The Effects Of PM2.5 And PM10 On The Hospitalization Of Cardiovascular And Cerebrovascular Diseases In Tianjin

The research on the effects of PM2.5 and PM10 on cardiovascular and cerebrovascular diseases has become a research hotspot at home and abroad,Cardiovascular and cerebrovascular diseases,as the primary diseases threatening human health,impose a heavy burden on society and individuals.This paper takes the number of hospitalized patients with cerebral infarction and acute coronary syndrome in Tianjin as the research object,and the harmfulness of PM2.5 and PM10 on cardiovascular and cerebrovascular diseases in Tianjin were studied.Objective:In this study,the number of hospitalized patients with cerebral infarction and acute coronary syndrome in Tianjin was used to calculate the excess risk of daily inpatients with cerebral infarction and acute coronary syndrome when the concentration ofPM2.5 and PM10 is increased by 10 units.To study the harmful effects of elevated PM2.5 and PM10 concentrations on cardiovascular and cerebrovascular diseases in Tianjin.Methods:1.Experimental data:The study collected data of cardiovascular and cerebrovascular diseases in Tianjin medical university general hospital from January 1,2013 to December 31,2016,the environmental data and meteorological data in the same period were collected from Tianjin environmental monitoring center and China meteorological data network,environmental data included PM2.5?PM10?NO2?CO?SO2 and O3 average daily concentration and meteorological data including daily average temperature and relative humidity.2.Data processing:(1)Data selection:According to the household registration information of the patients,duplicate cases and non-resident cases in Tianjin were excluded.Cerebral infarction and acute coronary syndrome were screened out according to the 10th edition of international disease classification standard,and the number of hospitalized patients with cerebral infarction and acute coronary syndrome was sorted into daily number of hospitalized patients,the original daily environmental data and meteorological data were integrated and processed,and the missing values in the original environmental data and meteorological data were supplemented by means of mean interpolation.(2)Descriptive statistics:Describe the total number of hospitalizations,gender and age distribution of cerebral infarction and acute coronary syndrome;descriptive statistics on the distribution and trends of environmental data and meteorological data in Tianjin;spearman correlation analysis was performed between environmental data and meteorological data.(3)Generalized additive model and modeling strategy:Establishing a generalized additive model of Poisson regression,using natural cubic spline function to smoothly fit the average temperature,relative humidity and time trend,and using dummy variable to control the effect of the day of the week and holidays.(4)Smgle-day lag analysis of single pollutant:Poisson regression of generalized additive model 1s set up,using natural cubic spline function to smoothly fit the average temperature,relative humidity and time trend,using dummy variables to control day of the week and holiday effect,the PM2.5 or PM10 concentration with a single day lag of 0-7 days(lagO-7)was introduced into the model,the lag 0 days refers to the PM2.5 or PM10 concentration on the day of hospitalization,and the lag 1 day refers to the day before the hospitalization and so on,to calculate the excess risk of daily hospitalization for cerebral infarction and acute coronary syndrome for every 10?g/m3 increase in PM2.5 or PM10 concentration under different lag days(ER)and its 95%confidence interval(Cl).(5)Moving average lag analysis of single pollutant:Using Poisson regression of generalized additive model,using natural cubic spline function to smoothly fit average temperature,relative humidity and time trends,using dummy variables control day of the week and holiday effect,the sliding average lag 01-07 days(lag01-07)PM2.5 or PM10 concentration was introduced into the model,moving average lag 01 days,which was the average of the particulate matter concentration on the day of hospitalization and the previous day,moving average lag O2 days 1s the average of the concentration of particles in the day and the first two days and so on,to calculat the excess risk ER value of the daily hospitalization of cerebral infarction and acute coronary syndrome for every 10?g/m3 increase in PM2.5 or PM10 concentration under different lag days(ER)and its 95%confidence interval(Cl).(6)Single-day lag analysis of multi-pollutants:Screening out the lag days of the increase in the number of hospitalized patients with cerebral infarction and acute coronary syndrome increased from the single-day lag analysis results of single pollutants,under the lag days,introduce NO2 and O3,respectively establish double pollutant analysis PM2.5+NO2?PM2.5+O3?PM10+NO2?PM 10+O3 and three pollutants analysis PM2.5+NO2+O3?PM10+NO2+O3,to calculate the excess risk ER value and 95 Cl of daily inpatients with cerebral infarction and acute coronary syndrome at every 10?g/m3 increase in PM2.5 or PM 10 concentration under the influence of multiple pollutants.(7)Subgroup analysis:The daily hospitalizations of cerebral infarction and acute coronary syndrome were divided into male and female according to gender,and were divided into 18-64 years old and>65 years old according to age,to calculate the excess risk ER value and 95 Cl of daily inpatients with cerebral infarction and acute coronary syndrome at every 10?g/m3 increase in PM2.5 or PM 10 concentration in different populations.3.Statistical analysis:The results of the study were expressed as ER values and 95%Cl,representing a 10 unit increase in PM2.5 or PM10 concentration,a percentage change in the number of hospitalizations per day,and ER>0 indicates the percentage increase in hospitalizations,ER<0 indicates the percentage of hospitalization reduction with a statistical significance of P<0.05.Results:1.From 2013 to 2016,the annual average concentration of CO in Tianjin was 1.92 mg/m3?1.63mg/m3?1.36mg/m3 and 1.37mg/m3 respectively;the annual average concentration of NO2 was 53.65?g/m3>54.40?g/m3?42.08?g/m3?48.10?g/m3;The annual average concentration of O3 was 78.58?g/m3?81.49?g/m3?77.18?g/m3 and 84.20?g/m3T;he annual average concentration of pM10 was 150.04?g/m3?133.06?g/m3?117.20?g/m3?102.10?g/m3T;he annual average concentration ofPM2.5 is 96.65?g/m3?83.32?g/m3?70.34?g/m3 and 69.05?g/m;average concentration of SO2 was 58.86?g/m3?48.91?g/m3?29.19?g/m3?20.77?g/m3.Compared with 2013,PM2.5 decreased by 28.55%in 2016,the mean value of PM10 decreased by 19.95%,the annual mean of NOdecreased by 10.34%,CO concentration decreased by 28.65%,the SO2 concentration decreased by 64.71%.O3 concentration increased by 7%.2.In the single-day lag analysis of single pollutant,on the lag 3days,PM2.5 increased by 10?g/m3,and ER value of the cerebral infarction and acute coronary syndrome was respectively 0.60%(0.18-1.03)and 0.67%(0.16-1.18),P<0.05,PM10 increased by 10?g/m3,and ER value of cerebral infarction and acute coronary syndrome was 0.38%(0.07-0.70)and 0.39%(0.01-0.78),respectively,P<0.05;In the moving average lag analysis of single pollutants,PM2.5 increased by 10?g/m3 on the lag0-4 days,and ER value of cerebral infarction ER was 0.72%(0.11-1.32),P<0.05.3.In the dual-pollutant analysis of PM2.5+NO2,the ER value of cerebral infarction was 1.13%(0.48-1.79)for every 10?g/mm3 increase in PM2.5 concentration,P<0.05;in the PM2.5+O3 double pollutant analysis,for every 10?g/m3 increase in PM2.5 concentration,the ER value of cerebral infarction and acute coronary syndrome was 0.60%(0.07-1.00)and 0.67%(0.16-1.19),respectively,P<0.05;in the analysis of PM2.5+NO2+O3 three pollutants,for every 10?g/m3 increase in PM2.5 concentration,the ER value of cerebral infarction was 1.13%(0.46-1.79),P<0.05.In the PMIO+NO2 double pollutants analysis,for every 10?g/m3 increase in PM10 concentration,the ER value of cerebral infarction was 0.64%(0.17-1.1),P<0.05;PM10+O3 double pollutants analysis,for every 10?g/m3 increase in PM10 concentration,the ER value of cerebral infarction and acute coronary syndrome was by 0.37%(0.06-0.69)and 0.40%(0.02-0.79),respectively,P<0.05;in the analysis of PMIO+NO2+O3 three pollutants,the concentration of PM10 increased by 10?g/m3,the ER value of cerebral infarction was 0.63%(0.16-1.10),P<0.05.4.In the analysis of gender subgroup,the single-day lag 3 days and the single day lag4 days,the PM2.5 concentration increased by 10?g/m3,the ER value of cerebral infarction in males was 0.580%(0.039-1.124)and 0.577%(0.035-1.122),P<0.05;on single lag 3 days,PM2.5 increased by 10?g/m3,the ER value of acute coronary syndrome in males was 0.84%(0.20-1.49),P<0.05;on single lag 5 days,for every 10?g/m3 increase in PM10 concentration,the ER value of acute coronary syndrome in females was 0.65%(0.03-1.26),P<0.05.5.In the analysis of the age subgroup,on the lag 3 days,the increase of PM2.5 concentration by 10?g/m3,the value of cerebral infarction ER of?65 years old was 0.81%(0.25-1.37),P<0.05,and the PM10 concentration increased by 10?g/m3,the value of cerebral infarction ER of?65 years old was 0.56%(0.15-0.98),P<0.05;on the lag 3 days,the concentration of PM2.5 increased,the ER value of acute coronary syndrome for 18-64 years old 0.82%(0.09-1.55),P<0.05,the concentration of PM10 increased,and the ER value of acs for 18-64 years old was 0.57%(0.03-1.12),P<0.05.Conclusion:1.In 2013-2016,the pollutants that did not meet the national air quality secondary standard in Tianjin were PM2.5?PM10,?and NO2,the concentration of air pollutants in Tianjin showed a downward trend.2.The increase in the concentration of PM2.5 and PM10 leads to an increase in the number of hospitalizations for cerebral infarction and acute coronary syndrome,and this hazard has a daily lag effect,the increase in PM2.5 concentration caused a greater increase in the number of hospitalizations for cerebral infarction and acute coronary syndrome than PM 10,the increase in PM2.5 concentration had a cumulative effect on the number of hospitalizations on cerebral infarction.3.NO2 may lead to an increase in the number of hospitalizations for cerebral infarction,and there is a joint effect with PM2.5 and PM10,there is no correlation between O3 and the number of hospitalized patients with cerebral infarction and acute coronary syndrome.4.In the gender subgroup analysis,the number of hospitalized patients with cerebral infarction and acute coronary syndrome was more sensitive to the increase of PM2.5 concentration,the number of hospitalized women with acute coronary syndrome was more susceptible to the increase of PM10 concentration.5.In the age subgroup analysis,the number of hospitalized patients with cerebral infarction in the age group of?65 years was more sensitive to the increase in PM2.5 and PM10 concentrations,the number of hospitalized patients with acute coronary syndrome in the 18-64 age group is more susceptible to the increased concentrations of PM2.5 and PM10.