Respiratory Disease Admissions Research Articles

Atmosphere particulate matter and respiratory diseases during COVID-19 in Korea

We aimed to examine the impact of COVID-19 non-pharmaceutical interventions (NPIs) on the relationship between air pollutants and hospital admissions for respiratory and non-respiratory diseases in six metropolitan cities in South Korea. This study compared the associations between particulate matter (PM10 and PM2.5) and hospital admission for respiratory and non-respiratory diseases before (2016–2019) and during (2020) the implementation of COVID-19 NPIs by using distributed lag non-linear models. In the Pre-COVID-19 period, the association between PM10 and admission risk for asthma and COPD showed an inverted U-shaped pattern. For PM2.5, S-shaped and inverted U-shaped changes were observed in asthma and COPD, respectively. Extremely high and low levels of PM10 and extremely low levels of PM2.5 significantly decreased the risk of admission for asthma and COPD. In the Post-COVID-19 outbreak period, the overall cumulative relationship between PM10 and PM2.5 and respiratory diseases and the effects of extreme levels of PM10 and PM2.5 on respiratory diseases were completely changed. For non-respiratory diseases, PM10 and PM2.5 were statistically insignificant for admission risk during both periods. Our study may provide evidence that implementing NPIs and reducing PM10 and PM2.5 exposure during the COVID-19 pandemic has contributed to reducing hospital admissions for environment-based respiratory diseases.

Thermal stress and hospital admissions for cardiorespiratory disease in Brazil

The growing body of scientific literature underscores the intricate relationship between meteorological conditions and human health, particularly in the context of extreme temperatures. However, conventional temperature-centric approaches often fall short in capturing the complexity of thermal stress experienced by individuals. Temperature alone, as a metric, fails to encompass the entirety of the thermal stress individuals face, necessitating a more nuanced understanding. In response to this limitation, climatologists have devised thermal indices—composite measures meticulously crafted to reflect the intricate interplay of meteorological factors influencing human perception of temperature. Recognizing the inadequacy of simplistic temperature-focused methodologies, our study aims to address the multifaceted nature of thermal stress. In this study, we explored the association between thermal indices and hospital admissions for circulatory and respiratory diseases in Brazil. We used an extensive dataset spanning 11 years (2008–2018) from the Brazilian Ministry of Health, encompassing a total of 23,791,093 hospitalizations for circulatory and respiratory diseases. We considered four distinct thermal indices—Discomfort Index (DI), Net Effective Temperature (NET), Humidex (H), and Heat Index (HI). We used an extension of the two-stage design with a case time series to assess this relationship. In the first stage, we applied a distributed lag non-linear modeling framework to create a cross-basis function. We next applied quasi-Poisson regression models adjusted by time-varying confounders. In the second stage, we applied meta-analysis with random effects to estimate the national relative risk (RR). Our findings suggest robust variations among the thermal indices under examination. These variations underscore the intricate nature of associations between temperature and health, with each index capturing distinct aspects of thermal conditions. Our results indicate that extreme thermal conditions, both at the low and high ends, are associated with increased risks of hospital admissions. The diverse impact observed among different indices emphasizes the complex interplay between various meteorological factors and their specific physiological consequences. This underscores the necessity for a comprehensive comprehension of temperature metrics to guide precise public health interventions, recognizing the multifaceted nature of temperature-health relationships.

Temperature and hospital admissions in the Eastern Mediterranean: a case study in Cyprus

Exposure to extreme temperatures can trigger a cascade of adverse cardiovascular and respiratory events. However, in Cyprus, a hotspot of climate change in the Eastern Mediterranean region, little is known about the temperature-related cardiorespiratory morbidity risks. We analyzed daily counts of hospital admissions for cardiovascular and respiratory diseases from four general hospitals in three districts in Cyprus from 2000 through 2019. For each district, we fitted time-series quasi-Poisson regression with distributed lag non-linear models to analyze the associations between daily mean temperature (lag 0–21 d) and hospital admissions for cardiorespiratory, cardiovascular, and respiratory diseases. A random-effects meta-analytical model was then applied to pool the district-specific estimates and obtain the national average associations. We analyzed 20 years of cause-specific hospitalization data with a total of 179 988 cardiovascular and respiratory events. The relationships between cardiorespiratory morbidity and temperature were overall U-shaped. During extreme temperature days, 15.85% (95% empirical CI [eCI]: 8.24, 22.40%) excess cardiovascular hospitalizations and 9.59% (95% eCI: −0.66, 18.69%) excess respiratory hospitalizations were attributable to extreme cold days (below the 2.5th percentile). Extreme hot days (above the 97.5th percentile) accounted for 0.17% (95% eCI: 0.03, 0.29%) excess cardiovascular hospitalizations and 0.23% (95% eCI: 0.07, 0.35%) excess respiratory hospitalizations. We found evidence of increased cardiovascular morbidity risk associated with extreme temperatures in Cyprus. Our study highlights the necessity to implement public health interventions and adaptive measures to mitigate the related temperature effects in an understudied region.

Short term exposure to low level ambient fine particulate matter and natural cause, cardiovascular, and respiratory morbidity among US adults with health insurance: case time series study

ObjectiveTo estimate the excess relative and absolute risks of hospital admissions and emergency department visits for natural causes, cardiovascular disease, and respiratory disease associated with daily exposure to fine particulate...

Non-COVID-19 hospitalization and mortality during the COVID-19 pandemic in Iran: a longitudinal assessment of 41 million people in 2019-2022.

During a COVID-19 pandemic, it is imperative to investigate the outcomes of all non-COVID-19 diseases. This study determines hospital admissions and mortality rates related to non-COVID-19 diseases during the COVID-19 pandemic among 41 million Iranians. This nationwide retrospective study used data from the Iran Health Insurance Organization. From September 23, 2019, to Feb 19, 2022, there were four study periods: pre-pandemic (Sept 23-Feb 19, 2020), first peak (Mar 20-Apr 19, 2020), first year (Feb 20, 2020-Feb 18, 2021), and the second year (Feb 19, 2021-Feb 19, 2022) following the pandemic. Cause-specific hospital admission and in-hospital mortality are the main outcomes analyzed based on age and sex. Negative binomial regression was used to estimate the monthly adjusted Incidence Rate Ratio (IRR) to compare hospital admission rates in aggregated data. A logistic regression was used to estimate the monthly adjusted in-hospital mortality Odds Ratio (OR) for different pandemic periods. During the study there were 6,522,114 non-COVID-19 hospital admissions and 139,679 deaths. Prior to the COVID-19 outbreak, the standardized hospital admission rate per million person-month was 7115.19, which decreased to 2856.35 during the first peak (IRR 0.40, [0.25-0.64]). In-hospital mortality also increased from 20.20 to 31.99 (OR 2.05, [1.97-2.13]). All age and sex groups had decreased admission rates, except for females at productive ages. Two years after the COVID-19 outbreak, the non-COVID-19 hospital admission rate (IRR 1.25, [1.13-1.40]) and mortality rate (OR 1.05, [1.04-1.07]) increased compared to the rates before the pandemic. The respiratory disease admission rate decreased in the first (IRR 0.23, [0.17-0.31]) and second years (IRR 0.35, [0.26-0.47] compared to the rate before the pandemic. There was a significant reduction in hospitalizations for pneumonia (IRR 0.30, [0.21-0.42]), influenza (IRR 0.04, [0.03-0.06]) and COPD (IRR 0.39, [0.23-0.65]) during the second year. There was a significant and continuous rise in the hematological admission rate during the study, reaching 186.99 per million person-month in the second year, reflecting an IRR of 2.84 [2.42-3.33]compared to the pre-pandemic period. The mortality rates of mental disorders (OR 2.15, [1.65-2.78]) and musculoskeletal (OR 1.48, [1.20-1.82), nervous system (OR 1.42, [1.26-1.60]), metabolic (OR 1.99, [1.80-2.19]) and circulatory diseases (OR 1.35, [1.31-1.39]) increased in the second year compare to pre-pandemic. Myocardial infarction (OR 1.33, [1.19-1.49]), heart failure (OR 1.59, [1.35-1.87]) and stroke (OR 1.35, [1.24-1.47]) showed an increase in mortality rates without changes in hospitalization. In the era of COVID-19, the changes seem to have had a long-term effect on non-COVID-19 diseases. Countries should prepare for similar crises in the future to ensure medical services are not suspended.

When to issue the alert of air pollution in Chinese cities? Evidence on the threshold effect of heavy air pollution from Chengdu

Since 2012, the issuing of the alert for heavy air pollution has become a standard practice in major Chinese cities. An air quality index (AQI) of 200 is adopted in many cases as the triggering line of the alert system. Based on city-level time series data on hospital admissions for respiratory system disease in Chengdu, between January 1, 2016 and May 1, 2017, we assessed the relevance of AQI 200 as the trigger of the alert system. Specifically, applying the Autoregressive Distributed Lag (ARDL) model, particularly its nonlinear form that accommodates the threshold effect, we searched through alternative levels of air pollution to determine whether and at what level a threshold effect of air pollution may exist. We found that while the linear form of the ARDL model showed a significant effect of air pollution similar to existing findings, the threshold form of ARDL showed that air pollution affects hospital admissions mainly when the AQI is above a certain threshold. This threshold lies in an AQI range no higher than 130, and associated with it is a sharply elevated effect on hospital admissions. Based on this finding, if an alert is triggered only when AQI is above 200, 53.2% of the hospital admissions due to air pollution will not be alerted, implying that a much lower level of AQI is needed to define a more relevant trigger of the air pollution alert system in China.

Ambient temperature and seasonal variation in inpatient mortality from respiratory diseases: a retrospective observational study.

The seasonal fluctuation in mortality and hospital admissions from respiratory diseases, with a winter peak and a summer trough, is widely recognized in extratropical countries. However, little is known about the seasonality of inpatient mortality and the role of ambient temperature remains uncertain. We aimed to analyse the association between ambient temperature and in-hospital mortality from respiratory diseases in the provinces of Madrid and Barcelona, Spain. We used data on daily hospitalisations, weather (ie, temperature and relative humidity) and air pollutants (ie, PM2.5, PM10, NO2and O3) for the Spanish provinces of Madrid and Barcelona during 2006-2019. We applied a daily time-series quasi-Poisson regression in combination with distributed lag non-linear models (DLNM) to assess, on the one hand, the seasonal variation in fatal hospitalisations and the contribution of ambient temperature, and on the other hand, the day-to-day association between temperature and fatal hospital admissions. The analyses were stratified by sex, age and primary diagnostic of hospitalisation. The study analysed 1710012 emergency hospital admissions for respiratory diseases (mean [SD] age, 60.4 [31.0] years; 44.2% women), from which 103845 resulted in in-hospital death (81.4 [12.3] years; 45.1%). We found a strong seasonal fluctuation in in-hospital mortality from respiratory diseases. While hospital admissions were higher during the cold season, the maximum incidence of inpatient mortality was during the summer and was strongly related to high temperatures. When analysing the day-to-day association between temperature and in-hospital mortality, we only found an effect for high temperatures. The relative risk (RR) of fatal hospitalisation at the 99th percentile of the distribution of daily temperatures vs the minimum mortality temperature (MMT) was 1.395 (95% eCI: 1.211-1.606) in Madrid and 1.612 (1.379-1.885) in Barcelona. In terms of attributable burden, summer temperatures (June-September) were responsible for 16.2% (8.8-23.3) and 22.3% (15.4-29.2) of overall fatal hospitalisations from respiratory diseases in Madrid and Barcelona, respectively. Women were more vulnerable to heat than men, whereas the results by diagnostic of admission showed heat effects for acute bronchitis and bronchiolitis, pneumonia and respiratory failure. Unless effective adaptation measures are taken in hospital facilities, climate warming could exacerbate the burden of inpatient mortality from respiratory diseases during the warm season. European Research Council Consolidator Grant EARLY-ADAPT, European Research Council Proof-of-Concept Grants HHS-EWS and FORECAST-AIR.

Prepayment meters strongly associated with multiple types of deprivation and emergency respiratory hospital admissions: an observational, cross-sectional study

BackgroundPrepayment meters (PPMs) require energy to be paid in advance. Action groups and media contend that PPMs are concentrated in the most vulnerable groups, prone to run out of credit...

Double trouble: The interaction of PM2.5 and O3 on respiratory hospital admissions

The co-occurrence of fine particulate matter (PM2.5) and ozone (O3) pollution during the warm season has become a growing public health concern. The interaction between PM2.5 and O3 and its contribution to disease burden associated with co-pollution has not been thoroughly examined. We collected data on hospital admissions for respiratory diseases from a city-wide hospital discharge database in Beijing between 2013 and 2019. City-wide 24-h mean PM2.5 and daily maximum 8-h mean O3 were averaged from 35 monitoring stations across Beijing. Conditional Poisson regression was employed to estimate the interaction between warm-season PM2.5 and O3 on respiratory admissions. A model incorporating a tensor product term was used to fit the non-linear interaction and estimate the number of respiratory admissions attributable to PM2.5 and O3 pollution. From January 18, 2013 to December 31, 2019, 1,191,308 respiratory admissions were recorded. We observed multiplicative interactions between warm-season PM2.5 and O3 on upper respiratory infections (P = 0.004), pneumonia (P = 0.002), chronic obstructive pulmonary disease (P = 0.041), and total respiratory disease (P < 0.001). PM2.5-O3 co-pollution during warm season exhibited a super-additive effect on respiratory admissions, with a relative excess risk due to interaction of 1.65% (95%CI: 0.46%–2.84%). There was a non-linear pattern of the synergistic effect between PM2.5 and O3 on respiratory admissions. Based on the World Health Organization global air quality guidelines, 12,421 respiratory admissions would be reduced if both daily PM2.5 and O3 concentrations had not exceeded the target (PM2.5 15 μg/m3, O3 100 μg/m3). The number of respiratory admissions attributable to either PM2.5 or O3 pollution decreased by 48.7% from 2013 to 2019. Prioritizing O3 control during the warm season is a cost-effective strategy for Beijing. These findings underscore the significance of concurrently addressing both PM2.5 pollution and O3 pollution during the warm season to alleviate the burden of respiratory diseases.

Implementation of Internet of Things (IoT) Technology in Air Pollution Monitoring in Jakarta: Quantitative Analysis of the Influence of Air Quality Change and Its Impact on Public Health in Jakarta

Air pollution is a pressing global issue, particularly in urban areas where rapid industrialization and urbanization have led to deteriorating air quality. Jakarta, as one of the world's most populous megacities, faces significant challenges in managing air pollution and safeguarding public health. This research paper explores the implementation of Internet of Things (IoT) technology for air pollution monitoring in Jakarta and quantitatively assesses the influence of air quality changes on public health outcomes. The study involves the deployment of IoT sensors to collect real-time data on key air pollutants, including particulate matter (PM2.5, PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3). Statistical analyses, including regression and correlation analyses, reveal strong associations between air quality variables and health indicators. Findings indicate that elevated levels of PM2.5 and NO2 are linked to increased hospital admissions for respiratory diseases, and CO levels are associated with hypertension and cardiovascular diseases. The study also explores public perception through surveys and questionnaires, highlighting a high level of awareness and support for government initiatives to improve air quality. The results emphasize the need for informed policy decisions, including stricter emission standards and public awareness campaigns, to combat air pollution and protect public health in Jakarta.

Association between wildfire, respiratory and cardiovascular disease admission: Mediating effect of air pollutants in Korea

Association between wildfire, respiratory and cardiovascular disease admission: Mediating effect of air pollutants in Korea

Effect of Ambient Temperature on Hospital Admissions for Respiratory Disease in Suburban Rural Villages of a Semi-Arid Region in Northwest China.

This study evaluated the effects of extreme temperatures on hospital admissions for respiratory diseases (RDs) in a semi-arid region in the Northwest of China. Distributed lag nonlinear model was constructed, and stratified analysis by gender and age was performed. The exposure-response curve between temperature and RD hospital admissions was almost W-shaped. Either extremely cold temperatures or moderately cold temperatures presented a short-term acute harmful effect, and the relative risks were higher among males (1.976, 95% confidence interval [CI]: 1.773-2.203; 1.242, 95% CI: 1.203-1.282) and the elderly (2.363, 95% CI: 1.724-3.240; 1.267, 95% CI: 1.154-1.390). Both extreme and moderately hot temperatures had higher risks among females (2.040, 95% CI: 1.815-2.292; 1.328, 95% CI: 1.276-1.381). The relationship between air temperature and RD hospital admissions was nonlinear. Vulnerable populations varied according to extreme temperature conditions.

Short-term effects of air pollution on respiratory hospitalizations in Ha Nam, during 2018-2020

Objectives: Air pollution has adverse effects on the respiratory system. Ha Nam is one of the most polluted provinces in Vietnam. This study aims at assessing the short-term association between air pollution and respiratory diseases among Ha Nam inhabitants during 2018-2020. Method: This ecological study used data from Ha Nam Provincial General Hospital and Obstetric-Paediatric Hospital for health information, and data from Center for Interdisciplinary Integrated Technology Field Monitoring (FIMO) for PM2.5 and temperature data. Time-series analysis was applied to estimate the risk of admissions due to respiratory diseases and daily ambient PM2.5 concentrations. Results: The majority of respiratory-related admissions were upper respiratory infections (47.3%) and pneumonia (40.8%). Number of male admissions were higher than that of female for most respiratory diseases, except chronic obstructive pulmonary disease (COPD). The strongest association between PM2.5 concentrations and hospital admissions for respiratory diseases in Ha Nam was observed in lag 2. Conclusion: The study found positive associations between PM2.5 concentration and hospital admissions. Further investigation with a large admissions are need to certained findings. estimate the number of admissions attributed to air pollution in Ha Nam. Keywords: PM2.5, respiratory diseases, hospital admissions.

Cold-induced adaptive thermogenesis is impaired by exposure of Asian sand dust in mice

Desertification and desert sandstorms caused by the worsening global warming pose increasing risks to human health. In particular, Asian sand dust (ASD) exposure has been related to an increase in mortality and hospital admissions for respiratory diseases. In this study, we investigated the effects of ASD on metabolic tissues in comparison to diesel particulate matter (DPM) that is known to cause adverse health effects. We found that larger lipid droplets were accumulated in the brown adipose tissues (BAT) of ASD-administered but not DPM-administered mice. Thermogenic gene expression was decreased in these mice as well. When ASD-administered mice were exposed to the cold, they failed to maintain their body temperature, suggesting that the ASD administration had led to impairments in cold-induced adaptive thermogenesis. However, impaired thermogenesis was not observed in DPM-administered mice. Furthermore, mice fed a high-fat diet that were chronically administered ASD demonstrated unexplained weight loss, indicating that chronic administration of ASD could be lethal in obese mice. We further identified that ASD-induced lung inflammation was not exacerbated in uncoupling protein 1 knockout mice, whose thermogenic capacity is impaired. Collectively, ASD exposure can impair cold-induced adaptive thermogenic responses in mice and increase the risk of mortality in obese mice.

Case-crossover study for the association between increased hospital admissions for respiratory diseases and the increase in atmospheric PM2.5 and PM2.5-bound trace elements in Pretoria, South Africa

ABSTRACT Outdoor PM2.5 was sampled in Pretoria, 18 April 2017 to 28 February 2020. A case-crossover epidemiology study was associated for increased PM2.5 and trace elements with increased hospital admissions for respiratory disorders (J00-J99). The results included a significant increase in hospital admissions, with total PM2.5 of 2.7% (95% CI: 0.6, 4.9) per 10 µg·m−3 increase. For the trace elements, Ca of 4.0% (95% CI: 1.4%−6.8%), Cl of 0.7% (95% CI: 0.0%−1.4%), Fe of 3.3% (95% CI: 0.5%−6.1%), K of 1.8% (95% CI: 0.2–3.5) and Si of 1.3% (95% CI: 0.1%−2.5%). When controlling for PM2.5, only Ca of 3.2% (95% CI: 0.3, 6.1) and within the 0–14 age group by 5.2% (95% CI: 1.5, 9.1). Controlling for a co-pollutant that is highly correlated with PM2.5 does reduce overestimation, but further studies should include deposition rates and parallel sampling analysis.

Development and application of photocatalytic coating for roadside NOx mitigation in Hong Kong

A facile chemical method for the development of photocatalytic coating products was proposed based on practical application perspective for the Hong Kong roadside nitrogen oxides (NOx) mitigation. TiO2-based photocatalytic coating PC-C film with crystallized size of around 5–6 nm was synthesized with the peptization of H2O2. The PC-C coating possesses a super-hydrophilicity surface and is proven to have a NOx degradation rate of 46.8% with an optimum pH level of 7. In addition, the PC-C coating presents a promising photocatalytic NOx degradation compared with other commercially available coating products and P25 when applied on two building materials of poly-methyl methacrylate (PMMA) and concrete surface. A weather resistance simulation and a 180-day on-site field trial were carried out the attenuation effects of photocatalytic coating applied in outdoor exposure. Based on epidemiological estimation and field investigation, hospital admissions for respiratory diseases (HARD) and mortality cases (MC) could be reduced with the application of PC-C coating along the street canyon. This work demonstrates the feasibility of air pollution control measures for the local roadside NOx using photocatalytic technology, offering promising health benefits with environmental remediation.

Low ambient temperature and hospitalization for cardiorespiratory diseases in Brazil

Studies have shown that larger temperature-related health impacts may be associated with cold rather than with hot temperatures. Although it remains unclear the cold-related health burden in warmer regions, in particular at the national level in Brazil. We address this gap by examining the association between low ambient temperature and daily hospital admissions for cardiovascular and respiratory diseases in Brazil between 2008 and 2018. We first applied a case time series design in combination with distributed lag non-linear modeling (DLNM) framework to assess the association of low ambient temperature with daily hospital admissions by Brazilian region. Here, we also stratified the analyses by sex, age group (15–45, 46–65, and >65 years), and cause (respiratory and cardiovascular hospital admissions). In the second stage, we performed a meta-analysis to estimate pooled effects across the Brazilian regions. Our sample included more than 23 million hospitalizations for cardiovascular and respiratory diseases nationwide between 2008 and 2018, of which 53% were admissions for respiratory diseases and 47% for cardiovascular diseases. Our findings suggest that low temperatures are associated with a relative risk of 1.17 (95% CI: 1.07; 1.27) and 1.07 (95% CI: 1.01; 1.14) for cardiovascular and respiratory admissions in Brazil, respectively. The pooled national results indicate robust positive associations for cardiovascular and respiratory hospital admissions in most of the subgroup analyses. In particular, for cardiovascular hospital admissions, men and older adults (>65 years old) were slightly more impacted by cold exposure. For respiratory admissions, the results did not indicate differences among the population groups by sex and age. This study can help decision-makers to create adaptive measures to protect public health from the effects of cold temperature.

Association of high ambient temperature with daily hospitalization for cardiorespiratory diseases in Brazil: A national time-series study between 2008 and 2018

Further research is needed to examine the nationwide impact of temperature on health in Brazil, a region with particular challenges related to climate conditions, environmental characteristics, and health equity. To address this gap, in this study, we looked at the relationship between high ambient temperature and hospital admissions for circulatory and respiratory diseases in 5572 Brazilian municipalities between 2008 and 2018. We used an extension of the two-stage design with a case time series to assess this relationship. In the first stage, we applied a distributed lag non-linear modeling framework to create a cross-basis function. We next applied quasi-Poisson regression models adjusted by PM2.5, O3, relative humidity, and time-varying confounders. We estimated relative risks (RRs) of the association of heat (percentile 99th) with hospitalization for circulatory and respiratory diseases by sex, age group, and Brazilian regions. In the second stage, we applied meta-analysis with random effects to estimate the national RR. Our study population includes 23,791,093 hospital admissions for cardiorespiratory diseases in Brazil between 2008 and 2018. Among those, 53.1% are respiratory diseases, and 46.9% are circulatory diseases. The robustness of the RR and the effect size varied significantly by region, sex, age group, and health outcome. Overall, our findings suggest that i) respiratory admissions had the highest RR, while circulatory admissions had inconsistent or null RR in several subgroup analyses; ii) there was a large difference in the cumulative risk ratio across regions; and iii) overall, women and the elderly population experienced the greatest impact from heat exposure. The pooled national results for the whole population (all ages and sex) suggest a relative risk of 1.29 (95% CI: 1.26; 1.32) associated with respiratory admissions. In contrast, national meta-analysis for circulatory admissions suggested robust positive associations only for people aged 15–45, 46–65, >65 years old; for men aged 15–45 years old; and women aged 15–45 and 46–65 years old. Our findings are essential for the body of scientific evidence that has assisted policymakers to promote health equity and to create adaptive measures and mitigations.

Fine and coarse particulate air pollution and hospital admissions for a wide range of respiratory diseases: a nationwide case-crossover study.

The associations between fine and coarse particulate matter (PM2.5 and PM2.5-10) air pollution and hospital admissions for full-spectrum respiratory diseases were rarely investigated, especially for age-specific associations. We aim to estimate the age-specific associations of short-term exposures to PM2.5 and PM2.5-10 with hospital admissions for full-spectrum respiratory diseases in China. We conducted an individual-level case-crossover study based on a nationwide hospital-based registry including 153 hospitals across 20 provincial regions in China in 2013-20. We applied conditional logistic regression models and distributed lag models to estimate the exposure- and lag-response associations. A total of 1 399 955 hospital admission records for various respiratory diseases were identified. The associations of PM2.5 and PM2.5-10 with total respiratory hospitalizations lasted for 4 days, and an interquartile range increase in PM2.5 (34.5 μg/m3) and PM2.5-10 (26.0 μg/m3) was associated with 1.73% [95% confidence interval (95% CI): 1.34%, 2.12%)] and 1.70% (95% CI: 1.31%, 2.10%) increases, respectively, in total respiratory hospitalizations over lag 0-4 days. Acute respiratory infections (i.e. pneumonia, bronchitis and bronchiolitis) were consistently associated with PM2.5 or PM2.5-10 exposure across different age groups. We found the disease spectrum varied by age, including rarely reported findings (i.e. acute laryngitis and tracheitis, and influenza) among children and well-established associations (i.e. chronic obstructive pulmonary disease, asthma, acute bronchitis and emphysema) among older populations. Besides, the associations were stronger in females, children and older populations. This nationwide case-crossover study provides robust evidence that short-term exposure to both PM2.5 and PM2.5-10 was associated with increased hospital admissions for a wide range of respiratory diseases, and the spectra of respiratory diseases varied by age. Females, children and older populations were more susceptible.

PM10 Levels and Prevalence of Respiratory Diseases in Communities around the Cement Industries

In the atmosphere, particulate matter of 10 microns (µm) or less in diameter (PM10) is an indicator of air pollution. Their harmful health effects on humans range from minor irritation to chronic respiratory infections. PM10 levels were assessed in the ambient air including the incidences of respiratory diseases among communities around the cement industries in Athi River Township in Kenya. The PM10 levels were collected for three consecutive days from five sites in Athi River and the control during the rainy and dry seasons. They were analyzed using the gravimetric technique. The prevalence levels of respiratory diseases were evaluated in the community health facilities during the same period. The PM10 levels ranged from 111.1–740.7 µg/m3 and 37.0–351.9 µg/m3 across the Athi River sites and were significantly (p &lt;0.05) higher than those of the control site that ranged from 9.2–15.3 µg/m3 and 10.2–13.5 µg/m3during the dry and rainy seasons, respectively. The study established negative correlations between PM10 levels and wind speed besides temperature. On the contrary, positive correlations were observed between PM10 and relative humidity during both seasons. Overall, the communities across the Athi River Township experienced a significantly (p&lt;0.05) higher number of consultation visits and hospital admissions for various respiratory diseases than the control community. The upper and lower respiratory tract infections were more pronounced in the Athi River during the dry than in the rainy seasons. This study calls for comprehensive research and collaborative efforts towards the establishment of environmental-health-driven programs to reduce PM10 levels and related respiratory impacts among communities.