The mortality trends analysis of ischemic heart disease attributed to (PM) 2.5 exposure in China from 1990 to 2019 in APC model

Abstract

Objective: To analyze the mortality trend of ischemic heart disease (IHD) attributed to particulate matter (PM) 2.5 exposure among Chinese populations from 1990 to 2019. To evaluate the influences of cohort, period, and age on long-term of IHD mortality trends.

Methods: Global burden of disease (GBD) data in 2019 regarding IHD death rate attributed to exposure to (PM) 2.5 in China from 1990 to 2019 were adopted. The age-period-cohort (APC) model based on the R language produced by the National Cancer Institute of the United States was used for statistical analysis to investigate the influences of different ages, periods, and cohorts on IHD death rate attributed to exposure to (PM) 2.5.

Results: The age-standardized death rate of IHD attributed to exposure to ambient (PM) 2.5 in China revealed an uptrend from 1990 to 2019. This increased from 8.63/100,000 in 1990 to 21.31/100,000 in 2019. This was an increase of 1.47%. The age-standardized IHD death rate attributed to exposure to household (PM) 2.5 showed a decreasing trend. This decreased from 19.61/100,000 in 1990 to 8.72/100,000 in 2019. This was a decrease of 0.74%. The results of the APC model indicated that the annual net drift of IHD mortality attributed to exposure to (PM) 2.5 was -0.10%. The annual net drifts of exposure to household and ambient (PM) 2.5 were -4.54% and 3.44%, respectively. The IHD death rate attributed to ambient and household (PM) 2.5 exposure in the same birth cohort enhanced with age. With time, the rate ration (RR) of period effects of IHD mortality attributed to ambient (PM) 2.5 exposure for both male and female showed an upward trend. The RR of period effects of IHD death rate attributed to household (PM) 2.5 exposure suggested a downtrend. In the consecutive birth cohorts, the population in China with a later birth cohort presented a higher risk of IHD death attributed to exposure to ambient (PM) 2.5 and a lower risk of IHD death attributed to household (PM) 2.5 exposure.

Conclusions: In China for the burden of IHD attributed to exposure to (PM) 2.5, the primary environmental risk was ambient (PM) 2.5 exposure compared to exposure to household PM2.5. IHD exposure to environmental air pollution posed a greater risk to young people.

Keywords: (PM) 2.5; Age-period-cohort model; ambient exposure; household exposure; ischemic heart disease.

Figure 1

The change trend of age-standardized mortality rate of ischemic heart disease (IHD) attributed to particulate matter (PM) 2.5 exposure in China from 1990 to 2019. A: Corresponding to both sexes for the mortality of IHD attributed to (PM) 2.5. B: Corresponding to female for the mortality of IHD attributed to (PM) 2.5. C: Corresponding to male for the mortality of IHD attributed to (PM) 2.5. D: Corresponding to both sexes for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively. E: Corresponding to female for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively. F: Corresponding to male for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively.

Figure 2

Local drifts with net drift values of the ischemic heart disease (IHD) mortality attributed to particulate matter (PM) 2.5 in China from 1990 to 2019. A: Corresponding to both sexes for the mortality of IHD attributed to (PM) 2.5. B: Corresponding to female for the mortality of IHD attributed to (PM) 2.5. C: Corresponding to male for the mortality of IHD attributed to (PM) 2.5. D: Corresponding to both sexes for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively. E: Corresponding to female for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively. F: Corresponding to male for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively.

Figure 3

The fitted longitudinal age curves of the ischemic heart disease (IHD) mortality attributed to particulate matter (PM) 2.5 exposure. A: Corresponding to both sexes for the mortality of IHD attributed to (PM) 2.5. B: Corresponding to female for the mortality of IHD attributed to (PM) 2.5. C: Corresponding to male for the mortality of IHD attributed to (PM) 2.5. D: Corresponding to both sexes for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively. E: Corresponding to female for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively. F: Corresponding to male for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively.

Figure 4

The rate ration (RR) of each period for the ischemic heart disease (IHD) mortality attributed to particulate matter (PM) 2.5 exposure. A: Corresponding to both sexes for the mortality of IHD attributed to(PM) 2.5. B: Corresponding to female for the mortality of IHD attributed to (PM) 2.5. C: Corresponding to male for the mortality of IHD attributed to (PM) 2.5. D: Corresponding to both sexes for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively. E: Corresponding to female for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively. F: Corresponding to male for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively.

Figure 5

Rate ratio of each cohort for the ischemic heart disease (IHD) mortality attributed to particulate matter (PM) 2.5 exposure. A: Corresponding to both sexes for the mortality of IHD attributed to (PM) 2.5. B: Corresponding to female for the mortality of IHD attributed to (PM) 2.5. C: Corresponding to male for the mortality of IHD attributed to (PM) 2.5. D: Corresponding to both sexes for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively. E: Corresponding to female for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively. F: Corresponding to male for the mortality of IHD attributed to ambient and household (PM) 2.5, respectively.