Short-term associations between ambient air pollution and cardiovascular disease mortality: an 11-year time-series study in Nanning, China.

Authors

Xia Luo, Linhan Liang, Yang Yu, Zhu Liang, Huiting Nong, Dan Gu, Li Chen, Zhi Li, Lin Ye, Huanhuan Chen

Published in

Frontiers in public health. Volume 14. Pages 1878398. Epub Jul 15, 2026.

Abstract

Short-term exposure to ambient air pollution has been associated with cardiovascular disease (CVD) mortality, but localized evidence from subtropical cities in southwestern China remains limited. This 11-year time-series study aimed to evaluate the short-term associations between six criteria air pollutants and daily CVD mortality in Nanning, China.
We conducted a time-series analysis using daily data on CVD mortality, air pollutant concentrations, and meteorological variables from 2014 to 2024 in Nanning. Generalized additive quasi-Poisson models were used to estimate associations across single-day lags (lag0-lag7) and cumulative lag windows (lag0-1 to lag0-7), adjusting for long-term trends, temperature, relative humidity, and day of the week. Exposure-response relationships were assessed using natural cubic splines. Stratified analyses were conducted by season and age group, and two-pollutant models and sensitivity analyses were performed to evaluate robustness.
A total of 87,913 CVD deaths were recorded during the study period, of which 57.5% occurred in males and 77.9% occurred among individuals aged ≥65 years. In single-day lag models, PM_2.5, PM₁₀, SO₂, NO₂, and O₃-8h showed significant positive associations with CVD mortality at early lag days. At lag0, the RRs were 1.014 (95% CI: 1.008-1.020) for PM_2.5, 1.009 (95% CI: 1.006-1.013) for PM₁₀, and 1.018 (95% CI: 1.011-1.026) for NO₂, while SO₂ showed its largest estimate at lag1 [RR = 1.044 (95% CI: 1.018-1.069)]. In cumulative lag models, PM_2.5, PM₁₀, SO₂, NO₂, and O₃-8h showed significant cumulative associations, whereas CO was significant mainly in shorter lag windows. Season-stratified analyses suggested pollutant-specific variation between cold and warm seasons, although formal pollutant-by-season interaction tests were not statistically significant. Age-stratified analyses indicated broader susceptibility among older adults. The main associations were generally robust in sensitivity analyses, distributed lag models, and two-pollutant models, particularly for PM_2.5, PM₁₀, and NO₂.
Short-term exposure to ambient air pollution was associated with increased CVD mortality, particularly for PM_2.5, PM₁₀, and NO₂, with consistent effects across single-day and cumulative lag structures. The results highlight the cardiovascular risks of particulate and traffic-related pollution and support pollutant-specific air quality management and targeted protection for older adults during high-pollution periods.

PMID:
42529026
Bibliographic data and abstract were imported from PubMed on 30 Jul 2026.

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