Burden of ischemic heart disease and stroke attributable to exposure to atmospheric PM_2.5 in Hubei province, China

Studies on mortality and disability-adjusted life years (DALYs) of cardiovascular diseases (CVDs) attributable to exposure to ambient PM_2.5 in China are very limited. This study aims to provide a city-level estimation of the PM_2.5-related disease burden of two major CVDs, ischemic heart disease (IHD) and stroke, by age and sex in Hubei province, China in 2016. PM_2.5 mass concentrations (μg/m³) at different cities were obtained from the Hubei Provincial Environmental Quality Supervision and Administration Bureau. The city-level demographic data in Hubei were obtained from the sixth demographic census of China in 2010. Sex- and age-specific mortality and DALY data were extracted from the Global Burden of Disease Study (GBD) 2016. The integrated exposure-response (IER) model, developed by the GBD, was used to estimate PM_2.5-related CVD premature deaths and DALYs in Hubei province. We found that 55.76 thousand deaths and 1.11 million DALYs of IHD and stroke could be attributed to exposure to ambient PM_2.5 in Hubei. Disease burden of IHD and stroke attributable to PM_2.5 increased with age and were higher in males than in females. The PM_2.5-related disease burden of IHD and stroke was mainly concentrated in the eastern part of Hubei. The highest population attributable fraction (PAF) of IHD and stroke was mainly concentrated in the western part of Hubei. Our findings suggest that China needs proper air quality management measures to effectively reduce ambient PM_2.5, especially for cities with heavy disease burden.