Short-term effects of ambient ozone exposure on daily hospitalizations for circulatory diseases in Ganzhou, China: A time-series study

Xiuyu Cao; Xiaojie You; Dongming Wang; Weihong Qiu; You Guo; Min Zhou; Weihong Chen; Xiaokang Zhang

doi:10.1016/j.chemosphere.2023.138513

Short-term effects of ambient ozone exposure on daily hospitalizations for circulatory diseases in Ganzhou, China: A time-series study

Chemosphere. 2023 Jun:327:138513. doi: 10.1016/j.chemosphere.2023.138513. Epub 2023 Mar 27.

Authors

Xiuyu Cao¹, Xiaojie You¹, Dongming Wang¹, Weihong Qiu², You Guo³, Min Zhou¹, Weihong Chen⁴, Xiaokang Zhang³

Affiliations

¹ Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
² Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China.
³ First Affiliated Hospital, Gannan Medical University, Ganzhou, China; Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China; School of Public Health and Health Management, Gannan Medical University, Ganzhou, China.
⁴ Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China. Electronic address: wchen@mails.tjmu.edu.cn.

PMID: 36990357
DOI: 10.1016/j.chemosphere.2023.138513

Abstract

Adverse health effects of ambient ozone are getting widespread attention, but the evidence on the relationship between ozone levels and circulatory system diseases are limited and inconsistent. Daily data for ambient ozone levels and hospitalizations for total circulatory diseases and five subtypes in Ganzhou, China from January 1, 2016 to December 31, 2020 were collected. We constructed a generalized additive model with quasi-Poisson regression accounting for lag effects to estimate the associations between ambient ozone levels and the number of hospitalized cases of total circulatory diseases and five subtypes. The differences among gender, age, and season subgroups were furtherly assessed through stratified analysis. A total of 201,799 hospitalized cases of total circulatory diseases were included in the present study, including 94,844 hypertension (HBP), 28,597 coronary heart disease (CHD), 42,120 cerebrovascular disease (CEVD), 21,636 heart failure (HF), and 14,602 arrhythmia. Significantly positive associations were observed between ambient ozone levels and daily hospitalizations for total circulatory diseases and all subtypes except arrhythmia. Each 10 μg/m³ increase in ozone concentration, the risk of hospitalizations for total circulatory diseases, HBP, CHD, CEVD, and HF increased by 0.718% (95% confidence interval, 0.156%-1.284%), 0.956% (0.346%-1.570%), 0.499% (0.057%-0.943%), 0.386% (0.025%-0.748%), and 0.907% (0.118%-1.702%), respectively. The above associations remained significant after adjusting for other air pollutants. The risk of hospitalization for circulatory diseases was higher in warm season (May to October) and varied in gender and age subgroups. This study suggested that short-term exposure to ambient ozone may increase the risk of hospitalizations for circulatory diseases. Our findings reinforce the importance of reducing ambient ozone pollution levels for protecting public health.

Keywords: Air pollution; Circulatory diseases; Hospitalizations; Ozone; Time-series study.

MeSH terms

Air Pollutants* / analysis
Air Pollution* / analysis
Cardiovascular Diseases* / chemically induced
Cardiovascular Diseases* / epidemiology
China / epidemiology
Environmental Exposure / analysis
Hospitalization
Humans
Ozone* / analysis
Particulate Matter / analysis

Substances

Air Pollutants
Ozone
Particulate Matter