Transient risk of ambient fine particulate matter on hourly cardiovascular events in Tainan City, Taiwan

by Pei-Chih Wu, Tain-Junn Cheng, Cheng-Pin Kuo, Joshua S. Fu, Hsin-Chih Lai, Tsu-Yun Chiu, Li-Wei Lai

Background

The association between daily changes in ambient fine particulate matter (PM_2.5) and cardiovascular diseases have been well established in mechanistic, epidemiologic and exposure studies. Only a few studies examined the effect of hourly variations in air pollution on triggering cardiovascular events. Whether the current PM_2.5 standards can protect vulnerable individuals with chronic cardiovascular diseases remain uncertain.

Methods

we conducted a time-stratified, case-crossover study to assess the associations between hourly changes in PM_2.5 levels and the vascular disease onset in residents of Tainan City, Taiwan, visiting Emergency Room of Chi Mei Medical Center between January 2006 and December 2016. There were 26,749 cases including 10,310 females (38.5%) and 16,439 males (61.5%) identified. The time of emergency visit was identified as the onset for each case and control cases were selected as the same times on other days, on the same day of the week in the same month and year respectively. Residential address was used to identify the ambient air pollution exposure concentrations from the closest station. Conditional logistic regression with the stepwise selection method was used to estimate adjusted odds ratios (ORs) for the association.

Results

When we only included cases occurring at PM_2.5>10 μg/m³ and PM_2.5>25 μg/m³, very significant ORs could be observed for 10 μg/m³ increases in PM_2.5 at 0 and 1 hour, implying fine particulate exposure could promptly trigger vascular disease events. Moreover, a very clear increase in risk could be observed with cumulative exposure from 0 to 48 hours, especially in those cases where PM_2.5>25 μg/m³.

Conclusions

Our study demonstrated that transient and low concentrations of ambient PM_2.5 trigger adult vascular disease events, especially cerebrovascular disease, regardless of age, sex, and exposure timing. Warning and delivery systems should be setup to protect people from these prompt adverse health impacts.