Rural-urban differences in associations between air pollution and cardiovascular hospital admissions in Guangxi, southwest China.

Epidemiological studies found that exposure to air pollution increases cardiovascular hospitalizations. However, studies on rural-urban differences in associations between hospitalizations for cardiovascular diseases and air pollution are limited. The generalized linear model (GLM) was applied to investigate the associations between cardiovascular hospitalizations and air pollution (SO ₂ , NO ₂ , PM _2.5 , PM ₁₀ , CO, and O ₃ ) in Guangxi, southwest China, in 2015 (January 1-December 31). The relative risk of pollutants (SO ₂ , NO ₂ ) on cardiovascular hospital admissions was significantly different between urban and rural areas. The effect of SO ₂ on cardiovascular hospitalizations was higher in urban areas than in rural areas at lag0 to lag3 and cumulative lag01 to lag03. In urban areas, there were positive associations between NO ₂ and cardiovascular hospitalizations at lag0, lag1 and cumulative lag01, lag02. In contrast, the effect of NO ₂ on cardiovascular hospitalizations was not significant in rural areas. Urban residents were more sensitive than rural residents to SO ₂ and NO ₂ . Subgroup analyses showed statistically significant differences between rural and urban areas in the association between SO ₂ and NO ₂ and cardiovascular hospitalizations for males. For age groups, people aged ≥ 65 years appeared to be more vulnerable to SO ₂ and NO ₂ in urban areas. The effects of PM _2.5 PM ₁₀ , CO, and O ₃ on cardiovascular hospitalizations were consistently negative for all groups. Our findings indicated that there were rural-urban differences in associations between cardiovascular hospitalizations and air pollutants. In rural areas, the risk of cardiovascular hospitalizations was mainly influenced by SO ₂ . Therefore, we expect to pay attention to protecting people from air pollution, particularly for those aged ≥ 65 years in urban areas.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)