Short-term effects of nitrogen dioxide on inpatient acute myocardial infarction in Lanzhou, China

ABSTRACT

Nitrogen dioxide (NO₂) represents a deleterious effect on acute myocardial infarction (AMI), but few relevant studies have been conducted in China. We aim to evaluate the acute effects of NO₂ exposure on hospitalization for AMI in Lanzhou, China. In this study, we applied a distributional lag nonlinear model (DLNM) to assess the association between NO₂ exposure and AMI hospitalization. We explored the sensitivity of various groups through stratified analysis by gender, age, and season. The daily average concentration of NO₂ is 47.50 ± 17.38 µg/m³. We observed a significant exposure-response relationship between NO2 concentration and AMI hospitalization. The single pollutant model analysis shows that NO₂ is positively correlated with AMI hospitalization at lag1, lag01, lag02, and lag03. The greatest lag effect estimate occurs at lag01, where a 10 µg/m³ increase in NO₂ concentrations is significantly associated with a relative risk (RR) of hospitalization due to AMI of 1.027 [95% confidence interval (CI): 1.013, 1.042]. The results of the stratified analysis by gender, age, and season indicate that males, those aged ≥65 years, and the cold season are more sensitive to the deleterious effects caused by NO₂ exposure. Short-term exposure to NO₂ can enhance the risk of AMI hospitalization in urban Lanzhou.

Implications: Exposure to particulate matter can lead to an increased incidence of AMI. Our study once again shows that NO₂ exposure increases the risk of AMI hospital admission. AMI is a common and expensive fatal condition. Reducing NO₂ exposure will benefit cardiovascular health and save on healthcare costs.

Acknowledgment

The authors acknowledge the contribution and collaboration of all those who participated in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

All authors contributed to the study conception and design. Tian Tian, Tong Liu, Jingping Niu, and Jiyuan Dong contributed to design the work. Runping Zhang, Jianglong Ling, and Ye Ruan were the principal writers of this paper. Wancheng Zhang and Aning Zhu were the major contributors in writing the manuscript.

Ethics approval and consent to participate

The present study was considered exempt from institutional review board approval since the data used was collected for administrative purpose without any personal identifiers.

Additional information

Funding

This study was supported by the Gansu Provincial Science and Technology Program Project (Key R&D Program) [20YF3FA027].

Notes on contributors

Wancheng Zhang

Wancheng Zhang is a master’s degree student in the Department of Labour Hygiene and Environmental Health, School of Public Health, Lanzhou University.

Anning Zhu

Anning Zhu is a master’s degree student in the Department of Labour Hygiene and Environmental Health, School of Public Health, Lanzhou University.

Jianglong Ling

Jianglong Ling is a master’s degree student in the Department of Labour Hygiene and Environmental Health, School of Public Health, Lanzhou University.

Runping Zhang

Runping Zhang is a master’s degree student in the Department of Labour Hygiene and Environmental Health, School of Public Health, Lanzhou University.

Tong Liu

Tong Liu is a Lecturer in the Department of Labour Hygiene and Environmental Hygiene, School of Public Health, Lanzhou University.

Tian Tian

Tian Tian is a Lecturer in the Department of Labour Hygiene and Environmental Hygiene, School of Public Health, Lanzhou University.

Jingping Niu

Jingping Niu is a Professor in the Department of Labour Health and Environmental Hygiene, School of Public Health, Lanzhou University.

Jiyuan Dong

Jiyuan Dong is an Associate Professor in the Department of Labour Health and Environmental Hygiene, School of Public Health, Lanzhou University.

Ye Ruan

Ye Ruan is an Associate Professor in the Department of Labour Health and Environmental Hygiene, School of Public Health, Lanzhou University.