Time-series Study On The Association Of Air Pollution And The Number Of Daily Inpatients Of Ischemic Heart Disease In Taiyuan

Objective:1.To know about the basic condition of the inpatient with ischemic heart disease in Taiyuan.2.To know about the basic condition of air pollution in Taiyuan.3.To build the relation model of air pollution and the number of daily inpatients of ischemic heart disease in Taiyuan,and quantitative analysis the effects of air pollution on the number of daily inpatients of ischemic heart disease.Methods:Daily air pollution from AQI monitoring system,temperature from the weather network and inpatient with cardiovascular diseases from five hospitals in Taiyuan during September 2013 to August 2015 were collected.To analysis the basic conditions of air pollution,weather factors and he number of daily inpatients of ischemic heart disease.The influence model of air pollution and the number of daily inpatients of ischemic heart disease was built by time-series analysis with the generalized additive model（GAM）.Results:1.The number of inpatient with ischemic heart disease in Taiyuan was collected 14538 cases,of which men more than women,≧ 65 more than < 65,spring and winter slightly more than summer and autumn from September 2013 to August 2015.2.The major air pollutants in Taiyuan are SO₂,PM₁₀,O₃ and PM_2.5 during September 2013 to August 2015.The main pollutant distribution of the four seasons ware different: The main pollutants were PM₁₀ and PM_2.5 in spring.The main pollutants were O₃ and PM_2.5 in summer.The main pollutants were SO₂,PM₁₀ and PM_2.5 in autumn and winter.Winter pollution was more serious than autumn.3.According to the gender stratification analysis: In single-pollutant model,SO₂,PM₁₀,CO,O₃ and PM_2.5 impact on the number of daily inpatients of female ischemic heart disease,the best effect lag day of which were respective the first day,fourth day,first day,same day,fourth day.An inter-quartile range（IQR）increase of SO₂,PM₁₀,CO,O₃ and PM_2.5 concentrations,the associated RR values with the increase of daily inpatients of female ischemic heart disease respective were 1.02（95% CI: 1.01-1.05）,1.10（95% CI: 1.02-1.18）,1.03（95% CI: 1.01-1.08）,1.13（95% CI: 1.03-1.23）,1.08（95% CI: 1.01-1.16）.Pollutants concentration per increased 10μg/m³,the increase percentage of the number of daily inpatients of female ischemic heart disease were 0.28%,1.22%,0.03%,1.87%,1.55%.In double-pollutant model,adjustment models after adjusting NO₂,PM₁₀,CO,O₃,PM_2.5 in the SO₂ model,SO₂,NO₂,CO,O₃ in the PM₁₀ model,NO₂ into the CO model,SO₂,NO₂,CO,enter the O₃ model,SO₂,CO,O₃ into the PM_2.5 model were all statistically significant.In single-pollutant model,SO₂,PM₁₀,CO and O₃ effect on the number of daily inpatients of male ischemic heart disease,the best effect lag day of which were respective the third day,same day,second day,same day.An inter-quartile range（IQR）increase of SO₂,PM₁₀,CO and O₃ contaminants,the associated RR values with the increase of daily inpatients of male ischemic heart disease respective were 1.02（95% CI: 1.00-1.09）,1.13（95% CI: 1.02-1.25）,1.04（95% CI: 1.01-1.09）,1.11（95% CI: 1.04-1.19）.Pollutants concentration per increased 10μg/m³,the increase percentage of the number of daily inpatients of male ischemic heart disease were 0.28%,1.62%,0.04%,1.73%.In double-pollutant model,adjustment models after adjusting PM₁₀,CO,PM_2.5 in SO₂ model,SO₂,NO₂,CO,O₃ into PM₁₀ model,NO₂,PM₁₀ and PM_2.5 in CO model,SO₂,NO₂,PM₁₀,CO,PM_2.5 in O₃ were all statistically significant.4.According to the age stratification analysis: In single-pollutant model,SO₂,PM₁₀ and O₃ effect on the number of daily inpatients of less than 65-year-old ischemic heart disease,the best effect lag day of which were respective the third day,fifth day,third day.An inter-quartile range（IQR）increase of SO₂,PM₁₀ and O₃ contaminants,the associated RR values with the increase of daily inpatients of less than 65-year-old ischemic heart disease were 1.04（95% CI: 1.01-1.09）,1.13（95% CI: 1.03-1.25）,1.12（95% CI: 1.05-1.20）.Pollutants concentration per increased 10μg/m³,the increase percentage of the number of daily inpatients of less than 65-year-old ischemic heart disease were 0.55%,1.57%,1.73%.In double-pollutant model,adjustment models after adjusting NO₂,PM₁₀,CO,PM_2.5 in SO₂ model,SO₂,NO₂,CO,O₃ into PM₁₀ model,SO₂,NO₂ in O₃ model were all statistically significant.In single-pollutant model,SO₂,CO and PM_2.5 effect on the number of daily inpatients of 65 years old and above ischemic heart disease,the best effect lag day of which were respective the third day,third day,same day.An inter-quartile range（IQR）increase of SO₂,CO and PM_2.5 contaminants,the associated RR values with the increase of daily inpatients of 65 years old and above ischemic heart disease were 1.04（95% CI: 1.01-1.07）,1.03（95% CI: 1.02-1.09）,1.14（95% CI: 1.06-1.22）.Pollutants concentration per increased 10μg/m³,the increase percentage of the number of daily inpatients of more than 65-year-old ischemic heart disease were 0.55%,0.03%,2.71%.In double-pollutant model,adjustment models after adjusting NO₂,PM₁₀ and PM_2.5 in SO₂ model,SO₂,NO₂,PM_2.5 in CO model,SO₂,NO₂,CO,O₃ in PM_2.5 model were all statistically significance.5.According to season stratification analysis: In single-pollutant model,PM₁₀ and PM_2.5 effect on the number of daily inpatients of ischemic heart disease in spring,the best effect lag day of which were respective the same day,fifth day.An inter-quartile range（IQR）increase of PM₁₀ and PM_2.5 contaminants,the associated RR values with the increase of daily inpatients of daily inpatients of ischemic heart disease in the spring were 1.02（95% CI: 1.01-1.07）and 1.07（95% CI: 1.01-1.13）.Pollutants concentration per increased 10μg/m³,the increase percentage of the number of daily inpatients of ischemic heart disease in spring were 0.24%,1.35%.In double-pollutant model,adjustment models after adjusting SO₂,NO₂,CO,O₃ respectively into the PM₁₀ model,SO₂,NO₂,CO,O₃ into the PM_2.5 model were all statistically significance.In single-pollutant model,SO₂,O₃ and PM_2.5 effect on the number of daily inpatients of ischemic heart disease in summer,the best effect lag day of which were respective the fourth day,same day,second day.An inter-quartile range（IQR）increase of SO₂,O₃ and PM_2.5 contaminants,respectively,the associated RR values with the increase of daily inpatients of daily inpatients of ischemic heart disease in the summer were 1.04（95% CI: 1.01-1.16）,1.07（95% CI: 1.01-1.11）,1.12（95% CI: 1.00-1.28）.Pollutants concentration per increased 10μg/m³,the increase percentage of the number of daily inpatients of ischemic heart disease in summer were 0.55%,1.01%.2.32%.In double-pollutant model,adjustment models after adjusting NO₂,PM₁₀,CO,O₃,PM_2.5 in SO₂ model,SO₂,NO₂,PM₁₀,CO,PM_2.5 in O₃ model,SO₂,NO₂,CO,O₃ into PM_2.5 model were all statistically significance.In single-pollutant model,PM₁₀,O₃ and PM_2.5 effect on the number of daily inpatients of ischemic heart disease in the autumn,the best effect lag day of which were respective the same day,fourth day,same day.An inter-quartile range（IQR）increase of PM₁₀,O₃ and PM_2.5 contaminants,the associated RR values with the increase of daily inpatients of daily inpatients of ischemic heart disease in autumn were 1.21（95% CI: 1.03-1.42）,1.16（95% CI: 1.04-1.30）,1.17（95% CI: 1.01-1.36）.Pollutants concentration per increased 10μg/m³,the increase percentage of the number of daily inpatients of ischemic heart disease in autumn were 2.53%,2.31%,3.29%.In double-pollutant model,adjustment models after adjusting SO₂,NO₂,CO,O₃ respectively into the PM₁₀ model,SO₂,NO₂,PM₁₀,CO into O₃ model,NO₂,CO,O₃ in PM_2.5 model were all statistically significance.In single-pollutant model,SO₂,PM₁₀ and PM_2.5 effect on the number of daily inpatients of ischemic heart disease in winter,the best effect lag day of which were all the forth day.An inter-quartile range（IQR）increase of SO₂,PM₁₀ and PM_2.5 contaminants,the associated RR values with the increase of daily inpatients of daily inpatients of ischemic heart disease in the winter were 1.52（95% CI: 1.00-2.18）,1.17（95% CI: 1.01-1.36）,1.20（95% CI: 1.03-1.39）.Pollutants concentration per increased 10μg/m³,the increase percentage of the number of daily inpatients of ischemic heart disease in winter were 7.15%,2.05%,3.87%.In double-pollutant model,adjustment models after adjusting NO₂,PM₁₀,CO,O₃,PM_2.5 into SO₂ model,O₃ in the PM₁₀ model,SO₂,NO₂,O₃ in the PM_2.5 model were all statistically significant.Conclusion:Air pollutants SO₂,PM₁₀,CO,O₃,PM_2.5can increase the number of daily inpatients of ischemic heart disease,and have a certain lag effect and exposure response relationship,which varies according to the different gender,age and season.