Table_1_Associations between short-term PM2.5 exposure and daily hospital admissions for circulatory system diseases in Ganzhou, China: A time series study.DOCX

ObjectivePrevious epidemiological studies have shown that both long-term and short-term exposure to fine particulate matters (PM2.5) were associated with the morbidity and mortality of circulatory system diseases (CSD). However, the impact of PM2.5 on CSD remains inconclusive. This study aimed to investigate the associations between PM2.5 and circulatory system diseases in Ganzhou.
MethodsWe conducted this time series study to explore the association between ambient PM2.5 exposure and daily hospital admissions for CSD from 2016 to 2020 in Ganzhou by using generalized additive models (GAMs). Stratified analyses were also performed by gender, age, and season.
ResultsBased on 201,799 hospitalized cases, significant and positive associations were found between short-term PM2.5 exposure and hospital admissions for CSD, including total CSD, hypertension, coronary heart disease (CHD), cerebrovascular disease (CEVD), heart failure (HF), and arrhythmia. Each 10 μg/m3 increase in PM2.5 concentrations was associated with a 2.588% (95% confidence interval [CI], 1.161%–4.035%), 2.773% (95% CI, 1.246%–4.324%), 2.865% (95% CI, 0.786%–4.893%), 1.691% (95% CI, 0.239%–3.165%), 4.173% (95% CI, 1.988%–6.404%) and 1.496% (95% CI, 0.030%–2.983%) increment in hospitalizations for total CSD, hypertension, CHD, CEVD, HF, and arrhythmia, respectively. As PM2.5 concentrations rise, the hospitalizations for arrhythmia showed a slow upward trend, while other CSD increased sharply at high PM2.5 levels. In subgroup analyses, the impacts of PM2.5 on hospitalizations for CSD were not materially changed, although the females had higher risks of hypertension, HF, and arrhythmia. The relationships between PM2.5 exposure and hospitalizations for CSD were more significant among individuals aged ≤65 years, except for arrhythmia. PM2.5 had stronger effects on total CSD, hypertension, CEVD, HF, and arrhythmia during cold seasons.
ConclusionPM2.5 exposure was positively associated with daily hospital admissions for CSD, which might provide informative insight on adverse effects of PM2.5.

研究目的：既往流行病学研究表明，长期与短期暴露于细颗粒物（fine particulate matters, PM2.5）均与循环系统疾病（circulatory system diseases, CSD）的发病及死亡风险相关。然而，PM2.5对循环系统疾病的影响仍未明确。本研究旨在探究赣州市PM2.5暴露与循环系统疾病之间的关联。
研究方法：本研究采用时间序列研究设计，借助广义相加模型（generalized additive models, GAMs），分析2016年至2020年赣州市环境PM2.5暴露与每日循环系统疾病住院人次的关联。同时按性别、年龄及季节开展分层分析。
研究结果：基于201,799例住院病例数据，本研究发现短期PM2.5暴露与循环系统疾病（涵盖全因循环系统疾病、高血压、冠心病（coronary heart disease, CHD）、脑血管疾病（cerebrovascular disease, CEVD）、心力衰竭（heart failure, HF）及心律失常）的住院人次存在显著正向关联。PM2.5浓度每升高10 μg/m³，全因循环系统疾病、高血压、冠心病、脑血管疾病、心力衰竭与心律失常的住院人次分别增加2.588%（95%置信区间（confidence interval, CI）：1.161%~4.035%）、2.773%（95% CI：1.246%~4.324%）、2.865%（95% CI：0.786%~4.893%）、1.691%（95% CI：0.239%~3.165%）、4.173%（95% CI：1.988%~6.404%）与1.496%（95% CI：0.030%~2.983%）。随着PM2.5浓度升高，心律失常的住院人次呈缓慢上升趋势，而其余循环系统疾病在PM2.5高浓度水平下住院人次则显著攀升。在亚组分析中，尽管女性群体罹患高血压、心力衰竭与心律失常的风险更高，但PM2.5对循环系统疾病住院人次的影响未发生显著改变。在年龄≤65岁的人群中，除心律失常外，PM2.5暴露与循环系统疾病住院人次的关联更为显著。寒冷季节中，PM2.5对全因循环系统疾病、高血压、脑血管疾病、心力衰竭与心律失常的影响更强。
研究结论：PM2.5暴露与循环系统疾病的每日住院人次呈正向关联，该结果可为阐明PM2.5的不良健康效应提供有价值的参考依据。