Risk Assessment Of Ozone And Meteorological Factors On Cardiovascular And Cerebrovascular Mortality In The Population

Objective:A large number of international environmental epidemiological studies have confirmed that atmospheric ozone（O₃）pollution has become an important health challenge,and short-term and long-term exposure to O₃has a significant impact on population health,including the increase of mortality and morbidity in the population.Environmental pollution is the result of a combination of events（called compound,interaction,interrelated or cascading events）,and extreme events brought about by climate change can enhance the accumulation of O₃and other pollutants,leading to their combination with air pollution,which poses a danger to human health.Therefore,conducting research on the impact of O₃pollution and meteorological factors on people’s health can not only enhance our understanding of the health threats caused by O₃pollution and meteorological factors,but also help policymakers design effective response strategies and long-term air pollution control measures.Methods:This study used meteorological factors,atmospheric pollutants and daily cardiovascular and cerebrovascular disease death data in Nanchang City,Jiangxi Province from 2014 to 2020 to initially understand the temporal trend of six major air pollutants,combined with the generalized additive model of Poisson distribution,established the exposure response relationship between O₃and cardiovascular and cerebrovascular mortality in different populations,and studied the lagging effect on the death of cardiovascular and cerebrovascular diseases in different subcategories.Secondly,the distribution lag nonlinear model was used to explore the health effects of average daily temperature,average daily relative humidity and average daily air pressure on cardiovascular and cerebrovascular disease mortality in the population,and the relative risk values of meteorological factors in different lag periods were explored.Finally,the Bayesian kernel machine regression model was used to comprehensively evaluate the nonlinear effect of the mixed effect of O₃and meteorological factors on the cardiovascular and cerebrovascular disease mortality in the population,estimate the posterior probability and univariate exposure response relationship of each exposure variable,and calculate the cumulative effect of O₃and various meteorological factors on population health.Outcome:（1）The relationship between O₃exposure and death from cardiovascular and cerebrovascular diseases decreased firstly,and the O₃concentration showed an upward trend after reaching the lowest values at 110ug/m³and 114ug/m³,respectively.O₃has a single-day lag and cumulative lag effect on the death of cardiovascular and cerebrovascular diseases in the population,and the longer the cumulative lag time,the greater the harm to the health of the population.O₃had statistically significant differences in the death of cardiovascular and cerebrovascular diseases in people of different genders,ages and education levels,with the risk of death in women being higher than that of men,and the risk value of high school/secondary school was much higher than that of other education levels.O₃had the greatest impact on cardiovascular mortality in people aged 18-65 years and cerebrovascular mortality in people aged 66-79 years.In addition,the dual pollution effect of O₃and PM₁₀had the greatest impact on the death of cardiovascular and cerebrovascular diseases.The compound effect of O₃,PM_2.5and PM₁₀on cardiovascular mortality was the largest,and the composite effect of O₃,SO₂and PM₁₀on cerebrovascular mortality was the largest.In different subclass disease studies,O₃had the greatest impact on hypertensive heart disease in the population.（2）The exposure response curve of the daily average temperature in Nanchang City to the total population of cardiovascular and cerebrovascular mortality lagged by21 days was"V"shaped.The minimum death temperature of cardiovascular system diseases（29.5°C）is higher than that of cerebrovascular system diseases（9.0°C）,and the risk of death from cardiovascular and cerebrovascular diseases is greatest in the short（0-5d）lag period and high temperature（>30.0°C）.The effect of daily average air pressure on death from cardiovascular and cerebrovascular diseases reached the lowest values at 1000.5k Pa and 1023.0k Pa,respectively,and showed a gradual upward trend.The longer the lag time and the greater the mean air pressure,the greatest impact on cardiovascular mortality.Short lag period,small mean air pressure,long lag period,and average air pressure will have a significant impact on cerebrovascular mortality.The relationship between daily average relative humidity and death from cardiovascular and cerebrovascular diseases fluctuated,with 31.0%as the lowest risk value.The short lag time（0-5d）and humidity<40.0%have the greatest impact on cardiovascular and cerebrovascular mortality.（3）The combined effect of O₃and meteorological factors on the death of cardiovascular and cerebrovascular diseases in the population has different effects due to different meteorological conditions,and the daily average temperature is divided into quartiles,and O₃is in the range of P₂₅-P₅₀,the daily average air pressure is P₅₀-P₇₅,and the daily average relative humidity is>P₇₅have the greatest effect on the individual risk of death from cardiovascular and cerebrovascular diseases in the population.O₃has the greatest combined effect on cardiovascular mortality in the population under meteorological conditions with daily average temperature in the P₅₀-P₇₀range,daily average air pressure in the P₂₀-P₅₀range and daily average relative humidity in the P₂₀-P₅₀range,while O₃has the greatest combined effect on cerebrovascular mortality under the daily average temperature>P₇₅,the daily average air pressure in the P₂₅-P₅₀range,and the daily average relative humidity in the P₂₅-P₅₀range.Conclusion:The O₃pollution in Nanchang City,Jiangxi Province has shown an increasing trend year by year in the past seven years,and there are periodic changes of high concentration in the warm season and low concentration in the cold season.Cardiovascular and cerebrovascular mortality in the population was the main cause of death during the study period in Nanchang,and it was generally on the rise.In addition,as climate change intensifies,extreme weather poses a great threat to people’s health.In this study,the time series method was used to explore the individual and comprehensive effects of O₃pollution and meteorological factors on the death of cardiovascular and cerebrovascular diseases in the population,and the impact of the interaction between the two on the diseases of the population was further clarified.It aims to provide reference for later research,and also provide literature support for the discovery of the relationship between O₃pollution and death from cardiovascular and cerebrovascular diseases in the population,so as to supply basic ideas for related research,take corresponding prevention and treatment measures,and better protect the health of the population.