Potential causal links between long-term ambient particulate matter exposure and cardiovascular mortality: New evidence from a large community-based cohort in South China

Mar 11, 2023Ecotoxicology and environmental safety

Long-term air pollution exposure linked to heart-related deaths in a large South China community

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Abstract

A hazard ratio of 1.033 indicates that each 1 μg/m³ increase in annual average particulate matter (PM) concentration is associated with increased overall cardiovascular disease (CVD) mortality.

Increased concentrations of PM, PM10, and PM2.5 are linked to higher mortality risks for myocardial infarction and ischemic heart disease.
The risk of chronic ischemic heart disease and hypertension is associated with PM10 and PM2.5 exposure.
Older adults, women, less-educated individuals, and inactive participants show higher susceptibility to CVD mortality risks from PM exposure.
Participants exposed to PM concentrations below 70 μg/m³ displayed increased vulnerability to CVD mortality risks associated with PM, PM10, and PM2.5.

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BACKGROUND: Cardiovascular disease (CVD) mortality is associated with long-term particulate matter (PM) exposure. However, evidence from large, highly-exposed population cohort and observational-data-based causal inference approaches remains limited.

AIMS: We examined the potential causal links between PM exposure and the CVD mortality in South China.

METHODS: 580,757 participants were recruited during 2009-2015 and followed up through 2020. Satellite-based annual concentrations of PM, PM, and PM(i.e., PM- PM) at 1 kmspatial resolution were estimated and assigned to each participant. Marginal structural Cox models with time-varying covariates, adjusted using inverse probability weighting, were developed to evaluate the association between prolonged PM exposure and CVD mortality. 2.5 10coarse10 2.5 2

RESULTS: For overall CVD mortality, the hazard ratios and 95% confidence interval for each 1 μg/mincrease in the annual average concentration of PM, PM, and PMwere 1.033 (1.028-1.037), 1.028 (1.024-1.032), and 1.022 (1.012-1.033), respectively. All three PMs were linked to a higher mortality risk for myocardial infarction and ischemic heart disease (IHD). The mortality risk of chronic IHD and hypertension was linked to PMand PM. Significant association between PMand other heart disease mortality was also observed. The older, women, less-educated participants, or inactive participants exhibited particularly higher susceptibility. Participants who were generally exposed to PMconcentrations below 70 μg/mwere more vulnerable to PM-, PM- and PM-CVD mortality risks. 3 3 2.5 10coarse2.5 10coarse10 2.5 10coarse

CONCLUSION: This large cohort study provides evidence for the potential causal links between increased CVD mortality and ambient PM exposure, as well as socio-demographics linked to the highest vulnerability.

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Potential causal links between long-term ambient particulate matter exposure and cardiovascular mortality: New evidence from a large community-based cohort in South China

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