Abstract
Abstract
Rapid industrialization worsened air pollution in Liuzhou, increasing cardiovascular disease (CVD) risks. We investigated short-term associations between six pollutants (PM₂.₅, PM₁₀, SO₂, NO₂, CO, O₃) and daily CVD outpatient visits (2,986,820 from 2014–2024) and evaluated the impact of 2018 policies targeting polluting chemical enterprises. Using a distributed lag nonlinear model within a generalized additive Poisson regression, we quantified percent changes per interquartile range increase, adjusting for meteorology and temporal trends, with pre/post-2018 comparisons. NO₂ (lag5: RR = 1.447, 95%CI: 1.413–1.483), PM₁₀ (lag1: RR = 1.095, 1.079–1.112), and PM₂.₅ (lag1: RR = 1.036, 1.021–1.051) significantly increased visits. After 2018, PM₂.₅, PM₁₀, SO₂, NO₂, and CO declined (p < 0.01); associations for SO₂, CO, PM₂.₅, and PM₁₀ weakened. NO₂ effects were stronger in females and cold seasons, persisting in two-pollutant models. No significant links for SO₂, CO, or O₃ in single-pollutant models. Short-term NO₂, PM₁₀, and PM₂.₅ independently boosted CVD outpatient demand. The 2018 policies reduced key pollutants and their health impacts, supporting ongoing air quality strategies.