[Acute effect of fine particulate matters on daily cardiovascular disease mortality in seven cities of China]

Value Assessment of Health Losses Caused by PM2.5 in Changsha City, China

With the advancement of urbanization, the harm caused to human health by PM2.5 pollution has been receiving increasing attention worldwide. In order to increase public awareness and understanding of the damage caused by PM2.5 in the air and gain the attention of relevant management departments, Changsha City is used as the research object, and the environmental quality data and public health data of Changsha City from 2013 to 2017 are used. All-cause death, respiratory death, cardiovascular death, chronic bronchitis, and asthma were selected as the endpoints of PM2.5 pollution health effects, according to an exposure-response coefficient, Poisson regression model, and health-impact-assessment-related methods (the Human Capital Approach, the Willingness to Pay Approach, and the Cost of Illness Approach), assessing the health loss and economic loss associated with PM2.5. The results show that the pollution of PM2.5 in Changsha City is serious, which has resulted in extensive health hazards and economic losses to local residents. From 2013 to 2017, when annual average PM2.5 concentrations fell to 10 μg/m3, the total annual losses from the five health-effect endpoints were $2788.41 million, $2123.18 million, $1657.29 million, $1402.90 million, and $1419.92 million, respectively. The proportion of Gross Domestic Product (GDP) in the current year was 2.69%, 1.87%, 1.34%, 1.04% and 0.93%, respectively. Furthermore, when the concentration of PM2.5 in Changsha City drops to the safety threshold of 10 μg/m3, the number of affected populations and health economic losses can far exceed the situation when it falls to 35 μg/m3, as stipulated by the national secondary standard. From 2013 to 2017, the total loss under the former situation was 1.48 times, 1.54 times, 1.86 times, 2.25 times, and 2.33 times that of the latter, respectively. Among them, all-cause death and cardiovascular death are the main sources of health loss. Taking 2017 as an example, when the annual average concentration dropped to 10 μg/m3, the health loss caused by deaths from all-cause death and cardiovascular disease was 49.16% of the total loss and 35.73%, respectively. Additionally, deaths as a result of respiratory disease, asthma, and chronic bronchitis contributed to 7.31%, 7.29%, and 0.51% of the total loss, respectively. The research results can provide a reference for the formulation of air pollution control policies based on health effects, which is of great significance for controlling air pollution and protecting people's health.

Association between Atmospheric Particulate Pollutants and Mortality for Cardio-Cerebrovascular Diseases in Chinese Korean Population: A Case-Crossover Study

Background: Air pollution in large Chinese cities has led to recent studies that highlighted the relationship between particulate matters (PM) and elevated risk of cardio-cerebrovascular mortality. However, it is unclear as to whether: (1) The same adverse relations exist in cities with relatively low levels of air pollution; and (2) the relationship between the two are similar across ethnic groups. Methods: We collected data of PM_2.5 (PM with an aerodynamic diameter ≤ 2.5 µm) and PM₁₀ (aerodynamic diameter ≤ 10 µm) in the Yanbian Korean Autonomous Prefecture between 1 January 2015 and 31 December 2016. Using a time-stratified case-crossover design, we investigated whether levels of particulate pollutants influence the risk of cardio-cerebrovascular disease mortality among ethnic Korean vs. ethnic Han residents residing in the Yanbian Korean Autonomous Prefecture. Results: Under the single air pollutant model, the odds ratios (ORs) of cardio-cerebrovascular disease were 1.025 (1.024–1.026) for each 10 μg/m³ increase in PM_2.5 at lag0 day, 1.012 (1.011–1.013) for each 10 μg/m³ increase in PM₁₀ at lag1 day. In the multi-pollutant model adjusted by PM₁₀, SO₂, and NO₂, the ORs of cardio-cerebrovascular disease were 1.150 (1.145–1.155) for ethnic Koreans and 1.154 (1.149–1.158) for ethnic Hans for each 10 μg/m³ increase in PM_2.5. In the multi-pollutant model adjusted by PM_2.5, SO₂, and NO₂, the ORs of cardio-cerebrovascular disease were 1.050 (1.047–1.053) for ethnic Koreans and 1.041 (1.039–1.043) for ethnic Hans for each 10 μg/m³ increase in PM₁₀. Conclusion: This study showed that PM_2.5 and PM₁₀ were associated with increased risks of acute death events in residential cardio-cerebrovascular disease in Yanbian, China.

Cardiac pathophysiology in response to environmental stress: a current review

Purpose

Environmental stressors are disturbing our ecosystem at an accelerating rate. An increasingly relevant stressor are air pollutants, whose levels are increasing worldwide with threats to human health. These air pollutants are associated with increased mortality and morbidity from cardiovascular diseases. In this review we discuss environmental stressors focusing mainly on the various types of air pollutants, their short-term and long-term cardiovascular effects, and providing the epidemiological evidence associated with adverse cardiovascular outcomes. Direct and indirect pathophysiological mechanisms are also linked with cardiovascular complications such as thrombosis, fibrinolysis, hypertension, ischemic heart diseases and arrhythmias.

RESULTS

Evidence to date suggests that humans are constantly being exposed to unhealthy levels of environmental toxicants with the potential of serious health conditions. Environmental stressors adversely affect the cardiovascular system and pose an increased risk for cardiovascular diseases for those who reside in highly polluted areas.

CONCLUSION

People with existing risk factors and those with established cardiovascular disease have increased susceptibility to environmental stressors. The literature reviewed in this article thus support public health policies aimed at reducing pollutant exposure to benefit public health.