Time Trends in Ischemic Heart Disease Mortality Attributable to PM2.5 Exposure in Southeastern China from 1990 to 2019: An Age-Period-Cohort Analysis

Weiwei Wang; Nan Zhou; Hao Yu; Huafeng Yang; Jinyi Zhou; Xin Hong

doi:10.3390/ijerph20020973

Time Trends in Ischemic Heart Disease Mortality Attributable to PM_2.5 Exposure in Southeastern China from 1990 to 2019: An Age-Period-Cohort Analysis

Int J Environ Res Public Health. 2023 Jan 5;20(2):973. doi: 10.3390/ijerph20020973.

Authors

Weiwei Wang¹, Nan Zhou^{1

2}, Hao Yu³, Huafeng Yang¹, Jinyi Zhou^{2

3}, Xin Hong^{1

2}

Affiliations

¹ Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, 3 Zizhulin Road, Gulou District, Nanjing 210003, China.
² Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing 211166, China.
³ Department of Non-Communicable Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiangsu Road, Gulou District, Nanjing 210009, China.

Abstract

PM_2.5 exposure is a major environmental risk factor for the mortality of ischemic heart disease (IHD). This study aimed to analyze trends in IHD mortality attributable to PM_2.5 exposure in Jiangsu Province, China, from 1990 to 2019, and their correlation with age, period, and birth cohort.

Methods: Data were extracted from the Global Burden of Disease study 2019 (GBD2019). The magnitude and direction of the trends in IHD mortality attributable to PM_2.5 exposure were analyzed by Joinpoint regression. The age-period-cohort (APC) model was used to evaluate the cohort and period effect.

Results: Age-standardized mortality rate (ASMR) of IHD attributable to PM_2.5 exposure decreased from 1990 to 2019, with an average annual percentage change (AAPC) of -1.71% (95%CI: -2.02~-1.40), which, due to ambient PM_2.5 (APM) exposure and household PM_2.5 (HPM) exposure increased with AAPCs of 1.45% (95%CI: 1.18~1.72) and -8.27% (95%CI: -8.84~-7.69), respectively. APC analysis revealed an exponential distribution in age effects on IHD mortality attributable to APM exposure, which rapidly increased in the elderly. The risk for IHD mortality due to HPM exposure showed a decline in the period and cohort effects, which, due to APM, increased in the period and cohort effects. However, favorable period effects were found in the recent decade. The overall net drift values for APM were above zero, and were below zero for HPM. The values for local drift with age both for APM and HPM exposures were initially reduced and then enhanced.

Conclusion: The main environmental risk factor for IHD mortality changed from HPM to APM exposure in Jiangsu Province, China. Corresponding health strategies and prevention management should be adopted to reduce ambient air pollution and decrease the effects of APM exposure on IHD mortality.

Keywords: PM2.5; age-period-cohort analysis; ambient PM2.5; household PM2.5; ischemic heart disease.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Air Pollutants* / analysis
Air Pollution* / adverse effects
Air Pollution* / analysis
China / epidemiology
Cohort Studies
Environmental Exposure / adverse effects
Environmental Exposure / analysis
Humans
Myocardial Ischemia*
Particulate Matter / analysis

Substances

Air Pollutants
Particulate Matter

Grants and funding

This research was funded by the Medical Science and Technology Development Foundation, Nanjing Municipality Health Bureau, grant number 2021-ZKX21054. The funder had no role in the decision to collect data, data analysis, or reporting of the results.