Time Series Analysis Of The Effects Of PM_2.5 Pollution On Cardiovascular And Cerebrovascular Mortality In Yangquan From 2019 To 2021

Objective:The quantitative relationship between PM_2.5pollution and mortality from cardiovascular and cerebrovascular diseases among residents in Yangquan was analyzed.Methods:Data in this study were Derived from the National Health Security Information System of the Chinese Center for Disease Control and Prevention,the data of daily mortality from cardiovascular diseases,atmospheric pollutants and meteorological indicators of residents in Yangquan from 2019 to 2021 were mainly collected to describe their general distribution characteristics,and the spearman rank correlation was used to analyze the correlation between air pollutants,meteorological indicators and the number of mortality from cardiovascular diseases.The natural spline functions were used to establish a generalized additive model based on controlling the long-term and seasonal trends of time,meteorological factors and other confounding factors.The model was carried out the analysis of the effects of atmospheric PM_2.5pollution on the mortality of cardiovascular and cerebrovascular diseases,and to explore the differences among different genders,ages,causes of death and seasons.Results:From 2019 to 2021,a total of 12990 people deaths due to cardiovascular and cerebrovascular diseases in Yangquan,among which 10362 males,2628 females,7463people aged≥65 years and 5527 people aged<65 years.There were 9689 and 3301deaths due to acute and non-acute cardiovascular and cerebrovascular events,and 5320and 7670 deaths in cold and warm seasons.The median daily average concentration of PM_2.5in Yangquan was 37μg/m³,and the number of days exceeding the second-level concentration limits of PM_2.5was 146,and the exceedance rate was 13.32%.The number of cardiovascular and cerebrovascular diseases deaths among Yangquan residents from 2019 to 2021 was positively correlated with the concentrations of PM_2.5,SO₂,CO,NO₂,PM₁₀and average air pressure（P<0.05）,and negatively correlated with the concentration of O_3-8h,average temperature and average relative humidity（P<0.05）.The results of single pollutant model fitting showed that the risk of death from cardiovascular and cerebrovascular diseases increased by 1.89%（95%CI:1.03%～2.75%）（P<0.05）with an increase of atmospheric PM_2.5concentration of 10μg/m³.The maximum single-day lag effect was 1.26%（95%CI:0.40%～2.13%）（P<0.05）on the day of exposure,and the maximum cumulative lag effect was 1.68%（95%CI:0.73%～2.63%）（P<0.05）on the 2^thday of exposure.The results of multi-pollutant model fitting showed that after the introduction of SO₂and O_3-8h,the effect values of atmospheric PM_2.5on the mortality of residents from cardiovascular and cerebrovascular diseases were 2.03%（95%CI:1.08%～2.98%）（P<0.05）and 1.20%（95%CI:0.33%～2.07%）（P<0.05）,which was not statistically significant differences from the single pollution model.When other pollutants were introduced,the effect of atmospheric PM_2.5on the death of residents from cardiovascular and cerebrovascular diseases disappeared（P>0.05）.The stratified analysis showed that for every 10μg/m3 increase in atmospheric PM_2.5concentration,the risk of cardiovascular and cerebrovascular diseases death increased by 1.38%（95%CI:0.24%～2.53%）（P<0.05）,2.13%（95%CI:0.99%～3.28%）（P<0.05）,1.87%（95%CI:0.93%～2.81%）（P<0.05）and 2.15%（95%CI:0.51%～3.81%）（P<0.05）for male,female,people aged≥65 years and<65 years,respectively.However,Z-test showed no statistically significant differences between different ages and different genders（P>0.05,P>0.05）.The risk of death from acute cardiovascular and cerebrovascular events increased by 2.06%（95%CI:1.10%～3.03%）（P<0.05）for every 10μg/m³increase in atmospheric PM_2.5concentration,but had no effect was found on deaths from non-acute cardiovascular and cerebrovascular events（P>0.05）.In cold season and warm season,the risk of death from cardiovascular diseases increased by 1.18%（95%CI:0.03%～2.33%）（P<0.05）and 1.89%（95%CI:0.07%～3.74%）（P<0.05）for every 10μg/m³increase in atmospheric PM_2.5concentration,respectively,but the difference was not statistically significant（P>0.05）.Conclusions:There was a positive correlation between atmospheric PM_2.5and deaths from cardiovascular and cerebrovascular diseases in Yangquan.With the increase of atmospheric PM_2.5concentration of 10μg/m³,the risk of death from cardiovascular and cerebrovascular diseases of residents increased by 1.89%,and there was a lag effect.The effect of atmospheric PM_2.5on cardiovascular diseases mortality may be mainly caused by the increased risk of death from acute cardiovascular events.Female mortality of cardiovascular diseases may be more susceptible to PM_2.5pollution.No age and seasonal differences were found.