PM(2.5) Air Pollution and Cardiovascular Disease-Associated Disability among Middle-Aged and Older Adults

BACKGROUND: Increasing evidence regards the role of ambient particles on morbidity and mortality caused by cardiovascular diseases (CVDs). However, there was no evidence about the association between ambient particles and CVD-associated disability. This study used large national representative data to investigate the relationship between long-term exposure to an aerodynamic diameter less than or equal to 2.5 µm (PM(2.5)) and CVD-associated disability among Chinese adults aged 45 years old and above and estimated the burden of CVD-associated disability attributed to PM(2.5). METHODS: Using data from the Second National Sample Survey on Disability, this study used a combination of self-reports or family members’ reports and on-site medical diagnosis by experienced specialists to ascertain CVD-associated disability in 852,742 adults aged 45 years old and above. Logistic regression models and spline regression models were used to examine the association between PM(2.5) long-term exposure and CVD-associated disability, and the population attributable risk was calculated to assess the burden of CVD-associated disability contributed to PM(2.5). RESULTS: Every increase of 10 μg/m(3) in PM(2.5) was associated with an 8% (OR = 1.08, 95% CI: 1.05, 1.10) increase the odds of CVD-associated disability. Stratified analyses by demographic factors suggested that this association was robust. There were 1.05 (0.74,1.35) million -3.53 (3.29,3.75) million CVD-associated disabilities attributed to high PM(2.5) concentration exposure (≥35 µg/m(3)) among middle-aged and older adults in 2006. A reduction in PM(2.5) concentrations to 35 µg/m(3) corresponded to a decrease of 13.59% (9.55%, 17.46%)–23.98% (17.17%, 30.25%) in CVD-associated disability by age group, respectively, and this magnitude increased in areas with a high prevalence of CVD-related disability. CONCLUSIONS: This study suggests that reducing PM(2.5) concentrations may contribute to preventing CVD-associated disability and decreasing air pollution-related medical expenditures and rehabilitation fees.