Association between short-term exposure to ambient PM2.5 and its components with hospital admissions for patients with coronary heart disease and comorbid diabetes mellitus in Beijing, China

Document Type

Journal Article

Publication Title

Environmental Research

Volume

269

PubMed ID

39805417

Publisher

Elsevier

School

School of Medical and Health Sciences

Funders

Program of the Natural Science Fund of China (82003559, 82073668) / T Cooperative Scientific Research Project of “Chunhui Program” of the Ministry of Education (202202172, HXKY20220056)

Comments

Zaheer, H., Lv, S., Li, Z., Wu, Z., Lu, F., Guo, M., ... & Guo, X. (2025). Association between short-term exposure to ambient PM2. 5 and its components with hospital admissions for patients with coronary heart disease and comorbid diabetes mellitus in Beijing, China. Environmental Research, 269. https://doi.org/10.1016/j.envres.2024.120729

Abstract

Existing researches had primarily investigated the associations between various air pollutants and the risk of coronary heart disease (CHD) or diabetes mellitus (DM) separately. However, the significance and effects of PM2.5 and its components in patients with CHD and comorbid DM (CHD-DM) remain unclear. Patient data was sourced from the Beijing Municipal Health Commission Information Centre between January 1, 2014, and December 31, 2018. We utilized Generalized Additive Models (GAM) to analyze the relationship between daily hospital admissions for CHD-DM patients and PM2.5 exposure. The hospital admissions were treated as count data, offset by the total CHD-DM population, with a logarithmic link function. Smooth functions were included to account for the non-linear effects of time trends and meteorological factors used in both Chinese and WHO air quality guidelines. In Beijing, records show 215,267 hospital admissions for patients with CHD-DM. Every 10 μg/m3 increase of particles with an aerodynamic diameter ≤2.5 μm (PM2.5) corresponded to a 0.62% (95%CI: 0.49 to 0.76) increment for CHD-DM patients' admissions. As for the PM2.5 components: Per 10 μg/m3 increase of SO42− was 2.31% (95%CI: 1.51 to 3.11), NO3− was 3.35% (95%CI: 2.47 to 4.23), for NH4+ the percentage change value was 4.37% (95%CI: 2.99 to 5.77), for OM was 5.36% (95%CI: 4.19 to 6.55), for BC was 36.51% (95%CI: 28.09 to 45.47) increment for CHD-DM patients’ admissions. Based on the WHO 2021 air quality guideline, our estimation suggests that a reduction in PM2.5 concentrations could prevent approximately 2.62% (95%CI: 2.04%–3.2%) hospital admissions, corresponding to 5632 (95%CI: 4397 to 6879) CHD-DM patients, could be avoidable. Patients with CHD-DM who were exposed to PM2.5 and its components had an increased risk of hospital admissions. Furthermore, among all PM2.5 components, BC may be the most significant contributor to the association between PM2.5 and hospital admissions among CHD-DM patients.

DOI

10.1016/j.envres.2024.120729

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