The Gender-Based Differences in Vulnerability to Ambient Air Pollution and Cerebrovascular Disease Mortality: Evidences Based on 26781 Deaths

The gender-based differences in the vulnerability to ambient air pollution have not been widely explored. This study aimed to investigate vulnerability differences to the short-term effects of PM2.5, PM₁₀ and O₃ between cerebrovascular diseases (CEVD) deaths of men and women. The general additive models (GAMs) and distributed lag non-linear models (DLNMs) were adopted, and both single-pollutant and two-pollutant models were performed to analyze the associations between ambient air pollution and daily CEVD deaths. Both models indicated that O₃ was the most suspicious pollutant that could induce excess CEVD deaths, and women tended to be more vulnerable to O₃. These results were confirmed by seasonal analysis, in which we also found both genders were more vulnerable to O₃ in winter. The exposure-response relationships revealed that women were usually more vulnerable to ambient air pollution than men, and the exposure-response curves differed significantly between genders. Our findings suggested that more attention should be paid on the adverse effects of ambient O₃, and the protection of women CEVD population against air pollution should be emphasized.