title: Long-term exposure to ambient air pollution and mortality due to cardiovascular disease and cerebrovascular disease in Shenyang, China.
abstract: BACKGROUND
  The relationship between ambient air pollution exposure and mortality of cardiovascular and cerebrovascular diseases in human is controversial, and there is little information about how exposures to ambient air pollution contribution to the mortality of cardiovascular and cerebrovascular diseases among Chinese. The aim of the present study was to examine whether exposure to ambient-air pollution increases the risk for cardiovascular and cerebrovascular disease.
  
  
  RESULTS
  We conducted a retrospective cohort study among humans to examine the association between compound-air pollutants [particulate matter <10 µm in aerodynamic diameter (PM(10)), sulfur dioxide (SO(2)) and nitrogen dioxide (NO(2))] and mortality in Shenyang, China, using 12 years of data (1998-2009). Also, stratified analysis by sex, age, education, and income was conducted for cardiovascular and cerebrovascular mortality. The results showed that an increase of 10 µg/m(3) in a year average concentration of PM(10) corresponds to 55% increase in the risk of a death cardiovascular disease (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.51 to 1.60) and 49% increase in cerebrovascular disease (HR, 1.49; 95% CI, 1.45 to 1.53), respectively. The corresponding figures of adjusted HR (95%CI) for a 10 µg/m(3) increase in NO(2) was 2.46 (2.31 to 2.63) for cardiovascular mortality and 2.44 (2.27 to 2.62) for cerebrovascular mortality, respectively. The effects of air pollution were more evident in female that in male, and nonsmokers and residents with BMI<18.5 were more vulnerable to outdoor air pollution.
  
  
  CONCLUSIONS
  Long-term exposure to ambient air pollution is associated with the death of cardiovascular and cerebrovascular diseases among Chinese populations.
authors.affiliation: Department of Biostatistics, School of Public Health, China Medical University, Shenyang, People's Republic of China.
authors.forename: Pengfei
authors.initials: P
authors.lastname: Zhang
authors.forename: Guanghui
authors.initials: G
authors.lastname: Dong
authors.forename: Baijun
authors.initials: B
authors.lastname: Sun
authors.forename: Liwen
authors.initials: L
authors.lastname: Zhang
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.forename: Nannan
authors.initials: N
authors.lastname: Ma
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.forename: Huimin
authors.initials: H
authors.lastname: Guo
authors.forename: Hui
authors.initials: H
authors.lastname: Huang
authors.forename: Yungling Leo
authors.initials: YL
authors.lastname: Lee
authors.forename: Naijun
authors.initials: N
authors.lastname: Tang
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000393:Air Pollutants / Q000009:adverse effects / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis / Q000331:legislation & jurisprudence / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000209:etiology / Q000401:mortality*; D002561:Cerebrovascular Disorders / Q000139:chemically induced / Q000209:etiology / Q000401:mortality*; D002681:China / Q000453:epidemiology; D004522:Educational Status; D004781:Environmental Exposure / Q000009:adverse effects* / Q000331:legislation & jurisprudence / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009585:Nitrogen Dioxide / Q000009:adverse effects / Q000032:analysis; D052638:Particulate Matter / Q000009:adverse effects / Q000032:analysis; D011640:Public Policy; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D012923:Social Class; D013458:Sulfur Dioxide / Q000009:adverse effects / Q000032:analysis; D013997:Time Factors
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D013458:Sulfur Dioxide; D009585:Nitrogen Dioxide