title: The effect of particulate matter size on cardiovascular health in Taipei Basin, Taiwan.
abstract: BACKGROUND
  Although the overall effect of particulate matter (PM) on cardiovascular disease (CVD) has been previously documented, the effect of different PM sizes (PM10, PM2.5-10and PM2.5) has not been well studied. This study estimates the effect of different PM sizes on the incidence of CVD in Taipei, Taiwan.
  
  
  METHODS
  We collected outpatients with CVD from 2006 to 2010 and data on the concentrations of air pollutants such as PM10, PM2.5-10, PM2.5, sulfur dioxide, carbon monoxide, nitrogen dioxide, and ozone. A Distributed Lag Non-linear Model (DLNM) was used to explore the effect of different PM sizes on CVD risk.
  
  
  RESULTS
  In high air pollution events, PM2.5was significantly associated with elevated risk (4.9%) [95% confidence interval (CI): 1.010-1.089] for CVD with increasing interquartile range (IQR) in single air pollutant model. PM2.5-10and PM10did not show a significant positive association with CVD in this study. After adjusting for other air pollutants such as SO2, CO, NO2, and O3, the estimated effect of PM2.5only decreased 0.2%. Moreover, patients under 40 years old did not show a significant association between PM2.5and CVD.
  
  
  CONCLUSIONS
  This study demonstrates that only PM2.5is significantly positively correlated with the number of daily outpatient visits for CVD during high air pollution events.
authors.affiliation: Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan; International Center for Health Information Technology (ICHIT), Taipei Medical University, Taiwan.
authors.forename: Hsuan-Chia
authors.initials: HC
authors.lastname: Yang
authors.affiliation: Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Shu-Hao
authors.initials: SH
authors.lastname: Chang
authors.affiliation: International Center for Health Information Technology (ICHIT), Taipei Medical University, Taiwan; Graduate Institute of Biomedical Informatics, College of Medicine Science and Technology, Taipei Medical University, Taipei, Taiwan.
authors.forename: Richard
authors.initials: R
authors.lastname: Lu
authors.affiliation: Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan; Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan; Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan. Electronic address: dmliou@ym.edu.tw.
authors.forename: Der-Ming
authors.initials: DM
authors.lastname: Liou
mesh_terms: D002318:Cardiovascular Diseases / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052638:Particulate Matter / Q000633:toxicity*; D013624:Taiwan
chemical_list: D052638:Particulate Matter
keywords: Cardiovascular disease; Distributed lag non-linear model; Particulate matter