AUTHOR=Feng Ya-Ting , Lang Cui-Feng , Chen Cong , Harry Asena Musonye , Fang Yang , Zhang Ruo-Di , Jiang Ling-Qiong , Fang Xi , Chen Yue , He Yi-Sheng , Wang Peng , Pan Hai-Feng 

TITLE=Association between air pollution exposure and coronary heart disease hospitalization in a humid sub-tropical region of China: A time-series study

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.1090443

DOI=10.3389/fpubh.2022.1090443

ISSN=2296-2565

ABSTRACT=Objective: Emerging evidence has highlighted the possible links of environmental pollution with several cardiovascular diseases (CVDs). The current study aimed to explore the impact of short-term air pollution exposure on CHD hospitalization in Hefei. 
Methods: Data about the daily number of CHD admissions (from 2014 to 2021) were retrieved from the First Affiliated Hospital of Anhui Medical University. Air pollutants and meteorological data were obtained from China Environmental Monitoring Station and China Meteorological Data Service Center respectively. The correlation between air pollution and CHD hospitalization was assessed using distributed lag non-linear model (DLNM) and Poisson generalized linear regression. 
Results: In the single-pollutant model, NO2, O3 and CO strongly correlated with CHD hospitalization rate. Specifically, exposure to NO2 (lag0, relative risk [RR]: 1.013, 95%CI: 1.002 - 1.024, per 10μg/m3 increase) and CO (lag13, RR:1.035, 95%CI: 1.001 - 1.071, per 1μg/m3 increase) revealed a positive correlation with increased rate of CHD hospitalization. Interestingly, O3 had a protective association with hospitalization of CHD (lag0, RR: 0.993, 95%CI: 0.988 - 0.999, per 10μg/m3 increase). Similar results, to those of the single-pollutant model, were revealed following verification using two-pollutant models. Subgroup analyses indicated that young people, women and people in hot seasons were more susceptible to NO2 exposure, while the elderly, women and people in cold seasons were more susceptible to O3. Furthermore, the elderly were more susceptible to CO exposure. 
Conclusion: Overall, exposure to NO2 and CO increase the rate of CHD hospitalization, but exposure to O3 shows a protective association with the rate of CHD hospitalization. Therefore, early preventive measures against air pollutants should be applied to protect vulnerable CHD patients.