2.5) on hospital admissions for cardiovascular disease in Beijing, China: A time-series study

Abstract

Background: Air pollution and cardiovascular disease are increasing problems in China. However, the short-term association between fine particulate matter (PM2.5) and cardiovascular disease (CVD) is not well documented. The purpose of this study is to estimate the short-term effects of PM2.5 on CVD admissions in Beijing, China. Methods: In total, 460,938 electronic hospitalization summary reports for CVD between 2013 and 2017 were obtained. A generalized additive model using a quasi-Poisson distribution was used to investigate the association between exposure to PM2.5 and hospitalizations for total and cause-specific CVD, including coronary heart disease (CHD), atrial fibrillation (AF), and heart failure (HF) after controlling for the season, the day of the week, public holidays, and weather conditions. A stratified analysis was also conducted for age (18-64 and ≥ 65 years), sex and season. Results: For every 10 μg/m3 increase in the PM2.5 concentration from the previous day to the current (lag 0-1) there was a significant increase in total CVD admissions (0.30, 95% CI: 0.20, 0.39%), with a strong association for older adults (aged ≥65 years), CHD (0.34, 95% CI: 0.22 to 0.45%) and AF (0.29, 95% CI, 0.03 to 0.55%). However, the observed increased risk was not statistically significant for HF hospitalizations. The associations in the single-pollutant models were robust to the inclusion of other pollutants in a two-pollutant model. No differences were found after stratification by sex and season. Conclusions: Exposure to PM2.5 increased the risk of hospitalizations from CVD, especially for CHD, and appeared to have more influence in the elderly. Precautions and protective measures and efforts to reduce exposure to PM2.5 should be strengthened, especially for the elderly.