| Objective: To investigate the general situation and time variation characteristics of the number of residents hospitalized with arrhythmia,air pollutants and meteorological factors from January 1,2015 to December 31,2020 in Hefei City.Time series method was used to explore the influence of air pollutants on the daily number of inpatients with arrhythmia in Hefei,analyze the expose-response relationship of air pollution arrhythmia hazards,and explore the influence of meteorological factors on the daily number of inpatients with arrhythmia in Hefei.Then,we evaluate the overall trend of the influence of meteorological factors on the risk of hospitalization for arrhythmia in the whole population of permanent residents and different gender and age groups in Hefei City.Through this study,we can identify the potentially susceptible population with increased risk of hospitalization for arrhythmia,and provide reference for public health prevention.Methods: The data of all patients admitted to the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital),the First Affiliated Hospital of Anhui Medical University and the Second Affiliated Hospital of Anhui Medical University from January 1,2015 to December 31,2020 were collected.Data on air pollutants and meteorological factors were collected at the same time.Inhalable Particulate Matter(PM10),Fine Particulate Matter(PM2.5),Sulfur Dioxide(Sulfur Dioxide,SO2),Nitrogen Dioxide(NO2),Ozone(O3),Carbon Monoxide(CO),Mean air temperature(Mean air temperature,MAT),Mean daily maximum air temperature(Max MAT),Mean daily minimum air temperature(Min MAT),Mean wind speed(MWS),Mean relative humidity(MRH),and Mean air pressure(MP),and two new variables reflecting temperature changes were obtained: Diurnal temperature range(DTR)and Temperature change between neighboring day(TCN)were calculated.On this basis,the distributed lag nonlinear model(Distributed Lag Nonlinear Models,DLNM)was used to establish a single pollutant distributed lag nonlinear model and a meteorological factor distributed lag nonlinear model.Under the control of confounding factors,the relationship between exposure and response of air pollutants and meteorological factors on the daily number of arrhythmia hospitalizations in Hefei was quantitatively analyzed.Results: 1.From January 1,2015 to December 31,2020,the number of observation days was 2192,and the number of hospitalized patients with arrhythmia in Hefei was 8923,with an average of about 4 patients per day.The average daily concentrations of PM10,SO2,NO2,PM2.5,O3 and CO were 77.10±40.11,10.59±6.49,41.44±18.44,50.79±32.93,90.69(μg/m3)±44.51 and 0.80±0.31(mg/m3),respectively.The mean values of MAT,DTR and TCN were 16.76±9.22,10.12±4.17 and 0±2.55(℃),respectively.The mean MWS was 5.35±1.789(knots),MRH 76.96±12.25(%),and MP 1024.60±9.73(kpa).2.In this study,an increase of PM2.5,PM10 and CO concentrations of 10μg/m3 in air pollutants was significantly associated with an increased risk of daily hospitalizations for arrhythmia,with a lag effect.SO2 and O3 were not associated with increased risk of daily hospitalizations for arrhythmia.In subgroup analysis,an increase of PM2.5,PM10,and CO concentrations of 10μg/m3 had an effect on the number of daily inpatients with bradycardia in female patients <65 years of age,with a lag effect.NO2 was positively correlated with the daily hospitalizations for arrhythmia in the cumulative lag model,and had an effect on the daily hospitalizations for males and tachyarrhythmias in the groups with a lag effect.3.This study showed that MAT,DTR,TCN and MP were statistically associated with the daily hospitalization number of arrhythmia.(1)There was a V-shaped relationship between MAT and the daily hospitalization number of arrhythmia.Exposure to low temperature had a significant lag effect on the daily hospitalization number of arrhythmia,and the cumulative lag lasted until lag0-21 days.The cumulative lag effect of high temperature reached its maximum at lag0-3 and lasted until lag0-6.In the stratified analysis,both cold and heat had cumulative effects on men,people ≥65 years old,and people with tachyarrhythmia,but the lag effect of cold was longer than that of heat.(2)There was an approximate "M" shaped relationship between DTR and the daily number of arrhythmia hospitalizations.When exposed to low DTR,the risk effect appeared at lag0-20 to lag0-21 days.In the stratified analysis,both low DTR and high DTR showed a cumulative lag effect on males and people aged ≥65 years.Low DTR also has a lag effect on tachyarrhythmias.(3)There was a nonlinear association between TCN and daily arrhythmia hospitalization number.When exposed to low TCN,the cumulative lag lasted from lag0-3 days to lag0-21 days,and the risk effect size gradually increased to lag0-21 days.In the stratified analysis,low TCN had an effect on people ≥65 years old and tachyarrhythmia with a lag effect.(4)There was a nonlinear relationship between MP and the daily number of arrhythmia hospitalizations.When exposed to low MP,lag0-2 and lag0-3 days had an effect,and the cumulative lag effect of high MP lasted for 5 days.The results showed that MP had a short lag effect on the daily number of arrhythmia hospitalizations.In the stratified analysis,both low MP and high MP had a lag effect on the population with tachyarrhythmia.Low MP level had a lagged effect on women and people over 65 years old,while high MP level had a lagged effect on men and people under 65 years old.Different MP levels had different effects on different populations.Conclusion: 1.This study showed that air pollutants(PM2.5,PM10,CO and NO2)and meteorological factors(MAT,DTR,TCN and MP)had different effects on the daily hospitalization number of arrhythmia in Hefei from 2015 to 2020.2.The increased concentrations of particulate matter(PM2.5,PM10)and CO in air pollutants have a more significant impact on women,people younger than 65 years old and bradyarrhythmia,leading to a higher risk of hospitalization for arrhythmia.Increased NO2 concentration has some effect on male and tachyarrhythmia population.3.Among the meteorological factors,high temperature,low temperature,sudden drop of temperature and low pressure have more significant effects on men,age ≥65 years and people with tachyarrhythmia,leading to a higher risk of hospitalization for arrhythmia.The results of this study are a supplement to the research on the hazards of air pollutants and climate change exposure in central China,and can provide scientific basis for the epidemiological study of arrhythmia and public health research in Hefei. |
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