title: Short-term exposure to ambient air pollution and coronary heart disease mortality in 8 Chinese cities.
abstract: BACKGROUND
  Coronary heart disease (CHD) accounted for a large fraction of death globally. The association between air pollution and CHD has been reported, but evidence from highly-polluted regions was scarce. We aimed to estimate the acute effects of outdoor air pollution on daily CHD mortality in China.
  
  
  METHODS
  We collected daily CHD deaths in 8 large Chinese cities from 1996 to 2008. We firstly obtained the city-specific effect estimates of air pollution using generalized additive models with quasi-Poisson regression, controlling for time trends, meteorological indicators and day of the week. The random-effect model in meta-analysis was used to pool the exposure-response relationships.
  
  
  RESULTS
  We identified a total of 0.13 million CHD deaths. On average, an increase of 10μg/m(3) in 2-day moving average concentrations of particulate matter≤10μm in aerodynamic diameter (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2) was significantly associated with increases of 0.36% [95% confidence intervals (CIs): 0.12%, 0.61%], 0.86% (95% CIs: 0.30%,1.41%) and 1.30% (95% CIs: 0.45%, 2.14%) in daily CHD mortality over the 8 Chinese cities, respectively. The pooled exposure-response curves were almost linear and no apparent thresholds were identified. The effects were more pronounced in cities with lower levels of air pollution. The effects of PM10 and NO2 were more robust than SO2.
  
  
  CONCLUSIONS
  Our findings contributed to the very limited evidence regarding the hazardous effects of ambient air pollution on CHD mortality in highly-polluted regions such as China.
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China.
authors.forename: Huichu
authors.initials: H
authors.lastname: Li
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China; Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China.
authors.forename: Renjie
authors.initials: R
authors.lastname: Chen
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China; Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Meng
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China.
authors.forename: Zhuohui
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Cai
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China.
authors.forename: Cuicui
authors.initials: C
authors.lastname: Wang
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China.
authors.forename: Changyuan
authors.initials: C
authors.lastname: Yang
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China; Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China. Electronic address: kanh@fudan.edu.cn.
authors.forename: Haidong
authors.initials: H
authors.lastname: Kan
mesh_terms: D000397:Air Pollution / Q000009:adverse effects*; D002681:China / Q000453:epidemiology; D002947:Cities / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality*; D004784:Environmental Monitoring / Q000379:methods; D006801:Humans; D052638:Particulate Matter / Q000009:adverse effects*; D012621:Seasons; D013997:Time Factors; D014505:Urban Population / Q000639:trends*
chemical_list: D052638:Particulate Matter
keywords: Air pollution; China; Coronary heart disease; Epidemiology; Mortality