Abstract
BackgroundFew studies have investigated the associations between outdoor air pollution and outpatient visits for respiratory diseases (RDs) in general population.MethodsWe collected daily outpatient data of primary RDs from five hospitals in Jinan during January 2012 and December 2016, as well as daily measurements of air pollutants from the Jinan Environmental Monitoring Center and daily meteorological variables from the China Meteorological Data Sharing Service System. A generalized additive model (GAM) with quasi-Poisson regression was constructed to estimate the associations between daily average concentrations of outdoor air pollutants (PM2.5,PM10, SO2, NO2, CO and O3) and daily outpatient visits of RDs after adjusting for long-time trends, seasonality, the “day of the week” effect, and weather conditions. Subgroup analysis stratified by gender, age group and the type of RDs was conducted.ResultsA total of 1,373,658 outpatient visits for RDs were identified. Increases of 10 μg/m3 in PM2.5, PM10, NO2, CO and O3 were associated with0.168% (95% CI, 0.072–0.265%), 0.149% (95% CI, 0.082–0.215%), 0.527% (95% CI, 0.211–0.843%), 0.013% (95% CI, 0.003–0.023%), and 0.189% (95% CI, 0.032–0.347%) increases in daily outpatient visits for RDs, respectively. PM2.5 and PM10 showed instant and continuous effects, while NO2, CO and O3 showed delayed effects on outpatient visits for RDs. In stratification analysis, PM2.5 and PM10 were associated with acute RDs only.ConclusionsExposure to outdoor air pollutants including PM2.5, PM10, NO2, CO and O3 associated with increased risk of outpatient visits for RDs.
Highlights
The adverse effects of outdoor air pollution have attracted intensive attention worldwide
Temperature negatively and pressure positively correlated with the concentrations of PM2.5, Particle matter≤10-μm in diameter (PM10), Sulfur dioxide (SO2), Nitrogen dioxides (NO2), and Carbon monoxide (CO)
The air pollutants were significantly correlated with each other. These results indicated that the confounding effects of the meteorological parameters and the effects of other air pollutants should be controlled in models
Summary
The adverse effects of outdoor air pollution have attracted intensive attention worldwide. Many recent studies conducted in China have demonstrated that outdoor air pollutants could increase the risk for mortality [3, 4], respiratory diseases (RDs) [5, 6], and cardiovascular diseases [7, 8]. Specific populations may be at different risk of air pollution because of the different susceptibility and vulnerability to adverse effects of pollutants [11]. For these reasons, the effect size of air pollution of one region cannot reflect that of another. Few studies have investigated the associations between outdoor air pollution and outpatient visits for respiratory diseases (RDs) in general population
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