Association between short-term exposure to air pollution and cardiovascular disease in older adults: A time-stratified case-crossover study in South Korea

IF 3.7 2区环境科学与生态学 Q2 ENVIRONMENTAL SCIENCES Atmospheric Environment Pub Date : 2025-06-01 Epub Date: 2025-02-27 DOI:10.1016/j.atmosenv.2025.121130

Min Chae Kim , Sun Jae Park , Hyeokjong Lee , Jihun Song , Hye Jun Kim , Sangwoo Park , Jaewon Kim , Su Kyoung Lee , Seogsong Jeong , Hyun-Young Shin , Kyae Hyung Kim , Sang Min Park

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Abstract

Particulate matter (PM) is known to increase the risk of cardiovascular disease (CVD). However, the association between short-term PM exposure and CVD incidence among older adults remains unclear. We aimed to assess the impact of PM_2.5 and PM_coarse on CVD risk and its specific types, including overall CVD, coronary heart disease, acute myocardial infarction, ischemic stroke, and hemorrhagic stroke.

We recruited 471,706 patients aged 65 years and older who were newly diagnosed with CVD between 2015 and 2021, using data from the National Health Insurance Service (NHIS) database in South Korea. PM concentrations, specifically those with diameters smaller than 2.5 μm (PM_2.5) and 10 μm (PM₁₀), were obtained from the National Ambient Air Monitoring System. The concentration of PM_coarse was calculated by subtracting PM_2.5 from PM₁₀. A time-stratified case-crossover design was applied to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for CVD using conditional logistic regression.

Compared to the lowest quartile of PM_2.5, the highest quartile of lag0 (aOR 1.04, 95% CI 1.02–1.05) and lag0-1 (aOR 1.03, 95% CI 1.02–1.04) had higher CVD risk. Similarly, the 4th quartile of lag0 (aOR 1.03, 95% CI 1.02–1.04) and lag0-1 (aOR 1.02, 95% CI 1.01–1.03) had higher odds for CVD compared to the 1st quartile of PM_coarse. The highest quartile of lag0-1 for PM_2.5 (aOR 1.04, 95% CI 1.02–1.06) and PM_coarse (aOR 1.02, 95% CI 1.00–1.04) showed increased odds of coronary heart disease. For stroke, however, a significant increase in CVD risk was observed only for ischemic stroke, not hemorrhagic stroke.

We found a significant dose-response relationship indicating that higher levels of short-term PM exposure were associated with an increased risk of CVD among older adults. Systematic management of short-term exposure to PM in older adults may reduce the risk of future CVD occurrence.

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短期暴露于空气污染与老年人心血管疾病之间的关系：韩国的一项时间分层病例交叉研究

众所周知，颗粒物（PM）会增加心血管疾病（CVD）的风险。然而，短期PM暴露与老年人心血管疾病发病率之间的关系尚不清楚。我们的目的是评估PM2.5和PMcoarse对CVD风险及其特定类型的影响，包括总体CVD、冠心病、急性心肌梗死、缺血性卒中和出血性卒中。我们招募了471706名65岁及以上的患者，他们在2015年至2021年间新诊断为心血管疾病，使用的数据来自韩国国家健康保险服务（NHIS）数据库。PM浓度，特别是直径小于2.5 μm （PM2.5）和10 μm （PM10）的浓度，来自国家环境空气监测系统。细颗粒物浓度由PM10减去PM2.5计算得到。采用时间分层病例交叉设计，利用条件逻辑回归估计CVD的校正优势比（aORs）和95%置信区间（CIs）。与PM2.5最低四分位数相比，lag0最高四分位数（aOR 1.04, 95% CI 1.02-1.05）和lag0-1最高四分位数（aOR 1.03, 95% CI 1.02-1.04）的心血管疾病风险更高。同样，lag0的第4四分位数（aOR 1.03, 95% CI 1.02 - 1.04）和lag0-1 （aOR 1.02, 95% CI 1.01-1.03）与pm粗的第1四分位数相比，CVD的几率更高。PM2.5 （aOR 1.04, 95% CI 1.02 - 1.06）和pmcrude （aOR 1.02, 95% CI 1.00-1.04）的最高四分位数lag0-1显示冠心病的几率增加。然而，对于中风，CVD风险的显著增加仅在缺血性中风中观察到，而不是出血性中风。我们发现了显著的剂量-反应关系，表明较高水平的短期PM暴露与老年人心血管疾病风险增加有关。系统管理短期暴露于PM的老年人可能会降低未来发生CVD的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Atmospheric Environment 环境科学-环境科学

CiteScore

9.40

自引率

8.00%

发文量

458

审稿时长

53 days

期刊介绍： Atmospheric Environment has an open access mirror journal Atmospheric Environment: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atmospheric Environment is the international journal for scientists in different disciplines related to atmospheric composition and its impacts. The journal publishes scientific articles with atmospheric relevance of emissions and depositions of gaseous and particulate compounds, chemical processes and physical effects in the atmosphere, as well as impacts of the changing atmospheric composition on human health, air quality, climate change, and ecosystems.