Association Between Short Term Exposure to Fine Particulate Matter and Peptic Ulcer: A Retrospective Cohort Study

Abstract

Background: To estimate the short term effect of particulate matter (particle diameter < 2.5 μm, or PM2.5) on the risk of peptic ulcer diseases (PUDs). Methods: A retrospective hospital-based cohort study was conducted in seven major cities in Zhejiang province, China (combined population > 57 million) which included a total of 647,092 subjects underwent gastroscopy examination (86,852 subjects among them were diagnosed as PUDs) recorded in 13 large hospitals from 2014 to 2018 to analyze relationship between PM2.5 and PUDs including duodenal ulcer (DU) and gastric ulcer (GU). Findings: Pooled estimated OR (95%CI) associated with a 10μg/m3 increase of 1-month average PM2.5 before the detection of PUDs was 1.050 (95%CI:1.038, 1.063). When the 3-month moving average and 6-month moving average concentrations were used as the exposure window, the association between PM2.5 concentrations and the incident of PUDs tends to be attenuated but remained significant (OR=1.030, 95%CI= 1.018-1.043 for 3-month moving average and OR=1.020, 95%CI=1.005-1.037 for 6-month moving average, respectively). The observed association tended to be stronger in DU and the association of PM2.5 and PUDs remained significant in the two-pollutant models. Interpretation: We observed a significant association between short-term exposure to PM2.5 and in a multi-site and large sample size study in China. Our findings could contribute to the evidence that a more general adverse role of air pollution on PUDs. Funding Statement: This study was supported by National Key Research and Development Program of China (No.2017YFC0908900 to Yu CH). Declaration of Interests: None of the authors have any competing interest to declare. Ethics Approval Statement: This study was approved by the Institutional Review Board of each executing hospital. Participants were verbally informed about the study.