Long-Term Exposure to Ambient Fine Particulate Matter and Incidence of Major Cardiovascular Diseases: A Prospective Study of 0.5 Million Adults in China

• Type of Material: Article
• Authors: Cong Liu, Fudan University, Shanghai; Ka Hung Chan, University of Oxford; Jun Lv, Peking University; Hubert Lam, University of Oxford; Katherine Newell, University of Oxford; Xia Meng, Fudan University; Yang Liu, Emory University; Renjie Chen, Fudan University; Christina Kartsonaki, University of Oxford; Neil Wright, University of Oxford; Huaidong Du, University of Oxford; Ling Yang, University of Oxford; Yiping Chen, University of Oxford; Yu Guo, Chinese Acad Med Sci; Pei Pei, Chinese Acad Med Sci; Canqing Yu, Peking University; Hongbing Shen, Nanjing Medical University; Tangchun Wu, Huazhong University of Science & Technology; Haidong Kan, Fudan University; Zhengming Chen, University of Oxford; Liming Li, Peking University
• Language: English
• Date: 2022-08-31
• Publisher: AMER CHEMICAL SOC
• Publication Version: Final Published Version
• Copyright Statement: © 2022 American Chemical Society
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1021/acs.est.2c03084
• Title of Journal or Parent Work: ENVIRONMENTAL SCIENCE & TECHNOLOGY
• Volume: 56
• Issue: 18
• Start Page: 13200
• End Page: 13211
• Keywords: Environmental Sciences; incidence; LUNG-CANCER; AIR-POLLUTION; Life Sciences & Biomedicine; cohort study; Environmental Sciences & Ecology; Engineering; fine particulate matter; satellite-based modeling; ASSOCIATIONS; cardiovascular disease; Technology; Science & Technology; BURDEN; EVENTS; Engineering, Environmental; RISK; KADOORIE; PM2.5; ALL-CAUSE MORTALITY
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Few cohort studies explored the long-term effects of ambient fine particulate matter (PM2.5) on incidence of cardiovascular diseases (CVDs), especially in countries with higher levels of air pollution. We aimed to evaluate the association between long-term exposure to PM2.5 and incidence of CVD in China. We performed a prospective cohort study in ten regions that recruited 512,689 adults during 2004-2008, with follow-up until 2017. Annual PM2.5 concentrations were estimated using a satellite-based model with national coverage and 1 x 1 km spatial resolution. Time-varying Cox proportional hazard regression models were used to estimate hazard ratios (HRs) for all-cause and cause-specific CVDs associated with PM2.5, adjusting for conventional covariates. During 5.08 million person-years of follow-up, 148,030 incident cases of CVD were identified. Long-term exposure to PM2.5 showed positive and linear association with incidence of CVD, without a threshold below any concentration. The adjusted HRs per 10 μg/m3 increase in PM2.5 was 1.04 (95%CI: 1.02, 1.07) for total CVD. The risk estimates differed between certain population subgroups, with greater HRs in men, in household with higher income, and in people using unclean heating fuels. This prospective study of large Chinese population provided essential epidemiological evidence for CVD incident risk associated with PM2.5.