Abstract
Ambient air pollution poses a significant risk for a group of common and often debilitating respiratory diseases, but its direct impact on cause-specific respiratory diseases using emergency room visit (ERV) as an indicator remains to be fully explored. In this study, we conducted a time-series study of ambient PM2.5, NO2, SO2 and their association with ERV for asthma, COPD and pneumonia in a four-year time span. Relative risks for ERV as per log increase in the level of ambient pollutants with time lags of up to 10 days were calculated, using a generalized additive model of Poisson regression. Daily 24-h average concentrations of PM2.5 and pollutant gases were obtained from a local Gutting air quality monitoring station. Results showed that the ERVs for pneumonia and asthma were associated with the level of PM2.5. The effects of PM2.5 on the risk of ERV for asthma were found to be significant at lag days 1 and 2 with increasing risk of 4.34% [RR: 1.091; CI: 1.020–1.166 (95%)] and 3.58% [RR: 1.074; CI: 1.007–1.146 (95%)], respectively. The ERV for pneumonia was associated with the level of PM2.5 at lag days 5, 6 and 7, with increasing risk of 1.92% [RR: 1.039; CI: 1.009–1.070 (95%)], 2.03% [RR: 1.041; CI: 1.009–1.075 (95%)], and 1.82% [RR: 1.037; CI: 1.001–1.075 (95%)], respectively. Further, PM2.5, but not NO2 and SO2, posed a significant risk of ERV for asthma during spring at lag days 0, 1 and 2 (17.12%, RR: 1.408, CI: 1.075–1.238; 15.30%, RR: 1.358 CI: 1.158–1.166; 11.94%, RR: 1.165, CI: 1.004–1.121), which was particularly evident for those who were younger than 75 years of age. In contrast, only PM2.5 was a significant risk of ERV for COPD, which was primarily for those who were younger than 75 years of age during summer season at lag days 3, 4 and 5. (26.66%, RR: 1.704, CI: 1.104–2.632; 26.99%; RR: 1.716, CI: 1.151–2.557; 24.09%; RR: 1.619, CI: 1.111–2.360). Collectively, these results suggested significant seasonal variation and differential time lag effects of PM2.5 on ERV for asthma, COPD and pneumonia.
Highlights
Ambient air pollution is associated with respiratory diseases and, in some cases, mortality [1,2,3,4,5,6], wherein exposure to ambient Particulate matter (PM) poses a significant risk for asthma, Chronic obstructive pulmonary disease (COPD), pneumonia and cancer[7,8,9,10,11,12]
We attempted to identify the relationship between the level of ambient air pollution, including the level of PM2.5, and emergency room visit (ERV) for three different respiratory diseases in a fouryear time series study
Our study showed significant seasonal variation and differential time lag effects on ERV for asthma, COPD and pneumonia
Summary
Ambient air pollution is associated with respiratory diseases and, in some cases, mortality [1,2,3,4,5,6], wherein exposure to ambient PMs poses a significant risk for asthma, COPD, pneumonia and cancer[7,8,9,10,11,12]. The WHO has reported that ambient air pollution is responsible for 3.7 million deaths in 2012, representing 6.7% of total deaths worldwide, raising significant environmental, public health, medical and economic concerns[13,14]. These documented impacts of ambient air pollution highlight an urgent need for better understanding of the nature of the disease-causing pollutants and their exact impact on the occurrence of diseases, for a group of common and often debilitating respiratory diseases. We report significant seasonal variation and differential time lag effects among three common respiratory diseases, including pneumonia, chronic obstructive pulmonary disease and asthma
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