title: The Impact of the 2013 Eastern China Smog on Outpatient Visits for Coronary Heart Disease in Shanghai, China.
abstract: There have been relatively few opportunities to examine the cardiovascular effects of an extreme air pollution event in China. We aimed to examine the impact of the 2013 Eastern China Smog occurring from 2 to 9 December 2013, on outpatient visits for coronary heart diseases (CHD) in a typical hospital in Shanghai, China. We used the over-dispersed, generalized additive model to estimate the relative risk (RR) of the 2013 Eastern China Smog on the outpatient visits by comparing the smog period (2-9 December 2013; 8 days) to the non-smog period (1 November-1 December 2013, and 10 December-28 February 2014; 112 days). This model also controlled for time trends, days of the week, holidays, and meteorological factors. A stratification analysis was performed to estimate sex- and age-specific RRs. The daily average PM2.5 (fine particulate matter with an aerodynamic diameter less than 2.5 μm) concentrations during the smog period were 212 μg/m³, which were three times higher than during the non-smog period (76 μg/m³). The smog in Eastern China in 2013 was significantly associated with an increased risk of outpatient visits for CHD. For example, the RR was 1.18 (95% CI: 1.04, 1.32) on lag 0 day. There were similar effects on males and females. Our analyses provided preliminary evidence that smog constituted a significant risk factor of CHD in China.
authors.affiliation: Department of Occupational Medicine, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China. huangfang19861986@163.com.|Department of Occupational Medicine, Yangpu District Central Hospital, Shanghai 200090, China. huangfang19861986@163.com.|Institute of Occupational and Environmental Medicine, Medical School, Tongji University School of Medicine, Shanghai 200090, China. huangfang19861986@163.com.
authors.forename: Fang
authors.initials: F
authors.lastname: Huang
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China. crj_1986@163.com.
authors.forename: Renjie
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Occupational Medicine, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China. 13641813262@163.com.|Department of Occupational Medicine, Yangpu District Central Hospital, Shanghai 200090, China. 13641813262@163.com.|Institute of Occupational and Environmental Medicine, Medical School, Tongji University School of Medicine, Shanghai 200090, China. 13641813262@163.com.
authors.forename: Yuetian
authors.initials: Y
authors.lastname: Shen
authors.affiliation: School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai 200032, China. haidongkan@gmail.com.
authors.forename: Haidong
authors.initials: H
authors.lastname: Kan
authors.affiliation: Department of Occupational Medicine, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China. kuangxingya@163.com.|Department of Occupational Medicine, Yangpu District Central Hospital, Shanghai 200090, China. kuangxingya@163.com.|Institute of Occupational and Environmental Medicine, Medical School, Tongji University School of Medicine, Shanghai 200090, China. kuangxingya@163.com.
authors.forename: Xingya
authors.initials: X
authors.lastname: Kuang
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002648:Child; D002681:China / Q000453:epidemiology; D002947:Cities; D003327:Coronary Disease / Q000139:chemically induced / Q000453:epidemiology*; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010045:Outpatients / Q000706:statistics & numerical data; D012306:Risk; D012621:Seasons; D012737:Sex Factors; D012905:Smog / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D012905:Smog
keywords: air pollution; coronary heart disease; outpatient visits; smog; time-series