Causal Associations of Air Pollution With Cardiovascular Disease and Respiratory Diseases Among Elder Diabetic Patients

Zhiwei Li, Shiyun Lv, Feng Lu, Moning Guo, Zhiyuan Wu, Yue Liu, Weiming Li, Mengmeng Liu, Siqi Yu, Yanshuang Jiang, Bo Gao, Xiaonan Wang, Xia Li, Wei Wang, Xiangtong Liu, Xiuhua Guo

Research output: Contribution to journalArticlepeer-review

Abstract

Extensive researches have linked air pollutants with cardiovascular disease (CVD) and respiratory diseases (RD), however, there is limited evidence on causal effects of air pollutants on morbidity of CVD or RD with comorbidities, particularly diabetes mellitus in elder patients. We included hospital admissions for CVD or RD among elder (≥65 years) diabetic patients between 2014 and 2019 in Beijing. A time-stratified case-crossover design based on negative-control exposure was used to assess causal associations of short-term exposure to air pollutants with CVD and RD among diabetic patients with the maximum lag of 7 days. A random forest regression model was used to calculate the contribution magnitude of air pollutants. A total of 493,046 hospital admissions were recorded. Per 10 μg/m3 uptick in PM1, PM2.5, PM10, SO2, NO2, O3, and 1 mg/m3 in CO was associated with 0.29 (0.05, 0.53), 0.14 (0.02, 0.26), 0.06 (0.00, 0.12), 0.36 (0.01, 0.70), 0.21 (0.02, 0.40), −0.08 (−0.25, 0.09), and 4.59 (0.56, 8.61) causal effect estimator for admission of CVD among diabetic patients, corresponding to 0.12 (0.05, 0.18), 0.09 (0.05, 0.13), 0.05, 0.23 (0.06, 0.41), 0.10 (0.02, 0.19), −0.04 (−0.06, −0.01), and 3.91(1.81, 6.01) causal effect estimator for RD among diabetic patients. The effect of gaseous pollutants was higher than particulate pollutants in random forest model. Short-term exposure to air pollution was causally associated with increased admission of CVD and RD among elder diabetic patients. Gaseous pollutants had a greater contribution to CVD and RD among elder diabetic patients.

Original languageEnglish
Article numbere2022GH000730
Pages (from-to)e2022GH000730
JournalGeoHealth
Volume7
Issue number6
DOIs
Publication statusPublished - Jun 2023
Externally publishedYes

Keywords

  • cardiovascular disease
  • causal inference
  • comorbidity
  • respiratory diseases

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