Differential effects of fine and coarse particles on daily emergency cardiovascular hospitalizations in Hong Kong

Few studies have investigated the relationship of hospital admissions for cardiovascular diseases with fine (PM2.5: particles with an aerodynamic diameter less than 2.5 μm) and coarse particles (PMc: particles with an aerodynamic diameter between 2.5 and 10 μm) simultaneously. We aimed to estimate the differential effects of PM2.5 and PMc on emergency hospital admissions for cardiovascular diseases, after controlling for the gaseous pollutants. We conducted a time series analysis in Hong Kong using daily emergency hospital admissions for cardiovascular diseases, PM2.5 and PMc concentrations from January 2000 to December 2005. PMc concentrations were estimated by subtracting PM2.5 from PM10 measurements. Generalized additive Poisson models allowing overdispersion and autocorrelation were used to examine the effects of PM2.5 and PMc simultaneously, adjusting for time trends, weather conditions, influenza outbreaks, and gaseous pollutants. In two-pollutant model, an interquartile range (IQR) increase in the 2-day moving average (lag01) concentration of PM2.5 and PMc corresponded to 1.86% (95% CI: 0.85%, 2.88%) and −0.16% (95% CI: −1.07%, 0.76%) change of emergency hospital admissions for total circulatory diseases respectively. Results were sensitive to further inclusion of nitrogen dioxide but not of ozone and sulfur dioxide. We did not find any effects of PMc on circulatory hospitalizations independent of PM2.5. In conclusion, we confirmed the stronger and significant adverse effects of PM2.5, but no independent effect of PMc on emergency cardiovascular hospitalizations. The biological mechanisms underlying the differential effects of PM2.5 and PMc on cardiovascular diseases were discussed.

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► We examined the differential effects of fine and coarse particles on cardiovascular diseases.
► We confirmed the stronger adverse effects of fine particles.
► We found no independent effects of coarse particles.
► PM2.5 is more harmful, likely because it penetrates deeper into the lungs.