Short-term exposure to PM2.5 and hospital admissions for respiratory causes in the Czech Republic

Abstract

Abstract Background and Aims The Regions Ostrava and Karvina are the most polluted areas in the Czech Republic. The aim of this study was the analysis of effect of ambient fine particles (PM2.5) on acute hospital admissions for respiratory causes. Methods In the period 2013-2019, a total of 20,490 cases of acute hospitalization from respiratory causes (J00-99 according to ICD-10) was registered. The daily PM2.5 concentrations were measured at 5 stations. The analyses were performed in two ways: i) including extreme values (max. 224 μg.m-3) and ii) for PM2.5<60 μg.m-3 (5% of the highest values were cut off). The generalized additive model (GAM) for Poisson distribution was used for the analyses; the „thin plate regression spline“ was applied to smooth the pressure, relative humidity and a temperature. The model was adjusted for meteorological conditions, incidence of acute respiratory infections, days off, the order of a day in a week and the area. The calculation was done for lag0 to lag3 days. The analyses were completed using the SW Stata v.14 and SW R v.3.6.1 with the use of mgcv package v.1.8-28. Results The median age of patients was 57 years (IQR 4-75 years), 56% were men. The annual PM2.5 values ranged from 18.5 to 31.0 μg.m-3. Based on the fully adjusted model, a10 μg.m-3 increase in PM2.5 was associated with an increase in hospital admission of 1.0% (95% CI: 0.2-1.8%) for lag0 and lag2, 1.2% (95% CI: 0.5-1.9%) for lag3. The percentage changes for models with values of PM2.5<60 μg.m-3 were higher - 1.8% (95% CI: 0.3-3.2%) for lag0 and 3.3% (95% CI: 2.0-4.7%) for lag1-lag3. Conclusions The analyses confirmed the effect of ambient fine particulates (PM2.5) on acute hospital admissions for respiratory causes in the regions Ostrava and Karvina. This presentation was supported by the project TH03030195 of the Technology Agency of the Czech Republic and the project Healthy Aging in the Industrial Environment CZ.02.1.01/0.0/0.0/16_019/0000798 (HAIE). Key messages • A positive association was confirmed between short-term concentrations of PM2.5 and acute hospital admissions for respiratory causes (lag0-lag3). • No statistically significant difference was found between the identified C-R functions and C-R functions published by the WHO for the relationship between respiratory hospitalizations and PM2.5.