Risks of hospital admissions from a spectrum of causes associated with particulate matter pollution

Abstract

Ambient particulate matter (PM) pollution has been linked to elevated hospital admissions (HAs), especially from respiratory and cardiovascular diseases. However, few studies have estimated the associations between PM pollution and HAs for a wider range of broad disease categories. This study aimed to evaluate the effects of PM with aerodynamic diameter ≤ 2.5 μm (PM2.5) and ≤10 μm (PM10) on a range of broad and specific causes of HAs in Chengdu, China during 2015–2016, using a generalized additive model (GAM). Age-, gender- and season-specific analyses were also performed on the broad categories. We further calculated the corresponding morbidity burden due to PM exposure. During the study period, the daily mean level for PM2.5 and PM10 was 57.3 μg/m3 and 94.7 μg/m3, respectively. For broad disease categories, each 10 μg/m3 increase in PM10 at lag06 was associated with increments of 0.65% (95% CI: 0.32%–0.99%) in HAs from respiratory, 0.49% (95% CI: 0.04%–0.95%) from circulatory and 0.91% (95% CI: 0.15%–1.69%) from skin and subcutaneous tissue diseases. By contrast, only respiratory HAs showed a significant positive association with elevated PM2.5 at lag06 (1.03% increase per 10 μg/m3, 95% CI: 0.50%–1.56%, p < 0.001). Increased HAs risks for several more refined specific causes within respiratory, circulatory, skin and subcutaneous tissue, nervous and genitourinary diseases were also observed. Subgroup analyses indicated that effect estimates were modified by age, gender and season. Overall, the largest morbidity burden was observed in myocardial infarction, about 11.27% (95% CI: 3.45%–18.07%) and 11.11% (95% CI: 4.07%–17.27%) of HAs for myocardial infarction could be attributable to PM2.5 and PM10 levels exceeding the WHO's air quality guidelines (24-h mean: 25 μg/m3 for PM2.5 and 50 μg/m3 for PM10). Our study suggests that both PM2.5 and PM10 increase risks of morbidity from broad range of causes of HAs in Chengdu, and result in substantial morbidity burden.