Sandstorm weather is a risk factor for mortality in ischemic heart disease patients in the Hexi Corridor, northwestern China

Impact of sand and dust storms on mortality in Jinan City, China

Background

Sand and dust storms (SDSs) cause considerable health risks worldwide. China is a country seriously affected by SDSs, however only few studies researched the risk of SDS in China. The insufficient evidence on SDS hampers effective measures to mitigate its harm.

Objective

To reveal the mortality risks associated with SDSs in Jinan City and identify sensitive populations vulnerable to these events.

Methods

For this time-stratified case-crossover study, we collected daily data on all-cause, circulatory, and respiratory deaths, as well as air pollution and meteorological information from Jinan City in China between January 1, 2013, and November 30, 2022. We initially utilized a time-stratified case-crossover design and logistic regression model to examine the short-term relationship between SDSs and mortality risks, adjusting for specific variables such as mean temperature, humidity, wind speeds, and holidays. Subsequently, we conducted stratified analyses by age, gender, and season.

Results

A total of 53 SDSs were observed, lasting for 88 days during the study period, which accounted for 2% of the study period. The excess mortality risks associated with SDSs were 13% (95% CI: 4-22%), 4% (95% CI: 1-8%), and 3% (95% CI: 1-6%) for respiratory, circulatory, and all-cause death, respectively. Females and people over 65 years of age are vulnerable to respiratory deaths caused by SDSs.

Conclusion

Short-term exposure to SDSs caused the significantly elevated risks of respiratory, circulatory and all-cause death. Females and individuals over the age of 65 are particularly vulnerable to the effects of SDSs.

The 2023 report of the synergetic roadmap on carbon neutrality and clean air for China: Carbon reduction, pollution mitigation, greening, and growth

The response to climate change and air pollution control demonstrates strong synergy across scientific mechanisms, targets, strategies, and governance systems. This report, based on a monitoring indicator system for coordinated governance of air pollution and climate change, employs an interdisciplinary approach combining natural and social sciences. It establishes 20 indicators across five key areas: air pollution and climate change, governance systems and practices, structural transformation and technologies, atmospheric components and emission reduction pathways, and health impacts and co-benefits. This report tries to provide actionable insights into the interconnectedness of air pollution and climate governance. It highlights key policy gaps, presents updated indicators, and offers a refined monitoring framework to track progress toward China's dual goals of reducing emissions and improving air quality. Compared to previous editions, this year's report has updated four key indicators: meteorological impacts on air quality, climate change and its effects, governance policies, and low-carbon building energy systems. The aim is to further refine the monitoring framework, track progress, and establish a comprehensive theory for collaborative governance while identifying challenges and proposing solutions for China's pathway to carbon neutrality and clean air. The report comprises six chapters. The executive summary chapter is followed by analyzing air pollution and climate change interactions. Governance systems and practices are discussed in the third chapter, focusing on policy implementation and local experiences. The fourth chapter addresses structural transformations and emission reduction technologies, including energy and industrial shifts, transportation, low-carbon buildings, carbon capture and storage, and power systems. The fifth chapter outlines atmospheric component dynamics and emission pathways, presenting insights into emission drivers and future strategies. The sixth chapter assesses health impacts and the benefits of coordinated actions. Since 2019, China Clean Air Policy Partnership has produced annual reports on China's progress in climate and air pollution governance, receiving positive feedback. In 2023, the report was co-developed with Tsinghua University's Carbon Neutrality Research Institute, involving over 100 experts and multiple academic forums. The collaboration aims to continuously improve the indicator system and establish the report as a key resource supporting China's efforts in pollution reduction, carbon mitigation, greening, and sustainable growth.

Climate Change and Cardiovascular Health: A Systematic Review

Importance

Climate change may increase the risk of adverse cardiovascular outcomes by causing direct physiologic changes, psychological distress, and disruption of health-related infrastructure. Yet, the association between numerous climate change-related environmental stressors and the incidence of adverse cardiovascular events has not been systematically reviewed.

Objective

To review the current evidence on the association between climate change-related environmental stressors and adverse cardiovascular outcomes.

Evidence Review

PubMed, Embase, Web of Science, and Cochrane Library were searched to identify peer-reviewed publications from January 1, 1970, through November 15, 2023, that evaluated associations between environmental exposures and cardiovascular mortality, acute cardiovascular events, and related health care utilization. Studies that examined only nonwildfire-sourced particulate air pollution were excluded. Two investigators independently screened 20 798 articles and selected 2564 for full-text review. Study quality was assessed using the Navigation Guide framework. Findings were qualitatively synthesized as substantial differences in study design precluded quantitative meta-analysis.

Findings

Of 492 observational studies that met inclusion criteria, 182 examined extreme temperature, 210 ground-level ozone, 45 wildfire smoke, and 63 extreme weather events, such as hurricanes, dust storms, and droughts. These studies presented findings from 30 high-income countries, 17 middle-income countries, and 1 low-income country. The strength of evidence was rated as sufficient for extreme temperature; ground-level ozone; tropical storms, hurricanes, and cyclones; and dust storms. Evidence was limited for wildfire smoke and inadequate for drought and mudslides. Exposure to extreme temperature was associated with increased cardiovascular mortality and morbidity, but the magnitude varied with temperature and duration of exposure. Ground-level ozone amplified the risk associated with higher temperatures and vice versa. Extreme weather events, such as hurricanes, were associated with increased cardiovascular risk that persisted for many months after the initial event. Some studies noted a small increase in cardiovascular mortality, out-of-hospital cardiac arrests, and hospitalizations for ischemic heart disease after exposure to wildfire smoke, while others found no association. Older adults, racial and ethnic minoritized populations, and lower-wealth communities were disproportionately affected.

Conclusions and Relevance

Several environmental stressors that are predicted to increase in frequency and intensity with climate change are associated with increased cardiovascular risk, but data on outcomes in low-income countries are lacking. Urgent action is needed to mitigate climate change-associated cardiovascular risk, particularly in vulnerable populations.

Characterization of air pollution and associated health risks in Gansu Province, China from 2015 to 2022

Air pollution poses a major threat to both the environment and public health. The air quality index (AQI), aggregate AQI, new health risk-based air quality index (NHAQI), and NHAQI-WHO were employed to quantitatively evaluate the characterization of air pollution and the associated health risk in Gansu Province before (P-I) and after (P-II) COVID-19 pandemic. The results indicated that AQI system undervalued the comprehensive health risk impact of the six criteria pollutants compared with the other three indices. The stringent lockdown measures contributed to a considerable reduction in SO2, CO, PM2.5, NO2 and PM10; these concentrations were 43.4%, 34.6%, 21.4%, 17.4%, and 14.2% lower in P-II than P-I, respectively. But the concentration of O3 had no obvious improvement. The higher sandstorm frequency in P-II led to no significant decrease in the ERtotal and even resulted in an increase in the average ERtotal in cities located in northwestern Gansu from 0.78% in P-I to 1.0% in P-II. The cumulative distribution of NHAQI-based population-weighted exposure revealed that 24% of the total population was still exposed to light pollution in spring during P-II, while the air quality in other three seasons had significant improvements and all people were under healthy air quality level.

Disease burden and risk factors of ischemic heart disease in China during 1990-2019 based on the Global Burden of Disease 2019 report: A systematic analysis

Objective

The aim of this study was to identify the disease burden and risk factors of ischemic heart disease (IHD) in China, during 1990-2019, through a systematic analysis using the Global Burden of Disease (GBD) 2019 report in order to provide first-hand information for primary and secondary prevention of IHD in China.

Methods

Data on the rates of incidence, death, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) of IHD were obtained from GBD2019 to determine the disease burden and risk factors of IHD in China.

Results

The rates of incidence, death, YLLs, YLDs, and DALYs of IHD in China increased at different levels during 1990-2019. The annual rate of change in incidence, death, YLLs, YLDs, and DALYs of IHD were 1.31%, 1.57%, 0.93%, 1.14%, and 0.94%, respectively. In 2019, the YLDs of IHD in Chinese women were higher, while the rates of incidence and death, YLLs, and DALYs were lower in Chinese women than in Chinese men. The disease burden of IHD had significant age differences, and people aged ≥70 years had the highest disease burden. A total of 24 risk factors were associated with the rates of death and DALYs of IHD, and the five most significant risk factors were high systolic blood pressure, high LDL cholesterol (LDL-C), smoking, ambient particulate matter pollution, and intake of a high-sodium diet. From 1990 to 2019, a high annual rate of change in IHD-related deaths and DALYs was observed due to ambient particulate matter pollution, high body mass index (BMI), and intake of a diet high in processed meat.

Conclusion

The results of the study revealed that the disease burden of IHD in China was on the rise, especially in people aged ≥70 years. The main disease burden of IHD in male patients was premature death and that in female patients was disability. Environmental, behavioral, and metabolic factors were considered the three main risks of the disease burden of IHD, with metabolic factors having the greatest impact. Therefore, periodic health check-ups and high-risk factor interventions for key populations should be strengthened from the grassroots level, which are conducive to further reducing the disease burden of IHD in China.