Short-term Exposure to PM_(2.5) and Cardiorespiratory Mortality and Morbidity: Case-crossover Analyses in Ho Chi Minh City, Vietnam

10.4209/aaqr.240107

Cong-Thanh Tran；Le My Thuan Nguyen；Chang-Fu Wu；Kuo-Liong Chien

Fine particulate matter ； Cardiovascular diseases ； Respiratory health ； Personal exposure ； Hospital-based

Aerosol and Air Quality Research

24卷10期（2024 / 10 / 01）

1 - 24+i-xvi

英文

Exposure to ambient fine particulate matter (PM_(2.5)) is a substantial environmental health issue for urban inhabitants in Ho Chi Minh City (HCMC). The effects of short-term exposure to ambient PM_(2.5) on cardiorespiratory mortality and morbidity were determined in HCMC by a retrospective, hospital-based, unidirectional, and symmetric bidirectional case-crossover study. Ambient PM_(2.5) concentrations were measured by validated low-cost particulate matter sensors in four urban districts from December 2019 to March 2021. Mortality, emergency visits, and hospital admissions for cardiorespiratory diseases were obtained from electronic hospital-based data from three hospitals in the study area. Control days in each stratum were defined as days before or after the case day, day of the event (e.g., death or illness), and each case had 4 control days. We applied conditional logistic regression and generalized linear mixed models to explore the associations between PM_(2.5) and cardiorespiratory mortality and morbidity. A total of 2,457 subjects with cardiorespiratory diseases were included in this study analysis. The daily PM_(2.5) concentrations on more than 80% of days during the study period exceeded the World Health Organization's standard of 15 µg m^(-3). The first event day (lag0) was associated with a significant risk for the diseases (odds ratio, 1.06, 95% confidence interval, 1.01-1.10, for a 10 µg m^(-3) increase in daily PM_(2.5)). The largest effect was observed in cardiovascular cases under 35 years of age. Males were observed to be more susceptible to PM_(2.5)-related cardiovascular diseases than females, whereas females were more vulnerable to PM_(2.5)-related respiratory diseases. We found robust evidence for the short-term exposure to PM_(2.5) being associated with an increase in adverse cardiovascular and respiratory events in urban inhabitants of HCMC, Vietnam. The findings may appeal to Vietnamese policymakers to modify reasonable safe standards for ambient PM_(2.5) in urban areas.