Association between short-term ambient particulate matters and acute liver injury outpatient visits: A hospital-based study

Abstract

Acute liver injury (ALI) manifests as a sudden liver malfunction, posing a serious, sometimes fatal, threat. This condition is of global medical significance due to its high prevalence and mortality rates. The link between ALI and environmental air contamination remains unstudied. This research delves into the potential connections between brief exposures to particulate matters (PMs) and daily ALI-related outpatient visits in China. Our study encompassed an analysis of 32,261 cases of ALI from January 1, 2013, to December 31, 2019, covering 2,549 days in total. We applied over-dispersed Poisson generalized additive models, incorporating both meteorological factors and day of the week. Notably, a 10 μg/m3 uptick in PM2.5 and PM10 led to 0.41% (95% Cl: 0.06%, 0.75%) and 0.34% (95% Cl: 0.13%, 0.56%) rises in ALI visits at lag 01, PMc exhibited a clear positive trend with ALI across cumulative exposure days, most notably at lag 02, where an increase of 10 μg/m3 in PMc corresponded to a 0.64% (95% CI: 0.23%, 1.05%) rise in outpatient attendances, respectively. The stratified analyses indicated that PMs exhibited stronger effects in females, individuals aged 36–59, and during the warm seasons. This study unveils initial findings suggesting that short-lived PM exposures could indirectly enhance the ALI risk.