Effect of Ambient Air Pollution on Hospitalization for Heart Failure in 26 of China's Largest Cities

There is growing interest in the association between ambient air pollution and congestive heart failure (CHF), but research data from developing countries are very limited. The primary aim of this study was to examine the association between short-term exposure to air pollution and hospital admission for CHF in China. A time-stratified case-crossover study was conducted between 2014 and 2015 in 26 large Chinese cities among 105,501 CHF hospitalizations. Conditional logistic regression models were applied to estimate the percentage changes in CHF admissions in relation to per interquartile range increases in air pollutant concentrations. Air pollution was positively associated with CHF hospitalizations. An interquartile range increase in fine particulate, particulate matter less than 10 µm in aerodynamic diameter, sulfur dioxide, nitrogen dioxide, carbon monoxide, and ozone concentrations on the current day corresponded to 1.2% (95% confidence interval [CI] 0.5%, 1.8%), 1.3% (95% CI 0.5%, 2.0%), 1.0% (95% CI 0.2%, 1.7%), 1.6% (95% CI 0.6%, 2.5%), 1.2% (95% CI 0.5%, 1.9%), and 0.4% (95% CI −0.9%, 1.7%) increases in CHF admissions, respectively. In conclusion, our findings contribute to the limited scientific literature concerning the effects of air pollution on CHF risk for high-exposure settings typical in developing countries, which may have significant public health implications for prevention of CHF in China.