Panjun GAO, Department of Health, Ethics & Society, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Netherlands
Pim MARTENS, Maastricht Sustainability Institute (MSI), Maastricht University, Netherlands
Thomas KRAFFT, Department of Health, Ethics & Society, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Netherlands
Fengying ZHANG, China National Environmental Monitoring Centre, China
Yongsheng WU, Shenzhen Center For Disease Control and Prevention, China
Lihuan HE, China National Environmental Monitoring Centre, China
Yingbin FU, Shenzhen Center For Disease Control and Prevention, China
Li WANG, Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, China
Background Air pollution is associated with adverse health events and climatic conditions, particularly temperature. However, inconsistent and insufficient evidence on their interplays has been reported in China. Therefore, research was conducted to evaluate the independent roles of air pollutants and modifications of season and temperature on cardiovascular mortality.
Method Shenzhen, a coastal city in southern China, was selected as the study area. In China, Shenzhen is the most crowded city and one of the most developed cities and has the most comprehensive local standards for atmospheric environmental protection. Cardiovascular death records, meteorological factors, and air pollutants in Shenzhen from 2013 to 2019 were collected. Associations of nitrogen oxides and ozone with cardiovascular mortality and modifications of season and temperature were analysed using adjusted generalized additive models.
Results Daily concentrations of nitrogen oxides and ozone were lower than the current national standard of China but higher than the Air Quality Guideline levels proposed by WHO in 2021[1]. Acute and lagged impacts of nitrogen oxides and ozone on cardiovascular mortality in our research were identified. Cardiovascular mortality associated with air pollutants was affected by season and temperature differently. Adverse effects of nitrogen oxides were more significant at low temperature, while effects of ozone were enhanced in the warm season, at high temperature, especially at extreme heat.
Conclusions Air pollutants with levels under China's current air quality standard still affect cardiovascular health. Furthermore, temperature, especially extreme heat, increases the risks of adverse health events associated with air pollution. Our findings supported further adjustments of national standards and prompted more interventions to cope with the extra challenges brought by climate change.
Mots clés : air pollution|climate change|cardiovascular mortality
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