Han Cao1, Bingxiao Li1, Wenjuan Peng1, Li Pan2, Ze Cui3, Wei Zhao4, Han Zhang5, Naijun Tang6, Kaijun Niu7, Jixin Sun3, Xiaoyan Han4, Zhengfang Wang5, Kuo Liu1, Huijing He2, Yajing Cao3, Zhiyuan Xu4, Anqi Shan6, Ge Meng7, Yanyan Sun1, Chunyue Guo1, Xiaohui Liu1, Yunyi Xie1, Fuyuan Wen1, Guangliang Shan8, Ling Zhang9. 1. Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China. 2. Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, and School of Basic Medicine, Peking Union Medical College, Beijing, China. 3. Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Prevention and Control, Shijiazhuang, Hebei, China. 4. Department of Chronic and Noncommunicable Disease Prevention and Control, Chaoyang District Center for Disease Prevention and Control, Beijing, China. 5. Health Management Center, Beijing Aerospace General Hospital, Beijing, China. 6. Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China. 7. Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China. 8. Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, and School of Basic Medicine, Peking Union Medical College, Beijing, China. Electronic address: guangliang_shan@163.com. 9. Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China. Electronic address: zlilyepi@ccmu.edu.cn.
Abstract
BACKGROUND: Evidence regarding the effects of long-term and high-level ambient air pollution exposure on cardiac conduction systems remains sparse. OBJECTIVES: To investigate the associations of long-term exposure to air pollution and cardiac conduction abnormalities in Chinese adults and explore the susceptibility characteristics. METHODS: In 2017, a total of 27,047 participants aged 18-80 years were recruited from the baseline survey of the Cohort Study on Chronic Disease of Communities Natural Population in Beijing, Tianjin and Hebei (CHCN-BTH). The three year (2014-2016) average pollutant concentrations were assessed by a spatial statistical model for PM2.5 and air monitoring stations for PM10, SO2, NO2, O3 and CO. Residential proximity to a roadway was calculated by neighborhood analysis. Associations were estimated by two-level generalized linear mixed models. Stratified analyses related to demographic characteristics, health behaviors, and cardiometabolic risk factors were performed. Two-pollutant models were used to evaluate the possible role of single pollutants. RESULTS: We detected significant associations of long-term air pollutant exposure with increased heart rate (HR), QRS and QTc, such that an interquartile range increase in PM2.5 was associated with 3.63% (95% CI: 3.07%, 4.19%), 1.21% (95% CI: 0.83%, 1.60%), and 0.13% (95% CI: 0.07%, 0.18%) changes in HR, QRS and QTc, respectively. Compared to the other pollutants, the estimates of PM2.5 remained the most stable across all two-pollutant models. Similarly, significant associations were observed between living closer to a major roadway and higher HR, QRS and QTc. Stratified analyses showed generally greater association estimates in older people, males, smokers, alcohol drinkers, and those with obesity, hypertension and diabetes. CONCLUSIONS: Long-term exposure to ambient air pollution was associated with cardiac conduction abnormalities in Chinese adults, especially in older people, males, smokers, alcohol drinkers, and those with cardiometabolic risk factors. PM2.5 may be the most stable pollutant to reflect the associations.
BACKGROUND: Evidence regarding the effects of long-term and high-level ambient air pollution exposure on cardiac conduction systems remains sparse. OBJECTIVES: To investigate the associations of long-term exposure to air pollution and cardiac conduction abnormalities in Chinese adults and explore the susceptibility characteristics. METHODS: In 2017, a total of 27,047 participants aged 18-80 years were recruited from the baseline survey of the Cohort Study on Chronic Disease of Communities Natural Population in Beijing, Tianjin and Hebei (CHCN-BTH). The three year (2014-2016) average pollutant concentrations were assessed by a spatial statistical model for PM2.5 and air monitoring stations for PM10, SO2, NO2, O3 and CO. Residential proximity to a roadway was calculated by neighborhood analysis. Associations were estimated by two-level generalized linear mixed models. Stratified analyses related to demographic characteristics, health behaviors, and cardiometabolic risk factors were performed. Two-pollutant models were used to evaluate the possible role of single pollutants. RESULTS: We detected significant associations of long-term air pollutant exposure with increased heart rate (HR), QRS and QTc, such that an interquartile range increase in PM2.5 was associated with 3.63% (95% CI: 3.07%, 4.19%), 1.21% (95% CI: 0.83%, 1.60%), and 0.13% (95% CI: 0.07%, 0.18%) changes in HR, QRS and QTc, respectively. Compared to the other pollutants, the estimates of PM2.5 remained the most stable across all two-pollutant models. Similarly, significant associations were observed between living closer to a major roadway and higher HR, QRS and QTc. Stratified analyses showed generally greater association estimates in older people, males, smokers, alcohol drinkers, and those with obesity, hypertension and diabetes. CONCLUSIONS: Long-term exposure to ambient air pollution was associated with cardiac conduction abnormalities in Chinese adults, especially in older people, males, smokers, alcohol drinkers, and those with cardiometabolic risk factors. PM2.5 may be the most stable pollutant to reflect the associations.