Abstract
Evidence is limited regarding the role of air pollution in acute lower respiratory infections among adults. We assessed the influence of long-term air pollution exposure on hospital admission for lower respiratory infections and whether there are vulnerable subgroups. We used a populational cohort in Catalonia, Spain, comprising 3,817,820 adults residing in Catalonia as of January 1, 2015. Air pollution exposure was assigned to individuaĺs residential address using locally-developed models. We characterized the concentration-response functions between long-term air pollution exposure and hospital admission for lower respiratory infections between 2015 and 2019. We assessed interaction between exposure and clinical and socio-economic factors on multiplicative and additive scales. An interquartile range exposure increase was associated with an 8% (95% Confidence Interval: 5%-11%) for Nitrogen Dioxide, 10% (95% Confidence Interval: 8%-13%) for Particulate Matter with diameter equal to or smaller than 2.5µm, 5% (95% Confidence Interval: 3%-7%) for Particulate Matter with diameter equal to or smaller than 10µm and 18% (95% Confidence Interval: 14%-22%) for ozone (adjusted by Nitrogen Dioxide) increase in hospital admissions for respiratory infections. Concentration-response functions were non-linear, with steeper slopes at exposures below the median or at most extreme high values. Associations were consistently greater for individuals over 65years or with hypertension diagnosis and males. Long-term exposure to air pollution was positively associated with hospital admission for lower respiratory infections. Individuals who were older than 65years, hypertensive or male were most vulnerable.
Published Version
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