Association Between Ambient Air Pollution And Daily Hospital Visits For Cardiovascular Diseases In Wuhan, China: A Time-Series Analysis Based On Medical Insurance Data.

Although a large number of studies have proved the adverse effects of exposure to air pollution on cardiovascular disease, few studies have done such research focusing on the medically insured population, a group of relatively healthier people representing the working population. We used generalized additive model (GAM) to estimate the short-term effects of ambient air pollution on CVDs in Wuhan, China. We extracted daily air pollution data, meteorological data, and daily hospital visits for CVDs (including hypertension, coronary heart disease [CHD], and heart disease [HD]) from November 1 st, 2013 to October 31 st , 2018. For each increase of 10 μg/m 3 in SO 2 , NO 2 , PM 10 , and PM 2.5 , the relative risks (RRs) of daily hospital visits for hypertension increased by 3.8% (95% confidence interval [CI]: 1.8%, 5.9%), 2.5% (95% CI: 1.9%, 3.2%), 0.5% (95% CI: 0.2%, 0.7%), and 0.7% (95% CI: 0.3%, 1.1%) at lag 0, respectively; For CHD, the RRs increased by 3.6% (95% CI: 1.8%, 5.5%), 2.6% (95% CI: 1.9%, 3.4%), 0.4% (95% CI: 0.1%, 0.7%), and 0.5% (95% CI: 0.1%, 0.9%) at lag 0, respectively; For HD, the RRs increased by 3.6% (95%CI: 1.4%, 5.8%), 2.1% (95%CI: 1.4%, 2.7%), 0.3% (95%CI: 0.1%, 0.6%), and 0.4% (95%CI: 0, 0.8%) at lag 0, respectively. We found that the influence of air pollution on daily hospital visits for CVDs is greater in the cold season than in the warm season. The results indicate that NO 2 and SO 2 may be potential confounders for co-pollutants in the multi-pollutant model. In conclusion, air pollutants including SO 2 , NO 2 , PM 10 , and PM 2.5 may be associated with the risk of hypertension, CHD, and HD. Our findings not only can be used as reference for studying the financing and the allocation of medical resources in the future, but also served as a piece of evidence that supports the policymaking on air pollution and CVDs.