Contribution of climate and air pollution to variation in coronary heart disease mortality rates in England

Association between polycyclic aromatic hydrocarbons exposure with red cell width distribution and ischemic heart disease: insights from a population-based study

This study investigates the association between polycyclic aromatic hydrocarbon (PAH) exposure, red blood cell distribution width (RDW), and ischemic heart disease (IHD) in a sample of 3003 participants from the National Health and Nutrition Examination Survey (NHANES). We hypothesize that RDW may mediate the effect of hydroxylated PAHs (OH-PAH) on IHD. Logistic regression models reveal significant associations between increased urinary PAH metabolite concentrations and IHD, as well as positive associations between PAH metabolites and RDW. Weighted Quantile Sum (WQS) regression and Bayesian Kernel Machine Regression (BKMR) analyses confirm the significant associations of the OH-PAH mixture with IHD and RDW. Mediation analysis demonstrates that RDW partially mediates the relationship between PAH exposure and IHD, accounting for 2-4.6% of the total effects. Our findings highlight the potential underlying mechanisms linking PAH exposure, RDW, and IHD and emphasize the importance of addressing environmental pollutants like PAHs in maintaining cardiovascular health and informing public health policies.

Association between provincial sunshine duration and mortality rates in China: Panel data study

Background

mortality rates are usually influenced by the variations of environmental factors. However, there are few studies on the impact of sunlight duration induced mortality. In this study, we examine provincial level associations between the sunshine duration and crude mortality rates.

Methods

we use China mortality data from the National Bureau of Statistics of China combined with China census data and data from the China Meteorological Data Service Centre. Annual mortality rates for 31 provinces, autonomous regions, and municipalities in China from 2005 to 19. Data are analyzed at the provincial level by using panel regression methods. The main outcome measures are the mortality rates associated with average daily sunshine duration. Then we perform a series of sentimental analyses.

Results

the average daily sunshine duration ratio cubed is positively associated with provincial level mortality rates (β = 11.509, 95% confidence interval 1.869 to 21.148). According to this estimate, increasing 2.895 h of additional daily sunshine is associated with an estimated 1.15% increase in the crude mortality rates. A series of sensitivity analyses show a consistent pattern of associations between average daily sunshine duration ratio cubed and mortality rates.

Conclusions

more sunshine duration is associated with increased mortality rates. While the associations documented cannot be assumed to be causal, they suggest a potential association between increased sunshine duration and increased mortality rates.

Effect of geographical factors on reference values of creatine kinase isoenzyme

The aim of this study was to investigate the geographical spatial distribution of creatine kinase isoenzyme (CK-MB) in order to provide a scientific basis for clinical examination. The reference values of CK-MB of 8697 healthy adults in 137 cities in China were collected by reading a large number of literates. Moran index was used to determine the spatial relationship, and 24 factors were selected, which belonged to terrain, climate, and soil indexes. Correlation analysis was conducted between CK-MB and geographical factors to determine significance, and 9 significance factors were extracted. Based on R language to evaluate the degree of multicollinearity of the model, CK-MB Ridge model, Lasso model, and PCA model were established, through calculating the relative error to choose the best model PCA, testing the normality of the predicted values, and choosing the disjunctive kriging interpolation to make the geographical distribution. The results show that CK-MB reference values of healthy adults were generally correlated with latitude, annual sunshine duration, annual mean relative humidity, annual precipitation amount, and annual range of air temperature and significantly correlated with annual mean air temperature, topsoil gravel content, topsoil cation exchange capacity in clay, and topsoil cation exchange capacity in silt. The geospatial distribution map shows that on the whole, it is higher in the north and lower in the south, and gradually increases from the southeast coastal area to the northwest inland area. If the geographical factors are obtained in a location, the CK-MB model can be used to predict the CK-MB of healthy adults in the region, which provides a reference for us to consider regional differences in clinical diagnosis.

Exposure to multiple air pollutants and the incidence of coronary heart disease: A fine-scale geographic analysis

Geographical variations in cardiovascular disease rates have been linked to individual air pollutants. Investigating the relation between cardiovascular disease and exposure to a complex mixture of air pollutants requires holistic approaches. We assessed the relationship between exposure to multiple air pollutants and the incidence of coronary heart disease (CHD) in a general population sample. We collected data in the Lille MONICA registry (2008-2011) on 3268 incident cases (age range: 35-74). Based on 20 indicators, we derived a composite environmental score (SEnv) for cumulative exposure to air pollution. Poisson regression models were used to analyse associations between CHD rates on one hand and SEnv and each single indicator on the other (considered in tertiles, where T3 is the most contaminated). We adjusted models for age, sex, area-level social deprivation, and neighbourhood spatial structure. The incidence of CHD was a spatially heterogeneous (p=0.006). There was a significant positive association between SEnv and CHD incidence (trend p=0.0151). The relative risks [95%CI] of CHD were 1.08 [0.98-1.18] and 1.16 [1.04-1.29] for the 2nd and 3rd tertile of SEnv exposure. In the single pollutant analysis, PM₁₀, NO₂, cadmium, copper, nickel, and palladium were significantly associated with CHD rates. Multiple air pollution was associated with an increased risk of CHD. Single pollutants reflecting road traffic pollution were the most strongly associated with CHD. Our present results are consistent with the literature data on the impact of road traffic on the CHD risk in urban areas.

Relationship between atmospheric pollutants and risk of death caused by cardiovascular and respiratory diseases and malignant tumors in Shenyang, China, from 2013 to 2016: an ecological research

Background:

Air pollutants and their pathogenic effects differ among regions and seasons. We aimed to explore the relationship between fine particulate matter (PM_2.5), sulfur dioxide (SO₂), and ozone-8 hours (O₃-8h) concentrations in heating and non-heating seasons and the associated death risk due to cardiovascular diseases (CDs), respiratory diseases (RDs), and malignant tumors.

Methods:

Data were collected in Shenyang, China, from April 2013 to March 2016. We analyzed the correlation or lagged effect of atmospheric pollutant concentration, meteorological conditions, and death risk due to disorders of the circulatory system, respiratory system, and malignant tumor in heating and non-heating seasons. We also used multivariate models to analyze the association of air pollutants during holidays with the death risk due to the evaluated diseases while considering the presence or absence of meteorological factors.

Results:

An increase in the daily average SO₂ concentration by 10 μg/m³ increased the death risk by CDs, which reached a maximum of 2.0% (95% confidence interval [CI]: 1.3%–2.7%) on lagging day 4 during the non-heating season and 0.2% (95% CI: 0.1%–0.4%) on lagging day 3 during the heating season. The risk of death caused by RDs peaked on lagging day 1 by 0.8% (95% CI: 0.4%–1.2%) during the heating season. An increase in O₃-8h concentration by 10 μg/m³ increased the risk of RD-related death on lagging day 2 by 1.0% (95% CI: 0.4%–1.7%) during the non-heating season, which was significantly higher than the 0.1% (95% CI: 0–0.9%) increase during the heating season. Further, an increase in the daily average PM_2.5 concentration by 10 μg/m³ increased the risk of death caused by RDs by 0.3% and 0.8% during heating and non-heating seasons, respectively, which peaked on lagging day 0. However, air pollution was not significantly associated with the risk of death caused by malignant tumors.

Conclusion:

Short-term exposure to PM_2.5, SO₂, and O₃ during the non-heating season resulted in higher risks of CD-related death, followed by RD-related death.

Short-term exposure to ambient air pollution and daily atherosclerotic heart disease mortality in a cool climate

The associations between exposure to short-term ambient air pollution and daily atherosclerotic heart disease (ASHD) mortality in cool climate have not been established. We performed a time-series analysis in Shenyang, the largest city of Northeastern China. We identified 7659 ASHD deaths and obtained deaths, ambient air pollution levels, and meteorological data for Shenyang during 2014-2017. The impact of ambient air pollution on daily ASHD deaths was analyzed using generalized additive models (GAMs). Cumulative lag effects were investigated using distributed lag non-linear models (DLNM). We found ASHD deaths significantly increased during days with higher air pollution. Particulate matter with diameter < 2.5 μm (PM_2.5), PM₁₀, and sulfur dioxide (SO₂) were positively associated with ASHD deaths among the total population. Both single- and multi-pollutants models indicated that PM_2.5, PM₁₀, and sulfur dioxide (SO₂) were positively associated with the deaths of women with AHSD, whereas only SO₂ was significant in men. This suggests significant gender-based differences in the fatal effects of ambient air pollution. Up to 28 days of single-day lag effects were observed for PM_2.5 and PM₁₀ in women. The cumulative lag effects of PM_2.5 and PM₁₀ showed increasing trends in both men and women; however, exposure to higher pollutant concentrations did not necessarily translate to greater risks. The ERRs differences between women and men were larger in cold days than in hot days, suggesting that lower temperature may exacerbate the adverse effects of air pollution on vulnerable women.

Analysis of the synoptic winter mortality climatology in five regions of England: Searching for evidence of weather signals

Although heat-related mortality has received considerable research attention, the impact of cold weather on public health is less well-developed, probably due to the fact that physiological responses to cold weather can vary substantially among individuals, age groups, diseases etc., depending on a number of behavioral and physiological factors. In the current work we use the classification techniques provided by the COST-733 software to link synoptic circulation patterns with excess cold-related mortality in 5 regions of England. We conclude that, regardless of the classification scheme used, the most hazardous conditions for public health in England are associated with the prevalence of the Easterly type of weather, favoring advection of cold air from continental Europe. It is noteworthy that there has been observed little-to-no regional variation with regards to the classification results among the 5 regions, suggestive of a spatially homogenous response of mortality to the atmospheric patterns identified. In general, the 10 different groupings of days used reveal that excess winter mortality is linked with the lowest daily minimum/maximum temperatures in the area. However it is not uncommon to observe high mortality rates during days with higher, in relative terms, temperatures, when rapidly changing weather results in an increase of mortality. Such a finding confirms the complexity of cold-related mortality and highlights the importance of synoptic climatology in understanding of the phenomenon.

Air pollution and chronic airway diseases: what should people know and do?

The health effects of air pollution remain a public health concern worldwide. Exposure to air pollution has many substantial adverse effects on human health. Globally, seven million deaths were attributable to the joint effects of household and ambient air pollution. Subjects with chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma are especially vulnerable to the detrimental effects of air pollutants. Air pollution can induce the acute exacerbation of COPD and onset of asthma, increase the respiratory morbidity and mortality. The health effects of air pollution depend on the components and sources of pollutants, which varied with countries, seasons, and times. Combustion of solid fuels is a major source of air pollutants in developing countries. To reduce the detrimental effects of air pollution, people especially those with COPD or asthma should be aware of the air quality and take extra measures such as reducing the time outdoor and wearing masks when necessary. For reducing the air pollutants indoor, people should use clean fuels and improve the stoves so as to burn fuel more efficiently and vent emissions to the outside. Air cleaners that can improve the air quality efficiently are recommended.

Independent at heart: persistent association of altitude with ischaemic heart disease mortality after consideration of climate, topography and built environment

BACKGROUND

Living at higher altitude was dose-dependently associated with lower risk of ischaemic heart disease (IHD). Higher altitudes have different climatic, topographic and built environment properties than lowland regions. It is unclear whether these environmental factors mediate/confound the association between altitude and IHD. We examined how much of the altitude-IHD association is explained by variations in exposure at place of residence to sunshine, temperature, precipitation, aspect, slope and distance to main road.

METHODS

We included 4.2 million individuals aged 40-84 at baseline living in Switzerland at altitudes 195-2971 m above sea level (ie, full range of residence), providing 77 127 IHD deaths. Mortality data 2000-2008, sociodemographic/economic information and coordinates of residence were obtained from the Swiss National Cohort, a longitudinal, census-based record linkage study. Environment information was modelled to residence level using Weibull regression models.

RESULTS

In the model not adjusted for other environmental factors, IHD mortality linearly decreased with increasing altitude resulting in a lower risk (HR, 95% CI 0.67, 0.60 to 0.74) for those living >1500 m (vs<600 m). This association remained after adjustment for all other environmental factors 0.74 (0.66 to 0.82).

CONCLUSIONS

The benefit of living at higher altitude was only partially confounded by variations in climate, topography and built environment. Rather, physical environment factors appear to have an independent effect and may impact on cardiovascular health in a cumulative way. Inclusion of additional modifiable factors as well as individual information on traditional IHD risk factors in our combined environmental model could help to identify strategies for the reduction of inequalities in IHD mortality.