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Frontiers of Environmental Science & Engineering

ISSN 2095-2201

ISSN 2095-221X(Online)

CN 10-1013/X

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2018 Impact Factor: 3.883

Front. Environ. Sci. Eng.    2023, Vol. 17 Issue (7) : 84    https://doi.org/10.1007/s11783-023-1684-2
RESEARCH ARTICLE
Long-term exposure to air pollution and cerebrovascular disease: findings from Beijing Health Management Cohort study
Yuhan Zhao1,2, Xiaoping Kang3, Xue Tian1,2, Lulu Liu1,2, Zemeng Zhao1,2, Lili Luo1,2, Lixin Tao1,2, Xiangtong Liu1,2, Xiaonan Wang1,2, Xiuhua Guo1,2, Juan Xia1,2(), Yanxia Luo1,2()
1. School of Public Health, Capital Medical University, Beijing 100069, China
2. Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing 100069, China
3. Beijing Xiaotangshan Hospital, Beijing 102211, China
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Abstract

● This study explored the long-term association by double robust additive models.

● Individual exposure concentrations were assessed by integrating GAM, LUR and BPNN.

● PM2.5, SO2 and NO2 are positively associated with cerebrovascular disease.

● CO could reduce the risk of cerebrovascular disease with the highest robustness.

● The elderly, women and people with normal BMI are at higher risk for air pollution.

The relationship between air pollution and cerebrovascular disease has become a popular topic, yet research findings are highly heterogeneous. This study aims to investigate this association based on detailed individual health data and a precise evaluation of their exposure levels. The integrated models of generalized additive model, land use regression model and back propagation neural network were used to evaluate the exposure concentrations. And doubly robust additive model was conducted to explore the association between cerebrovascular disease and air pollution after adjusted for demographic characteristics, physical examination, disease information, geographic and socioeconomic status. A total of 25097 subjects were included in the Beijing Health Management Cohort from 2013 to 2018. With a 1 μg/m3 increase in the concentrations of PM2.5, SO2 and NO2, the incidence risk of cerebrovascular disease increased by 1.02 (95% CI: 1.008–1.034), 1.06 (95% CI: 1.034–1.095) and 1.02 (95% CI: 1.010–1.029) respectively. Whereas CO exposure could decrease the risk, with an odds ratio of 0.38 (95% CI: 0.212–0.626). In the subgroup analysis, individuals under the age of 50 with normal BMI were at higher risk caused by PM2.5, and SO2 was considered more hazardous to women. Meanwhile, the protective effect of CO on women and those with normal BMI was stronger. Successful reduction of long-term exposure to PM2.5, SO2 and NO2 would lead to substantial benefits for decrease the risk of cerebrovascular disease especially for the health of the susceptible individuals.

Keywords Air pollution      Cerebrovascular disease      Incidence      Long-term exposure      Doubly robust additive model     
Corresponding Author(s): Juan Xia,Yanxia Luo   
Issue Date: 03 February 2023
 Cite this article:   
Yuhan Zhao,Xiaoping Kang,Xue Tian, et al. Long-term exposure to air pollution and cerebrovascular disease: findings from Beijing Health Management Cohort study[J]. Front. Environ. Sci. Eng., 2023, 17(7): 84.
 URL:  
https://academic.hep.com.cn/fese/EN/10.1007/s11783-023-1684-2
https://academic.hep.com.cn/fese/EN/Y2023/V17/I7/84
Fig.1  Flowchart of the study.
VariablesCharacteristicsValues
Sex, n (%)Male14621(58.26)
Female10476(41.74)
Age group (years), n (%)18 ≤ Age ≤ 4918806(74.93)
≥ 506291(25.07)
Marriage, n (%)Unmarried2107(8.40)
Married22990(91.60)
Family history of cerebrovascular disease, n (%)602(2.40)
Comorbidity, n (%)Hypertension6082(24.23)
Hyperlipidemia2006(7.99)
Heart disease1299(5.18)
Diabetes473(1.88)
Physiologic and biochemical indicator, mean (SD)BMI (kg/m2)25.03(3.66)
WHR0.87(0.08)
SBP (mmHg)121.33(16.01)
DBP (mmHg)72.02(10.90)
HR (beats/minute)78.35(11.48)
LDL-C (mmol/L)3.00(0.81)
HDL-C (mmol/L)1.33(0.36)
TC (mmol/L)1.56(1.53)
Triglyceride (mmol/L)4.64(0.90)
Glucose (mmol/L)5.36(1.35)
Population density in the district (per 100000), mean (SD)1434.23(7034)
Disposable income per capita in the district (yuan), median (IQR)38786.15(7130.86)
Tab.1  Baseline characteristics of the cohort (N = 25097)
Air pollutantsMeanSDMinP25MedianP75Max
PM2.5 (μg/m3)83.7630.97061.7576.09113.01139.13
PM10 (μg/m3)113.6250.14078.55107.91159.78208.07
SO2 (μg/m3)13.3810.2907.8511.4916.8255.80
NO2 (μg/m3)39.7414.78028.7941.4451.2085.19
CO (mg/m3)1.260.630.220.901.081.473.60
O3 (μg/m3)36.010.2133.2035.8036.1336.1937.26
Tab.2  The predicted individual air pollution exposure levels
Air pollutantsOR95% CIP valueE value
PM2.51.021.008–1.034*1.17
PM101.000.988–1.0090.731.04
SO21.061.034–1.095*1.32
NO21.021.010–1.029*1.16
CO0.380.212–0.626*4.77
O30.970.502–1.8370.921.23
Tab.3  Effect of long-term air pollution exposure on cerebrovascular disease
Fig.2  Association of air pollution with cerebrovascular disease in different subgroups of the population.
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