Ambient air pollution and cardiovascular disease mortality in Anhui province: An individual-level case-crossover study

Abstract Background: Investigating the short-term dynamics between air pollution and cardiovascular disease (CVD) mortality presents a compelling research imperative. Prior studies have noted associations, yet few have captured the intricate, short-term interactions within the Anhui Province, a region undergoing rapid urbanization and industrialization. Methods: A comprehensive case-crossover analysis was conducted in Hefei, Anhui Province, China, between 2017 and 2020. Our objective was to discern the immediate effects of six prevalent air pollutants on CVD mortality risks. By harnessing high-resolution satellite data, we traced daily concentrations of fine particulate matter (PM2.5), inhalable particulate matter (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3) to the exposure dosages of individuals. Results: The analysis unveiled a substantial correlation between elevated levels of all six pollutants and an increase in CVD mortality. The temporal lag between exposure and peak mortality differed among pollutants, with exposure-response (E-R) curves delineating a mostly linear pattern, especially pronounced at lower concentrations of PM2.5, PM10, and CO. A notable uptick in effect was observed at higher concentrations of NO2, SO2, and O3, with SO2 emerging as the most impactful on CVD mortality. Additionally, our gender-specific examinations revealed a heightened vulnerability to air pollutants among women, with seasonality also influencing exposure sensitivity. Conclusions: This research corroborates the adverse effects of short-term air pollution exposure on CVD mortality and underscores the heightened risk associated with certain pollutants and demographic cohorts. The findings foster a nuanced understanding of exposure-mortality relationships and advocate for public health initiatives aimed at mitigating air pollution exposure, particularly in more susceptible populations and during certain seasons. This study fills an important knowledge gap in regional case-crossover research and lays the groundwork for informed air quality management and health policy in Anhui Province.