Spatio-temporal trends in deaths due to cardiovascular diseases attributable to air pollution in India and its states: evidence from the Global Burden of Disease study 2019

BackgroundCardiovascular disease (CVD) is the predominant cause of global mortality, has been growingly linked to air pollution, which paradoxically aligns with economic growth. This study aims to examine the trends and patterns in CVD mortality caused by air pollution. MethodsThis study uses data from the State-Level Disease Burden Initiative in India, from 1990 to 2019. Age-standardized death rates were examined through the application of joinpoint regression analysis, while the impact of air pollution on CVD mortality was assessed by estimating the combined effects of age, period, and cohort using age-period-cohort (APC) analysis. ResultsRelative risks are notably low across genders at younger ages, with males at 0.09 (95% CI: 0.08-0.10) and females at 0.11 (95% CI: 0.10-0.12) at 25-29 years, which increases with age, with individuals aged 85-95 years facing the highest risk. Period effect shows that the risk of deaths due to air pollution increased in 2015-19 compared to 2000-04. Deaths attributable to ambient particulate matter pollution exhibit a net increasing trend with an average annual percent change (AAPC) of 1.13 (95% CI 0.98-1.3). Deaths from household air pollution consistently show a significant downward trend, with an AAPC of -3.62 (95% CI -3.79 to -3.4). ConclusionEnhanced and region-specific air quality management strategies, including ambient and household air pollution controls, can provide substantial public health benefits and aid in the country's economic advancement.