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Relationship between fine particulate air pollution and ischaemic heart disease morbidity and mortality
  1. Wuxiang Xie1,
  2. Gang Li2,
  3. Dong Zhao1,
  4. Xueqin Xie3,
  5. Zaihua Wei2,
  6. Wei Wang1,
  7. Miao Wang1,
  8. Guoxing Li4,
  9. Wanru Liu3,
  10. Jiayi Sun1,
  11. Zhangrong Jia1,
  12. Qian Zhang1,
  13. Jing Liu1
  1. 1Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
  2. 2Information Statistics Center, Beijing Center for Diseases Prevention and Control, Beijing, China
  3. 3Beijing Public Health Information Center, Beijing, China
  4. 4Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China
  1. Correspondence to Professor Jing Liu, Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Street, Chaoyang District, Beijing, China; ejingliu{at}


Objective To assess the relationship between fine particulate matter (PM2.5) concentration and ischaemic heart disease (IHD) morbidity and mortality.

Methods A time-series study conducted in Beijing from 1 January 2010 to 31 December 2012. Data on 369 469 IHD cases and 53 247 IHD deaths were collected by the Beijing Monitoring System for Cardiovascular Diseases, which covers all hospital admissions and deaths from IHD from Beijing's population of 19.61 million.

Results The mean daily PM2.5 concentration was 96.2 μg/m3 with a range from 3.9 to 493.9 μg/m3. Only 15.3% of the daily PM2.5 concentrations achieved WHO Air Quality Guidelines target (25 μg/m3) in the study period. The dose–response relationships between PM2.5 and IHD morbidity and mortality were non-linear, with a steeper dose–response function at lower concentrations and a shallower response at higher concentrations. A 10 μg/m3 increase in PM2.5 was associated with a 0.27% (95% CI 0.21 to 0.33%, p<2.00×10−16) increase in IHD morbidity and a 0.25% (95% CI 0.10 to 0.40%, p=1.15×10−3) increase in mortality on the same day. During the 3 years, there were 7703 cases and 1475 deaths advanced by PM2.5 pollution over expected rates if daily levels had not exceeded the WHO target.

Conclusions PM2.5 concentration was significantly associated with IHD morbidity and mortality in Beijing. Our findings provide a rationale for the urgent need for stringent control of air pollution to reduce PM2.5 concentration.

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