Hourly air pollution exposure and the onset of symptomatic arrhythmia: an individual-level case–crossover study in 322 Chinese cities

作者：Xiaowei Xue, Jialu Hu, Dingcheng Xiang, Huichu Li, Yixuan Jiang, Weiyi Fang, Hongbing Yan, Jiyan Chen, Weimin Wang, Xi Su, Bo Yu, Yan Wang, Yawei Xu, Lefeng Wang, Chunjie Li, Yundai Chen, Dong Zhao, Haidong Kan, Junbo Ge, Yong Huo, Renjie Chen · 发表于：Canadian Medical Association Journal · 年份：2023 · DOI：10.1503/cmaj.220929 · 被引用次数：34 · 研究领域：Air Quality and Health Impacts、Heme Oxygenase-1 and Carbon Monoxide、Air Quality Monitoring and Forecasting

Background: Few studies have explored the relationship between air pollution and arrhythmia onset at the hourly level. We aimed to examine the association of exposure to air pollution with the onset of acute symptomatic arrhythmia at an hourly level. Methods: We conducted a nationwide, time-stratified, case–crossover study in China between 2015 and 2021. We obtained hourly information on the onset of symptomatic arrhythmia (including atrial fibrillation, atrial flutter, atrial and ventricular premature beats and supraventricular tachycardia) from the Chinese Cardiovascular Association Database — Chest Pain Center (including 2025 certified hospitals in 322 cities). We obtained data on hourly concentrations of 6 air pollutants from the nearest monitors, including fine particles (PM 2.5 ), coarse particles (PM 2.5–10 ), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), carbon monoxide (CO) and ozone. For each patient, we matched the case period to 3 or 4 control periods during the same hour, day of week, month and year. We used conditional logistic regression models to analyze the data. Results: We included a total of 190 115 patients with acute onset of symptomatic arrhythmia. Air pollution was associated with increased risk of onset of symptomatic arrhythmia within the first few hours of exposure; this risk attenuated substantially after 24 hours. An interquartile range increase in PM 2.5 , NO 2 , SO 2 and CO in the first 24 hours after exposure (i.e., lag period 0–24 h)...