The Association between Air Pollution and Outpatient and Inpatient Visits in Shenzhen, China.

Yachuan Liu,Li Zhang,Xiaojian Liu,Shanen Chen,Hanwu Ma,Jing Zheng,Lili Chen,Denan Lin,Yongsheng Wu,Jian Xu,Jinquan Cheng,Lin Zhou

doi:10.3390/ijerph15020178

Abstract

Nowadays, air pollution is a severe environmental problem in China. To investigate the effects of ambient air pollution on health, a time series analysis of daily outpatient and inpatient visits in 2015 were conducted in Shenzhen (China). Generalized additive model was employed to analyze associations between six air pollutants (namely SO2, CO, NO2, O3, PM10, and PM2.5) and daily outpatient and inpatient visits after adjusting confounding meteorological factors, time and day of the week effects. Significant associations between air pollutants and two types of hospital visits were observed. The estimated increase in overall outpatient visits associated with each 10 µg/m3 increase in air pollutant concentration ranged from 0.48% (O3 at lag 2) to 11.48% (SO2 with 2-day moving average); for overall inpatient visits ranged from 0.73% (O3 at lag 7) to 17.13% (SO2 with 8-day moving average). Our results also suggested a heterogeneity of the health effects across different outcomes and in different populations. The findings in present study indicate that even in Shenzhen, a less polluted area in China, significant associations exist between air pollution and daily number of overall outpatient and inpatient visits.

Highlights

IntroductionExposures to air pollution increase risk in mortality, in susceptible populations, and present enormous burden on existing public health system
Ambient air pollution was at least suspected to cause adverse health effects, which was estimated to be responsible for more than 2 million deaths annually and 6.4 years of lost life worldwide [1].Exposures to air pollution increase risk in mortality, in susceptible populations, and present enormous burden on existing public health system
The estimated increase in overall outpatient visits associated with each 10 μg/m3 increase in air pollutant concentrations ranged from 0.48% (O3 at lag 2) to 11.48% (SO2 with 2-day moving average); for overall inpatient visits ranged from 0.73% (O3 at lag 7) to 17.13% (SO2 with 8-day moving average)

Summary

Introduction

Exposures to air pollution increase risk in mortality, in susceptible populations, and present enormous burden on existing public health system. Assessing the association between air pollution and diseases can allow a better coordination of mitigation and intervention resources. A broad epidemiological studies have shown that increased ambient air pollutant concentrations are associated with excess daily mortality [2], hospital admissions [3] and emergency hospital visits [4]. These research studies were conducted to assess health impact of air pollution on specific diseases. Associations have been observed between air pollution and emergency department visits for asthma [4,5,6], for effects of nitrogen dioxide (NO2 ), ozone (O3 ), sulfur dioxide (SO2 ) and particulate concentrations. Air pollutants including NO2 , SO2 and particulate matter less than 2.5 μm in aerodynamic diameter (PM2.5 ) have been reported to be risk factors of hospital

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