AIM:To evaluate the possibility of an association between polyethylene glycol(PEG) and acute renal failure(ARF) in elderly patients using a health insurance claims database.METHODS:We conducted a population-based case...AIM:To evaluate the possibility of an association between polyethylene glycol(PEG) and acute renal failure(ARF) in elderly patients using a health insurance claims database.METHODS:We conducted a population-based casecrossover study using information obtained from Korean Health Insurance Review and Assessment Service(HIRA) claims from January 1,2005 to December 31,2005(Seoul,Korea).The study population consisted of elderly patients who received PEG prior to experiencing their first ARF-related hospitalization from April 1,2005 to December 31,2005.For each patient,one case and two control periods were matched.PEG use in a 2-or 4-wk window period prior to hospitalization for ARF was compared with PEG use in two earlier 2-or 4-wk control window periods.Conditional logistic regression analysis was used to estimate odds ratios(ORs) and 95% CI,adjusting for concomitant uses of diuretics,angiotensin converting enzyme inhibitors,non-steroidal anti-inflammatory drugs,antibiotics,anti-cancer drugs,and contrast media.RESULTS:Within the HIRA database which contained 1 093 262 elderly patients,1156 hospitalized ARF cases were identified.Among these cases,PEG was prescribed to 17(1.5%) patients before hospitalization.The adjusted ORs when applying the 2-and 4-wk window periods were 0.4(95% CI:0.03-5.24) and 2.1(95% CI:0.16-27.78),respectively.CONCLUSION:No increased risk of ARF was found in elderly PEG users.However,based on the limited number of study subjects,further analysis should be performed to confirm these results.展开更多
Stock volatility constitutes an adverse psychological stressor,but few large-scale studies have focused on its impact on major adverse cardiovascular events(MACEs)and suicide.Here,we conducted an individual-level time...Stock volatility constitutes an adverse psychological stressor,but few large-scale studies have focused on its impact on major adverse cardiovascular events(MACEs)and suicide.Here,we conducted an individual-level time-stratified case-crossover study to explore the association of daily stock volatility(daily returns and intra-daily oscillations for three kinds of stock indices)with MACEs and suicide among more than 12 million individual decedents from all counties in the mainland of China between 2013 and 2019.For daily stock returns,both stock increases and decreases were associated with increased mortal-ity risks of all MACEs and suicide.There were consistent and positive associations between intra-daily stock oscillations and mortality due to MACEs and suicide.The excess mortality risks occurred at the cur-rent day(lag 0 d),persisted for two days,and were greatest for suicide and hemorrhagic stroke.Taking the present-day Shanghai and Shenzhen 300 Index as an example,a 1%decrease in daily returns was associated with 0.74%-1.04%and 1.77%increases in mortality risks of MACEs and suicide,respectively;the corresponding risk increments were 0.57%-0.85%and 0.92%for a 1%increase in daily returns and 0.67%-0.77%and 1.09%for a 1%increase in intra-daily stock oscillations.The excess risks were more pro-nounced among individuals aged 65-74 years,males,and those with lower education levels.Our findings revealed considerable health risks linked to sociopsychological stressors,which are helpful for the gov-ernment and general public to mitigate the immediate cardiovascular and mental health risks associated with stock market volatility.展开更多
Falls represent a significant public health issue worldwide.Previous studies have demonstrated associations of temperature with fall risk,but the effect and burden of hourly relative humidity and fall morbidity have b...Falls represent a significant public health issue worldwide.Previous studies have demonstrated associations of temperature with fall risk,but the effect and burden of hourly relative humidity and fall morbidity have been rarely investigated.Fall data and meteorological data were collected from the National Injury Surveillance System during 2006−2021 in China.Associations between hourly relative humidity and fall onset were analyzed using conditional logistic regression combined with a distributed lag nonlinear model.Stratified analysis was used to identify potential association modifiers.Several sensitivity analyses were applied to examine the robustness of the results.The study involved 4197495 fall-related cases.Relative humidity exhibited monotonic relationships with the fall onset risk.The excess risk(ER)of falls appeared immediately at lag 0 h and persisted for 8 h.A 10%decrease in relative humidity was associated with a 1.35%(95%confidence interval[CI]:0.83−1.87%)increase in excess risk of falls and much higher risk for males(ER=1.89%,95%CI:1.29−2.48%)than that for females(ER=0.52%,95%CI:0.14−0.90%).The excess risk of fall injury was the highest among individuals aged 5−14 years(ER=3.45%,95%CI:2.57−4.32%)compared to other age groups.Moreover,compared to the highest relative humidity,the attributable fraction(AF)due to low relative humidity exposure was 4.94%(95%CI:4.88−4.98%).Subgroup analyses revealed that males,individuals aged 5−14 years,students,cases occurring in public places,and cases engaged in sports activities were more susceptible to relative humidity than their correspondents.Regional disparities were observed,with individuals in southern China or warm regions showing greater sensitivity to changes in relative humidity.Results of this study suggest that hourly low relative humidity exposure is associated with an increased risk of fall onset.These findings underscore the necessity of time-specific interventions to mitigate the relative humidity risk.展开更多
Few studies have explored the acute effects of fine particulate matter(PM_(2.5))constituents on respiratory diseases(RDs),particularly across a broad spectrum of RD subtypes.We analyzed the associations between PM_(2....Few studies have explored the acute effects of fine particulate matter(PM_(2.5))constituents on respiratory diseases(RDs),particularly across a broad spectrum of RD subtypes.We analyzed the associations between PM_(2.5) and its five major constituents[organic matter(OM),black carbon(BC),sulfate(SO_(4)^(2−)),nitrate(NO_(3)^(−)),and ammonium(NH_(4)^(+))]and RDs(10 major categories and 35 specific)based on the hospitalization records from 153 hospitals in 20 provincial distractions from 2013 to 2020.We found that short-term exposure(lag 0−1)to PM_(2.5) constituents per interquartile range increase was associated with higher hospitalization risks for acute upper respiratory infections,influenza and pneumonia,other acute lower respiratory infections,chronic lower respiratory diseases,other diseases of the pleura,and other diseases of the respiratory system;the effect estimates were 2.45−2.99%,2.02−2.71%,2.98−3.62%,3.06−3.65%,3.22−4.52%,and 2.23−3.66%,respectively.Among 35 specific RDs,12 were significantly affected by PM_(2.5) and its constituents.Individuals aged>60 years were sensitive to PM_(2.5) constituent exposure.Our individual-level nationwide study provided a more comprehensive perspective on the associations between PM_(2.5) constituents and various major and specific RDs,highlighting the necessity of prioritizing targeted control strategies for key constituents to effectively mitigate the burden of RDs in China.展开更多
A growing number of studies associated increased mortality with exposures to specific fine particulate(PM_(2.5))constituents,while great heterogeneity exists between locations.In China,evidence linking PM_(2.5)constit...A growing number of studies associated increased mortality with exposures to specific fine particulate(PM_(2.5))constituents,while great heterogeneity exists between locations.In China,evidence linking PM_(2.5)constituents and mortality was extensively sparse.This study primarily aimed to quantify short-term associations between PM_(2.5)constituents and non-accidental mortality among the Chinese population.We collected daily mortality records from 32 counties in China between January 1,2011,and December 31,2013.Daily concentrations of main PM_(2.5)constituents(organic carbon(OC),elemental carbon(EC),nitrate(NO_(3)^(-)),sulfate(SO_(4)^(2−)),and ammonium(NH_(4)^(+)))were estimated using the modified Community Multiscale Air Quality model.Time-stratified case-crossover design with conditional logistic regression models was adopted to estimate mortality risks associated with short-term exposures to PM_(2.5)mass and its constituents.Stratification analyses were done by sex,age,and season.A total of 116,959 non-accidental deaths were investigated.PM_(2.5)concentrations on the day of death were averaged at 75.7μg m^(−3)(control day:75.6μg m^(−3)),with an interquartile range(IQR)of 65.2μg m^(−3).Per IQR rise in PM_(2.5),EC,OC,NO_(3)^(-),SO_(4)^(2−),and NH_(4)^(+)at lag-04 day was associated with an increase in non-accidental mortality of 2.4%(95%confidence interval,(1.0–3.7),1.7%(0.8–2.7),2.9%(1.6–4.3),2.1%(0.4–3.9),1.0%(0.2–1.9),and 1.6%(0.3–2.9),respectively.Both PM_(2.5)mass and its constituents were strongly associated with elevated cardiovascular mortality risks,but only PM_(2.5),EC,and OC were positively associated with respiratory mortality at lag-3 day.PM_(2.5)mass and its constituents associated effects on mortality varied among sex-and age-specific subpopulations.Differences in the seasonal pattern of associations exist among PM_(2.5)constituents,with stronger effects related to EC and NO_(3)^(-)in warm months but SO_(4)^(2−)and NH_(4)^(+)in cold months.Short-term exposures to PM_(2.5)compositions were positively associated with increased risks of mortality,particularly those constituents from combustion-related sources.展开更多
Few national studies have systemically examined the effects of criteria air pollutants on cardiovascular morbidity.This study aimed to investigate the associations between all criteria air pollutants and hospitalizati...Few national studies have systemically examined the effects of criteria air pollutants on cardiovascular morbidity.This study aimed to investigate the associations between all criteria air pollutants and hospitalization of causespecific cardiovascular diseases(CVD)in China.We obtained data on CVD hospitalization events of four major categories and 12 specific diseases from 153 hospitals distributed in 20 provincial-level regions from 2013 to 2020.We adopted a time-stratified case-crossover study design using individual cases to capture the effect of short-term exposure to six criteria air pollutants on CVD hospitalizations,using conditional logistic regression models.More than 1.1 million CVD hospitalization events were included.The lag pattern exploration demonstrated the largest effect for six air pollutants on lag 0–1 day.PM_(2.5),PM_(10),NO_(2),and CO were significantly associated with increased hospitalization from ischemic heart diseases,cerebrovascular diseases,other heart diseases,and five specific causes of CVD.The effect estimates of NO_(2)were the most robust when adjusting for copollutants.The concentration-response curves were positive and linear for most pollutant–endpoint pairs(except for O_(3)),and these positive associations remained even below the 24-h levels recommended by WHO Air Quality Guidelines and China Air Quality Standards.This nationwide case-crossover study in China demonstrated that short-term exposure to multiple ambient air pollutants may significantly increase the risk of cause-specific CVD hospitalizations even under the most stringent air quality regulations,striking an alert for potential CVD patients against these environmental risk factors.展开更多
Few multicity studies have examined the acute effects of nitrogen dioxide(NO_(2))on respiratory disease(RD),especially its specific causes.This study aimed to investigate the associations between short-term exposure t...Few multicity studies have examined the acute effects of nitrogen dioxide(NO_(2))on respiratory disease(RD),especially its specific causes.This study aimed to investigate the associations between short-term exposure to NO_(2)and hospitalization of full-spectrum RDs in China.Hospitalization of 10 major categories and 40 cause-specific RDs were obtained from 20 provinces over the study period of 2013−2020.A time-stratified case-crossover study was conducted at the individual level to explore the associations between NO_(2)and RDs.NO_(2)was significantly associated with increased hospitalization of eight major RDs(acute upper respiratory infections,influenza and pneumonia,acute lower respiratory infections,upper respiratory tract diseases,chronic lower respiratory diseases,respiratory interstitium diseases,pleura diseases,and other respiratory diseases)and 18 specific causes of RDs,with the largest associations observed on lag 0−1 day.The effect estimates ranged from 0.75 to 4.09%per 10μg/m^(3)of NO_(2)exposure.The associations remained robust after controlling for copollutants.The concentration−response curves were mostly positive and linear.This nationwide study provides comprehensive information on the acute effects of NO_(2)on respiratory morbidity across the full spectrum,highlighting the need for caution with regard to this important traffic-related air pollutant in current pollution control programs.展开更多
Incident chronic kidney disease(CKD)may be accelerated(could be indicated by repeated admissions to the hospital)by environmental triggers such as ambient particulate matter(PM).Additionally,hospital admission is a se...Incident chronic kidney disease(CKD)may be accelerated(could be indicated by repeated admissions to the hospital)by environmental triggers such as ambient particulate matter(PM).Additionally,hospital admission is a sensitive proxy reflecting the disease burden.However,the association of PM exposure with hospital admissions for CKD is still unknown,let alone the excess risks(ERs)in hospital admissions for CKD due to high PM level exposure.In this study,a two-stage time-stratified case-crossover study was conducted to investigate the association of ambient air PM exposure with hospital admission for CKD in 282 Chinese cities of prefecture-level or above during 2013–2017.City-specific associations of single and cumulative 0–3 days lagged exposure to fine particulate matter(PM_(2.5))and inhalable particles(PM_(10))with hospital admissions for total CKD and its subtypes were evaluated by the conditional logistic regression model,then were pooled using the random-effect model.A total of 3,490,416 hospital admissions for CKD were identified.We found that per interquartile range(IQR)increment in PM_(2.5) at lag02 and per IQR increment in PM_(10) at lag03 were associated with increases of 2.36%(95%CI:1.58%,3.14%)and 2.87%(95%CI:1.91%,3.85%)in hospital admissions for total CKD,respectively.Compared to control concentrations(PM_(2.5):35μg/m^(3);PM_(10):50μg/m^(3)),the largest ERs in hospital admissions for total CKD were 2.63%(95%CI:2.15%–3.11%)and 4.45%(95%CI:3.85%–5.06%)in association with exposure to heavily excessive PM_(2.5)(≥75μg/m^(3))and PM_(10)(≥150μg/m^(3)),respectively.Moreover,the attributable fractions(AFs)for CKD admissions were 2.83%for PM_(2.5) and 3.46%for PM_(10) during the study period.These findings suggested that exposure to PM_(2.5) and PM_(10) is associated with substantially increased risk and burden of CKD admissions.展开更多
Existing evidence suggested that short-term exposure to fine particulate matter(PM_(2.5))may increase the risk of death from myocardial infarction(MI),while PM_(2.5) constituents responsible for this association has n...Existing evidence suggested that short-term exposure to fine particulate matter(PM_(2.5))may increase the risk of death from myocardial infarction(MI),while PM_(2.5) constituents responsible for this association has not been determined.We collected 12,927 MI deaths from 32 counties in southern China during 2011–2013.County-level exposures of ambient PM_(2.5) and its 5 constituents(i.e.,elemental carbon(EC),organic carbon(OC),sulfate(SO_(4)^(2-)),ammonium(NH_(4)^(+)),and nitrate(NO_(3)^(-)))were aggregated from gridded datasets predicted by Community Multiscale Air Quality Modeling System.We employed a space-time-stratified casecrossover design and conditional logistic regression models to quantify the association of MI mortality with short-term exposure to PM_(2.5) and its constituents across various lag days.Over the study period,the daily mean PM_(2.5) mass concentration was 77.8(standard deviation(SD)=72.7)μg/m^(3).We estimated an odds ratio of 1.038(95%confidence interval(CI):1.003-1.074),1.038(1.013-1.063)and 1.057(1.023-1.097)for MI mortality associated with per interquartile range(IQR)increase in the 3-day moving-average exposure to PM_(2.5)(IQR=76.3μg/m 3),EC(4.1μg/m^(3))and OC(9.1μg/m^(3)),respectively.We did not identify significant association between MI death and exposure to water-soluble ions(SO_(4)^(2-),NH_(4)^(+)and NO_(3)^(-)).Likelihood ratio tests supported no evident violations of linear assumptions for constituents-MI associations.Subgroup analyses showed stronger associations between MI death and EC/OC exposure in the elderly,males and cold months.Short-term exposure to PM_(2.5) constituents,particularly those carbonaceous aerosols,was associated with increased risks of MI mortality.展开更多
Emerging evidence suggests that heat waves and ozone(O_(3))contribute to increased mortality risks.Since widowhood is a common event that can increase individuals'susceptibility to the environment,it is of great i...Emerging evidence suggests that heat waves and ozone(O_(3))contribute to increased mortality risks.Since widowhood is a common event that can increase individuals'susceptibility to the environment,it is of great importance and interest to elucidate the widowhood disparity in mortality attributable to heat waves and O_(3).We therefore conducted a case-crossover study of 1,214,763 nonaccidental deaths in Jiangsu Province,China,during 2015–2021 to investigate the independent and interactive associations of exposure to heat waves and O_(3) with mortality by widowhood status.Grid-level heat waves were defined by multiple combinations of apparent temperature thresholds and durations.Residential heat waves and O_(3) exposures were assessed using validated grid datasets.Conditional logistic regression models were applied for exposure-response analyses and evalua-tions of additive interactions.Exposure to heat waves and O_(3) was significantly associated with increased odds of mortality in both widowed(odds ratio for heat waves,1.25;O_(3),1.06 per interquartile range increase)and married subjects(1.08;1.03),and these associations were higher in widowed subjects.A significant synergistic interaction was observed between heat waves and O_(3),which was stronger in widowed subjects(relative excess odds due to interaction,0.14 vs.0.03).Up to 6.43%and 3.56%of deaths were attributable to heat waves,O_(3) pollution,and their compound events in widowed and married subjects,respectively.Our findings suggest that widowed individuals are more susceptible to heat waves and O_(3) and highlight the need to consider differences associated with widowhood disparities in preventing premature deaths due to heat waves and O_(3) exposures.展开更多
文摘AIM:To evaluate the possibility of an association between polyethylene glycol(PEG) and acute renal failure(ARF) in elderly patients using a health insurance claims database.METHODS:We conducted a population-based casecrossover study using information obtained from Korean Health Insurance Review and Assessment Service(HIRA) claims from January 1,2005 to December 31,2005(Seoul,Korea).The study population consisted of elderly patients who received PEG prior to experiencing their first ARF-related hospitalization from April 1,2005 to December 31,2005.For each patient,one case and two control periods were matched.PEG use in a 2-or 4-wk window period prior to hospitalization for ARF was compared with PEG use in two earlier 2-or 4-wk control window periods.Conditional logistic regression analysis was used to estimate odds ratios(ORs) and 95% CI,adjusting for concomitant uses of diuretics,angiotensin converting enzyme inhibitors,non-steroidal anti-inflammatory drugs,antibiotics,anti-cancer drugs,and contrast media.RESULTS:Within the HIRA database which contained 1 093 262 elderly patients,1156 hospitalized ARF cases were identified.Among these cases,PEG was prescribed to 17(1.5%) patients before hospitalization.The adjusted ORs when applying the 2-and 4-wk window periods were 0.4(95% CI:0.03-5.24) and 2.1(95% CI:0.16-27.78),respectively.CONCLUSION:No increased risk of ARF was found in elderly PEG users.However,based on the limited number of study subjects,further analysis should be performed to confirm these results.
基金supported by the National Key Research and Development Program(2022YFC3702701)the Shanghai Municipal Science and Technology Commission(21TQ015)the Shanghai International Science and Technology Partnership Project,China(21230780200).
文摘Stock volatility constitutes an adverse psychological stressor,but few large-scale studies have focused on its impact on major adverse cardiovascular events(MACEs)and suicide.Here,we conducted an individual-level time-stratified case-crossover study to explore the association of daily stock volatility(daily returns and intra-daily oscillations for three kinds of stock indices)with MACEs and suicide among more than 12 million individual decedents from all counties in the mainland of China between 2013 and 2019.For daily stock returns,both stock increases and decreases were associated with increased mortal-ity risks of all MACEs and suicide.There were consistent and positive associations between intra-daily stock oscillations and mortality due to MACEs and suicide.The excess mortality risks occurred at the cur-rent day(lag 0 d),persisted for two days,and were greatest for suicide and hemorrhagic stroke.Taking the present-day Shanghai and Shenzhen 300 Index as an example,a 1%decrease in daily returns was associated with 0.74%-1.04%and 1.77%increases in mortality risks of MACEs and suicide,respectively;the corresponding risk increments were 0.57%-0.85%and 0.92%for a 1%increase in daily returns and 0.67%-0.77%and 1.09%for a 1%increase in intra-daily stock oscillations.The excess risks were more pro-nounced among individuals aged 65-74 years,males,and those with lower education levels.Our findings revealed considerable health risks linked to sociopsychological stressors,which are helpful for the gov-ernment and general public to mitigate the immediate cardiovascular and mental health risks associated with stock market volatility.
基金supported by the National Natural Science Foundation of China(42075173,W.M.,42275187,W.M.)Young Elite Scientists Sponsorship Program by CAST(2022QNRC001,G.H.).
文摘Falls represent a significant public health issue worldwide.Previous studies have demonstrated associations of temperature with fall risk,but the effect and burden of hourly relative humidity and fall morbidity have been rarely investigated.Fall data and meteorological data were collected from the National Injury Surveillance System during 2006−2021 in China.Associations between hourly relative humidity and fall onset were analyzed using conditional logistic regression combined with a distributed lag nonlinear model.Stratified analysis was used to identify potential association modifiers.Several sensitivity analyses were applied to examine the robustness of the results.The study involved 4197495 fall-related cases.Relative humidity exhibited monotonic relationships with the fall onset risk.The excess risk(ER)of falls appeared immediately at lag 0 h and persisted for 8 h.A 10%decrease in relative humidity was associated with a 1.35%(95%confidence interval[CI]:0.83−1.87%)increase in excess risk of falls and much higher risk for males(ER=1.89%,95%CI:1.29−2.48%)than that for females(ER=0.52%,95%CI:0.14−0.90%).The excess risk of fall injury was the highest among individuals aged 5−14 years(ER=3.45%,95%CI:2.57−4.32%)compared to other age groups.Moreover,compared to the highest relative humidity,the attributable fraction(AF)due to low relative humidity exposure was 4.94%(95%CI:4.88−4.98%).Subgroup analyses revealed that males,individuals aged 5−14 years,students,cases occurring in public places,and cases engaged in sports activities were more susceptible to relative humidity than their correspondents.Regional disparities were observed,with individuals in southern China or warm regions showing greater sensitivity to changes in relative humidity.Results of this study suggest that hourly low relative humidity exposure is associated with an increased risk of fall onset.These findings underscore the necessity of time-specific interventions to mitigate the relative humidity risk.
基金supported by the National Natural Science Foundation of China(82422065)the National Key Research and Development Program of China(2022YFC2704604)+1 种基金the Shanghai 3-year Public Health Action Plan(GWVI-11.2-YQ32,GWVI-11.1-39,GWVI-11.2-YQ31)the Shanghai B&R Joint Laboratory Project(22230750300).
文摘Few studies have explored the acute effects of fine particulate matter(PM_(2.5))constituents on respiratory diseases(RDs),particularly across a broad spectrum of RD subtypes.We analyzed the associations between PM_(2.5) and its five major constituents[organic matter(OM),black carbon(BC),sulfate(SO_(4)^(2−)),nitrate(NO_(3)^(−)),and ammonium(NH_(4)^(+))]and RDs(10 major categories and 35 specific)based on the hospitalization records from 153 hospitals in 20 provincial distractions from 2013 to 2020.We found that short-term exposure(lag 0−1)to PM_(2.5) constituents per interquartile range increase was associated with higher hospitalization risks for acute upper respiratory infections,influenza and pneumonia,other acute lower respiratory infections,chronic lower respiratory diseases,other diseases of the pleura,and other diseases of the respiratory system;the effect estimates were 2.45−2.99%,2.02−2.71%,2.98−3.62%,3.06−3.65%,3.22−4.52%,and 2.23−3.66%,respectively.Among 35 specific RDs,12 were significantly affected by PM_(2.5) and its constituents.Individuals aged>60 years were sensitive to PM_(2.5) constituent exposure.Our individual-level nationwide study provided a more comprehensive perspective on the associations between PM_(2.5) constituents and various major and specific RDs,highlighting the necessity of prioritizing targeted control strategies for key constituents to effectively mitigate the burden of RDs in China.
基金supported by Hubei Provincial Natural Science Foundation of China(2021CFB032)Youth Fund Project of Humanities and Social Sciences Research of the Ministry of Education(21YJCZH229)the Science and Technology Research Project of Hubei Provincial Department of Education(Q20201104)。
文摘A growing number of studies associated increased mortality with exposures to specific fine particulate(PM_(2.5))constituents,while great heterogeneity exists between locations.In China,evidence linking PM_(2.5)constituents and mortality was extensively sparse.This study primarily aimed to quantify short-term associations between PM_(2.5)constituents and non-accidental mortality among the Chinese population.We collected daily mortality records from 32 counties in China between January 1,2011,and December 31,2013.Daily concentrations of main PM_(2.5)constituents(organic carbon(OC),elemental carbon(EC),nitrate(NO_(3)^(-)),sulfate(SO_(4)^(2−)),and ammonium(NH_(4)^(+)))were estimated using the modified Community Multiscale Air Quality model.Time-stratified case-crossover design with conditional logistic regression models was adopted to estimate mortality risks associated with short-term exposures to PM_(2.5)mass and its constituents.Stratification analyses were done by sex,age,and season.A total of 116,959 non-accidental deaths were investigated.PM_(2.5)concentrations on the day of death were averaged at 75.7μg m^(−3)(control day:75.6μg m^(−3)),with an interquartile range(IQR)of 65.2μg m^(−3).Per IQR rise in PM_(2.5),EC,OC,NO_(3)^(-),SO_(4)^(2−),and NH_(4)^(+)at lag-04 day was associated with an increase in non-accidental mortality of 2.4%(95%confidence interval,(1.0–3.7),1.7%(0.8–2.7),2.9%(1.6–4.3),2.1%(0.4–3.9),1.0%(0.2–1.9),and 1.6%(0.3–2.9),respectively.Both PM_(2.5)mass and its constituents were strongly associated with elevated cardiovascular mortality risks,but only PM_(2.5),EC,and OC were positively associated with respiratory mortality at lag-3 day.PM_(2.5)mass and its constituents associated effects on mortality varied among sex-and age-specific subpopulations.Differences in the seasonal pattern of associations exist among PM_(2.5)constituents,with stronger effects related to EC and NO_(3)^(-)in warm months but SO_(4)^(2−)and NH_(4)^(+)in cold months.Short-term exposures to PM_(2.5)compositions were positively associated with increased risks of mortality,particularly those constituents from combustion-related sources.
基金supported by the National Natural Science Foundation of China(grant numbers 92043301 and 91843302)the Shanghai International Science and Technology Partnership Project(grant number 21230780200).
文摘Few national studies have systemically examined the effects of criteria air pollutants on cardiovascular morbidity.This study aimed to investigate the associations between all criteria air pollutants and hospitalization of causespecific cardiovascular diseases(CVD)in China.We obtained data on CVD hospitalization events of four major categories and 12 specific diseases from 153 hospitals distributed in 20 provincial-level regions from 2013 to 2020.We adopted a time-stratified case-crossover study design using individual cases to capture the effect of short-term exposure to six criteria air pollutants on CVD hospitalizations,using conditional logistic regression models.More than 1.1 million CVD hospitalization events were included.The lag pattern exploration demonstrated the largest effect for six air pollutants on lag 0–1 day.PM_(2.5),PM_(10),NO_(2),and CO were significantly associated with increased hospitalization from ischemic heart diseases,cerebrovascular diseases,other heart diseases,and five specific causes of CVD.The effect estimates of NO_(2)were the most robust when adjusting for copollutants.The concentration-response curves were positive and linear for most pollutant–endpoint pairs(except for O_(3)),and these positive associations remained even below the 24-h levels recommended by WHO Air Quality Guidelines and China Air Quality Standards.This nationwide case-crossover study in China demonstrated that short-term exposure to multiple ambient air pollutants may significantly increase the risk of cause-specific CVD hospitalizations even under the most stringent air quality regulations,striking an alert for potential CVD patients against these environmental risk factors.
基金supported by the National Natural Science Foundation of China(Grant Nos.92043301,82103790)the Shanghai International Science and Technology Partnership Project(Grant No.21230780200).
文摘Few multicity studies have examined the acute effects of nitrogen dioxide(NO_(2))on respiratory disease(RD),especially its specific causes.This study aimed to investigate the associations between short-term exposure to NO_(2)and hospitalization of full-spectrum RDs in China.Hospitalization of 10 major categories and 40 cause-specific RDs were obtained from 20 provinces over the study period of 2013−2020.A time-stratified case-crossover study was conducted at the individual level to explore the associations between NO_(2)and RDs.NO_(2)was significantly associated with increased hospitalization of eight major RDs(acute upper respiratory infections,influenza and pneumonia,acute lower respiratory infections,upper respiratory tract diseases,chronic lower respiratory diseases,respiratory interstitium diseases,pleura diseases,and other respiratory diseases)and 18 specific causes of RDs,with the largest associations observed on lag 0−1 day.The effect estimates ranged from 0.75 to 4.09%per 10μg/m^(3)of NO_(2)exposure.The associations remained robust after controlling for copollutants.The concentration−response curves were mostly positive and linear.This nationwide study provides comprehensive information on the acute effects of NO_(2)on respiratory morbidity across the full spectrum,highlighting the need for caution with regard to this important traffic-related air pollutant in current pollution control programs.
基金National Key Research and Development Program of China(grant number:2022YFC3702604 and 2022YFC3702704)Youth Top Talent Program of Xi’an Jiaotong University.
文摘Incident chronic kidney disease(CKD)may be accelerated(could be indicated by repeated admissions to the hospital)by environmental triggers such as ambient particulate matter(PM).Additionally,hospital admission is a sensitive proxy reflecting the disease burden.However,the association of PM exposure with hospital admissions for CKD is still unknown,let alone the excess risks(ERs)in hospital admissions for CKD due to high PM level exposure.In this study,a two-stage time-stratified case-crossover study was conducted to investigate the association of ambient air PM exposure with hospital admission for CKD in 282 Chinese cities of prefecture-level or above during 2013–2017.City-specific associations of single and cumulative 0–3 days lagged exposure to fine particulate matter(PM_(2.5))and inhalable particles(PM_(10))with hospital admissions for total CKD and its subtypes were evaluated by the conditional logistic regression model,then were pooled using the random-effect model.A total of 3,490,416 hospital admissions for CKD were identified.We found that per interquartile range(IQR)increment in PM_(2.5) at lag02 and per IQR increment in PM_(10) at lag03 were associated with increases of 2.36%(95%CI:1.58%,3.14%)and 2.87%(95%CI:1.91%,3.85%)in hospital admissions for total CKD,respectively.Compared to control concentrations(PM_(2.5):35μg/m^(3);PM_(10):50μg/m^(3)),the largest ERs in hospital admissions for total CKD were 2.63%(95%CI:2.15%–3.11%)and 4.45%(95%CI:3.85%–5.06%)in association with exposure to heavily excessive PM_(2.5)(≥75μg/m^(3))and PM_(10)(≥150μg/m^(3)),respectively.Moreover,the attributable fractions(AFs)for CKD admissions were 2.83%for PM_(2.5) and 3.46%for PM_(10) during the study period.These findings suggested that exposure to PM_(2.5) and PM_(10) is associated with substantially increased risk and burden of CKD admissions.
基金supported by the Hubei Provincial Natural Science Foundation of China(No.2021CFB032)the Youth Fund Project of Humanities and Social Sciences Research of the Ministry of Education(No.21YJCZH229)the Science and Technology Research Project of Hubei Provincial Department of Education(No.Q20201104).
文摘Existing evidence suggested that short-term exposure to fine particulate matter(PM_(2.5))may increase the risk of death from myocardial infarction(MI),while PM_(2.5) constituents responsible for this association has not been determined.We collected 12,927 MI deaths from 32 counties in southern China during 2011–2013.County-level exposures of ambient PM_(2.5) and its 5 constituents(i.e.,elemental carbon(EC),organic carbon(OC),sulfate(SO_(4)^(2-)),ammonium(NH_(4)^(+)),and nitrate(NO_(3)^(-)))were aggregated from gridded datasets predicted by Community Multiscale Air Quality Modeling System.We employed a space-time-stratified casecrossover design and conditional logistic regression models to quantify the association of MI mortality with short-term exposure to PM_(2.5) and its constituents across various lag days.Over the study period,the daily mean PM_(2.5) mass concentration was 77.8(standard deviation(SD)=72.7)μg/m^(3).We estimated an odds ratio of 1.038(95%confidence interval(CI):1.003-1.074),1.038(1.013-1.063)and 1.057(1.023-1.097)for MI mortality associated with per interquartile range(IQR)increase in the 3-day moving-average exposure to PM_(2.5)(IQR=76.3μg/m 3),EC(4.1μg/m^(3))and OC(9.1μg/m^(3)),respectively.We did not identify significant association between MI death and exposure to water-soluble ions(SO_(4)^(2-),NH_(4)^(+)and NO_(3)^(-)).Likelihood ratio tests supported no evident violations of linear assumptions for constituents-MI associations.Subgroup analyses showed stronger associations between MI death and EC/OC exposure in the elderly,males and cold months.Short-term exposure to PM_(2.5) constituents,particularly those carbonaceous aerosols,was associated with increased risks of MI mortality.
基金supported by the Natural Science Foundation of Guangdong Province(2025A1515011041)the Key Project of Medical Science Research of Jiangsu Provincial Health Commission(K2023045)the Shenzhen Medical Research Fund(A2302033).
文摘Emerging evidence suggests that heat waves and ozone(O_(3))contribute to increased mortality risks.Since widowhood is a common event that can increase individuals'susceptibility to the environment,it is of great importance and interest to elucidate the widowhood disparity in mortality attributable to heat waves and O_(3).We therefore conducted a case-crossover study of 1,214,763 nonaccidental deaths in Jiangsu Province,China,during 2015–2021 to investigate the independent and interactive associations of exposure to heat waves and O_(3) with mortality by widowhood status.Grid-level heat waves were defined by multiple combinations of apparent temperature thresholds and durations.Residential heat waves and O_(3) exposures were assessed using validated grid datasets.Conditional logistic regression models were applied for exposure-response analyses and evalua-tions of additive interactions.Exposure to heat waves and O_(3) was significantly associated with increased odds of mortality in both widowed(odds ratio for heat waves,1.25;O_(3),1.06 per interquartile range increase)and married subjects(1.08;1.03),and these associations were higher in widowed subjects.A significant synergistic interaction was observed between heat waves and O_(3),which was stronger in widowed subjects(relative excess odds due to interaction,0.14 vs.0.03).Up to 6.43%and 3.56%of deaths were attributable to heat waves,O_(3) pollution,and their compound events in widowed and married subjects,respectively.Our findings suggest that widowed individuals are more susceptible to heat waves and O_(3) and highlight the need to consider differences associated with widowhood disparities in preventing premature deaths due to heat waves and O_(3) exposures.
