Benefits of active commuting on cardiovascular health modified by ambient fine particulate matter in China: A prospective cohort study

Ecotoxicology and Environmental Safety

卷:224

Yang Liu¹  Xueli Yang²  Keyong Huang³  Liancheng Zhao⁴  Xigui Wu⁵  Xianping Wu⁶  Fanghong Lu⁷  Xiangfeng Lu⁸  Jianxin Li⁹  Qingyang Xiao⁹  Ling Yu⁹  Ying Li⁹  Jianfeng Huang⁹  Jichun Chen⁹  Jie Cao⁹  Dongsheng Hu⁹  Chong Shen⁹  Dongfeng Gu⁹  Yuan Lin⁹  Fengchao Liang¹⁰  Shufeng Chen¹¹  Xiaoqing Liu¹²  Fangchao Liu¹³ 

[1] Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518071, China;

[2] Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China;

[3] Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China;

[4] Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan 250062, China;

[5] Center for Chronic and Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu 610041, China;

[6] Department of Cardiology, Fujian Provincial Hospital, Fuzhou 350014, China;

[7] Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China;

[8] Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China;

[9] Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China;

[10] Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China;

[11] Division of Epidemiology, Guangdong Provincial People’s Hospital and Cardiovascular Institute, Guangzhou 510080, China;

[12] School of Environment, Tsinghua University, Beijing 100084, China;

[13] School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China;

关键词: Active commuting;    Air pollution;    Fine particulate matter;    Cardiovascular disease;    Cohort study;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Active commuting as a contributor to daily physical activity is beneficial for cardiovascular health, but leads to more chances of exposure to ambient air pollution. This study aimed to investigate associations between active commuting to work with cardiovascular disease (CVD), mortality and life expectancy among general Chinese adults, and to further evaluate the modification effect of fine particulate matter (PM2.5) exposure on these associations. Methods: We included 76,176 Chinese adults without CVD from three large cohorts of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project. Information about commuting mode and physical activity were collected by unified questionnaire. Satellite-based PM2.5 concentrations at 1-km spatial resolution was used for estimating PM2.5 exposure of participants. Hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD incidence, mortality and all-cause mortality were estimated using Cox proportional hazards regression models. Multiplicative interaction term of commuting mode and PM2.5 level was tested to investigate potential effect modification. Results: During 448,499 person-years of follow-up, 2230 CVD events and 2777 all-cause deaths were recorded. Compared with the non-active commuters, the multivariable-adjusted HRs (95% CIs) of CVD incidence and all-cause mortality were 0.95(0.85–1.05) and 0.79(0.72–0.87) for walking commuters, respectively. Corresponding HRs (95% CIs) for cycling commuters were 0.71(0.62–0.82) and 0.67(0.59–0.76). Active commuters over 45 years old were estimated to have more CVD-free years and life expectancy than non-active commuters under lower PM2.5 concentration. However, these beneficial effects of active commuting were alleviated or counteracted by long-term exposure to high PM2.5 concentration. Significant multiplicative interaction of commuting mode and PM2.5 level was showed in all-cause mortality, with the lowest risk observed in cycling participants exposed to lower level of PM2.5. Conclusions: Active commuting was associated with lower risk of CVD, all-cause mortality, and longer life expectancy among Chinese adults under ambient settings with lower PM2.5 level. It will be valuable to encourage active commuting among adults and develop stringent strategies on ambient PM2.5 pollution control for prevention of CVD and prolongation of life expectancy.

【 授权许可】

Unknown