Short-term effect of ambient sulfur dioxide (SO2) on cause-specific cardiovascular hospital admission in Beijing, China: A time series study

Abstract Evidence of the short-term effect of SO2 on hospital admissions for cause-specific cardiovascular diseases (CVD) is still limited. This study aimed to examine the short-term associations between SO2 and cause-specific CVD hospital admission in Beijing. A total of 460,938 hospitalizations for total CVD were obtained from electronic hospitalization summary reports from 2013 to 2017. A time series analysis was conducted to investigate the association between SO2 exposure and hospitalizations for total and cause-specific CVD, including coronary heart disease (CHD), atrial fibrillation (AF), and heart failure (HF). Stratified analysis was also conducted by age group (18–64 years and ≥65 years), sex and season. A generalized additive quasi-Poisson model was used to examine the associations between SO2 and cause-specific CVD after controlling for seasonality, day of the week, public holidays, and weather conditions. We found an almost linear relationship between the exposure to SO2 and cause-specific CVD admissions. A 10 μg/m3 increase in the two-day average concentration (lag0-1) of SO2 was associated with an increase of 1.38% (95% CI:0.99%; 1.77%) in hospital admission for total CVD, 1.58% (95% CI: 1.16%; 2%) for CHD and 1.69% (95% CI:0.41%; 2.99%) for AF. Nevertheless, a statistically significant association was not observed for admissions for HF. The observed associations in the single-pollutant models were robust to the inclusion of pollutants in the two-pollutant model, but the estimate was attenuated when adjusting for fine particulate matter (PM2.5). No difference in the association was observed for the effect modifiers of sex, season and age. A statistically significant association between hospitalizations and SO2 was observed. The observed association between SO2 and hospitalization might not be independent of fine particulate matter ( PM 2.5 ), and further studies should be conducted to demonstrate the independent effect of SO2.

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