Acute effect of ambient air pollution on heart failure in Guangzhou, China

- Little evidence about air pollution and heart failure (HF) was available in developing countries.
- Air pollution was associated with increased emergency ambulance dispatches due to HF in Guangzhou, China.
- The effect estimates were strongest at lag 0 day and in cool period.
- The effect estimates were larger than most of previous studies.

BackgroundHeart failure (HF) is a global public health problem of increasing importance. The association between acute exposure to air pollution and HF has been well established in developed countries, but little evidence was available in developing countries where air pollution levels were much higher. We conducted a time-series study to investigate the short-term association between air pollution and overall emergency ambulance dispatches (EAD) due to HF in Guangzhou, China.MethodsDaily data of EAD due to HF from 1 January 2008 to 31 December 2012 were obtained from Guangzhou Emergency Center. We applied the over-dispersed Poisson generalized addictive model to analyze the associations after controlling for the seasonality, day of the week and weather conditions.ResultsWe identified a total of 3375 EAD for HF. A 10-μg/m3 increase in the present-day concentrations of particulate matter with an aerodynamic diameter of less than 10 μm, sulfur dioxide and nitrogen dioxide corresponded to increases of 3.54% [95% confidence interval (CI): 1.35%, 5.74%], 5.29% (95% CI: 2.28%, 8.30%) and 4.34% (95% CI: 1.71%, 6.97%) in daily EAD for HF, respectively. The effects of air pollution on acute HF were restricted on the concurrent day and in the cool seasons.ConclusionsOur results provided the first population-based evidence in Mainland China that outdoor air pollution could trigger the exacerbation of HF.