title: Acute Effects of Particulate Air Pollution on the Incidence of Coronary Heart Disease in Shanghai, China.
abstract: BACKGROUND
  Evidence based on ecological studies in China suggests that short-term exposure to particulate matter (PM) is associated with cardiovascular mortality. However, there is less evidence of PM-related morbidity for coronary heart disease (CHD) in China. This study aims to investigate the relationship between acute PM exposure and CHD incidence in people aged above 40 in Shanghai.
  
  
  METHODS
  Daily CHD events during 2005-2012 were identified from outpatient and emergency department visits. Daily average concentrations for particulate matter with aerodynamic diameter less than 10 microns (PM10) were collected over the 8-year period. Particulate matter with aerodynamic diameter less than 2.5 microns (PM2.5) were measured from 2009 to 2012. Analyses were performed using quasi-poisson regression models adjusting for confounders, including long-term trend, seasonality, day of the week, public holiday and meteorological factors. The effects were also examined by gender and age group (41-65 years, and >65 years).
  
  
  RESULTS
  There were 619928 CHD outpatient and emergency department visits. The average concentrations of PM10 and PM2.5 were 81.7 μg/m3 and 38.6 μg/m3, respectively. Elevated exposure to PM10 and PM2.5 was related with increased risk of CHD outpatients and emergency department visits in a short time course. A 10 μg/m3 increase in the 2-day PM10 and PM2.5 was associated with increase of 0.23% (95% CI: 0.12%, 0.34%) and 0.74% (95% CI: 0.44%, 1.04%) in CHD morbidity, respectively. The associations appeared to be more evident in the male and the elderly.
  
  
  CONCLUSIONS
  Short-term exposure to high levels of PM10 and PM2.5 was associated with increased risk of CHD outpatient and emergency department visits. Season, gender and age were effect modifiers of their association.
authors.affiliation: Department of Environment Health, School of Public Health, Fudan University, Shanghai, China.|Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China.
authors.forename: Xiaofang
authors.initials: X
authors.lastname: Ye
authors.affiliation: Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China.
authors.forename: Li
authors.initials: L
authors.lastname: Peng
authors.affiliation: School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China.
authors.forename: Haidong
authors.initials: H
authors.lastname: Kan
authors.affiliation: School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China.|Fudan Tyndall Centre, Shanghai, China.
authors.forename: Weibing
authors.initials: W
authors.lastname: Wang
authors.affiliation: Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China.
authors.forename: Fuhai
authors.initials: F
authors.lastname: Geng
authors.affiliation: Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Mu
authors.affiliation: Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China.
authors.forename: Dandan
authors.initials: D
authors.lastname: Yang
mesh_terms: D000397:Air Pollution / Q000009:adverse effects*; D002681:China / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000209:etiology*; D004636:Emergency Service, Hospital; D006801:Humans; D015994:Incidence; D010045:Outpatients / Q000706:statistics & numerical data; D010316:Particle Size; D052638:Particulate Matter / Q000009:adverse effects*
chemical_list: D052638:Particulate Matter