Abstract
BackgroundPositive associations between ambient PM2.5 and cardiorespiratory disease have been well demonstrated during the past decade. However, few studies have examined the adverse effects of PM2.5 based on an entire population of a megalopolis. In addition, most studies in China have used averaged data, which results in variations between monitoring and personal exposure values, creating an inherent and unavoidable type of measurement error.MethodsThis study was conducted in Wuhan, a megacity in central China with about 10.9 million people. Daily hospital admission records, from October 2016 to December 2018, were obtained from the Wuhan Information center of Health and Family Planning, which administrates all hospitals in Wuhan. Daily air pollution concentrations and weather variables in Wuhan during the study period were collected. We developed a land use regression model (LUR) to assess individual PM2.5 exposure. Time-stratified case-crossover design and conditional logistic regression models were adopted to estimate cardiorespiratory hospitalization risks associated with short-term exposure to PM2.5. We also conducted stratification analyses by age, sex, and season.ResultsA total of 2,806,115 hospital admissions records were collected during the study period, from which we identified 332,090 cardiovascular disease admissions and 159,365 respiratory disease admissions. Short-term exposure to PM2.5 was associated with an increased risk of a cardiorespiratory hospital admission. A 10 μg/m3 increase in PM2.5 (lag0–2 days) was associated with an increase in hospital admissions of 1.23% (95% CI 1.01–1.45%) and 1.95% (95% CI 1.63–2.27%) for cardiovascular and respiratory diseases, respectively. The elderly were at higher PM-induced risk. The associations appeared to be more evident in the cold season than in the warm season.ConclusionsThis study contributes evidence of short-term effects of PM2.5 on cardiorespiratory hospital admissions, which may be helpful for air pollution control and disease prevention in Wuhan.
Highlights
Positive associations between ambient PM2.5 and cardiorespiratory disease have been well demonstrated during the past decade
A total of 2,806,115 hospital admission records were collected during the study period, from which we identified 332,090 for total cardiovascular diseases and 159,365 for total respiratory diseases
In season-specific analyses, we found a greater effect of P M2.5 for all cardiorespiratory diseases in the cold season than in the warm season
Summary
Positive associations between ambient PM2.5 and cardiorespiratory disease have been well demonstrated during the past decade. Few studies have examined the adverse effects of P M2.5 based on an entire population of a megalopolis. 10.5 million disability-adjusted life years (DALYs) globally are attributable to ambient particulate matter pollution, making it the eighth leading risk for death [4]. Several large-scale studies, conducted in western developed countries [7, 8], have examined the associations between air pollution and cardiorespiratory hospital admissions, these results may not be applicable to developing countries due to local climate conditions, PM chemical components and population susceptibility. Studies that examine the association between PM2.5 and cardiorespiratory hospital admissions based on all citizens of a large city are needed to better understand the real impact of ambient fine particulate matter in China
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