The Association Of Atmospheric Pollutants Such As Aerosol With Cardio-cerebro-vascular Diseases In Hangzhou City Using Poisson Regression Analysis

Background & ObjectiveIn recent years,the proportion of total morbidity and mortality resulting from cardio-cerebro-vascular diseases in population has increased year by year. Cardio-cerebro-vascular diseases have seriously endangered human's health.The onsets of morbidity and mortality of cardio-cerebro-vascular diseases result from many factors.Environmental factors are the very important risk factors for the diseases.As the environmental risk factors,atmospheric pollutants on cardio-cerebro-vascular diseases was more and more obtained attention,and have become a research hotspot in foreign countries.However,the current basic research in this area is still primary stage. So far,a few study focused on this area.The relationship between atmospheric environment and the disease is very complex.For further exploring the relationship, many basic studies will be conducted.In the current study,we analysed the relationship of the concentration of atmospheric pollutants and acute attack of cardio-cerebro-vascular diseases in Hangzhou. Material and MethodsThe data of information about cardio-cerebro-vascular diseases among monitoring population in Hangzhou from January 1,2002 to December 31,2004 was provided by the Center for Disease Control and Prevention of Hangzhou.The data of PM₁₀,SO₂ and NO₂ in Hangzhou over the same period was provided by the Center for Environmental Monitoring of Hangzhou,and the data of the average daily temperature and daily relative humidity in Hangzhou over the same period was provided by Meteorological Center of Hangzhou.The monitoring data of atmospheric aerosol optical thickness in Hangzhou over the same period was provided by EU European Space Agency using remote sensing satellites.The general characteristics of acute attack of cardio-cerebro-vascular diseases among surveillance population in Hangzhou were presented using general description and chi-square analysis.The situation of atmospheric pollution and periodical changes in Hangzhou were analyzed using Kruskal-Wallis H test and Spearman rank correlation. The relationship between the concentration of atmospheric pollutants and acute attack of cardio-cerebro-vascular diseases in Hangzhou was assessed using Mann-Whitney u test and Poisson regression.ResultsThe first three rank of acute attack of cardio-cerebro-vascular diseases was cerebral hemorrhage,cerebral infarction and coronary heart disease.They accounted for 88.5% among the total acute attack of cardio-cerebro-vascular diseases.The density of acute attack of cardio-cerebro-vascular diseases was the highest in the first and fourth seasons.Meanwhile,the concentration of atmospheric pollutants was the highest in the first and fourth seasons.There was a significantly different distribution of age among the patients with acute attack of coronary heart disease,cerebral hemorrhage and cerebral infarction(x²=22.138,P＜0.01).The average age of patients with cerebral infarction was the highest for 73.2 years old,and the average age of patients with coronary heart disease was the lowest for 68.9 years old.The distribution of gender was different among the patients with acute attack of coronary heart disease and cerebral infarction.The male patients with acute attack of coronary heart disease was more than females(x²=4.429,P＜0.05).There was a significantly difference on the distribution of hypertension between the patients with various cardio-cerebro-vascular diseases(x²=92.152,P＜0.01).The patients with hypertension accounted for 72.3% for cerebral hemorrhage,and 58.8%for cerebral embolism,31.8%for coronary heart disease,respectively.These results suggested that gender,age and hypertension in acute attack of various cardio-cerebro-vascular diseases had the different affect.The PM10 was over air quality standards in 23.4%days from Jan 1,2002 to Dec 31, 2004,and 13.6%for NO₂.There were statistically significant differences on atmospheric pollutants in different seasons(PM₁₀:x²=82.561,P＜0.01;SO₂: x²=249.138,P＜0.01;NO₂:x²=288.475,P＜0.01).The concentrations of atmospheric pollutants were the highest in the first and fourth seasons,and the lowest in the third season.There were statistically significant differences on the average concentration of PM₁₀in different years(x²=14.503,P＜0.01).The trend of concentration of PM₁₀was going down from 2002 to 2004.There was negative correlation between the meteorological factors such as temperature and relative humidity and the average concentration of the indicator with atmospheric pollutants.The relationship between the concentration of atmospheric pollutants and acute attack of cardio-cerebro-vascular diseases was analyzed,using the single-factor analysis and multi-factor analysis.Based on single-factor analysis,the value of AOD 6-day lag and the concentration of PM₁₀7-day lag were associated with acute attack of coronary heart disease(AOD:Z=-2.778,P＜0.05;PM₁₀:Z=2.220,P＜0.05).The concentration of SO₂ 4-day lag was also associated with acute attack of cerebral infarction(Z=5.438, P＜0.01).Statistical correlation between cerebral hemorrhage and the concentrations of all atmospheric pollutants was not observed.The concentrations of NO₂ in 0 day and 7 days lag were not related with three types of acute attack of cardio-cerebro-vascular diseases.Based on the multi-factor analysis,there was statistical correlation between acute attack of coronary heart disease and the concentration of PM₁₀7-day lag(Z=5.438,P＜0.01).There was no statistical correlation between acute attack of coronary heart disease and the value of AOD 6-day lag,and no statistical correlation between acute attack of cerebral infarction and the concentration of SO₂ 4-day lag.ConclusionThis study indicated that high blood pressure and gender,age variously affected on the different types of acute attacks of cardio-cerebro-vascular diseases.In various types of atmospheric pollutants,days that PM₁₀was over air quality standards were maxiamal, and followed by NO₂.The concentration of atmospheric pollutants on atmospheric pollutants in different season were differences,and the highest in the first and fourth seasons,and the lowest in the third season.Meteorological factors on the concentration of atmospheric pollutants had a greater influence.This study description that there is statistical correlation between coronary heart disease with acute attack and PM₁₀.Increase in concentration of PM₁₀may increase the risk of acute attack of coronary heart disease.The concentration of SO₂ and NO₂ act on various types of cardiovascular and cerebrovascular diseases is not very different with influence.In this study,there are some differences comparise the results on the lag period with the results before study,to be the next in-depth study.