Long-term effects of particulate matter on incident cardiovascular diseases in middle-aged and elder adults: The CHARLS cohort study

Shiyun Lv; Yadi Shi; Yongxi Xue; Yaoyu Hu; Meiling Hu; Shuting Li; Wenhan Xie; Yuan Li; Yixin Ouyang; Zhiwei Li; Mengmeng Liu; Jing Wei; Xiuhua Guo; Xiangtong Liu

doi:10.1016/j.ecoenv.2023.115181

Long-term effects of particulate matter on incident cardiovascular diseases in middle-aged and elder adults: The CHARLS cohort study

Ecotoxicol Environ Saf. 2023 Jun 30:262:115181. doi: 10.1016/j.ecoenv.2023.115181. Online ahead of print.

Authors

Shiyun Lv¹, Yadi Shi², Yongxi Xue², Yaoyu Hu², Meiling Hu², Shuting Li², Wenhan Xie², Yuan Li², Yixin Ouyang², Zhiwei Li¹, Mengmeng Liu³, Jing Wei⁴, Xiuhua Guo⁵, Xiangtong Liu⁶

Affiliations

¹ School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
² School of Public Health, Capital Medical University, Beijing 100069, China.
³ School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China; National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing 100069, China.
⁴ Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, Maryland 20742, USA.
⁵ School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China; National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing 100069, China. Electronic address: statguo@ccmu.edu.cn.
⁶ School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China. Electronic address: xiangtongl@ccmu.edu.cn.

PMID: 37393817
DOI: 10.1016/j.ecoenv.2023.115181

Abstract

Background: Although there is evidence of long-term effects of particulate matter (PM) on cardiovascular diseases (CVD), researches about long-term effects of PM₁ on CVD are limited. We aimed to examine the long-term effects and magnitude of PM, especially PM₁, on incident CVD in China.

Methods: We included 6016 participants aged ≥ 45 years without CVD at baseline in 2011 from the China Health and Retirement Longitudinal Study. Personal PM (PM₁, PM_2.5, and PM₁₀) concentrations were estimated using geocoded residential address. Generalized linear mixed models and SHapley Additive exPlanation were utilized to calculate the impacts and contributions of PM on CVD. Sensitivity analyses were used to check the robustness.

Results: After a follow up of 4-year, 481 (7.99 %) participants developed CVD. Per 10 μg/m³ uptick in 1-year average concentrations of PM₁, PM_2.5 and PM₁₀ was associated with a 1.20 [95 % confidence interval (CI): 1.05-1.37], 1.13 (95 % CI: 1.11-1.15), and 1.10 (95 % CI: 1.06-1.13) fold risk of incident CVD, respectively. The 2-year average concentrations of PM₁, PM_2.5 and PM₁₀ were associated with incident CVD, corresponding to a 1.03 (95 % CI: 0.96-1.10), 1.11 (95 % CI: 1.02-1.21), and 1.09 (95 % CI: 1.03-1.15) fold risk, respectively. The SHapley Additive exPlanation values of PM₁, PM_2.5, and PM₁₀ were 0.170, 0.153, and 0.053, respectively, corresponding to the first, second, and fifth among all air pollutants. Effects of PM₁, PM_2.5 and PM₁₀ on CVD remained statistically significant in two-pollutant models. The elderly, males, smokers and alcohol drinkers tended to have slightly higher effects, while the differences were not statistically significant (all P-values > 0.05) between subgroups.

Conclusion: Long-term exposure to PM₁, PM_2.5, and PM₁₀ was associated with an increased incidence of CVD. The smaller the particle size, the more important it was for incident CVD indicating that emphasis should be placed on small size of PM.

Keywords: Cardiovascular diseases; PM(1); SHapley Additive exPlanation.