Abstract
BackgroundHeavy fine particulate matter (PM2.5) air pollution occurs frequently in China. However, epidemiological research on the association between short-term exposure to PM2.5 pollution and respiratory disease morbidity is still limited. This study aimed to explore the association between PM2.5 pollution and hospital emergency room visits (ERV) for total and cause-specific respiratory diseases in urban areas in Beijing.MethodsDaily counts of respiratory ERV from Jan 1 to Dec 31, 2013, were obtained from ten general hospitals located in urban areas in Beijing. Concurrently, data on PM2.5 were collected from the Beijing Environmental Protection Bureau, including 17 ambient air quality monitoring stations. A generalized-additive model was used to explore the respiratory effects of PM2.5, after controlling for confounding variables. Subgroup analyses were also conducted by age and gender.ResultsA total of 92,464 respiratory emergency visits were recorded during the study period. The mean daily PM2.5 concentration was 102.1±73.6 μg/m3. Every 10 μg/m3 increase in PM2.5 concentration at lag0 was associated with an increase in ERV, as follows: 0.23% for total respiratory disease (95% confidence interval [CI]: 0.11%-0.34%), 0.19% for upper respiratory tract infection (URTI) (95%CI: 0.04%-0.35%), 0.34% for lower respiratory tract infection (LRTI) (95%CI: 0.14%-0.53%) and 1.46% for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (95%CI: 0.13%-2.79%). The strongest association was identified between AECOPD and PM2.5 concentration at lag0-3 (3.15%, 95%CI: 1.39%-4.91%). The estimated effects were robust after adjusting for SO2, O3, CO and NO2. Females and people 60 years of age and older demonstrated a higher risk of respiratory disease after PM2.5 exposure.ConclusionPM2.5 was significantly associated with respiratory ERV, particularly for URTI, LRTI and AECOPD in Beijing. The susceptibility to PM2.5 pollution varied by gender and age.
Highlights
Because of the rapid industrialization and economic growth experienced over the past ten years, air pollution has become a serious issue in China
Every 10 μg/m3 increase in PM2.5 concentration at lag0 was associated with an increase in emergency room visits (ERV), as follows: 0.23% for total respiratory disease (95% confidence interval [CI]: 0.11%-0.34%), 0.19% for upper respiratory tract infection (URTI) (95%CI: 0.04%-0.35%), 0.34% for lower respiratory tract infection (LRTI) (95%CI: 0.14%-0.53%) and 1.46% for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (95%CI: 0.13%-2.79%)
The estimated effects using spatially assigned PM2.5 concentrations in the generalized additive mixed model (GAMM) were slightly smaller, and the confidence intervals were larger than those using mean PM2.5 in the generalized-additive model (GAM), which was not consistent with the results reported by Xu M, et al [21], likely due to the larger standard error generated by more missing values of air pollutants in the GAMM in our study or because of the smaller spatial variation of PM2.5 concentrations in urban areas compared to that in the entire city
Summary
Because of the rapid industrialization and economic growth experienced over the past ten years, air pollution has become a serious issue in China. From 2013 to 2014, the annual mean fine particulate matter (PM2.5, particles with an aerodynamic diameter 2.5 μm) concentration for most of the 31 provincial capital cities in China exceeded the Chinese Ambient Air Quality Standards Grade II standard (35 μg/m3) [3]. As the capital of China, Beijing has experienced a more serious challenge in terms of deteriorating air quality because of the coal burning and wind-blown dust from the surrounding industrial cities as well as the vehicle exhaust from the rapidly growing number of automobiles [4]. Heavy fine particulate matter (PM2.5) air pollution occurs frequently in China. This study aimed to explore the association between PM2.5 pollution and hospital emergency room visits (ERV) for total and cause-specific respiratory diseases in urban areas in Beijing
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